Comparative facile methods for preparing graphene oxide-hydroxyapatite for bone tissue engineering

Injectable in situ gelling methylcellulose-based hydrogels for bone tissue regeneration

Injectable bone substitutes (IBSs) represent a compelling choice for bone tissue regeneration, as they can be exploited to optimally fill complex bone defects in a minimally invasive manner. In this context, in situ gelling methylcellulose (MC) hydrogels may be engineered to be free-flowing injectable solutions at room temperature and gels upon exposure to body temperature. Moreover, incorporating a suitable inorganic phase can further enhance the mechanical properties of MC hydrogels and promote mineralization, thus assisting early cell adhesion to the hydrogel and effectively guiding bone tissue regeneration. In this work, thermo-responsive IBSs were designed selecting MC as the organic matrix and calcium phosphate (CaP) or CaP modified with graphene oxide (CaPGO) as the inorganic component. The resulting biocomposites displayed a transition temperature around body temperature, preserved injectability even after loading with the inorganic components, and exhibited adequate retention on an ex vivo calf femoral bone defect model. The addition of CaP and CaPGO promoted the in vitro mineralization process already 14 days after immersion in simulated body fluid. Interestingly, combined X-ray diffraction and solid state nuclear magnetic resonance characterizations revealed that the formed biomimetic phase was constituted by crystalline hydroxyapatite and amorphous calcium phosphate. In vitro biological characterization revealed the beneficial impact of CaP and CaPGO, indicating their potential in promoting cell adhesion, proliferation and osteogenic differentiation. Remarkably, the addition of GO, which is very attractive for its bioactive properties, did not negatively affect the injectability of the hydrogel nor the mineralization process, but had a positive impact on cell growth and osteogenic differentiation on both pre-differentiated and undifferentiated cells. Overall, the proposed formulations represent potential candidates for use as IBSs for application in bone regeneration both under physiological and pathological conditions.

Potential Application Prospects of Biomolecule-Modified Two-Dimensional Chiral Nanomaterials in Biomedicine

Chirality, one of the most fundamental properties of natural molecules, plays a significant role in biochemical reactions. Nanomaterials with chiral characteristics have superior properties, such as catalytic properties, optoelectronic properties, and photothermal properties, which have significant potential for specific applications in nanomedicine. Biomolecular modifications such as nucleic acids, peptides, proteins, and polysaccharides are sources of chirality for nanomaterials with great potential for application in addition to intrinsic chirality, artificial macromolecules, and metals. Two-dimensional (2D) nanomaterials, as opposed to other dimensions, due to proper surface area, extensive modification sites, drug loading potential, and simplicity of preparation, are prepared and utilized in diagnostic applications, drug delivery research, and tumor therapy. Current advanced studies on 2D chiral nanomaterials for biomedicine are focused on novel chiral development, structural control, and materials sustainability applications. However, despite the advances in biomedical research, chiral 2D nanomaterials still confront challenges such as the difficulty of synthesis, quality control, batch preparation, chiral stability, and chiral recognition and selectivity. This review aims to provide a comprehensive overview of the origins, synthesis, applications, and challenges of 2D chiral nanomaterials with biomolecules as cargo and chiral modifications and highlight their potential roles in biomedicine.

Autophagy-modulating biomaterials: multifunctional weapons to promote tissue regeneration

Autophagy is a self-renewal mechanism that maintains homeostasis and can promote tissue regeneration by regulating inflammation, reducing oxidative stress and promoting cell differentiation. The interaction between biomaterials and tissue cells significantly affects biomaterial-tissue integration and tissue regeneration. In recent years, it has been found that biomaterials can affect various processes related to tissue regeneration by regulating autophagy. The utilization of biomaterials in a controlled environment has become a prominent approach for enhancing the tissue regeneration capabilities. This involves the regulation of autophagy in diverse cell types implicated in tissue regeneration, encompassing the modulation of inflammatory responses, oxidative stress, cell differentiation, proliferation, migration, apoptosis, and extracellular matrix formation. In addition, biomaterials possess the potential to serve as carriers for drug delivery, enabling the regulation of autophagy by either activating or inhibiting its processes. This review summarizes the relationship between autophagy and tissue regeneration and discusses the role of biomaterial-based autophagy in tissue regeneration. In addition, recent advanced technologies used to design autophagy-modulating biomaterials are summarized, and rational design of biomaterials for providing controlled autophagy regulation via modification of the chemistry and surface of biomaterials and incorporation of cells and molecules is discussed. A better understanding of biomaterial-based autophagy and tissue regeneration, as well as the underlying molecular mechanisms, may lead to new possibilities for promoting tissue regeneration. Video Abstract.

