Effect of void structure on the toughness of double network hydrogels

Biomedical applications of stimuli-responsive "smart" interpenetrating polymer network hydrogels

In recent years, owing to the ongoing advancements in polymer materials, hydrogels have found increasing applications in the biomedical domain, notably in the realm of stimuli-responsive "smart" hydrogels. Nonetheless, conventional single-network stimuli-responsive "smart" hydrogels frequently exhibit deficiencies, including low mechanical strength, limited biocompatibility, and extended response times. In response, researchers have addressed these challenges by introducing a second network to create stimuli-responsive "smart" Interpenetrating Polymer Network (IPN) hydrogels. The mechanical strength of the material can be significantly improved due to the topological entanglement and physical interactions within the interpenetrating structure. Simultaneously, combining different network structures enhances the biocompatibility and stimulus responsiveness of the gel, endowing it with unique properties such as cell adhesion, conductivity, hemostasis/antioxidation, and color-changing capabilities. This article primarily aims to elucidate the stimulus-inducing factors in stimuli-responsive "smart" IPN hydrogels, the impact of the gels on cell behaviors and their biomedical application range. Additionally, we also offer an in-depth exposition of their categorization, mechanisms, performance characteristics, and related aspects. This review furnishes a comprehensive assessment and outlook for the advancement of stimuli-responsive "smart" IPN hydrogels within the biomedical arena. We believe that, as the biomedical field increasingly demands novel materials featuring improved mechanical properties, robust biocompatibility, and heightened stimulus responsiveness, stimuli-responsive "smart" IPN hydrogels will hold substantial promise for wide-ranging applications in this domain.

Polysaccharide-Based Double-Network Hydrogels: Polysaccharide Effect, Strengthening Mechanisms, and Applications

Polysaccharides are carbohydrate polymers that are major components of plants, animals, and microorganisms, with unique properties. Biological hydrogels are polymeric networks that imbibe and retain large amounts of water and are the major components of living organisms. The mechanical properties of hydrogels are critical for their functionality and applications. Since synthetic polymeric double-network (DN) hydrogels possess unique network structures with high and tunable mechanical properties, many natural functional polysaccharides have attracted increased attention due to their rich and convenient sources, unique chemical structure and chain conformation, inherently desirable cytocompatibility, biodegradability and environmental friendliness, diverse bioactivities, and rheological properties, which rationally make them prominent constituents in designing various strong and tough polysaccharide-based DN hydrogels over the past ten years. This review focuses on the latest developments of polysaccharide-based DN hydrogels to comprehend the relationship among the polysaccharide properties, inner strengthening mechanisms, and applications. The aim of this review is to provide an insightful mechanical interpretation of the design strategy of novel polysaccharide-based DN hydrogels and their applications by introducing the correlation between performance and composition. The mechanical behavior of DN hydrogels and the roles of varieties of marine, microbial, plant, and animal polysaccharides are emphatically explained.

Advances in the Development of Nano-Engineered Mechanically Robust Hydrogels for Minimally Invasive Treatment of Bone Defects

Injectable hydrogels were discovered as attractive materials for bone tissue engineering applications given their outstanding biocompatibility, high water content, and versatile fabrication platforms into materials with different physiochemical properties. However, traditional hydrogels suffer from weak mechanical strength, limiting their use in heavy load-bearing areas. Thus, the fabrication of mechanically robust injectable hydrogels that are suitable for load-bearing environments is of great interest. Successful material design for bone tissue engineering requires an understanding of the composition and structure of the material chosen, as well as the appropriate selection of biomimetic natural or synthetic materials. This review focuses on recent advancements in materials-design considerations and approaches to prepare mechanically robust injectable hydrogels for bone tissue engineering applications. We outline the materials-design approaches through a selection of materials and fabrication methods. Finally, we discuss unmet needs and current challenges in the development of ideal materials for bone tissue regeneration and highlight emerging strategies in the field.

