Engineering mesoporous bioactive glasses for emerging stimuli-responsive drug delivery and theranostic applications

Mesoporous bioactive glasses (MBGs), which belong to the category of modern porous nanomaterials, have garnered significant attention due to their impressive biological activities, appealing physicochemical properties, and desirable morphological features. They hold immense potential for utilization in diverse fields, including adsorption, separation, catalysis, bioengineering, and medicine. Despite possessing interior porous structures, excellent morphological characteristics, and superior biocompatibility, primitive MBGs face challenges related to weak encapsulation efficiency, drug loading, and mechanical strength when applied in biomedical fields. It is important to note that the advantageous attributes of MBGs can be effectively preserved by incorporating supramolecular assemblies, miscellaneous metal species, and their conjugates into the material surfaces or intrinsic mesoporous networks. The innovative advancements in these modified colloidal inorganic nanocarriers inspire researchers to explore novel applications, such as stimuli-responsive drug delivery, with exceptional in-vivo performances. In view of the above, we outline the fabrication process of calcium-silicon-phosphorus based MBGs, followed by discussions on their significant progress in various engineered strategies involving surface functionalization, nanostructures, and network modification. Furthermore, we emphasize the recent advancements in the textural and physicochemical properties of MBGs, along with their theranostic potentials in multiple cancerous and non-cancerous diseases. Lastly, we recapitulate compelling viewpoints, with specific considerations given from bench to bedside.

Vat Polymerization by Three-Dimensional Printing and Curing of Antibacterial Zinc Oxide Nanoparticles Embedded in Poly(ethylene glycol) Diacrylate for Biomedical Applications

Digital light processing (DLP) is a vat photopolymerization 3D printing technique with increasingly broad application prospects, particularly in personalized medicine, such as the creation of medical devices. Different resins and printing parameters affect the functionality of these devices. One of the many problems that biomedical implants encounter is inflammation and bacteria growth. For this reason, many studies turn to the addition of antibacterial agents to either the bulk material or as a coating. Zinc oxide nanoparticles (ZnO NPs) have shown desirable properties, including antibacterial activity with negligible toxicity to the human body, allowing their use in a wide range of applications. In this project, we developed a resin of poly(ethylene glycol) diacrylate (PEGDA), a cross-linker known for its excellent mechanical properties and high biocompatibility in a 4:1 weight ratio of monomers to water. The material's mechanical properties (Young's modulus, maximum elongation, and ultimate tensile strength) were found similar to those of human cartilage. Furthermore, the ZnO NPs embedding matrix showed strong antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S.A.). As the ZnO NPs ratio was changed, only a minor effect on the mechanical properties of the material was observed, whereas strong antibacterial properties against both bacteria were achieved in the case of 1.5 wt.% NPs.

Tissue-engineered small-diameter vascular grafts containing novel copper-doped bioactive glass biomaterials to promote angiogenic activity and endothelial regeneration

Small-diameter vascular grafts frequently fail because of obstruction and infection. Despite the wide range of commercially available vascular grafts, the anatomical uniqueness of defect sites demands patient-specific designs. This study aims to increase the success rate of implantation by fabricating bilayer vascular grafts containing bioactive glasses (BGs) and modifying their composition by removing hemostatic ions to make them blood-compatible and to enhance their antibacterial and angiogenesis properties. The porous vascular graft tubes were 3D printed using polycaprolactone, polyglycerol sebacate, and the modified BGs. The polycaprolactone sheath was then wrapped around the 3D-printed layer using the electrospinning technique to prevent blood leakage. The results demonstrated that the incorporation of modified BGs into the polymeric matrix not only improved the mechanical properties of the vascular graft but also significantly enhanced its antibacterial activity against both gram-negative and gram-positive strains. In addition, no hemolysis or platelet activity was detected after incorporating modified BGs into the vascular grafts. Copper-releasing vascular grafts significantly enhanced endothelial cell proliferation, motility, and VEGF secretion. Additionally, In vivo angiogenesis (CD31 immunofluorescent staining) and gene expression experiments showed that copper-releasing vascular grafts considerably promoted the formation of new blood vessels, low-grade inflammation (decreased expression of IL-1β and TNF-α), and high-level angiogenesis (increased expression of angiogenic growth factors including VEGF, PDGF-BB, and HEBGF). These observations indicate that the use of BGs with suitable compositional modifications in vascular grafts may promote the clinical success of patient-specific vascular prostheses by accelerating tissue regeneration without any coagulation problems.