Can Graphene Pave the Way to Successful Periodontal and Dental Prosthetic Treatments? A Narrative Review

Graphene, as a promising material, holds the potential to significantly enhance the field of dental practices. Incorporating graphene into dental materials imparts enhanced strength and durability, while graphene-based nanocomposites offer the prospect of innovative solutions such as antimicrobial dental implants or scaffolds. Ongoing research into graphene-based dental adhesives and composites also suggests their capacity to improve the quality and reliability of dental restorations. This narrative review aims to provide an up-to-date overview of the application of graphene derivatives in the dental domain, with a particular focus on their application in prosthodontics and periodontics. It is important to acknowledge that further research and development are imperative to fully explore the potential of graphene and ensure its safe use in dental practices.

Biomineralization of bone-like hydroxyapatite to upgrade the mechanical and osteoblastic performances of poly(lactic acid) scaffolds

Biomimetic mineralization of high-strength apatite structure essentially relies on mimicking the inorganic building blocks of naturally occurring bones. However, conventional routes still have substantial function gaps in providing precision control over the geometrical dimensions and crystalline morphology of biomineralized apatite. Herein, we conceived the concept of microwave-assisted biomineralization (MAB) to customize 1D hydroxyapatite nanowhiskers (HANWs) at graphene templates, rendering the formation of graphene-hydroxyapatite (Gr-HA) nanohybrids. The HANWs essentially resembled bone apatite in elemental composition (Ca/P = 1.74), diameter (~20 nm), crystallinity (63 %), and rodlike geometry (aspect ratio of ~6). The Gr-HA nanohybrids were uniformly incorporated into poly(lactic acid) (PLA) microfibers (~1 μm) by electrospinning, engendering fibrous membranes with a set of Gr-HA loadings (10, 20 and 30 wt%). Intimate interactions were generated between Gr-HA and PLA matrix, contributing to significant promotion of the mechanical properties for PLA composite membranes. For example, the yield strength and elastic modulus of the PLA composite membranes loaded with 30 wt% Gr-HA achieved 5.4 and 66.4 MPa, increasing nearly 182 % and over 94 % compared to those of pure PLA, respectively. Moreover, the bone-like HANWs endowed PLA membranes with excellent cytocompatibility and good bioactivity, as demonstrated by over 38 % increase in cell viability and rapid apatite formation in mineral solution. The impressive combination of mechanical properties and biological characteristics make the PLA/Gr-HA scaffolds promising for guided tissue/bone regeneration therapy.

Advances in the Physico-Chemical, Antimicrobial and Angiogenic Properties of Graphene-Oxide/Cellulose Nanocomposites for Wound Healing

Graphene oxide (GO) and its reduced form (rGO) have recently attracted a fascinating interest due to their physico-chemical properties, which have opened up new and interesting opportunities in a wide range of biomedical applications, such as wound healing. It is worth noting that GO and rGO may offer a convenient access to its ready dispersion within various polymeric matrices (such as cellulose and its derivative forms), owing to their large surface area, based on a carbon skeleton with many functional groups (i.e., hydroxyl, carboxyl, epoxy bridge, and carbonyl moieties). This results in new synergic properties due to the presence of both components (GO or rGO and polymers), acting at different length-scales. Furthermore, they have shown efficient antimicrobial and angiogenic properties, mostly related to the intracellular formation of reactive oxygen species (ROS), which are advantageous in wound care management. For this reason, GO or rGO integration in cellulose-based matrixes have allowed for designing highly advanced multifunctional hybrid nanocomposites with tailored properties. The current review aims to discuss a potential relationship between structural and physico-chemical properties (i.e., size, edge density, surface chemistry, hydrophilicity) of the nanocomposites with antimicrobials and angiogenic mechanisms that synergically influence the wound healing phenomenon, by paying particular attention to recent findings of GO or rGO/cellulose nanocomposites. Accordingly, after providing a general overview of cellulose and its derivatives, the production methods used for GO and rGO synthesis, the mechanisms that guide antimicrobial and angiogenic processes of tissue repair, as well as the most recent and remarkable outcomes on GO/cellulose scaffolds in wound healing applications, will be presented.

Graphene oxide reinforced SrHAP composite as a drug carrier in bone regeneration

Strontium substituted HAP (SrHAP), with a 10 mol% substitution, was mineralized on increasing weight percentages of graphene oxide (2, 4 and 6). The GS composites were comprehensively characterized for drug delivery in bone reconstruction. The formation of SrHAP was verified by XRD and FT-IR results. The apatite crystallization was influenced by graphene oxide content and strontium. The EDS results confirmed the presence of strontium and HR-SEM depicted rod shape apatite, of length between 58 and 135 nm, uniformly embedded on graphene oxide. The reinforcement of graphene oxide increased the surface area, porosity, microhardness (upto 0.59 GPa), protein adsorption (upto 18.16 μg/mg), water uptake and degradation properties. Also, the increase in graphene oxide fraction significantly enhanced the curcumin encapsulation efficiency (upto 80.16%) and the drug release was considerably retarded over SrHAP. The in vitro studies using human osteoblast-like MG-63 cells demonstrated that curcumin-loaded composite was biocompatible and promoted proliferation, differentiation and matrix mineralization. The results highlight the combinational therapy of osteogenic ion (strontium) and osteogenic drug (curcumin) as a promising platform in bone tissue engineering.

