In vitro testing of calcium phosphate (HA, TCP, and biphasic HA-TCP) whiskers

Evaluation of polyetheretherketone composites modified by calcium silicate and carbon nanotubes for bone regeneration: mechanical properties, biomineralization and induction of osteoblasts

Desired orthopedic implant materials must have a good biological activity and possess appropriate mechanical property that correspond to those of human bone. Although polyetheretherketone (PEEK) has displayed a promising application prospect in musculoskeletal and dentistry reconstruction thanks to its non-biodegradability and good biocompatibility in the body, the poor osseointegration and insufficient mechanical strength have significantly limited its application in the repair of load-bearing bones and surgical operations. In this study, carbon nanotubes (CNT)/calcium silicate (CS)/polyetheretherketone ternary composites were fabricated for the first time. The addition of CS was mainly aimed at improving biological activities and surface hydrophilicity, but it inevitably compromised the mechanical strength of PEEK. CNT can reinforce the composites even when brittle CS was introduced and further upgraded the biocompatibility of PEEK. The CNT/CS/PEEK composites exhibited higher mechanical strengths in tensile and bending tests, 64% and 90% higher than those of brittle CS/PEEK binary composites. Besides, after incorporation of CNT and CS into PEEK, the hydrophilicity, surface roughness and ability to induce apatite-layer deposition were significantly enhanced. More importantly, the adhesion, proliferation, and osteogenic differentiation of mouse embryo osteoblasts were effectively promoted on CNT/CS/PEEK composites. In contrast to PEEK, these composites exhibited a more satisfactory biocompatibility and osteoinductive activity. Overall, these results demonstrate that ternary CNT/CS/PEEK composites have the potential to serve as a feasible substitute to conventional metal alloys in musculoskeletal regeneration and orthopedic implantation.

Dual Modification of Porous Ca-P/PLA Composites with APTES and Alendronate Improves Their Mechanical Strength and Cytobiocompatibility towards Human Osteoblasts

Synthetic implants are used to treat large bone defects that are often unable to regenerate, for example those caused by osteoporosis. It is necessary that the materials used to manufacture them are biocompatible and resorbable. Polymer-ceramic composites, such as those based on poly(L-lactide) (PLLA) and calcium phosphate ceramics (Ca-P), are often used for these purposes. In this study, we attempted to investigate an innovative strategy for two-step (dual) modification of composites and their components to improve the compatibility of composite components and the adhesion between PLA and Ca-P whiskers, and to increase the mechanical strength of the composite, as well as improve osteological bioactivity and prevent bone resorption in composites intended for bone regeneration. In the first step, Ca-P whiskers were modified with a saturated fatty acid namely, lauric acid (LA), or a silane coupling agent γ-aminopropyltriethoxysilane (APTES). Then, the composite, characterized by the best mechanical properties, was modified in the second stage of the work with an active chemical compound used in medicine as a first-line drug in osteoporosis-sodium alendronate, belonging to the group of bisphosphonates (BP). As a result of the research covered in this work, the composite modified with APTES and alendronate was found to be a promising candidate for future biomedical engineering applications.

Nanosized calcium deficient hydroxyapatites for tooth enamel protection

Calcium phosphates (CaP) are extensively studied as additives to dental care products for tooth enamel protection against caries. However, it is not clear yet whether substituted CaP could provide better enamel protection. In this study we produced, characterized and tested in vitro substituted and co‐substituted calcium deficient hydroxyapatite (CDHAp) with Sr²⁺ and F⁻ ions. X‐ray powder diffractometry, Fourier transformation infrared spectroscopy, scanning electron microscopy, energy‐dispersive X‐ray analysis, Brunauer–Emmett–Teller were used to characterize synthesized powders and also cytotoxicity was evaluated. pH = f(t) test was performed to estimate, weather synthesized CDHAp suspensions are able to increase pH of experimental media after acid addition. Synthesis products were incorporated into paste to perform in vitro remineralization on the bovine enamel. In addition to mentioned instrumental methods, profilometry was used for evaluation of remineralised enamel samples. The obtained results confirmed formation of CDHAp substituted with 1.5–1.6 wt% of fluoride and 7.4–7.8 wt% of strontium. pH = f(t) experiment pointed out that pH increased by approximately 0.3 within 10 min after acid addition for all CDHAp suspensions. A new layer of the corresponding CDHAp was formed on the enamel. Its thickness increased by 0.8 ± 0.1 μm per day and reached up to 5.8 μm after 7 days. Additionally, octa calcium phosphates were detected on the surface of control samples. In conclusion, we can assume that CDHAp substituted with Sr²⁺ and/or F⁻ could be used as an effective additive to dental care products promoting formation of protecting layer on the enamel, but there was no significant difference among sample groups.

