In vitro physiochemical properties of a biomimetic gelatin/chitosan oligosaccharide/calcium silicate cement

Limitations and modifications in the clinical application of calcium sulfate

Calcium sulfate and calcium sulfate-based biomaterials have been widely used in non-load-bearing bone defects for hundreds of years due to their superior biocompatibility, biodegradability, and non-toxicity. However, lower compressive strength and rapid degradation rate are the main limitations in clinical applications. Excessive absorption causes a sharp increase in sulfate ion and calcium ion concentrations around the bone defect site, resulting in delayed wound healing and hypercalcemia. In addition, the space between calcium sulfate and the host bone, resulting from excessively rapid absorption, has adverse effects on bone healing or fusion techniques. This issue has been recognized and addressed. The lack of sufficient mechanical strength makes it challenging to use calcium sulfate and calcium sulfate-based biomaterials in load-bearing areas. To overcome these defects, the introduction of various inorganic additives, such as calcium carbonate, calcium phosphate, and calcium silicate, into calcium sulfate is an effective measure. Inorganic materials with different physical and chemical properties can greatly improve the properties of calcium sulfate composites. For example, the hydrolysis products of calcium carbonate are alkaline substances that can buffer the acidic environment caused by the degradation of calcium sulfate; calcium phosphate has poor degradation, which can effectively avoid the excessive absorption of calcium sulfate; and calcium silicate can promote the compressive strength and stimulate new bone formation. The purpose of this review is to review the poor properties of calcium sulfate and its complications in clinical application and to explore the effect of various inorganic additives on the physicochemical properties and biological properties of calcium sulfate.

Mussel-Inspired Epoxy Bioadhesive with Enhanced Interfacial Interactions for Wound Repair

The balance between high mechanical properties and strong adhesion strength is crucial in designing and preparing a bio-based hydrogel adhesive for wound closure. Although the adhesion performance of bioadhesives has been remarkably improved by modification with catechol groups, their mechanical properties are yet to meet the biomedical requirements. In this study, mussel-inspired epoxy bioadhesives (CSD-PEG) were synthesized based on catechol-modified chitosan oligosaccharide (CSD) and polyethylene glycol diglycidyl ether (PEGDGE) through nucleophilic substitution. Notably, the CSD-PEG adhesive showed high mechanical and adhesion strengths, which were up to 50.7 kPa and 136.7 kPa, respectively. It was confirmed that a certain amount of the epoxy and catechol groups provided multiple interfacial interactions among the adhesives, substrates, and polymer chains for enhancing the performance of adhesives. The adhesives showed good binding and repairing effects for wound closure and favorable biocompatibility in vivo. The prepared CSD-PEG adhesives are expected to be a promising candidate for surgical tissue repair, wound closure, and tissue engineering fields. STATEMENT OF SIGNIFICANCE: Current reported adhesives composed of biopolymers generally suffer from poor mechanical properties or weak tissue adhesiveness. Therefore, to achieve simultaneously high mechanical and adhesion properties in a bio-based adhesive for wound closure is a big challenge. In this study, mussel-inspired adhesive hydrogels (CSD-PEG) were prepared based on catechol-modified chitosan oligosaccharide (CSD) and polyethylene glycol diglycidyl ether (PEGDGE). The tensile strength and adhesive strength of CSD-PEG on porcine skin reached 50.7 kPa and 136.7 kPa, respectively, which were higher than those for most reported biopolymeric adhesives, mainly due to the multiple interfacial interactions between the catechol and epoxy groups. The CSD-PEG bioadhesives also showed good binding and repairing effects for wound closure and tissue regeneration in vivo.

In vitro comparisons of microscale and nanoscale calcium silicate particles

Calcium silicate (CaSi) materials have been used for bone repair and generation due to their osteogenic properties. Tailoring the surface chemistry and structure of CaSi can enhance its clinical performance. There is no direct comparison between microscale and nanoscale CaSi particles. Therefore, this article aimed to compare and evaluate the surface chemistry, structure, and in vitro properties of microscale CaSi (μCaSi) and nanoscale CaSi (nCaSi) particles synthesized by the sol-gel method and precipitation method, respectively. As a result, the semi-crystalline μCaSi powders were assemblies of irregular microparticles containing a major β-dicalcium silicate phase, while the amorphous nCaSi powders consisted of spherical particles with a size of 100 nm. After soaking in a Tris-HCl solution, the amount of Si ions released from nCaSi was higher than that released from μCaSi, but there was no significant difference in Ca ion release between the two CaSi particles. Compared to microscale CaSi (μCaSi), nanoscale CaSi (nCaSi) significantly enhanced the growth and differentiation of human mesenchymal stem cells (hMSC) and inhibited the function of RAW 264.7 macrophages. In the case of antibacterial activity against Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus), nanoscale nCaSi displayed a higher bacteriostatic ratio, a greater growth inhibition zone and more reactive oxygen species (ROS) production than microscale μCaSi. The conclusion is that nanoscale CaSi had greater antibacterial and osteogenic activity compared to microscale CaSi. Next generation CaSi-based materials with unique properties are emerging to meet specific clinical needs.