Fast Recovery Double-Network Hydrogels Based on Particulate Macro-RAFT Agents

Synthetic hydrogels struggle to match the high strength, toughness, and recoverability of biological tissues under periodic mechanical loading. Although the hydrophobic polymer chain of polystyrene (PS) may initially collapse into a nanosphere upon contact with water, it has the ability to be elongated when it is subjected to an external force. To address this challenge, we employ the reversible addition-fragmentation chain transfer (RAFT) method to design a carboxyl-substituted polystyrene (CPS) which can form a covalently cross-linked network with four-armed amino-terminated polyethylene glycol (4-armed-PEG-NH2), and a ductile polyacrylamide network is introduced in order to prepare a double-network (DN) hydrogel. Our results demonstrate that the DN hydrogel exhibits exceptional mechanical properties (0.62 kJ m-2 fracture energy, 2510.89 kJ m-3 toughness, 0.43 MPa strength, and 820% elongation) when a sufficient external force is applied to fracture it. Moreover, when the DN hydrogel is subjected to a 200% strain, it displays superior recoverability (94.5%). This holds a significant potential in enhancing the mechanical performance of synthetic hydrogels and can have wide-ranging applications in fields such as tissue engineering for hydrophobic polymers.

Stretchable and sensitive sodium alginate ionic hydrogel fibers for flexible strain sensors

Ionic conductive hydrogel fibers based on natural polymers provide an immense focus for a new generation of electronics due to their flexibility and knittability. The feasibility of utilizing pure natural polymer-based hydrogel fibers could be drastically improved if their mechanical and transparent performances satisfy the requirements of actual practice. Herein, we report a facile fabrication strategy for significantly stretchable and sensitive sodium alginate ionic hydrogel fibers (SAIFs), by glycerol initiating physical crosslinking and by CaCl2 inducing ionic crosslinking. The obtained ionic hydrogel fibers not only show significant stretchability (tensile strength of 1.55 MPa and fracture strain of ∼161 %), but also exhibit wide-range sensing, satisfactorily stable, rapidly responsive, and multiply sensitive abilities to external stimulus. In addition, the ionic hydrogel fibers have excellent transparency (over 90 % in a wide wavelength range), and good anti-evaporation and anti-freezing properties. Furthermore, the SAIFs have been easily knitted into a textile, and successfully applied as wearable sensors to recognize human motions, by observing the output electrical signals. Our methodology for fabrication intelligent SAIFs will shed light on artificial flexible electronics and other textile-based strain sensors.

The model pH-controlled delivery system based on gelatin-tannin hydrogels containing ferrous ascorbate: iron releasein vitro

Hydrogels have become an essential class among all biomaterials. The specialized biomaterials are highly valued in the field of biomedical applications. One of the problems in wound management is local microelement deficiency associated with extensive wound lesions. The significant lack of elemental iron in the human body leads to serious consequences and prolongs treatment. The synthesis of gelatin-tannin hydrogels with ion delivery function is proposed in this study. The ability to release ions in low acid solution is a sphere of great interest. The pH drop in the wound cavity is usually associated with the contamination of some bacterial cultures. pH-controlled delivery of iron in buffer solutions (рН = 5.5/6.4/7.4) was considered for these hydrogels. The kinetics of iron release was determined by visible spectroscopy. Theoretical models were applied to describe the process of ion delivery. The structure of materials was examined by IR-spectroscopy and demonstrated the incorporation of ferrous ascorbate into hydrogel matrix. Thermal analysis was used to point out the key differences in thermal behavior by isoconversional methods (Flynn-Wall-Ozawa/Kissinger-Akahira-Sunose). The mechanical properties of the materials have been studied. The effect of iron ascorbate on polymer network parameters was discussed. The current study demonstrated the possibility of obtaining gelatin-tannin hydrogels for pH-dependent iron delivery. That provides future perspectives to expand the set of releasing microelements for biomedical applications.

Non-destructive, continuous monitoring of biochemical, mechanical, and structural maturation in engineered tissue

Regulatory guidelines for tissue engineered products require stringent characterization during production and necessitate the development of novel, non-destructive methods to quantify key functional parameters for clinical translation. Traditional assessments of engineered tissues are destructive, expensive, and time consuming. Here, we introduce a non-destructive, inexpensive, and rapid sampling and analysis system that can continuously monitor the mechanical, biochemical, and structural properties of a single sample over extended periods of time. The label-free system combines the imaging modalities of fluorescent lifetime imaging and ultrasound backscatter microscopy through a fiber-based interface for sterile monitoring of tissue quality. We tested the multimodal system using tissue engineered articular cartilage as an experimental model. We identified strong correlations between optical and destructive testing. Combining FLIm and UBM results, we created a novel statistical model of tissue homogeneity that can be applied to tissue engineered constructs prior to implantation. Continuous monitoring of engineered tissues with this non-destructive system has the potential for in-process monitoring of tissue engineered products, reducing costs and improving quality controls in research, manufacturing, and clinical applications.