Comprehensive Review on Design and Manufacturing of Bio-scaffolds for Bone Reconstruction

Bio-scaffolds are synthetic entities widely employed in bone and soft-tissue regeneration applications. These bio-scaffolds are applied to the defect site to provide support and favor cell attachment and growth, thereby enhancing the regeneration of the defective site. The progressive research in bio-scaffold fabrication has led to identification of biocompatible and mechanically stable materials. The difficulties in obtaining grafts and expenditure incurred in the transplantation procedures have also been overcome by the implantation of bio-scaffolds. Drugs, cells, growth factors, and biomolecules can be embedded with bio-scaffolds to provide localized treatments. The right choice of materials and fabrication approaches can help in developing bio-scaffolds with required properties. This review mostly focuses on the available materials and bio-scaffold techniques for bone and soft-tissue regeneration application. The first part of this review gives insight into the various classes of biomaterials involved in bio-scaffold fabrication followed by design and simulation techniques. The latter discusses the various additive, subtractive, hybrid, and other improved techniques involved in the development of bio-scaffolds for bone regeneration applications. Techniques involving multimaterial printing and multidimensional printing have also been briefly discussed.

A Review on Development of Bio-Inspired Implants Using 3D Printing

Biomimetics is an emerging field of science that adapts the working principles from nature to fine-tune the engineering design aspects to mimic biological structure and functions. The application mainly focuses on the development of medical implants for hard and soft tissue replacements. Additive manufacturing or 3D printing is an established processing norm with a superior resolution and control over process parameters than conventional methods and has allowed the incessant amalgamation of biomimetics into material manufacturing, thereby improving the adaptation of biomaterials and implants into the human body. The conventional manufacturing practices had design restrictions that prevented mimicking the natural architecture of human tissues into material manufacturing. However, with additive manufacturing, the material construction happens layer-by-layer over multiple axes simultaneously, thus enabling finer control over material placement, thereby overcoming the design challenge that prevented developing complex human architectures. This review substantiates the dexterity of additive manufacturing in utilizing biomimetics to 3D print ceramic, polymer, and metal implants with excellent resemblance to natural tissue. It also cites some clinical references of experimental and commercial approaches employing biomimetic 3D printing of implants.

In Vitro Properties of Manganese-Substituted Tricalcium Phosphate Coatings for Titanium Biomedical Implants Deposited by Arc Plasma

Bioactive manganese (Mn)-doped ceramic coatings for intraosseous titanium (Ti) implants are developed. Arc plasma deposition procedure is used for coatings preparation. X-ray Diffraction, Scanning Electron Microscopy-Energy Dispersive X-ray Spectroscopy, and Electron Paramagnetic Resonance (EPR) methods are applied for coatings characterization. The coatings are homogeneous, composed of the main phase α-tricalcium phosphate (α-TCP) (about 67%) and the minor phase hydroxyapatite (about 33%), and the Mn content is 2.3 wt%. EPR spectroscopy demonstrates that the Mn ions are incorporated in the TCP structure and are present in the coating in Mn2+ and Mn3+ oxidation states, being aggregated in clusters. The wetting contact angle of the deposited coatings is suitable for cells' adhesion and proliferation. In vitro soaking in physiological solution for 90 days leads to a drastic change in phase composition; the transformation into calcium carbonate and octacalcium phosphate takes place, and no more Mn is present. The absence of antibacterial activity against Escherichia coli, Enterococcus faecalis, and Pseudomonas aeruginosa bacteria strains is observed. A study of the metabolic activity of mouse fibroblasts of the NCTC L929 cell line on the coatings using the MTT (dye compound 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) test demonstrates that there is no toxic effect on the cell culture. Moreover, the coating material supports the adhesion and proliferation of the cells. A good adhesion, spreading, and proliferative activity of the human tooth postnatal dental pulp stem cells (DPSC) is demonstrated. The developed coatings are promising for implant application in orthopedics and dentistry.

The degradation behavior of calcium-rich hydroxyapatite foams in vitro

Hydroxyapatite (HA) is a well-known regenerative biomaterial. However, the slow degradation rate of HA is still an obstacle in clinical applications. In this study, we concentrated on investigating the degradation behavior of the calcium-rich HA foams, which had a demonstrated effect on blood differentiation in previous studies. The HA foams were processed by an emulsion method and were infiltrated with calcium nitrate to create a calcium carbonate second phase, heterogeneously distributed on and under the surface of the foam. During the 28-day solubility test, the calcium carbonate phase contributed to enhanced Ca²⁺ ion release into the saline compared to phase pure HA foams. Both types of foams were biocompatible as demonstrated by human endothelial cell culture on their surface. The release of calcium ions, the degradation behavior, and the endothelial cell differentiation behavior suggest this biphasic ceramic is a candidate for bone marrow in vitro culture and a possible bone substitute material.