Enhanced antibacterial activity of calcium silicate-based hybrid cements for bone repair

Calcium silicate cement has attracted much attention for bone defect repair and regeneration due to its osteogenic properties. Biomaterial-associated infections and washout have become a common clinical problem. In order to enhance the antibacterial and washout performance of calcium silicate cement to meet clinical needs, different types of chitosan, including chitosan polysaccharide (CTS), quaternary ammonium chitosan (QTS), and chitosan oligosaccharide (COS), as a liquid phase were added to the calcium silicate powder. The physicochemical properties, in vitro bioactivity, antibacterial efficacy, and osteogenic effects (MG63 cells) of the cement were evaluated. Antibacterial activity was conducted with Gram-negative Escherichia coli (E. coli) and a Gram-positive Staphylococcus aureus (S. aureus) bacteria. The amount of intracellular reactive oxygen species (ROS) produced in the bacteria cultured with the chitosan solution was also detected. The experimental results showed that the chitosan additive did not affect the crystalline phase of calcium silicate cement, but increased the setting time and strength of the cement in a concentration-dependent manner. Within the scope of this study, CTS and QTS solutions with a concentration of not <1 wt% improved the washout resistance of the control cement, while the COS solutions failed to strengthen the cement. When soaked in simulated body fluid (SBF) for 1 day, all cement samples formed apatite spherules. As the soaking time increased, the diametral tensile strength of all cements decreased and the porosity increased. The assays of MG63 cell function showed lower osteogenic activity of osteoblastic cells grown on the surfaces of the chitosan-incorporated cements in comparison with the control cement without chitosan. At the same 1% concentration, compared with QTS and COS cement, CTS cement had lower cell attachment, proliferation, differentiation, and mineralization. Conversely, the CTS cement resulted in the highest bacteriostasis ratio among the three hybrid cements against two bacteria. The ROS production followed the order of CTS > QTS > COS at the same 1% concentration. In conclusion, calcium silicate cement with 1% QTS may be a viable candidate for bone defect repair in view of anti-washout performance, setting time, antibacterial activity, and osteogenic activity shown in this study.

Calcium Phosphate Cement with Antimicrobial Properties and Radiopacity as an Endodontic Material

Calcium phosphate cements (CPCs) have several advantages for use as endodontic materials, and such advantages include ease of use, biocompatibility, potential hydroxyapatite-forming ability, and bond creation between the dentin and appropriate filling materials. However, unlike tricalcium silicate (CS)-based materials, CPCs do not have antibacterial properties. The present study doped a nonwashable CPC with 0.25–1.0 wt % hinokitiol and added 0, 5, and 10 wt % CS. The CPCs with 0.25–0.5 wt % hinokitiol showed appreciable antimicrobial properties without alterations in their working or setting times, mechanical properties, or cytocompatibility. Addition of CS slightly retarded the apatite formation of CPC and the working and setting time was obviously reduced. Moreover, addition of CS dramatically increased the compressive strength of CPC. Doping CS with 5 wt % ZnO provided additional antibacterial effects to the present CPC system. CS and hinokitiol exerted a synergic antibacterial effect, and the CPC with 0.25 wt % hinokitiol and 10 wt % CS (doped with 5 wt % ZnO) had higher antibacterial properties than that of pure CS. The addition of 10 wt % bismuth subgallate doubled the CPC radiopacity. The results demonstrate that hinokitiol and CS can improve the antibacterial properties of CPCs, and they can thus be considered for endodontic applications.

In vitro degradation and angiogenesis of the porous calcium silicate–gelatin composite scaffold

Calcium silicate-gelatin scaffolds stimulated the release of angiogenesis factors such as von Willebrand factor and angiopoietin-1 more than the calcium silicate scaffold.