Recent Advances in Design Strategies of Tough Hydrogels

Hydrogels are a fascinating class of materials popular in numerous fields, including tissue engineering, drug delivery, soft robotics, and sensors, attributed to their 3D network porous structure containing a significant amount of water. However, traditional hydrogels exhibit poor mechanical strength, limiting their practical applications. Thus, many researchers have focused on the development of mechanically enhanced hydrogels. This review describes the design considerations for constructing tough hydrogels and some of the latest strategies in recent years. These tough hydrogels have an up-and-coming prospect and bring great hope to the fields of biomedicine and others. Nonetheless, it is still no small challenge to realize hydrogel materials that are tough, multifunctional, intelligent, and zero-defect. This article is protected by copyright. All rights reserved.

Polyelectrolyte Gels: Fundamentals, Fabrication and Applications

Polyelectrolyte gels are an important class of polymer gels and a versatile platform with charged polymer networks with ionisable groups. They have drawn significant recent attention as a class of smart material and have demonstrated potential for a variety of applications. This review begins with the fundamentals of polyelectrolyte gels, which encompass various classifications (i.e., origin, charge, shape) and crucial aspects (ionic conductivity and stimuli responsiveness). It further centralises recent developments of polyelectrolyte gels, emphasising their synthesis, structure-property relationships and responsive properties. Sequentially, this review demonstrates how polyelectrolyte gels' flourishing properties create attractiveness to a range of applications including tissue engineering, drug delivery, actuators and bioelectronics. Finally, the review outlines the indisputable appeal, further improvements and emerging trends in polyelectrolyte gels.

Recent Advances in Design Strategies for Tough and Stretchable Hydrogels

The development of multifunctional hydrogels with excellent stretchability and toughness is one of the most fascinating subjects in soft matter research. Numerous research efforts have focused on the design of new hydrogel systems with superior mechanical properties because of their potential applications in diverse fields. In this Minireview, we consider the most up-to-date mechanically strong hydrogels and summarize their design strategies based on the formation of double networks and dual physical crosslinking. Based on the synthetic approaches and different toughening mechanisms, double-network hydrogels can be further classified into three different categories, namely chemically crosslinked, hybrid physically-chemically crosslinked, and fully physically crosslinked. In addition to the above-mentioned methods, we also discuss few uniquely designed hydrogels with the intention of guiding the future development of these fascinating materials for superior mechanical performance.

Fully physically cross-linked double network hydrogels with strong mechanical properties, good recovery and self-healing properties

Combining a hydrophobic interaction crosslinked curdlan as the first network and hydrophobic interaction crosslinked polyacrylamide as the second network, we have fabricated a curdlan/HPAAm double network (DN) hydrogel using a one-pot method. The resulting DN hydrogel exhibited good mechanical properties, i.e. an elastic modulus of 103 kPa, a tensile fracture strength of 0.81 MPa, a tensile stretch of 25.3 and a compressive stress of 62.5 MPa when the compressive strain increased up to 99%. The DN gel could withstand ten compression tests under 90% compressive strain without observable damage. The DN gel demonstrated 84% stiffness recovery and 97% toughness recovery after the deformed samples were relaxed and stored at 95 °C for 4 h. The stiffness and fracture stress of the DN gel were enhanced after sterilization treatment at 120 °C. Furthermore, the gels exhibited 52% self-healing of fracture stretch after the samples were cut and brought into contact at 95 °C for 4 h. The self-recovery and self-healing properties of the DN gel both originated from the first curdlan network via the reformation of hydrophobic interactions and the second HPAAm network via reformation of the broken hydrophobic associations.