Dual-functional composite scaffolds for inhibiting infection and promoting bone regeneration

The treatment of infected bone defects is an intractable problem in orthopedics. It comprises two critical parts, namely that of infection control and bone defect repair. According to these two core tasks during treatment, the ideal approach of simultaneously controlling infection and repairing bone defects is promising treatment strategy. Several engineered biomaterials and drug delivery systems with dual functions of anti-bacterial action and ostogenesis-promotion have been developed and demonstrated excellent therapeutic effects. Compared with the conventional treatment method, the dual-functional composite scaffold can provide one-stage treatment avoiding multiple surgeries, thereby remarkably simplifying the treatment process and reducing the treatment time, overcoming the disadvantages of conventional bone transplantation. In this review, the impaired bone repair ability and its specific mechanisms in the microenvironment of pathogen infection and excessive inflammation were analyzed, providing a theoretical basis for the treatment of infectious bone defects. Furthermore, we discussed the composite dual-functional scaffold composed of a combination of antibacterial and osteogenic material. Finally, a series of advanced drug delivery systems with antibacterial and bone-promoting capabilities were summarized and discussed. This review provides a comprehensive understanding for the microenvironment of infectious bone defects and leading-edge design strategies for the antibacterial and bone-promoting dual-function scaffold, thus providing clinically significant treatment methods for infectious bone defects.

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Antibacterial and bone-promoting dual-function scaffolds are ideal strategies for treatment of infectious bone defects.

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The effect of infection on bone repair was summarized in detail from four important aspects.

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A variety of dual-function scaffolds based on antibacterial and osteogenic materials were discussed.

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Dual-function drug delivery systems promoting repair of infectious bone defects by locally releasing functional agents.

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Leading-edge design strategies, challenges and prospects for dual-functional biomaterials were provided.

Gamma Radiation Induced Synthesis of Novel Chitosan/Gold/Bioactive Glass Nanocomposite for Promising Antimicrobial, and Antibiofilm Activities

In the present study we reported, for the first time, the gamma irradiation induced synthesis of chitosan/Au/bioactive glass (CS/Au/BG) nanocomposite. The bioactive glass (BG), with the composition 45% SiO2, 32.5% CaO, 15% Na2O, and 7.5% P2O5 wt% was synthesized through the sol–gel technique. XRD, SEM, EDX, and elemental mapping images were utilized to evaluate the structure of pure BG and CS/Au/BG nanocomposite. The antimicrobial efficacy was evaluated by zone of inhibition (ZOI), minimum inhibitory concentration (MIC), growth curve assay, and Ultraviolet irradiation effect. Investigation was carried on the antibiofilm effectiveness. Membrane leakage as well as SEM imaging were used to evaluate the antibacterial reaction mechanism. The crystallite size of CS/Au/BG nanocomposite was determined via Scherer equation as 22.83 nm. CS/Au/BG possessed the most ZOI activity against the tested microbes. The highest inhibition % of BG, and CS/Au/BG nanocomposite was investigated for S. aureus (15.65%, and 77.24%), followed by C. albicans (13.32%, and 64.75%). The quantity of protein leakage was directly-proportional after increasing the concentration of BG, and CS/Au/BG and counted to be 70.58, and 198.25 µg/mL, respectively (after applied 10 mg/mL). The promising results suggested the use of novel CS/Au/BG nanocomposite as an encourage candidate for wastewater treatment application against pathogenic microbes.

