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Reinforcement of Calcium Phosphate Cement with Hybrid Silk Fibroin/Kappa-Carrageenan Nanofibers. Biomedicines 2023; 11:biomedicines11030850. [PMID: 36979830 PMCID: PMC10045238 DOI: 10.3390/biomedicines11030850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023] Open
Abstract
Calcium phosphate cements (CPCs) offer a promising solution for treating bone defects due to their osteoconductive, injectable, biocompatible, and bone replacement properties. However, their brittle nature restricts their utilization to non-load-bearing applications. In this study, the impact of hybrid silk fibroin (SF) and kappa-carrageenan (k-CG) nanofibers as reinforcements in CPC was investigated. The CPC composite was fabricated by incorporating electrospun nanofibers in 1, 3, and 5% volume fractions. The morphology, mineralization, mechanical properties, setting time, injectability, cell adhesion, and mineralization of the CPC composites were analyzed. The results demonstrated that the addition of the nanofibers improved the CPC mixture, leading to an increase in compressive strength (14.8 ± 0.3 MPa compared to 8.1 ± 0.4 MPa of the unreinforced CPC). Similar improvements were seen in the bending strength and work fracture (WOF). The MC3T3-E1 cell culture experiments indicated that cells attached well to the surfaces of all cement samples and tended to join their adjacent cells. Additionally, the CPC composites showed higher cell mineralization after a culture period of 14 days, indicating that the SF/k-CG combination has potential for applications as a CPC reinforcement and bone cell regeneration promoter.
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A Review on the Enhancement of Calcium Phosphate Cement with Biological Materials in Bone Defect Healing. Polymers (Basel) 2021; 13:polym13183075. [PMID: 34577976 PMCID: PMC8472520 DOI: 10.3390/polym13183075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/05/2021] [Accepted: 09/10/2021] [Indexed: 01/28/2023] Open
Abstract
Calcium phosphate cement (CPC) is a promising material used in the treatment of bone defects due to its profitable features of self-setting capability, osteoconductivity, injectability, mouldability, and biocompatibility. However, the major limitations of CPC, such as the brittleness, lack of osteogenic property, and poor washout resistance, remain to be resolved. Thus, significant research effort has been committed to modify and reinforce CPC. The mixture of CPC with various biological materials, defined as the materials produced by living organisms, have been fabricated by researchers and their characteristics have been investigated in vitro and in vivo. This present review aimed to provide a comprehensive overview enabling the readers to compare the physical, mechanical, and biological properties of CPC upon the incorporation of different biological materials. By mixing the bone-related transcription factors, proteins, and/or polysaccharides with CPC, researchers have demonstrated that these combinations not only resolved the lack of mechanical strength and osteogenic effects of CPC but also further improve its own functional properties. However, exceptions were seen in CPC incorporated with certain proteins (such as elastin-like polypeptide and calcitonin gene-related peptide) as well as blood components. In conclusion, the addition of biological materials potentially improves CPC features, which vary depending on the types of materials embedded into it. The significant enhancement of CPC seen in vitro and in vivo requires further verification in human trials for its clinical application.
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Ghimire A, Song J. Anti-Periprosthetic Infection Strategies: From Implant Surface Topographical Engineering to Smart Drug-Releasing Coatings. ACS APPLIED MATERIALS & INTERFACES 2021; 13:20921-20937. [PMID: 33914499 PMCID: PMC8130912 DOI: 10.1021/acsami.1c01389] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Despite advanced implant sterilization and aseptic surgical techniques, periprosthetic bacterial infection remains a major challenge for orthopedic and dental implants. Bacterial colonization/biofilm formation around implants and their invasion into the dense skeletal tissue matrices are difficult to treat and could lead to implant failure and osteomyelitis. These complications require major revision surgeries and extended antibiotic therapies that are associated with high treatment cost, morbidity, and even mortality. Effective preventative measures mitigating risks for implant-related infections are thus in dire need. This review focuses on recent developments of anti-periprosthetic infection strategies aimed at either reducing bacterial adhesion, colonization, and biofilm formation or killing bacteria directly in contact with and/or in the vicinity of implants. These goals are accomplished through antifouling, quorum-sensing interfering, or bactericidal implant surface topographical engineering or surface coatings through chemical modifications. Surface topographical engineering of lotus leaf mimicking super-hydrophobic antifouling features and cicada wing-mimicking, bacterium-piercing nanopillars are both presented. Conventional physical coating/passive release of bactericidal agents is contrasted with their covalent tethering to implant surfaces through either stable linkages or linkages labile to bacterial enzyme cleavage or environmental perturbations. Pros and cons of these emerging anti-periprosthetic infection approaches are discussed in terms of their safety, efficacy, and translational potentials.