Specialty Tough Hydrogels and Their Biomedical Applications

Hydrogels have long been explored as attractive materials for biomedical applications given their outstanding biocompatibility, high water content, and versatile fabrication platforms into materials with different physiochemical properties and geometries. Nonetheless, conventional hydrogels suffer from weak mechanical properties, restricting their use in persistent load-bearing applications often required of materials used in medical settings. Thus, the fabrication of mechanically robust hydrogels that can prolong the lifetime of clinically suitable materials under uncompromising in vivo conditions is of great interest. This review focuses on design considerations and strategies to construct such tough hydrogels. Several promising advances in the proposed use of specialty tough hydrogels for soft actuators, drug delivery vehicles, adhesives, coatings, and in tissue engineering settings are highlighted. While challenges remain before these specialty tough hydrogels will be deemed translationally acceptable for clinical applications, promising preliminary results undoubtedly spur great hope in the potential impact this embryonic research field can have on the biomedical community.

Highly Stretchable and Compressible Cellulose Ionic Hydrogels for Flexible Strain Sensors

Stretchable and compressible hydrogels based on natural polymers have received immense considerations for electronics. The feasibility of using pure natural polymer-based hydrogels could be improved if their mechanical behaviors satisfy the requirements of practical applications. Herein, we report highly stretchable (tensile strain ∼126%) and compressible (compression strain ∼80%) cellulose ionic hydrogels (CIHs) among pure natural polymer-based hydrogels including cellulose, chitin, and chitosan via chemical cross-linking based on free radical polymerization of allyl cellulose in NaOH/urea aqueous solution. In addition, the hydrogels have good transparency (transmittance of ∼89% at 550 nm) and ionic conductivity (∼0.16 mS cm^-1) and can be worked at -20 °C without freezing and visual loss of transparency. Moreover, the CIHs can serve as reliable and stable strain sensors and have been successfully used to monitor human activities. Significantly, the various properties of hydrogel can be controlled through rationally adjusting the chemically cross-linked density. Our methodology will prove useful in developing the satisfied mechanical and transparent CIHs for a myriad of applications in flexible electronics.

Reduced Graphene Oxide-Based Double Network Polymeric Hydrogels for Pressure and Temperature Sensing

We demonstrate the fabrication of novel reduced graphene oxide (rGO)-based double network (DN) hydrogels through the polymerization of poly(N-isopropylacrylamide) (PNIPAm) and carboxymethyl chitosan (CMC). The facile synthesis of DN hydrogels includes the reduction of graphene oxide (GO) by CMC, and the subsequent polymerization of PNIPAm. The presence of rGO in the fabricated PNIPAm/CMC/rGO DN hydrogels enhances the compressibility and flexibility of hydrogels with respect to pure PNIPAm hydrogels, and they exhibit favorable thermoresponsivity, compressibility, and conductivity. The created hydrogels can be continuously cyclically compressed and have excellent bending properties. Furthermore, it was found that the hydrogels are pressure- and temperature-sensitive, and can be applied to the design of both pressure and temperature sensors to detect mechanical deformation and to measure temperature. Our preliminary results suggest that these rGO-based DN hydrogels exhibit a high potential for the fabrication of soft robotics and artificially intelligent skin-like devices.

Multifunctional smart hydrogels: potential in tissue engineering and cancer therapy

In recent years, clinical applications have been proposed for various hydrogel products. Hydrogels can be derived from animal tissues, plant extracts and/or adipose tissue extracellular matrices; each type of hydrogel presents significantly different functional properties and may be used for many different applications, including medical therapies, environmental pollution treatments, and industrial materials. Due to complicated preparation techniques and the complexities associated with the selection of suitable materials, the applications of many host-guest supramolecular polymeric hydrogels are limited. Thus, improvements in the design and construction of smart materials are highly desirable in order to increase the lifetimes of functional materials. Here, we summarize different functional hydrogels and their varied preparation methods and source materials. The multifunctional properties of hydrogels, particularly their unique ability to adapt to certain environmental stimuli, are chiefly based on the incorporation of smart materials. Smart materials may be temperature sensitive, pH sensitive, pH/temperature dual sensitive, photoresponsive or salt responsive and may be used for hydrogel wound repair, hydrogel bone repair, hydrogel drug delivery, cancer therapy, and so on. This review focuses on the recent development of smart hydrogels for tissue engineering applications and describes some of the latest advances in using smart materials to create hydrogels for cancer therapy.

Hierarchical structural double network hydrogel with high strength, toughness, and good recoverability

Hierarchical structural double network hydrogel (H-DN gel) was prepared with high strength (tensile fracture stress ∼6.1 MPa), toughness (13.6 MJ m⁻³) and good recoverability.