Chitosan-Based Biomaterial Scaffolds for the Repair of Infected Bone Defects

The treatment of infected bone defects includes infection control and repair of the bone defect. The development of biomaterials with anti-infection and osteogenic ability provides a promising strategy for the repair of infected bone defects. Owing to its antibacterial properties, chitosan (an emerging natural polymer) has been widely studied in bone tissue engineering. Moreover, it has been shown that chitosan promotes the adhesion and proliferation of osteoblast-related cells, and can serve as an ideal carrier for bone-promoting substances. In this review, the specific molecular mechanisms underlying the antibacterial effects of chitosan and its ability to promote bone repair are discussed. Furthermore, the properties of several kinds of functionalized chitosan are analyzed and compared with those of pure chitosan. The latest research on the combination of chitosan with different types of functionalized materials and biomolecules for the treatment of infected bone defects is also summarized. Finally, the current shortcomings of chitosan-based biomaterials for the treatment of infected bone defects and future research directions are discussed. This review provides a theoretical basis and advanced design strategies for the use of chitosan-based biomaterials in the treatment of infected bone defects.

Antibiofilm effects of titanium surfaces modified by laser texturing and hot-pressing sintering with silver

Peri-implant diseases are one of the main causes of dental implant failure. New strategies for dental implants manufacturing have been developed to prevent the accumulation of bacteria and related inflammatory reactions. The main aim of this work was to develop laser-treated titanium surfaces covered with silver that generate a electrical dipole to inhibit the oral bacteria accumulation. Two approaches were developed for that purpose. In one approach a pattern of different titanium dioxide thickness was produced on the titanium surface, using a Q-Switched Nd:YAG laser system operating at 1064 nm. The second approach was to incorporate silver particles on a laser textured titanium surface. The incorporation of the silver was performed by laser sintering and hot-pressing approaches. The anti-biofilm effect of the discs were tested against biofilms involving 14 different bacterial strains growth for 24 and 72 hr. The morphological aspects of the surfaces were evaluated by optical and field emission guns scanning electronical microscopy (FEGSEM) and therefore the wettability and roughness were also assessed. Physicochemical analyses revealed that the test surfaces were hydrophilic and moderately rough. The oxidized titanium surfaces showed no signs of antibacterial effects when compared to polished discs. However, the discs with silver revealed a decrease of accumulation of Porphyromonas gingivalis and Prevotella intermedia strains. Thus, the combination of Nd:YAG laser irradiation and hot-pressing was effective to produce silver-based patterns on titanium surfaces to inhibit the growth of pathogenic bacterial species. The laser parameters can be optimized to achieve different patterns, roughness, and thickness of the modified titanium layer regarding the type and region of the implant.

Mesoporous Bioactive Glasses Cytocompatibility Assessment: A Review of In Vitro Studies

Thanks to their high porosity and surface area, mesoporous bioactive glasses (MBGs) have gained significant interest in the field of medical applications, in particular, with regards to enhanced bioactive properties which facilitate bone regeneration. The aim of this article is to review the state of the art regarding the biocompatibility evaluation of MBGs and provide a discussion of the various approaches taken. The research was performed using PubMed database and covered articles published in the last five years. From a total of 91 articles, 63 were selected after analyzing them according to our inclusion and exclusion criteria. In vitro methodologies and techniques used for biocompatibility assessment were investigated. Among the biocompatibility assessment techniques, scanning electron microscopy (SEM) has been widely used to study cell morphology and adhesion. Viability and proliferation were assessed using different assays including cell counting and/or cell metabolic activity measurement. Finally, cell differentiation tests relied on the alkaline phosphatase assay; however, these were often complemented by specific bimolecular tests according to the exact application of the mesoporous bioactive glass. The standardization and validation of all tests performed for MBG cytocompatibility is a key aspect and crucial point and should be considered in order to avoid inconsistencies, bias between studies, and unnecessary consumption of time. Therefore, introducing standard tests would serve an important role in the future assessment and development of MBG materials.