pH-Responsive PVA-Based Nanofibers Containing GO Modified with Ag Nanoparticles: Physico-Chemical Characterization, Wound Dressing, and Drug Delivery

Site-specific drug delivery and carrying repairing agents for wound healing purposes can be achieved using the intertwined three-dimensional structure of nanofibers. This study aimed to optimize and fabricate poly (vinyl alcohol) (PVA)-graphene oxide (GO)-silver (Ag) nanofibers containing curcumin (CUR) using the electrospinning method for potential wound healing applications. Fourier Transform Infrared (FTIR) spectrophotometry, X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Dynamic Light Scattering (DLS), and zeta potential were used to characterize the nanostructures. The mechanical properties of the nanostructures were subsequently examined by tensile strength and elongation test. As shown by MIC analysis of E. coli and S. aureus bacteria, the fabricated nanofibers had superior inhibitory effects on the bacteria growth. Ag nanoparticles incorporation into the nanofibers resulted in increased loading and encapsulation efficiencies from 21% to 56% and from 61% to 86%, respectively. CUR release from PVA/GO-Ag-CUR nanofiber at pH 7.4 was prevented, while the acidic microenvironment (pH 5.4) increased the release of CUR from PVA/GO-Ag-CUR nanofiber, corroborating the pH-sensitivity of the nanofibers. Using the in vitro wound healing test on NIH 3T3 fibroblast cells, we observed accelerated growth and proliferation of cells cultured on PVA/GO-Ag-CUR nanofibers.

Antibacterial amorphous magnesium phosphate/graphene oxide for accelerating bone regeneration

Magnesium phosphates (MgP)s have attracted interest as an alternative biomaterial compared to the calcium phosphate (CaP)s compounds in the bone regeneration application in terms of their prominent biodegradability, lack of cytotoxicity, and ability of bone repair stimulation. Among them, amorphous magnesium phosphates (AMP)s indicated a higher rate of resorption, while preserving high osteoblasts viability and proliferation, which is comparable to their CaP peers. However, fast degradation of AMP leads to the initial fast release of Mg²⁺ ions and adverse effects on its excellent biological features. It seems that the addition of graphene oxide (GO) to magnesium phosphate can moderate its degradation rate. Hence, a novel in situ synthesized AMP powders containing 0.05, 0.25, 0.5, and 1 wt% of graphene oxide (AMP/GO) were developed to achieve a favorable degradation rate, desirable antibacterial properties against both Escherichia coli (E. coli), Staphylococcus aureus (S. aureus) accompanying with proper cell viability and proliferation. The incorporation of 0.5 wt% of graphene oxide into the AMP ceramic led to reduce the release of Mg²⁺ ions from 571.2 ± 12.9 mg/L to 372.8 ± 14.7 mg/L and P ions from 354.8 ± 11.9 mg/L to 245.3 ± 9.9 mg/L, at day 10 of immersion in PBS. Besides, AMP/0.5 GO bioceramics were capable of eradicating all bacterial colonies of both strains. On the other hand, MG63 cells viability went up from 143.46% ± 7.54 to 184.46% ± 11.54 on the 7th day of culture in the presence of 0.5 wt% of GO compared to pure AMP ceramic. Furthermore, alizarin red staining and alkaline phosphatase (ALP) activity demonstrated the ability of AMP/GO to maintain the osteogenic phenotype of MG63 cells during 7 days culture. Therefore, it can be concluded that well distributed and in situ synthesized AMP/0.5GO powders can be a promising biomaterial for bone tissue regeneration.

Graphene Oxide Thin Films with Drug Delivery Function

Graphene oxide has been used in different fields of nanomedicine as a manager of drug delivery due to its inherent physical and chemical properties that allow its use in thin films with biomedical applications. Several studies demonstrated its efficacy in the control of the amount and the timely delivery of drugs when it is incorporated in multilayer films. It has been demonstrated that oxide graphene layers are able to work as drug delivery or just to delay consecutive drug dosage, allowing the operation of time-controlled systems. This review presents the latest research developments of biomedical applications using graphene oxide as the main component of a drug delivery system, with focus on the production and characterization of films, in vitro and in vivo assays, main applications of graphene oxide biomedical devices, and its biocompatibility properties.