Pore size effect of collagen scaffolds on cartilage regeneration

Scaffold pore size is an important factor affecting tissue regeneration efficiency. The effect of pore size on cartilage tissue regeneration was compared by using four types of collagen porous scaffolds with different pore sizes. The collagen porous scaffolds were prepared by using pre-prepared ice particulates that had diameters of 150-250, 250-355, 355-425 and 425-500μm. All the scaffolds had spherical large pores with good interconnectivity and high porosity that facilitated cell seeding and spatial cell distribution. Chondrocytes adhered to the walls of the spherical pores and showed a homogeneous distribution throughout the scaffolds. The in vivo implantation results indicated that the pore size did not exhibit any obvious effect on cell proliferation but exhibited different effects on cartilage regeneration. The collagen porous scaffolds prepared with ice particulates 150-250μm in size best promoted the expression and production of type II collagen and aggrecan, increasing the formation and the mechanical properties of the cartilage.

An evaluation of the inflammatory response of lipopolysaccharide-treated primary dental pulp cells with regard to calcium silicate-based cements

This study compared the biological changes of lipopolysaccharide (LPS)-treated dental pulp (DP) cells directly cultured on mineral trioxide aggregate (MTA) and calcium silicate (CS) cements. DP cells were treated with LPS for 24 h. Then, the LPS-treated DP cells were cultured on MTA or CS cements. Cell viability, cell death mechanism and interleukin (IL)-1β expressions were analysed. A one-way analysis of variance was used to evaluate the significance of the differences between the means. A significantly higher IL-1β expression (2.9-fold) was found for LPS-treated cells (P<0.05) compared with DP cells without LPS treatment at 24 h. Absorbance values of LPS-treated cells cultured on CS cement were higher than a tissue culture plate. A significant difference (P<0.05) in cell viability was observed between cells on CS and MTA cements 24 h after seeding. At 48 h, a high concentration of Si (5 mM) was released from MTA, which induced LPS-treated DP cell apoptosis. The present study demonstrates that CS cement is biocompatible with cultured LPS-treated DP cells. MTA stimulates inflammation in LPS-treated DP cells, which leads to greater IL-1β expression and apoptosis.

In vitro physicochemical properties, osteogenic activity, and immunocompatibility of calcium silicate-gelatin bone grafts for load-bearing applications

The use of a composite made of natural polymer gelatin and bioactive calcium silicate resembling the morphology and properties of natural bone may provide a solution to the problem of ceramic brittleness for load-bearing applications. The in vitro bioactivity, degradability, osteogenic activity, and immunocompatibility of three types of calcium silicate-gelatin composite bone grafts were characterized. The osteogenic activity and immunocompatibility were evaluated by incubating the bone grafts with human dental pulp cells. After soaking in a simulated body fluid (SBF) for 1 day, all materials were covered with clusters of "bone-like" apatite spherulites. The control material without gelatin exhibited an insignificant change in strength, degradability, and porosity and a small weight loss of 6% after 180 days of soaking in the SBF solution. In contrast, the soaking time imposed in this study did have a statistically significant effect on compressive strength, porosity, and weight loss of the gelatin-containing composites. After 180 days of soaking, the composite with 10 wt % gelatin lost 47% and 10% in compressive strength and weight, respectively, with a porosity of 23%. However, the presence of gelatin promoted greater cell attachment and proliferation on the composite bone grafts. Pulp cells on the calcium silicate-gelatin bone grafts expressed higher levels of osteocalcin, osteopontin, and bone sialoprotein. The inhibition of inducible nitric oxide synthase and interleukin-1 expression and the activation of interleukin-10 were increased with increasing gelatin content. Overall, these findings provide evidence that composite bone grafts containing 10 wt % gelatin with a high initial strength were bioactive, nontoxic, and osteogenic and may be able to promote bone healing for load-bearing applications.

The role of silicon in osteoblast-like cell proliferation and apoptosis

The optimal concentration at which Si induces cell functions has not been fully elucidated. In the present study the effects of Si concentration (0-6 mM) on the biological functions of MG63 cells were investigated. Cell proliferation in the presence of 2 mM Si- and 4 mM Si-containing media progressively increased with culture time, whereas that of 6mM Si treated MG63 cells was significantly (P<0.05) reduced. The unusually high Si concentration (6 mM) induced a significant (P<0.05) increase in the sub-G1 phase of cells from the original 3.60% up to 43.01% after culture for 12 h. In contrast, the other lower Si concentration treated MG63 cells in the sub-G1 phase were in the range 3-5% at all culture time points. 4 mM Si treated MG63 cells, but not 6 mM Si treated MG63 cells, showed remarkably enhanced collagen type I (COL I) gene expression and extracellular signal-regulated kinase (ERK) secretion, which were significantly (P<0.05) higher than those in the control medium. The activation of ERK was also stimulated in MG63 cells by 4 mM Si. Cells cultured in the presence of 4 mM Si were found to have calcium matrix formation on day 7 that was 15-fold greater than that in the control medium. The results obtained in this study may be useful in designing calcium silicate-based materials with optimal biological properties.