In-vitro mechanical and biological evaluation of novel zirconia reinforced bioglass scaffolds for bone repair

Bone defects resulting from infections, tumors, or traumas represent a major health care issue. Tissue engineering has been working togehter with medicine to develop techniques to repair bone damage and increase patient's life quality. In that context, scaffolds composed of bioactive ceramics have been explored, although their poor mechanical properties restrain their clinical applications as highly porous structures. As an alternative solution, this study aimed to evaluate the mechanical properties and biological response of novel zirconia reinforced bioactive glass scaffolds (ZRBG) manufactured by the replica method. The microstructure, chemical composition, compressive strength, density, in-vitro bioactivity, and cell viability were analyzed and compared to scaffolds made of monolithic zirconia of similar architecture (45, 60 and 85 ppi). The microstructure of ZRGB scaffolds consisted of a bioactive glass matrix with dispersed zirconia particles (~33% glassy phase) and the compressive strength values (ZRBG scaffolds: 0.33 ± 0.11, 0.41 ± 0.20 and 0.48 ± 0.6 MPa; ZRBG scaffolds with extra BG coating: 0.38 ± 0.13, 0.45 ± 0.11 and 0.50 ± 0.14 MPa for 45, 60 and 80 ppi, respectively) were not statistically different from those of zirconia scaffolds (0.25 ± 0.14 MPa for 45 ppi, 0.32 ± 0.11 MPa for 60 ppi and 0.44 ± 0.07 MPa for 80 ppi). No bioactivity was exhibited by monolithic zirconia scaffolds while significant bioactive response was found for ZRBG scaffolds. The cell viability of ZRBG scaffolds in osteogenic medium was improved up to 171% over zirconia scaffolds. This work provides promosing results for further exploring this technique for implant dentistry.

Multi-Scale Surface Treatments of Titanium Implants for Rapid Osseointegration: A Review

The propose of this review was to summarize the advances in multi-scale surface technology of titanium implants to accelerate the osseointegration process. The several multi-scaled methods used for improving wettability, roughness, and bioactivity of implant surfaces are reviewed. In addition, macro-scale methods (e.g., 3D printing (3DP) and laser surface texturing (LST)), micro-scale (e.g., grit-blasting, acid-etching, and Sand-blasted, Large-grit, and Acid-etching (SLA)) and nano-scale methods (e.g., plasma-spraying and anodization) are also discussed, and these surfaces are known to have favorable properties in clinical applications. Functionalized coatings with organic and non-organic loadings suggest good prospects for the future of modern biotechnology. Nevertheless, because of high cost and low clinical validation, these partial coatings have not been commercially available so far. A large number of in vitro and in vivo investigations are necessary in order to obtain in-depth exploration about the efficiency of functional implant surfaces. The prospective titanium implants should possess the optimum chemistry, bionic characteristics, and standardized modern topographies to achieve rapid osseointegration.

Cutting-edge filler technologies to release bio-active components for restorative and preventive dentistry

Advancements in materials used for restorative and preventive treatment is being directed toward "bio-active" functionality. Incorporation of filler particles that release active components is a popular method to create bio-active materials, and many approaches are available to develop fillers with the ability to release components that provide "bio-protective" or "bio-promoting" properties; e.g. metal/calcium phosphate nanoparticles, multiple ion-releasing glass fillers, and non-biodegradable polymer particles. In this review paper, recent developments in cutting-edge filler technologies to release bio-active components are addressed and summarized according to their usefulness and functions, including control of bacterial infection, tooth strengthening, and promotion of tissue regeneration.

Bioactive Glass Applications in Dentistry

At present, researchers in the field of biomaterials are focusing on the oral hard and soft tissue engineering with bioactive ingredients by activating body immune cells or different proteins of the body. By doing this natural ground substance, tissue component and long-lasting tissues grow. One of the current biomaterials is known as bioactive glass (BAG). The bioactive properties make BAG applicable to several clinical applications involving the regeneration of hard tissues in medicine and dentistry. In dentistry, its uses include dental restorative materials, mineralizing agents, as a coating material for dental implants, pulp capping, root canal treatment, and air-abrasion, and in medicine it has its applications from orthopedics to soft-tissue restoration. This review aims to provide an overview of promising and current uses of bioactive glasses in dentistry.