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Affiliation(s)
- Ananta Ghimire
- Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Jie Song
- Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Kucko NW, de Lacerda Schickert S, Sobral Marques T, Herber RP, van den Beuken JJJP, Zuo Y, Leeuwenburgh SCG. Tough and Osteocompatible Calcium Phosphate Cements Reinforced with Poly(vinyl alcohol) Fibers. ACS Biomater Sci Eng 2019; 5:2491-2505. [DOI: 10.1021/acsbiomaterials.9b00226] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nathan W. Kucko
- Department of Regenerative Biomaterials, Radboud University Medical Center, Philips van Leydenlaan 25 6525 EX, Nijmegen, The Netherlands
- CAM Bioceramics B.V., Zernikedreef 6 2333 CL, Leiden, The Netherlands
| | - Sónia de Lacerda Schickert
- Department of Regenerative Biomaterials, Radboud University Medical Center, Philips van Leydenlaan 25 6525 EX, Nijmegen, The Netherlands
| | - Tomás Sobral Marques
- Department of Regenerative Biomaterials, Radboud University Medical Center, Philips van Leydenlaan 25 6525 EX, Nijmegen, The Netherlands
| | - Ralf-Peter Herber
- CAM Bioceramics B.V., Zernikedreef 6 2333 CL, Leiden, The Netherlands
| | - Jeroen J. J. P. van den Beuken
- Department of Regenerative Biomaterials, Radboud University Medical Center, Philips van Leydenlaan 25 6525 EX, Nijmegen, The Netherlands
| | - Yi Zuo
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University 610064 Chengdu, China
| | - Sander C. G. Leeuwenburgh
- Department of Regenerative Biomaterials, Radboud University Medical Center, Philips van Leydenlaan 25 6525 EX, Nijmegen, The Netherlands
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Pan C, Zhou Z, Yu X. Coatings as the useful drug delivery system for the prevention of implant-related infections. J Orthop Surg Res 2018; 13:220. [PMID: 30176886 PMCID: PMC6122451 DOI: 10.1186/s13018-018-0930-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/22/2018] [Indexed: 12/13/2022] Open
Abstract
Implant-related infections (IRIs) which led to a large amount of medical expenditure were caused by bacteria and fungi that involve the implants in the operation or in ward. Traditional treatments of IRIs were comprised of repeated radical debridement, replacement of internal fixators, and intravenous antibiotics. It needed a long time and numbers of surgeries to cure, which meant a catastrophe to patients. So how to prevent it was more important than to cure it. As an excellent local release system, coating is a good idea by its local drug infusion and barrier effect on resisting biofilms which were the main cause of IRIs. So in this review, materials used for coatings and evidences of prevention were elaborated.
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Affiliation(s)
- Chenhao Pan
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 China
| | - Zubin Zhou
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 China
| | - Xiaowei Yu
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 China
- Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital East Campus, Shanghai University of Medicine and Health Sciences, Shanghai, 201306 China
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Setting mechanism of a new injectable Dicalcium Phosphate Dihydrate (DCPD) forming cement. J Mech Behav Biomed Mater 2018; 79:226-234. [DOI: 10.1016/j.jmbbm.2017.12.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 12/23/2017] [Accepted: 12/29/2017] [Indexed: 11/17/2022]
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Castro AGB, Polini A, Azami Z, Leeuwenburgh SCG, Jansen JA, Yang F, van den Beucken JJJP. Incorporation of PLLA micro-fillers for mechanical reinforcement of calcium-phosphate cement. J Mech Behav Biomed Mater 2017; 71:286-294. [PMID: 28376362 DOI: 10.1016/j.jmbbm.2017.03.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 03/18/2017] [Accepted: 03/26/2017] [Indexed: 01/09/2023]
Abstract
Calcium phosphate cements (CPCs) are biocompatible, resorbable, injectable and osteoconductive. Those properties render such materials suitable for applications where bone repair and regeneration is required However, their brittle nature limits their application only to non-load-bearing applications. The incorporation of long polymeric fibers can improve the mechanical properties of CPCs, but aggregation is a major problem. Instead, short polymeric fillers can be easily dispersed in the cement matrix, but their reinforcing effect has not been studied yet. In this study, continuous poly-L-lactic acid fibers (PLLA) with a smooth or porous surface morphology were prepared by electrospinning. PLLA micro-fillers were developed, by means of an aminolysis process, and added to α-TCP or α-TCP/PLGA-based cements. Micro-filler distribution as well as the morphology, cohesiveness, setting times and mechanical properties were evaluated. PLLA micro-fillers were homogeneously dispersed throughout the cement while the handling properties were not significantly affected. A decrease in the initial setting times was observed when PLLA was added, while the mechanical properties were comparable to those of the α-TPC or α-TCP/PLGA compositions.