Fracture toughness of hydrogels: measurement and interpretation

The fracture mechanics of hydrogels, especially those with significantly enhanced toughness, has attracted extensive research interests. In this article we discuss the experimental measurement and theoretical interpretation of the fracture toughness for soft hydrogels. We first review the definition of fracture toughness for elastic materials, and the commonly used experimental configurations to measure it. In reality most gels are inelastic. For gels that are rate insensitive, we discuss how to interpret the fracture toughness associated with two distinct scenarios: crack initiation and steady-state crack propagation. A formulation to estimate energy dissipation during steady-state crack propagation is developed, and connections to previous models in the literature are made. For gels with rate-dependent behaviors, we review the physical mechanisms responsible for the rate-dependence, and outline the difficulties to rigorously define the fracture toughness for both crack initiation and propagation. We conclude by discussing a few fundamental questions on the fracture of tough gels that are yet to be answered.

Hydrogels as a Replacement Material for Damaged Articular Hyaline Cartilage

Hyaline cartilage is a strong durable material that lubricates joint movement. Due to its avascular structure, cartilage has a poor self-healing ability, thus, a challenge in joint recovery. When severely damaged, cartilage may need to be replaced. However, currently we are unable to replicate the hyaline cartilage, and as such, alternative materials with considerably different properties are used. This results in undesirable side effects, including inadequate lubrication, wear debris, wear of the opposing articular cartilage, and weakening of the surrounding tissue. With the number of surgeries for cartilage repair increasing, a need for materials that can better mimic cartilage, and support the surrounding material in its typical function, is becoming evident. Here, we present a brief overview of the structure and properties of the hyaline cartilage and the current methods for cartilage repair. We then highlight some of the alternative materials under development as potential methods of repair; this is followed by an overview of the development of tough hydrogels. In particular, double network (DN) hydrogels are a promising replacement material, with continually improving physical properties. These hydrogels are coming closer to replicating the strength and toughness of the hyaline cartilage, while offering excellent lubrication. We conclude by highlighting several different methods of integrating replacement materials with the native joint to ensure stability and optimal behaviour.

Smart Macroporous IPN Hydrogels Responsive to pH, Temperature, and Ionic Strength: Synthesis, Characterization, and Evaluation of Controlled Release of Drugs

Fast responsive macroporous interpenetrating polymer network (IPN) hydrogels were fabricated in this work by a sequential strategy, as follows: the first network, consisting of poly(N,N-dimethylaminoethyl methacrylate) (PDMAEM) cross-linked with N,N'-methylenebisacrylamide (BAAm), was prepared at -18 °C, the second network consisting of poly(acrylamide) (PAAm) cross-linked with BAAm, being also generated by cryogelation technique. Both single network cryogels (SNC) and IPN cryogels were characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, and water uptake. The presence of weak polycation PDMAEM endows the SNCs and the IPNs cryogels with sensitivity at numerous external stimuli such as pH, temperature, ionic strength, electric field, among which the first three were investigated in this work. It was found that the initial concentration of monomers in both networks was the key factor in tailoring the properties of IPN cryogels such as swelling kinetics, equilibrium water content (EWC), phase transition temperature and the response at ionic strength. The pore size increased after the formation of the second network, the swelling kinetics in pure water being comparable with that of the SNC, phase transition temperature being situated in the range 35-36 °C for IPN cryogels. The water uptake at equilibrium (WUeq) abruptly increased at pH < 3.0 in the case of SNCs, whereas the response of IPN cryogels at the decrease of pH from 6.0 to 1.0 was strongly dependent on the gel structure, the values of WUeq being lower at a higher concentration of DMAEM in the first network, the monomer concentration in the second network being about 10 wt %. The pH response was very much diminished when the monomer concentration was high in both networks (15 wt % in the first network, and 21 wt % in the second network). The increase of the ionic strength from 0 up to 0.3 M NaCl led to the decrease of the WUeq, for all cryogels, the level of dehydration being higher and faster for the SNC than for the corresponding IPN cryogel. The release of diclofenac sodium (DS), as a model acidic drug, triggered by pH, temperature, and ionic strength from the IPN cryogels was evaluated. A pulsatile release of DS from the IPN cryogels was presented, with a slower release at 34 °C (below VPTT) and a faster release at 37 and 40 °C (above the VPTT).