Additive manufacturing of biodegradable porous orthopaedic screw

Advent of additive manufacturing in biomedical field has nurtured fabrication of complex, customizable and reproducible orthopaedic implants. Layer-by-layer deposition of biodegradable polymer employed in development of porous orthopaedic screws promises gradual dissolution and complete metabolic resorption thereby overcoming the limitations of conventional metallic screws. In the present study, screws with different pore sizes (916 × 918 μm to 254 × 146 μm) were 3D printed at 200 μm layer height by varying printing parameters such as print speed, fill density and travel speed to augment the bone ingrowth. Micro-CT analysis and scanning electron micrographs of screws with 45% fill density confirmed porous interconnections (40.1%) and optimal pore size (259 × 207 × 200 μm) without compromising the mechanical strength (24.58 ± 1.36 MPa). Due to the open pore structure, the 3D printed screws showed increased weight gain due to the deposition of calcium when incubated in simulated body fluid. Osteoblast-like cells attached on screw and infiltrated into the pores over 14 days of in vitro culture. Further, the screws also supported greater human mesenchymal stem cell adhesion, proliferation and mineralized matrix synthesis over a period of 21 days in vitro culture as compared to non-porous screws. These porous screws showed significantly increased vascularization in a rat subcutaneous implantation as compared to control screws. Porous screws produced by additive manufacturing may promote better osteointegration due to enhanced mineralization and vascularization.

Ultrasound-assisted synthesis of nanocrystallized silicocarnotite biomaterial with improved sinterability and osteogenic activity

It has been proved that silicon-substituted calcium phosphate ceramics possess superior bone regeneration and resorbability to HA, while the synthesis of single-phase nanocrystallized high Si-containing calcium phosphate is still a challenge. In the present work, a novel and facile aqueous precipitation method assisted with ultrasonic irradiation was adopted firstly to synthesise a single-phase nanocrystallized calcium silicophosphate (Ca₅(PO₄)₂SiO₄, CPS) biomaterial. Crystallization and morphology of Si-apatite precursors synthesized with or without ultrasonic assistance were primarily investigated and the related mechanism was discussed. Moreover, the sinterability, in vitro bioactivity and osteogenic activity of the synthesized CPS were studied in detail. Results showed that an ultrasonic cavitation effect could be beneficial to form a highly dispersive CPS precursor with a single Si-apatite phase, which greatly reduced the calcination temperature of CPS from 1350 °C to 1000 °C. Nanocrystallized CPS powders were obtained successfully under ultrasound-assisted conditions, which showed superior sinterability, in vitro bioactivity and osteogenic activity than those of micron-sized CPS and HA powders. It might be a promising candidate material for bone tissue regeneration applications.

Inversely 3D-Printed β-TCP Scaffolds for Bone Replacement

The aim of this study was to predefine the pore structure of β-tricalcium phosphate (β-TCP) scaffolds with different macro pore sizes (500, 750, and 1000 µm), to characterize β-TCP scaffolds, and to investigate the growth behavior of cells within these scaffolds. The lead structures for directional bone growth (sacrificial structures) were produced from polylactide (PLA) using the fused deposition modeling techniques. The molds were then filled with β-TCP slurry and sintered at 1250 °C, whereby the lead structures (voids) were burnt out. The scaffolds were mechanically characterized (native and after incubation in simulated body fluid (SBF) for 28 d). In addition, biocompatibility was investigated by live/dead, cell proliferation and lactate dehydrogenase assays. The scaffolds with a strand spacing of 500 µm showed the highest compressive strength, both untreated (3.4 ± 0.2 MPa) and treated with simulated body fluid (2.8 ± 0.2 MPa). The simulated body fluid reduced the stability of the samples to 82% (500), 62% (750) and 56% (1000). The strand spacing and the powder properties of the samples were decisive factors for stability. The fact that β-TCP is a biocompatible material is confirmed by the experiments. No lactate dehydrogenase activity of the cells was measured, which means that no cytotoxicity of the material could be detected. In addition, the proliferation rate of all three sizes increased steadily over the test days until saturation. The cells were largely adhered to or within the scaffolds and did not migrate through the scaffolds to the bottom of the cell culture plate. The cells showed increased growth, not only on the outer surface (e.g., 500: 36 ± 33 vital cells/mm² after three days, 180 ± 33 cells/mm² after seven days, and 308 ± 69 cells/mm² after 10 days), but also on the inner surface of the samples (e.g., 750: 49 ± 17 vital cells/mm² after three days, 200 ± 84 cells/mm² after seven days, and 218 ± 99 living cells/mm² after 10 days). This means that the inverse 3D printing method is very suitable for the presetting of the pore structure and for the ingrowth of the cells. The experiments on which this work is based have shown that the fused deposition modeling process with subsequent slip casting and sintering is well suited for the production of scaffolds for bone replacement.