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Affiliation(s)
- Antonio G B Castro
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Alessandro Polini
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Zohal Azami
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Sander C G Leeuwenburgh
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - John A Jansen
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Fang Yang
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
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Salem AM, Jones SJ, Ellis IR, Chadwick RG. Investigating the addition of collagen and its integrin binding sequence (RGD) to glass polyalkenoate: In terms of material and cellular properties to explore a more biocompatible method of root caries restoration. J Dent 2016; 54:68-76. [PMID: 27662793 DOI: 10.1016/j.jdent.2016.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 09/08/2016] [Accepted: 09/19/2016] [Indexed: 10/21/2022] Open
Abstract
AIMS Placement of a restoration to treat root caries disrupts many tissues. There is scope for the restorative material to interact with these to augment reductions in micro leakage afforded by an adhesive restorative material. OBJECTIVES 1) To investigate the effects of incorporating bioactive molecules into a glass polyalkenoate (GPA) 2) To quantify the changes in physical properties of the material. METHODS Biocompatibility of the GPA cement (Chemfil Superior, Dentsply De Trey, Konstanz, Germany) in unmodified and modified forms was ascertained using cell culture techniques. The optimum concentration of bioactive components required to promote cell attachment was determined indirectly by quantification and localisation of the fibroblast marker vimentin. The properties of surface hardness, compressive strength and adhesive bond strength were also determined prior to and following addition of the bio-additives: collagen type I and a pentapeptide containing Arg-Gly-Asp (RGD). RESULTS Addition of Type I Collagen (100μg/ml) and RGD (5mg/ml) to ChemFil Superior had no statistically significant effect upon the compressive strength and bond strength to bovine enamel but significantly (P<0.05) increased the materials shore hardness. The addition of RGD to ChemFil Superior increased most the expression of vimentin, indicating that the cells had become more fibroblastic. This may be indicative of increased synthesis of extracellular matrix macromolecules with the potential to foster adhesion of the modified glass polyalkenoate to distracted gingival tissues. CONCLUSIONS The results suggest that addition of bioactive molecules to GPA cement for subgingival restorations has potential clinical applications. CLINICAL SIGNIFICANCE It is possible to envisage that the additions, as described in this paper, could foster the attachment of displaced gingival tissues to GPA restorative materials placed subgingivally where root caries has been treated. This would offer potential to form a seal around the restoration by the attached gingival tissues avoiding a periodontal pocket and depriving residual cariogenic bacteria of a nutrient supply. Further investigation of the effects upon other similar materials of such additions is warranted.
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Affiliation(s)
- A M Salem
- The Dental School, Park Place, Dundee, DD1 4HN, UK.
| | - S J Jones
- The Dental School, Park Place, Dundee, DD1 4HN, UK.
| | - I R Ellis
- The Dental School, Park Place, Dundee, DD1 4HN, UK.
| | - R G Chadwick
- The Dental School, Park Place, Dundee, DD1 4HN, UK.