In situ synthesis of hydroxyapatite nanorods on graphene oxide nanosheets and their reinforcement in biopolymer scaffold

Introduction

It is urgently needed to develop composite bone scaffold with excellent mechanical properties and bioactivity in bone tissue engineering. Combining graphene oxide (GO) and hydroxyapatite (HAP) for the reinforcement of biopolymer bone scaffold has emerged as a promising strategy. However, the dispersion of GO and HAP remains to be a big challenge.

Objectives

In this present work, the mechanical properties of GO and the bioactivity of and HAP were combined respectively via in situ synthesis for reinforcing biopolymer bone scaffold.

Methods

GO nanosheets were employed to in situ synthesize GO-HAP nanocomposite via hydrothermal reaction, in which their abundant oxygen-containing groups served as anchor sites for the chelation of Ca2+ and then Ca2+ absorbed HPO42- via electrovalent bonding to form homogeneously dispersed HAP nanorods. Thereby, the GO-HAP nanocomposite was blended with biopolymer poly-L-lactic acid (PLLA) for fabricating biopolymer scaffold by selective laser sintering (SLS).

Results

GO nanosheets were uniformly decorated with HAP nanorods, which were about 60 nm in length and 5 nm in diameter. The compressive strength and modulus of PLLA/12%GO-HAP were significantly increased by 53.71% and 98.80% compared to the pure PLLA scaffold, respectively, explained on the base of pull out, crack bridging, deflection and pinning mechanisms. Meanwhile, the mineralization experiments indicated the PLLA/GO-HAP scaffold displayed good bioactivity by inducing the formation of apatite layer. Besides, cell culturing experiments demonstrated the favorable cytocompatibility of scaffold by promoting cell adhesion and proliferation.

Conclusions

The present findings show the potential of PLLA/GO-HAP composite scaffold via in situ synthesis in bone tissue engineering.

Biological Effects of the Novel Mulberry Surface Characterized by Micro/Nanopores and Plasma-Based Graphene Oxide Deposition on Titanium

Purpose

This paper presents a technique for developing a novel surface for dental implants using a combination of nitriding and anodic oxidation, followed by the deposition of graphene oxide using atmospheric plasma. The effects of various surface treatments on bacterial adhesion and osteoblast activation were also evaluated.

Methods

CP titanium (control) was processed into disk-shaped specimens. Nitriding was conducted using vacuum nitriding, followed by anodic oxidation, which was performed in an electrolyte using a DC power supply, to form the novel “mulberry surface.” Graphene oxide deposition was performed using atmospheric plasma with an inflow of carbon sources. After analyzing the sample surfaces, antibacterial activity was evaluated using Streptococcus mutans and Porphyromonas gingivalis bacteria. The viability, adhesion, proliferation, and differentiation of osteoblasts were also assessed. Analysis of variance (ANOVA) with Tukey’s post-hoc test was used to calculate statistical differences.

Results

We observed that the mulberry surface was formed on samples treated with nitriding and anodic oxidation, and these samples exhibited more effective antibacterial activity than the control. We also found that the samples with additional graphene oxide deposition exhibited better biocompatibility, which was validated by osteoblast adhesion, proliferation, and differentiation.

Conclusion

The development of the mulberry surface along with graphene oxide deposition inhibits bacterial adhesion to the implant and enhances the adhesion, proliferation, and differentiation of osteoblasts. These results indicate that the mulberry surface and graphene oxide deposition together can inhibit peri-implantitis and promote osseointegration.

Inductive Materials for Regenerative Engineering

Regenerative engineering has pioneered several novel biomaterials to treat critical-sized bone injuries. However, despite significant improvement in synthetic materials research, some limitations still exist. The constraints correlated with the current grafting methods signify a treatment paradigm shift to osteoinductive regenerative engineering approaches. Because of their intrinsic potential, inductive biomaterials may represent alternative approaches to treating critical bone injuries. Osteoinductive scaffolds stimulate stem cell differentiation into the osteoblastic lineage, enhancing bone regeneration. Inductive biomaterials comprise polymers, calcium phosphate ceramics, metals, and graphene family materials. This review will assess the cellular behavior toward properties of inductive materials.