Acrylic acid grafted tamarind kernel polysaccharide-based hydrogel for bone tissue engineering in absence of any osteo-inducing factors

PURPOSE

With increased life expectancy, disorders in lifestyle and other clinical conditions, and the changes in the connective tissues such as in bone, impose diverse biomedical problems. Cells belong to osteogenic lineages are extremely specific for their surface requirements. Therefore, suitable surfaces are the critical bottle neck for successful bone tissue engineering. This study involves assessment of polysaccharide-based hydrogel which effectively allows growth, differentiation and mineralisation of osteogenic cells even in the absence of osteogenic inducing factors.

MATERIALS AND METHODS

Tamarind Kernel Polysaccharide was grafted with acrylic acid at different mole ratio. The critical parameter, surface morphology for bio application was assessed by SEM. MTT assay has been performed with hydrogels on Saos-2 cells. The biocompatibility and adhesion of different cell lines (F-11, Saos-2, Raw 264.7 and MSCs) on hydrogel surface was performed by Phalloidin and DAPI staining. Further the differentiation, mineralization and expression of different osteogenic markers, ALP assay, Alizarin Red staining and q-PCR was performed.

RESULTS

The hydrogels show highly porous and interconnected pores. MTT assay demonstrates the hydrogel have no cytotoxicity towards Saos-2 cells and are suitable for proliferation of different lineage of cell lines. ALP, Alizarin red staining and q-PCR assay shows that the hydrogel surface enhances the differentiation, mineralization and expression of different osteogenic genes in Saos-2 cells in the absence of any osteogenic inducing factors. Conclusion Synthesized hydrogel surface triggers signalling events towards osteogenesis even in the absence of added growth factors. We proposed that this material can be used for effective bone tissue engineering in vitro at low cost.

Zirconia/Hydroxyapatite Composites Synthesized Via Sol-Gel: Influence of Hydroxyapatite Content and Heating on Their Biological Properties

Zirconia (ZrO₂) and zirconia-based glasses and ceramics are materials proposed for use in the dental and orthopedic fields. In this work, ZrO₂ glass was modified by adding different amounts of bioactive and biocompatible hydroxyapatite (HAp). ZrO₂/HAp composites were synthesized via the sol-gel method and heated to different temperatures to induce modifications of their chemical structure, as ascertained by Fourier transform infrared spectroscopy (FTIR) analysis. The aim was to investigate the effect of both HAp content and heating on the biological performances of ZrO₂. The materials’ bioactivity was studied by soaking samples in a simulated body fluid (SBF). FTIR and scanning electron microscopy (SEM)) analyses carried out after exposure to SBF showed that all materials are bioactive, i.e., they are able to form a hydroxyapatite layer on their surface. Moreover, the samples were soaked in a solution containing bovine serum albumin (BSA). FTIR analysis proved that the synthesized materials are able to adsorb the blood protein, the first step of cell adhesion. WST-8 ([2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2,4-disulfophenyl)-2H-tetrazolium, monosodium salt]) assay showed that no cytotoxicity effects were induced by the materials’ extract. However, the results proved that bioactivity increases with both the HAp content and the temperature used for the thermal treatment, whereas biocompatibility increases with heating but is not affected by the HAp content.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

A microstructural study of the degradation and calcium release from hydroxyapatite-calcium oxide ceramics made by infiltration

Hydroxyapatite pellets, partially densified in a low-temperature heat treatment, were infiltrated with calcium nitrate solution followed by in-situ precipitation of Ca(OH)₂ and CaCO₃. The infiltrated bodies were then densified to high relative density and the calcium carbonate transformed to calcium oxide during sintering and resulted in biphasic hydroxyapatite-CaO ceramics. This work investigated the influence of the infiltration on surface morphology, weight change, and microstructural-level degradation caused by exposure to saline at pH=7.4 and a temperature of 20°C. The CaO rendered the materials more susceptible to degradation, and released calcium into the saline faster than single phase, calcium deficient hydroxyapatite (HA) that were used as a control. In consequence, these ceramics could be used to release calcium into the culture microenvironments of bone tissue or bone marrow cells next to a scaffold surface.