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Uskoković V. When 1+1>2: Nanostructured composites for hard tissue engineering applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 57:434-51. [PMID: 26354283 PMCID: PMC4567690 DOI: 10.1016/j.msec.2015.07.050] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/15/2015] [Accepted: 07/23/2015] [Indexed: 12/20/2022]
Abstract
Multicomponent, synergistic and multifunctional nanostructures have taken over the spotlight in the realm of biomedical nanotechnologies. The most prospective materials for bone regeneration today are almost exclusively composites comprising two or more components that compensate for the shortcomings of each one of them alone. This is quite natural in view of the fact that all hard tissues in the human body, except perhaps the tooth enamel, are composite nanostructures. This review article highlights some of the most prospective breakthroughs made in this research direction, with the hard tissues in main focus being those comprising bone, tooth cementum, dentin and enamel. The major obstacles to creating collagen/apatite composites modeled after the structure of bone are mentioned, including the immunogenicity of xenogeneic collagen and continuously failing attempts to replicate the biomineralization process in vitro. Composites comprising a polymeric component and calcium phosphate are discussed in light of their ability to emulate the soft/hard composite structure of bone. Hard tissue engineering composites created using hard material components other than calcium phosphates, including silica, metals and several types of nanotubes, are also discoursed on, alongside additional components deliverable using these materials, such as cells, growth factors, peptides, antibiotics, antiresorptive and anabolic agents, pharmacokinetic conjugates and various cell-specific targeting moieties. It is concluded that a variety of hard tissue structures in the body necessitates a similar variety of biomaterials for their regeneration. The ongoing development of nanocomposites for bone restoration will result in smart, theranostic materials, capable of acting therapeutically in direct feedback with the outcome of in situ disease monitoring at the cellular and subcellular scales. Progress in this research direction is expected to take us to the next generation of biomaterials, designed with the purpose of fulfilling Daedalus' dream - not restoring the tissues, but rather augmenting them.
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Affiliation(s)
- Vuk Uskoković
- Advanced Materials and Nanobiotechnology Laboratory, Department of Bioengineering, University of Illinois, Chicago, IL, USA.
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Gan Q, Zhu J, Yuan Y, Liu H, Qian J, Li Y, Liu C. A dual-delivery system of pH-responsive chitosan-functionalized mesoporous silica nanoparticles bearing BMP-2 and dexamethasone for enhanced bone regeneration. J Mater Chem B 2015; 3:2056-2066. [PMID: 32262373 DOI: 10.1039/c4tb01897d] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone morphogenetic protein-2 (BMP-2) is considered one of the most effective and extensively used growth factors to induce osteoblast differentiation and accelerate bone regeneration. Dexamethasone (Dex) with suitable dosage can enhance BMP-2-induced osteoblast differentiation. To strengthen this synergistic osteoinductive effect, a pH-responsive chitosan-functionalized mesoporous silica nanoparticle (chi-MSN) ensemble was fabricated for dual-delivery of BMP-2 and Dex. The MSNs are prepared by a CTAB-templated sol-gel method, and further coated by chitosan via the crosslinking of glycidoxypropyltrimethoxysilane (GPTMS). The small Dex is encapsulated in the mesopores and the large BMP-2 is incorporated into the chitosan coating. These chi-MSNs can quickly release BMP-2 in a bioactive form and can then be efficiently endocytosed and further realize a controlled release of Dex with the decreased pH value into/in cells. With the synergistic action of BMP-2 and Dex outside and inside the cell, this dual hybrid delivery system can significantly stimulate osteoblast differentiation and bone regeneration in vitro and in vivo. Together, this dual-delivery strategy for osteogenic protein delivery may enhance clinical outcomes by retaining the bioactivity and optimizing the release mode of the drug/protein.
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Affiliation(s)
- Qi Gan
- The State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, P. R. China
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Dorozhkin SV. Self-setting calcium orthophosphate formulations. J Funct Biomater 2013; 4:209-311. [PMID: 24956191 PMCID: PMC4030932 DOI: 10.3390/jfb4040209] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 10/18/2013] [Accepted: 10/21/2013] [Indexed: 01/08/2023] Open
Abstract
In early 1980s, researchers discovered self-setting calcium orthophosphate cements, which are bioactive and biodegradable grafting bioceramics in the form of a powder and a liquid. After mixing, both phases form pastes, which set and harden forming either a non-stoichiometric calcium deficient hydroxyapatite or brushite. Since both of them are remarkably biocompartible, bioresorbable and osteoconductive, self-setting calcium orthophosphate formulations appear to be promising bioceramics for bone grafting. Furthermore, such formulations possess excellent molding capabilities, easy manipulation and nearly perfect adaptation to the complex shapes of bone defects, followed by gradual bioresorption and new bone formation. In addition, reinforced formulations have been introduced, which might be described as calcium orthophosphate concretes. The discovery of self-setting properties opened up a new era in the medical application of calcium orthophosphates and many commercial trademarks have been introduced as a result. Currently such formulations are widely used as synthetic bone grafts, with several advantages, such as pourability and injectability. Moreover, their low-temperature setting reactions and intrinsic porosity allow loading by drugs, biomolecules and even cells for tissue engineering purposes. In this review, an insight into the self-setting calcium orthophosphate formulations, as excellent bioceramics suitable for both dental and bone grafting applications, has been provided.
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