Bioactive Hydrogels: Design and Characterization of Cellulose-Derived Injectable Composites

Cellulose represents a low cost, abundant, and renewable polysaccharide with great versatility; it has a hierarchical structure composed of nanofibers with high aspect ratio (3–4 nm wide, hundreds of μm long). TEMPO-mediated oxidation represents one of the most diffused methods to obtain cellulose nanofibers (CNFs): It is possible to obtain physically crosslinked hydrogels by means of divalent cation addition. The presence of inorganic components, such as calcium phosphates (CaP), can improve not only their mechanical properties but also the bioactivity of the gels. The aim of this work is to design and characterize a TEMPO-oxidized cellulose nanofibers (TOCNFs) injectable hydrogel embedded with inorganic particles, CaP and CaP-GO, for bone tissue regeneration. Inorganic particles act as physical crosslinkers, as proven by rheological characterization, which reported an increase in mechanical properties. The average load value registered in injection tests was in the range of 1.5–4.4 N, far below 30 N, considered a reasonable injection force upper limit. Samples were stable for up to 28 days and both CaP and CaP-GO accelerate mineralization as suggested by SEM and XRD analysis. No cytotoxic effects were shown on SAOS-2 cells cultured with eluates. This work demonstrated that the physicochemical properties of TOCNFs-based dispersions could be enhanced and modulated through the addition of the inorganic phases, maintaining the injectability and bioactivity of the hydrogels.

Innovative Biomaterials for the Treatment of Bone Cancer

Bone cancer is a demanding challenge for contemporary medicine due to its high frequency of presentation and significant heterogeneity of malignant lesions developing within the bone. To date, available treatments are rarely curative and are primarily aimed at prolonging patients' survival and ameliorating their quality of life. Furthermore, both pharmacological and surgical therapies are aggravated by a consistent burden of adverse events and subsequent disability due to the loss of healthy bone structural and functional properties. Therefore, great research efforts are being made to develop innovative biomaterials able to selectively inhibit bone cancer progression while reducing the loss of bone structural properties secondary to local tissue invasion. In this review, we describe the state of the art of innovative biomaterials for the treatment of bone cancer. Along with physiological bone remodeling, the development of bone metastasis and osteosarcoma will be depicted. Subsequently, recent advances on nanocarrier-based drug delivery systems, as well as the application of novel, multifunctional biomaterials for the treatment of bone cancer will be discussed. Eventually, actual limitations and promising future perspectives regarding the employment of such approaches in the clinical scenario will be debated.

Applications of Ceramic/Graphene Composites and Hybrids

Research activity on ceramic/graphene composites and hybrids has increased dramatically in the last decade. In this review, we provide an overview of recent contributions involving ceramics, graphene, and graphene-related materials (GRM, i.e., graphene oxide, reduced graphene oxide, and graphene nanoplatelets) with a primary focus on applications. We have adopted a broad scope of the term ceramics, therefore including some applications of GRM with certain metal oxides and cement-based matrices in the review. Applications of ceramic/graphene hybrids and composites cover many different areas, in particular, energy production and storage (batteries, supercapacitors, solar and fuel cells), energy harvesting, sensors and biosensors, electromagnetic interference shielding, biomaterials, thermal management (heat dissipation and heat conduction functions), engineering components, catalysts, etc. A section on ceramic/GRM composites processed by additive manufacturing methods is included due to their industrial potential and waste reduction capability. All these applications of ceramic/graphene composites and hybrids are listed and mentioned in the present review, ending with the authors' outlook of those that seem most promising, based on the research efforts carried out in this field.

Nanohybrid composed of graphene oxide functionalized with sodium hyaluronate accelerates bone healing in the tibia of rats

This study synthesized and characterized a nanohybrid composed of graphene oxide (GO) functionalized with sodium hyaluronate (HY) (GO-HY), evaluated its effect in vitro and determined its osteogenic potential in vivo. The synthesized nanohybrid was analyzed by Scanning electron microscopy (SEM), Raman spectrometry, Thermogravimetry, Fourier-transform infrared (FTIR) spectroscopy and X-ray diffraction. MC3T3-E1 cell viability was assessed by MTT assay in 48 and 72 h. Bone defects were created in tibia of 40 Wistar rats and filled with blood clot (control), 1% HY, GO (50, 100 and 200 μg/mL) and the nanohybrid (50, 100 and 200 μg/mL). After 7 and 14 days, histomorphometric analysis was carried out to assess osteogenic potential of the nanohybrid. Immunohistochemical analysis evaluated the expression of vascular endothelial growth factor (VEGF) in bone defects. Thermogravimetric analysis, Raman and FTIR spectrometry confirmed the functionalization of GO with HY by covalent bonds. Five μg/mL concentrations of the nanohybrid did not alter the viability of the MC3T3-E1 cells. Histomorphometric analysis demonstrated that the nanohybrid at 100 μg/mL significantly accelerated the bone repair in tibia of rats when compared to controls (p < 0.01). Immunohistochemical analysis showed a significantly less intense VEGF expression in tibia treated with the nanohybrid when compared to controls (p < 0.05). The nanohybrid composed of GO functionalized with HY was able to induce the acceleration of the tissue regeneration process in bone defects created in the tibia of rats. This novel nanohybrid is a promising material for the field of bone tissue engineering.