Double-network hydrogel and its potential biomedical application: A review

Double-network hydrogels are one of the most promising candidates as artificial soft supporting tissues owing to their excellent mechanical performance, water storage capability, and biocompatibility. A double-network hydrogel consists of two contrasting polymer networks: rigid and brittle first network and soft and ductile second network. To satisfy this double-network requirement, polyelectrolyte and neutral polymer are suitable as the first and the second networks, respectively. Combination of these two networks gives rise to extraordinarily tough double-network hydrogel as a result of substantial internal fracture of the brittle first network at large deformation, which contributes to the energy dissipation. Therefore, the first network serves as the sacrificial bonds to toughen the material. The double-network principle is universal and many kinds of double-network hydrogels composed of various chemical species have been developed. Moreover, a molecular stent technology has been developed to synthesize the double-network hydrogels using neutral polymer network as the brittle first network. The sulfonic double-network hydrogel was found to induce spontaneous hyaline cartilage regeneration in vivo.

Fundamentals of double network hydrogels

Double network (DN) hydrogels as promising soft-and-tough materials intrinsically possess extraordinary mechanical strength and toughness due to their unique contrasting network structures, strong interpenetrating network entanglement, and efficient energy dissipation.

Superior mechanical properties of double-network hydrogels reinforced by carbon nanotubes without organic modification

A facile method is developed to fabricate nanocomposite double-network (DN) gels with excellent mechanical properties, which do not fracture upon loading up to 78 MPa and a strain above 0.98, by compositing of carbon nanotubes (CNTs) without organic modification. Investigations of swelling behaviors, and compressive and tensile properties indicate that equilibrium swelling ratio, compressive modulus and stress, fracture stress, Young's modulus, and yield stress are significantly improved in the presence of CNTs. Scanning electron microscopy (SEM) reveals that the pore size of nanocomposite DN gels is decreased and some embedded micro-network structures are observed on the fracture surface in comparison to DN gels without CNTs, which leads to the enhancement of mechanical properties. The compressive loading-unloading behaviors show that the area of hysteresis loop, dissipated energy, for the first compressive cycle, increases with addition of CNTs, which is much higher than that for the successive cycles. Furthermore, the energy dissipation mechanism, similar to the Mullins effect observed in filled rubbers, is demonstrated for better understanding the nanocomposite DN polymer gels with CNTs.

A robust, one-pot synthesis of highly mechanical and recoverable double network hydrogels using thermoreversible sol-gel polysaccharide

A new type of physically linked double-network hydrogel is synthesized by a simple, time-saving, facile, easily controlled, one-pot method. The resulting agar/polyacrylamide double-network hydrogels exhibit good mechanical properties, excellent recoverability, and a unique free-shapeable property, which makes them very promising hydrogels for load-bearing soft tissues.

Synthesis and Fracture Process Analysis of Double Network Hydrogels with a Well-Defined First Network

To investigate the effect of inhomogeneity in the first network on the enormously high toughness of double network (DN) gels, we fabricated DN gels with a nearly homogeneous first network structure (named St-TPEG/PAAm DN gels) based on tetra-PEG (TPEG) gels via a molecular stent method. The St-TPEG/PAAm DN gels also show excellent mechanical properties and yielding-like phenomena comparable to conventional DN gels. This result demonstrates that the inhomogeneity within the first network is not essential for the specific toughening mechanism of DN gels. On the other hand, the St-TPEG/PAAm DN gels and conventional DN gels undergo substantially different fracture processes before the yielding point. This suggests the importance of a "homogenization process" for the yielding of DN gels. Since the St-TPEG/PAAm DN gels consist of a well-defined first network, they may serve as model DN gels in the future for further studies on fracture processes of DN gels.

Progress of key strategies in development of electrospun scaffolds: bone tissue

There has been unprecedented development in tissue engineering (TE) over the last few years owing to its potential applications, particularly in bone reconstruction or regeneration. In this article, we illustrate several advantages and disadvantages of different approaches to the design of electrospun TE scaffolds. We also review the major benefits of electrospun fibers for three-dimensional scaffolds in hard connective TE applications and identify the key strategies that can improve the mechanical properties of scaffolds for bone TE applications. A few interesting results of recent investigations have been explained for future trends in TE scaffold research.