Solution Combustion Synthesis of Nanoscale Materials

Solution combustion is an exciting phenomenon, which involves propagation of self-sustained exothermic reactions along an aqueous or sol-gel media. This process allows for the synthesis of a variety of nanoscale materials, including oxides, metals, alloys, and sulfides. This Review focuses on the analysis of new approaches and results in the field of solution combustion synthesis (SCS) obtained during recent years. Thermodynamics and kinetics of reactive solutions used in different chemical routes are considered, and the role of process parameters is discussed, emphasizing the chemical mechanisms that are responsible for rapid self-sustained combustion reactions. The basic principles for controlling the composition, structure, and nanostructure of SCS products, and routes to regulate the size and morphology of the nanoscale materials are also reviewed. Recently developed systems that lead to the formation of novel materials and unique structures (e.g., thin films and two-dimensional crystals) with unusual properties are outlined. To demonstrate the versatility of the approach, several application categories of SCS produced materials, such as for energy conversion and storage, optical devices, catalysts, and various important nanoceramics (e.g., bio-, electro-, magnetic), are discussed.

Smart electroconductive bioactive ceramics to promote in situ electrostimulation of bone

Biomaterials can still be reinvented to become simple and universal bone regeneration solutions. Following this roadmap, conductive CNT-based "smart" materials accumulate exciting grafting qualities for tuning the in vitro cellular phenotype. Biphasic electrical stimulation of human osteoblastic cells was performed in vitro on either dielectric bioactive bone grafts or conductive CNT-reinforced composites. The efficiency of the electrical stimuli delivery, as well as the effect of stimulation on cellular functions were investigated. Conductive substrates boosted the local culture medium conductivity and the confinement of the exogenous electrical fields. Hence, bone cell proliferation, DNA content and mRNA expression were maximized on the conductive substrates yielding superior stimuli delivering efficiency over dielectric ones. These findings are suggestive that bioactive bone grafts with electrical conductivity are capable of high spatial and temporal control of bone cell stimulation.

Apatite bone cement reinforced with calcium silicate fibers

Several research efforts have been made in the attempt to reinforce calcium phosphate cements (CPCs) with polymeric and carbon fibers. Due to their low compatibility with the cement matrix, results were not satisfactory. In this context, calcium silicate fibers (CaSiO3) may be an alternative material to overcome the main drawback of reinforced CPCs since, despite of their good mechanical properties, they may interact chemically with the CPC matrix. In this work CaSiO3 fibers, with aspect ratio of 9.6, were synthesized by a reactive molten salt synthesis and used as reinforcement in apatite cement. 5 wt.% of reinforcement addition has increased the compressive strength of the CPC by 250% (from 14.5 to 50.4 MPa) without preventing the cement to set. Ca and Si release in samples containing fibers could be explained by CaSiO3 partial hydrolysis which leads to a quick increase in Ca concentration and in silica gel precipitation. The latter may be responsible for apatite precipitation in needle like form during cement setting reaction. The material developed presents potential properties to be employed in bone repair treatment.

The use of physiological solutions or media in calcium phosphate synthesis and processing

This review examined the literature to spot uses, if any, of physiological solutions/media for the in situ synthesis of calcium phosphates (CaP) under processing conditions (i.e. temperature, pH, concentration of inorganic ions present in media) mimicking those prevalent in the human hard tissue environments. There happens to be a variety of aqueous solutions or media developed for different purposes; sometimes they have been named as physiological saline, isotonic solution, cell culture solution, metastable CaP solution, supersaturated calcification solution, simulated body fluid or even dialysate solution (for dialysis patients). Most of the time such solutions were not used as the aqueous medium to perform the biomimetic synthesis of calcium phosphates, and their use was usually limited to the in vitro testing of synthetic biomaterials. This review illustrates that only a limited number of research studies used physiological solutions or media such as Earle's balanced salt solution, Bachra et al. solutions or Tris-buffered simulated body fluid solution containing 27mM HCO3(-) for synthesizing CaP, and these studies have consistently reported the formation of X-ray-amorphous CaP nanopowders instead of Ap-CaP or stoichiometric hydroxyapatite (HA, Ca10(PO4)6(OH)2) at 37°C and pH 7.4. By relying on the published articles, this review highlights the significance of the use of aqueous solutions containing 0.8-1.5 mMMg(2+), 22-27mM HCO3(-), 142-145mM Na(+), 5-5.8mM K(+), 103-133mM Cl(-), 1.8-3.75mM Ca(2+), and 0.8-1.67mM HPO4(2-), which essentially mimic the composition and the overall ionic strength of the human extracellular fluid (ECF), in forming the nanospheres of X-ray-amorphous CaP.