Simultaneous engineering of nanofillers and patterned surface macropores of graphene/hydroxyapatite/polyetheretherketone ternary composites for potential bone implants

Incorporating bioactive nanofillers and creating porous surfaces are two common strategies used to improve the tissue integration of polyetheretherketone (PEEK) material. However, few studies have reported the combined use of both strategies to modify PEEK. Herein, for the first time, dual nanoparticles of graphene oxide (GO) and hydroxyapatite (HAp) were incorporated into PEEK matrix to obtain ternary composites that were laser machined to create macropores with diameters ranging from 200 μm to 600 μm on the surfaces. The surface morphology and chemistry, mechanical properties, and cellular responses of the composites were investigated. The results show that micropatterned pores with a depth of 50 μm were created on the surfaces of the composites, which do not significantly affect the mechanical properties of the resultant composites. More importantly, the incorporation of GO and HAp significantly improves the cell adhesion and proliferation on the surface of PEEK. Compared to the smooth surface composite, the composites with macroporous surface exhibit markedly enhanced cell viability. The combined use of nanofillers and surface macropores may be a promising way of improving tissue integration of PEEK for bone implants.

Graphene-Based Biomaterials for Bone Regenerative Engineering: A Comprehensive Review of the Field and Considerations Regarding Biocompatibility and Biodegradation

Graphene and its derivatives have continued to garner worldwide interest due to their unique characteristics. Having expanded into biomedical applications, there have been efforts to employ their exceptional properties for the regeneration of different tissues, particularly bone. This article presents a comprehensive review on the usage of graphene-based materials for bone regenerative engineering. The graphene family of materials (GFMs) are used either alone or in combination with other biomaterials in the form of fillers in composites, coatings for both scaffolds and implants, or vehicles for the delivery of various signaling and therapeutic agents. The applications of the GFMs in each of these diverse areas are discussed and emphasis is placed on the characteristics of the GFMs that have implications in this regard. In tandem and of importance, this article evaluates the safety and biocompatibility of the GFMs and carefully elucidates how various factors influence the biocompatibility and biodegradability of this new class of nanomaterials. In conclusion, the challenges and opportunities regarding the use of the GFMs in regenerative engineering applications are discussed, and future perspectives for the developments in this field are proposed.

Osteogenic and Anti-Inflammatory Behavior of Injectable Calcium Phosphate Loaded with Therapeutic Drugs

Bone fractures related to musculoskeletal disorders determine long-term disability in older people with a consequent significant economic burden. The recovery of pathologically impaired tissue architecture allows avoiding bone loss-derived consequences such as bone height reduction, deterioration of bone structure, inflamed bone pain, and high mortality for thighbone fractures. Actually, standard therapy for osteoporosis treatment is based on the systemic administration of biphosphonates and anti-inflammatory drugs, which entail several side effects including gastrointestinal (GI) diseases, fever, and articular pain. Hence, the demand of innovative therapeutic approaches for locally treating bone lesions has been increasing in the last few years. In this scenario, the development of injectable materials loaded with therapeutically active agents (i.e., anti-inflammatory drugs, antibiotics, and peptides mimicking growth factors) could be an effective tool to treat bone loss and inflammation related to musculoskeletal diseases, including osteoporosis and osteoarthritis. According to this challenge, here, we propose three different compositions of injectable calcium phosphates (CaP) as new carrier materials of therapeutic compounds such as bisphosphonates (i.e., alendronate), anti-inflammatory drugs (i.e., diclofenac sodium), and natural molecules (i.e., harpagoside) for the local bone disease treatment. Biological quantitative analyses were performed for screening osteoinductive and anti-inflammatory properties of injectable drug-loaded systems. Meanwhile, cell morphological features were analyzed through scanning electron microscopy and confocal investigations. The results exhibited that the three systems exerted an osteoinductive effect during later phases of osteogenesis. Simultaneously, all compositions showed an anti-inflammatory activity on inflammation in vitro models.

Graphene Family Nanomaterial Reinforced Magnesium-Based Matrix Composites for Biomedical Application: A Comprehensive Review

Together with the enhancement of the load-bearing implant process for bone substitution and reproduction, an increasing requirement was observed concerning biodegradable magnesium and its alloys with lighter density and outstanding characteristics. Regardless of the current great potential of Mg utilization currently, the broader use of Mg alloys continues to be constrained by several natural causes, such as low resistance of corrosion, inadequate mechanical integrity during the healing process, and poor antibacterial performance. In this perspective, Mg-based composite encapsulated within graphene family nanomaterials (GFNs) such as graphene (Gr), graphene oxide (GO), graphene nanoplatelets (GNPs), and reduced graphene oxide (rGO) as reinforcement agents present great antibacterial activity, as well as cellular response and depicted numerous benefits for biomedical use. Magnesium matrix nanocomposites reinforced with GFNs possess enhanced mechanical properties and high corrosion resistance (low concentration graphene). It is worth noting that numerous elements including the production technique of the Mg-based composite containing GFNs and the size, distribution, and amounts of GFNs in the Mg-based matrix have a crucial role in their properties and applications. Then, the antibacterial mechanisms of GFN-based composite are briefly described. Subsequently, the antibacterial and strengthening mechanisms of GFN-embedded Mg-based composites are briefly described. This review article is designed to wrap up and explore the most pertinent research performed in the direction of Mg-based composites encapsulated within GFNs. Feasible upcoming investigation directions in the field of GFN-embedded Mg-based composites are discussed in detail.