Nano-scale modification of titanium implant surfaces to enhance osseointegration

The main aim of this review study was to report the state of art on the nano-scale technological advancements of titanium implant surfaces to enhance the osseointegration process. Several methods of surface modification are chronologically described bridging ordinary methods (e.g. grit blasting and etching) and advanced physicochemical approaches such as 3D-laser texturing and biomimetic modification. Functionalization procedures by using proteins, peptides, and bioactive ceramics have provided an enhancement in wettability and bioactivity of implant surfaces. Furthermore, recent findings have revealed a combined beneficial effect of micro- and nano-scale modification and biomimetic functionalization of titanium surfaces. However, some technological developments of implant surfaces are not commercially available yet due to costs and a lack of clinical validation for such recent surfaces. Further in vitro and in vivo studies are required to endorse the use of enhanced biomimetic implant surfaces. STATEMENT OF SIGNIFICANCE: Grit-blasting followed by acid-etching is currently used for titanium implant modifications, although recent technological biomimetic physicochemical methods have revealed enhanced osteoconductive and anti-microbial outcomes. An improvement in wettability and bioactivity of titanium implant surfaces has been accomplished by combining micro and nano-scale modification and functionalization with protein, peptides, and bioactive compounds. Such morphological and chemical modification of the titanium surfaces induce the migration and differentiation of osteogenic cells followed by an enhancement of the mineral matrix formation that accelerate the osseointegration process. Additionally, the incorporation of bioactive molecules into the nanostructured surfaces is a promising strategy to avoid early and late implant failures induced by the biofilm accumulation.

Two to six-year disease resolution and marginal bone stability rates of a modified resective-implantoplasty therapy in 32 peri-implantitis cases

BACKGROUND

Different nonsurgical, antibacterial, surgical, and regenerative approaches to treat peri-implantitis have been proposed, but there is no an actual "gold" standard treatment showing the most favorable results to counteract peri-implantitis effects.

PURPOSE

To evaluate radiographically and clinically the disease resolution and peri-implant marginal bone stability rates of peri-implantitis cases treated through a combined resective-implantoplasty therapy in a moderate to long-term period.

MATERIALS AND METHODS

Records of patients diagnosed with peri-implantitis and treated through the same protocol applying a combined resective-implantoplasty therapy with minimum 2-year follow-up were screened. Eligible patients were contacted and asked to undergo clinical and radiologic examination. Progressive marginal bone loss, bleeding on probing, suppuration, implant mobility, and implant fracture were considered to establish the disease resolution rate and peri-implant bone stability of the treated implants.

RESULTS

Twenty-three patients with 32 treated implants fulfilled the inclusion criteria. Over the 2 to 6-year follow-up, (mean time: 3.4 ± 1.5 years), the disease resolution rate was 83% (patient level) and 87% (implant level). Four implants (13%) were lost or removed due to continuous MBL and osseointegration failure. At follow-up, peri-implant marginal bone remained stable with no further bone loss in 87% of the treated implants. BOP was absent in 89.3% (implant level), suppuration was resolved in all cases, and no pain or implant fracture was reported.

CONCLUSION

Implantoplasty treated cases showed high disease resolution rate and peri-implant marginal bone stability. This surgical antibiofilm strategy can counteract peri-implantitis progression providing an adequate environment for implant function and longevity over a moderate to long-term period.

Development of a novel biomaterial with an important osteoinductive capacity for hard tissue engineering

In this study we designed a composite biomaterial based on a high viscosity soft propolis extract (70% propolis) and shell clam, with antiseptic and osteoinductive qualities, that can be used in dentistry, orthopedics and other areas where hard tissue regeneration is needed. We assessed it in interaction with stabilized human cells isolated from dental papilla of wisdom teeth (D1MSCs). We performed detailed characterization of the obtained material by Scanning Electronic Microscopy (SEM), X-Ray Diffraction (XRD), Energy Dispersive X-Ray Spectroscopy (EDX), Fourier Transform Infrared Spectroscopy (FTIR) techniques. SEM investigation revealed the roughness and porosity of the shell, which acted like a scaffold, as it allowed cells to penetrate the pores, proliferate on the surface, spread and grow in the depressions provided by the substrate. in vitro cell viability, proliferation and differentiation assays showed that the newly obtain biomaterial presented low toxicity on D1MSCs and determined the development of numerous osteogenic nodules that were in a higher number even than in the specific induction medium. Our results demonstrated that the shell-propolis based biomaterial promoted and sustained human stem cells attachment, proliferation and differentiation, presenting an important osteoinductive effect essential for mineralized tissue reparation process.