Revisiting whitlockite, the second most abundant biomineral in bone: nanocrystal synthesis in physiologically relevant conditions and biocompatibility evaluation

The synthesis of pure whitlockite (WH: Ca18Mg2(HPO4)2(PO4)12) has remained a challenge even though it is the second most abundant inorganic in living bone. Although a few reports about the precipitation of WH in heterogeneous phases have been published, to date, synthesizing WH without utilizing any effects of a buffer or various other ions remains difficult. Thus, the related research fields have encountered difficulties and have not been fully developed. Here, we developed a large-scale synthesis method for pure WH nanoparticles in a ternary Ca(OH)2-Mg(OH)2-H3PO4 system based on a systematic approach. We used excess Mg(2+) to impede the growth of hydroxyapatite (HAP: Ca10(PO4)6(OH)2) and the formation of other kinetically favored calcium phosphate intermediate phases. In addition, we designed and investigated the synthesis conditions of WH under the acidic pH conditions required to dissolve HAP, which is the most thermodynamically stable phase above pH 4.2, and to incorporate the HPO4(2-) group into the chemical structure of WH. We demonstrated that pure WH nanoparticles can be precipitated under Mg(2+)-rich and acidic pH conditions without any intermediate phases. Interestingly, this synthesized nano-WH showed comparable biocompatibility with HAP. Our methodology for determining the synthesis conditions of WH could provide a new platform for investigating other important precipitants in aqueous systems.

Formation of nanostructured fluorapatite via microwave assisted solution combustion synthesis

Fluorapatite (FA) has potential applications in dentistry and orthopedics, but its synthesis procedures are time consuming. The goal of the present study is to develop a quick microwave assisted solution combustion synthesis method (MASCS) for the production of FA particles. With this new processing, FA particles were successfully synthesized in minutes. Additionally, unique structures including nanotubes, hexagonal crystals, nanowhiskers, and plate agglomerates were prepared by controlling the solution composition and reaction time. In particular, the as-synthesized FA nanotubes presented a "Y" shape inner channel along the crystal axis. It is supposed that the channel formation is caused by the crystal growth and removal of water soluble salts during processing. The as-synthesized FA nanotubes showed good cytocompatibility, the cells cultured with a higher FA concentration demonstrated greater growth rate. With this new and easily applied MASCS processing application, FA nanoparticles have increased potential in dental and orthopedic applications.

Synthesis methods for nanosized hydroxyapatite with diverse structures

Hydroxyapatite (HAp) is the major mineral constituent of vertebrate bones and teeth. It has been well documented that HAp nanoparticles can significantly increase the biocompatibility and bioactivity of man-made biomaterials. Over the past decade, HAp nanoparticles have therefore increasingly been in demand, and extensive efforts have been devoted to develop many synthetic routes, involving both scientifically and economically new features. Several investigations have also been made to determine how critical properties of HAp can be effectively controlled by varying the processing parameters. With such a wide variety of methods for the preparation of HAp nanoparticles, choosing a specific procedure to synthesize a well-defined powder can be laborious; accordingly, in the present review, we have summarized all the available information on the preparation methodologies of HAp, and highlighted the inherent advantages and disadvantages involved in each method. This article is focused on nanosized HAp, although recent articles on microsized particles, especially those assembled from nanoparticles and/or nanocrystals, have also been reviewed for comparison. We have also provided several scientific figures and discussed a number of critical issues and challenges which require further research and development.

Cytocompatibility evaluation of microwave sintered biphasic calcium phosphate scaffolds synthesized using pH control

Compounds belonging to the calcium phosphate (CaP) system are known to be major constituents of bone and are bioactive to different extents in vitro and in vivo. Their chemical similarity makes them prime candidates for implants and bone tissue engineering scaffolds. CaP nanoparticles of amorphous hydroxyapatite (aHA) and dicalcium phosphate dihydrate (DCPD) were synthesized using chemical precipitation. Uniaxially pressed aHA and DCPD powders were subjected to microwave radiation to promote solid state phase transformations resulting in crystalline hydroxyapatite (HA), tricalcium phosphate (TCP) and biphasic compositions: HA/TCP and TCP/calcium pyrophosphate (CPP) and their subsequent densification. Phase composition of microwave sintered compacts was confirmed via X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). Solution pH during crystal growth was found to have a profound effect on particle morphology and post-sintered phases, despite constant sintering temperature. Cytocompatibility assessment using 7F2 cells, corresponding to adult mouse osteoblasts, on microwave and conventional, furnace sintered samples demonstrated that manufacturing method does not impact cellular viability after 24 h or proliferation over 7 days. New CaP deposition and extracellular matrix components were observed in vitro via scanning electron microscopy (SEM).