Injectable Functional Biomaterials for Minimally Invasive Surgery

Injectable materials represent very attractive ready-to-use biomaterials for application in minimally invasive surgical procedures. It is shown that this approach to treat, for example, vertebral fracture, craniofacial defects, or tumor resection has significant clinical potential in the biomedical field. In the last four decades, calcium phosphate cements have been widely used as injectable materials for orthopedic surgery due to their excellent properties in terms of biocompatibility and osteoconductivity. However, few clinical studies have demonstrated certain weaknesses of these cements, which include high viscosity, long degradation time, and difficulties being manipulated. To overcome these limitations, the use of sol-gel technology has been investigated, which has shown good results for synthesis of injectable calcium phosphate-based materials. In the last few decades, injectable hydrogels have gained increasing attention owing to their structural similarities with the extracellular matrix, easy process conditions, and potential applications in minimally invasive surgery. However, the need to protect cells during injection leads to the development of double network injectable hydrogels that are capable of being cross-linked in situ. This review will provide the current state of the art and recent advances in the field of injectable biomaterials for minimally invasive surgery.

Hydroxyapatite/silk fibroin composite biomimetic scaffold for dental pulp repair

Dental pulp repair is a difficult clinical problem. In the present study, the authors aimed to mimic the extracellular matrix of dental pulp tissue structurally and compositionally. Nanofibrous silk fibroin (SF) scaffolds containing hydroxyapatite (HAp) nanoparticles were fabricated by using the freeze-drying approach. Rod-shaped HAp was successfully embedded in the composite scaffold, the diameter of which was about 100–200 nm as shown by transmission electron microscopy analysis. The three-dimensional microstructure of the composite scaffold prepared in various ratios of HAp to SF was observed by scanning electron microscopy and the pore size of the optimal scaffold was about 30–120 μm. Meanwhile, the hemocompatibility of the composite scaffolds was evaluated based on their impact on the clotting function by way of activated partial thromboplastin time, prothrombin time and thromboelastographic assays. The scaffolds possessed a low hemolysis rate of red blood cells. Furthermore, cell culture tests using dental pulp stem cells found that the scaffolds had good biocompatibility. There biomimetic HAp/SF composite scaffolds may serve as a promising biomaterial for dental pulp repair.

Nanomaterials for bone tissue regeneration: updates and future perspectives

Joint replacement and bone reconstructive surgeries are on the rise globally. Current strategies for implants and bone regeneration are associated with poor integration and healing resulting in repeated surgeries. A multidisciplinary approach involving basic biological sciences, tissue engineering, regenerative medicine and clinical research is required to overcome this problem. Considering the nanostructured nature of bone, expertise and resources available through recent advancements in nanobiotechnology enable researchers to design and fabricate devices and drug delivery systems at the nanoscale to be more compatible with the bone tissue environment. The focus of this review is to present the recent progress made in the rationale and design of nanomaterials for tissue engineering and drug delivery relevant to bone regeneration.

Biphasic Injectable Bone Cement with Fe3O4/GO Nanocomposites for the Minimally Invasive Treatment of Tumor-Induced Bone Destruction

Minimally invasive surgery will be gradually applied to the surgical treatment of bone tumors. One of the difficulties in the minimally invasive treatment of bone tumors is the lack of injectable materials that can be used to treat tumor-induced bone defects. Therefore, it is imperative to develop an injectable bone filler that can not only be injected into the defect site by minimally invasive methods to provide strong support and repair bone tissue but also inactivate residual tumor cells around the defect. To achieve this aim, in our study, for the first time, we doped Fe₃O₄/graphene oxide (GO) nanocomposites into α-tricalcium phosphate (α-TCP)/calcium sulfate (CS) biphasic bone cement to prepare an injectable magnetic bone cement (α-TCP/CS/Fe₃O₄/GO, αCFG), which can be applied in bone tumor minimally invasive surgery and fit ideally even if the area is irregular. The magnetothermal performance of the αCFG bone cement could be well adjusted by altering the content of Fe₃O₄/GO nanocomposites and the magnetic field parameters, but a 10 wt % Fe₃O₄/GO content formed the most stable bone cement with excellent magnetothermal performance. The αCFG bone cement not only promotes bone regeneration but also exhibits enhanced tumor treatment effects. Such multifunctional bone cement could provide a promising clinical strategy for the minimally invasive treatment of tumor-induced bone destruction.