Bioactive Glasses: Where Are We and Where Are We Going?

Bioactive glasses caused a revolution in healthcare and paved the way for modern biomaterial-driven regenerative medicine. The first 45S5 glass composition, invented by Larry Hench fifty years ago, was able to bond to living bone and to stimulate osteogenesis through the release of biologically-active ions. 45S5-based glass products have been successfully implanted in millions of patients worldwide, mainly to repair bone and dental defects and, over the years, many other bioactive glass compositions have been proposed for innovative biomedical applications, such as soft tissue repair and drug delivery. The full potential of bioactive glasses seems still yet to be fulfilled, and many of today's achievements were unthinkable when research began. As a result, the research involving bioactive glasses is highly stimulating and requires a cross-disciplinary collaboration among glass chemists, bioengineers, and clinicians. The present article provides a picture of the current clinical applications of bioactive glasses, and depicts six relevant challenges deserving to be tackled in the near future. We hope that this work can be useful to both early-stage researchers, who are moving with their first steps in the world of bioactive glasses, and experienced scientists, to stimulate discussion about future research and discover new applications for glass in medicine.

Recent Evidence on Bioactive Glass Antimicrobial and Antibiofilm Activity: A Mini-Review

Bone defects caused by trauma or pathological events are major clinical and socioeconomic burdens. Thus, the efforts of regenerative medicine have been focused on the development of non-biodegradable materials resembling bone features. Consequently, the use of bioactive glass as a promising alternative to inert graft materials has been proposed. Bioactive glass is a synthetic silica-based material with excellent mechanical properties able to bond to the host bone tissue. Indeed, when immersed in physiological fluids, bioactive glass reacts, developing an apatite layer on the granule’s surface, playing a key role in the osteogenesis process. Moreover, the contact of bioactive glass with biological fluids results in the increase of osmotic pressure and pH due to the leaching of ions from granules’ surface, thus making the surrounding environment hostile to microbial growth. The bioactive glass antimicrobial activity is effective against a wide selection of aerobic and anaerobic bacteria, either in planktonic or sessile forms. Furthermore, bioglass is able to reduce pathogens’ biofilm production. For the aforementioned reasons, the use of bioactive glass might be a promising solution for the reconstruction of bone defects, as well as for the treatment and eradication of bone infections, characterized by bone necrosis and destruction of the bone structure.

Adipose-derived stem cell therapies for bone regeneration

INTRODUCTION

Cell-based therapies exploit the heterogeneous and self-sufficient biological environment of stem cells to restore, maintain and improve tissue functions. Adipose-derived stem cells (ASCs) are, to this aim, promising cell types thanks to advantageous isolation procedures, growth kinetics, plasticity and trophic properties. Specifically, bone regeneration represents a suitable, though often challenging, target setting to test and apply ASC-based therapeutic strategies. Areas covered: ASCs are extremely plastic and secrete bioactive peptides that mediate paracrine functions, mediating their trophic actions in vivo. Numerous preclinical studies demonstrated that ASCs improve bone healing. Clinical trials are ongoing to validate the clinical feasibility of these approaches. This review is intended to define the state-of-the-art on ASCs, encompassing the biological features that make them suitable for bone regenerative strategies, and to provide an update on existing preclinical and clinical applications. Expert opinion: ASCs offer numerous advantages over other stem cells in terms of feasibility of clinical translation. Data obtained from in vivo experimentation are encouraging, and clinical trials are ongoing. More robust validations are thus expected to be achieved during the next few years, and will likely pave the way to optimized patient-tailored treatments for bone regeneration.