Biphasic, triphasic and multiphasic calcium orthophosphates

Biphasic, triphasic and multiphasic (polyphasic) calcium orthophosphates have been sought as biomaterials for reconstruction of bone defects in maxillofacial, dental and orthopedic applications. In general, this concept is determined by advantageous balances of more stable (frequently hydroxyapatite) and more resorbable (typically tricalcium orthophosphates) phases of calcium orthophosphates, while the optimum ratios depend on the particular applications. Therefore, all currently known biphasic, triphasic and multiphasic formulations of calcium orthophosphate bioceramics are sparingly soluble in water and, thus, after being implanted they are gradually resorbed inside the body, releasing calcium and orthophosphate ions into the biological medium and, hence, seeding new bone formation. The available formulations have already demonstrated proven biocompatibility, osteoconductivity, safety and predictability in vitro, in vivo, as well as in clinical models. More recently, in vitro and in vivo studies have shown that some of them might possess osteoinductive properties. Hence, in the field of tissue engineering biphasic, triphasic and multiphasic calcium orthophosphates represent promising biomaterials to construct various scaffolds capable of carrying and/or modulating the behavior of cells. Furthermore, such scaffolds are also suitable for drug delivery applications. This review summarizes the available information on biphasic, triphasic and multiphasic calcium orthophosphates, including their biomedical applications. New formulations are also proposed.

Preparation and analysis of chemically gradient functional bioceramic coating formed by pulsed laser deposition

Bioactive ceramic coatings based on calcium phosphates yield better functionality in the human body for a variety of metallic implant devices including orthopaedic and dental prostheses. In the present study chemically and hence functionally gradient bioceramic coating was obtained by pulsed laser deposition method. Calcium phosphate bioactive ceramic coatings based on hydroxyapatite (HA) and tricalcium phosphate (TCP) were deposited over titanium substrate to produce gradation in physico-chemical characteristics and in vitro dissolution behaviour. Sintered targets of HA and α-TCP were deposited in a multi target laser deposition system. The obtained deposits were characterized by X-ray diffraction, fourier transform infrared spectroscopy, scanning electron microscopy and energy dispersive X-ray analysis. Inductively coupled plasma spectroscopy was used to estimate the in vitro dissolution behaviour of coatings. The variation in mechanical property of the gradient layer was evaluated through scratch test and micro-indentation hardness. The bioactivity was examined in vitro with respect to the ability of HA layer to form on the surface as a result of contact with simulated body fluid. It could be inferred that chemically gradient functional bioceramic coating can be produced by laser deposition of multiple sintered targets with variable chemical composition.

In vivo degradation of low temperature calcium and magnesium phosphate ceramics in a heterotopic model

Bone replacement using synthetic and degradable materials is desirable in various clinical conditions. Most applied commercial materials are based on hydroxyapatite, which is not chemically degradable under physiological conditions. Here we report the effect of a long-term intramuscular implantation regime on the dissolution of various low temperature calcium and magnesium phosphate ceramics in vivo. The specimens were analysed by consecutive radiographs, micro-computed tomography scans, compressive strength testing, scanning electron microscopy and X-ray diffractometry. After 15months in vivo, the investigated materials brushite (CaHPO(4)·2H(2)O), newberyite (MgHPO(4)·3H(2)O), struvite (MgNH(4)PO(4)·6H(2)O) and hydroxyapatite (Ca(9)(PO(4))(5)HPO(4)OH) showed significant differences regarding changes of their characteristics. Struvite presented the highest loss of mechanical performance (95%), followed by newberyite (67%) and brushite (41%). This was accompanied by both a distinct extent of cement dissolution as well as changes of the phase composition of the retrieved cement implants. While the secondary phosphate phases (brushite, newberyite, struvite) completely dissolved, re-precipitates of whitlockite and octacalcium phosphate were formed in either particulate or whisker-like morphology. Furthermore, for the first time the possibility of a macropore-free volume degradation mechanism of bioceramics was demonstrated.

In vitro effects of low frequency electromagnetic fields on osteoblast proliferation and maturation in an inflammatory environment

An in vitro model was set up to investigate the effects of low frequency pulsed electromagnetic fields (PEMF) and its induced electric fields on osteoblast cells under inflammatory conditions. Osteoblasts (7F2) were seeded on top of chitosan scaffolds and co-cultured with macrophage cells (RAW 264.7) growing on the bottom of culture wells, stimulated by lipopolysaccharide to release reactive oxygen species including nitric oxide (NO). The co-culture was exposed to PEMF (magnitude of the magnetic field = 1.5 mT; induced electric voltage = 2.5 mV; frequency = 75 Hz; pulse duration = 1.3 ms) for 9 h. The osteoblasts were examined for their proliferation, viability, alkaline phosphatase (ALP) activity, and genetic expressions of type I collagen (COL I) and osteocalcin (OC), immediately and 7 days after PEMF exposure (days 0 and 7). Macrophage cell viability and NO concentration in the medium were monitored before and after PEMF exposure. The PEMF-exposed co-culture released a significantly higher amount of NO (65 µM) compared to control (17 µM) on day 7. Despite the high level of NO in the medium that was reported to be cytotoxic, PEMF-exposed osteoblasts had enhanced cell proliferation (23%), viability (36%), and COL I mRNA expression (3.4-fold) compared to the controls. The osteoblasts subjected to the PEMF had 41% less ALP activity than the control, which was associated with the active cell proliferation and COL I expression. The expression of OC mRNA was not seen in either the PEMF or control group, indicating cells had not entered the mineralization stage by day 7.

Formation and properties of magnesium-ammonium-phosphate hexahydrate biocements in the Ca-Mg-PO4 system

Calcium substituted trimagnesium phosphate with the general formula Ca(x)Mg((3-x))(PO(4))(2) (0 < x < 1.5) was synthesized by calcination of powder mixtures with the appropriate stoichiometry and reacted with 3.5 M diammonium hydrogenphosphate solution to form a cementitious matrix of magnesium ammonium phosphate hexahydrate (struvite). The degree of ionic substitution was shown to influence physical cement properties; clinically suitable cement formulations with setting times in the range 5-15 min and compressive strengths of >50 MPa were obtained for x ≤ 0.75 together with a grinding time ≥ 1 h and a powder to liquid ratio ≥ 2.5 g/ml. The cement cytocompatibility was investigated by culturing human osteoblast cell line MG63 on cement surfaces demonstrating pronounced cell growth during 13 days cultivation.

Nano-beta-tricalcium phosphates synthesis and biodegradation: 2. Biodegradation and apatite layer formation on nabo-β-TCP synthesized via microwave treatment

The degradation and/or apatite layer precipitation ability of porous β-tricalcium phosphate(β-TCP) samples treated and untreated with microwave radiation during synthesis is investigated. Microwave heating was used to accelerate the formation of CDHA with the Ca/P ratio 1.5 in a shorter processing time which later forms β-TCP at around 650 ◦C. Soaking in simulated body fluid (SBF) for several periods (4, 8, 12, 24, 36, 48, 60 and 72 h) is performed in a cumulative manner. The deposition of an apatite layer is followed through diffuse reflected FT-IR, SEM and EDS. A microwave-treated sample having a smaller particle size than its parent induces the formation of a homogeneous carbonated apatite layer on its surface.On the other hand, the parent β-TCP sample exhibited less ability to induce Ca–P formation after being soaked in SBF. The formation of an apatite layer is attributed to the increase in surface area consequent to reduced particle and grain sizes besides the presence of a minor amount of hydroxyapatite phase in the microwave-treated β-TCP sample. The results prove that it is possible to control the biodegradation and apatite layer formation on sintered β-TCP porous disks through controlling the particle size.

Cytocompatibility of brushite and monetite cell culture scaffolds made by three-dimensional powder printing

This study investigated the cytocompatibility of low-temperature direct 3-D printed calcium phosphate scaffolds in vitro. The fabrication of the scaffolds was performed with a commercial 3-D powder printing system. Diluted phosphoric acid was printed into tricalcium phosphate powder, leading to the formation of dicalcium phosphate dihydrate (brushite). Hydrothermal conversion of the brushite matrices led to the formation of dicalcium phosphate anhydrous (monetite). The biocompatibility was investigated using the osteoblastic cell line MC3T3-E1. Cell viability and the expression of alkaline phosphatase served as parameters. The culture medium was analyzed for pH value, concentration of free calcium and phosphate ions and osteocalcin. Both types of scaffolds showed a considerable increase of cell proliferation and viability; the monetite matrices were a little inferior compared with the brushite ones. The activity of alkaline phosphatase showed a similar pattern. Optical and electron microscopy revealed an obvious cell growth on the surface of both materials. Analysis of the culture medium showed minor alterations of pH value within the physiological range. The concentrations of free calcium and phosphate ions were obviously different among brushite and monetite cultures, due to their different solubility. The content of osteocalcin of the culture medium was reduced by the printed scaffolds due to adsorption. We conclude that the powder printed brushite and monetite matrices have a suitable biocompatibility for their use as cell culture scaffolds. Both materials enable osteoblastic cells in vitro to proliferate and differentiate due to the expression of typical osteoblastic markers.