Biomimetic Hydroxyapatite on Graphene Supports for Biomedical Applications: A Review

Hydroxyapatite (HA) has been widely used in fields of materials science, tissue engineering, biomedicine, energy and environmental science, and analytical science due to its simple preparation, low-cost, and high biocompatibility. To overcome the weak mechanical properties of pure HA, various reinforcing materials were incorporated with HA to form high-performance composite materials. Due to the unique structural, biological, electrical, mechanical, thermal, and optical properties, graphene has exhibited great potentials for supporting the biomimetic synthesis of HA. In this review, we present recent advance in the biomimetic synthesis of HA on graphene supports for biomedical applications. More focuses on the biomimetic synthesis methods of HA and HA on graphene supports, as well as the biomedical applications of biomimetic graphene-HA nanohybrids in drug delivery, cell growth, bone regeneration, biosensors, and antibacterial test are performed. We believe that this review is state-of-the-art, and it will be valuable for readers to understand the biomimetic synthesis mechanisms of HA and other bioactive minerals, at the same time it can inspire the design and synthesis of graphene-based novel nanomaterials for advanced applications.

In situ sol-gel synthesis of hyaluronan derivatives bio-nanocomposite hydrogels

The main driving idea of the present study was the comparison between two different chemical modifications of hyaluronic acid (HA) followed by the development of nanocomposite hydrogels directly in situ by biomineralization of photocrosslinkable HA polymers through sol-gel synthesis. In this way, it has been possible to overcome some limitations due to classical approaches based on the physical blending of inorganic fillers into polymer matrix. To this aim, methacrylated and maleated HA, synthesized with similar degree of substitution (DS) were compared in terms of mechanical and physico-chemical properties. The success of in situ biomineralization was highlighted by reflect Fourier transform infrared spectroscopy and thermogravimetric analysis. Furthermore, mechanical characterization demonstrated the reinforcing effect of inorganic fillers evidencing a strong correlation with DS. The swelling behavior resulted to be correlated with filler concentration. Finally, the cytotoxicity tests revealed the absence of toxic components and an increase of cell proliferation over culture time was observed, highlighting these bio-nanocomposite hyaluronan derivatives as biocompatible hydrogel with tunable properties.

Mesoporous bioactive glass combined with graphene oxide scaffolds for bone repair

Recently there has been an increasing interest in bioactive factors with robust osteogenic ability and angiogenesis function to repair bone defects. However, previously tested factors have not achieved satisfactory results due to low loading doses and a short protein half-life. Finding a validated stable substitute for these growth factors and apply it to the construction of porous scaffolds with the dual function of osteogenesis and angiogenesis is therefore vital for bone tissue regeneration engineering. Graphene oxide (GO) has attracted increasing attention due to its good biocompatibility, osteogenic, and angiogenic functions. This study aims to design a scaffold composed of mesoporous bioactive glasses (MBG) and GO to investigate whether the composite porous scaffold promotes local angiogenesis and bone healing. Our in vitro studies demonstrate that the MBG-GO scaffolds have better cytocompatibility and higher osteogenesis differentiation ability with rat bone marrow mesenchymal stem cells (rBMSCs) than the purely MBG scaffold. Moreover, MBG-GO scaffolds promote vascular ingrowth and, importantly, enhance bone repair at the defect site in a rat cranial defect model. The new bone was fully integrated not only with the periphery but also with the center of the scaffold. From these results, it is believed that the MBG-GO scaffolds possess excellent osteogenic-angiogenic properties which will make them appealing candidates for repairing bone defects. The novelty of this research is to provide a new material to treat bone defects in the clinic.

Injectable strontium-doped hydroxyapatite integrated with phosphoserine-tethered poly(epsilon-lysine) dendrons for osteoporotic bone defect repair

The control of the inflammatory response induced by the implantation of foreign biomaterials is fundamental in determining tissue healing. It has been shown that the activation of specific macrophage pathways upon contact with a biomaterial can lead either to a chronic inflammation preventing a physiological tissue repair or to an improved tissue healing. In the case of bone repair, calcium phosphate cements with good osteoconductivity properties have been successfully applied in bone defect filling and repair, but poor handling properties, insufficient viscous flow and unmatched degradation rate are still problems that remain unsolved. In this study, a strontium-doped hydroxyapatite (HA) gel was modified by integrating branched poly(epsilon-lysine) dendrons with third-generation branches exposing phosphoserine (SrHA/G3-K PS). The interaction of this material with macrophages was investigated in vitro, focusing on the secretion and gene expression of specific pro-inflammatory cytokines. Our results showed that the addition of strontium and G3-K PS to HA sol-gel could down-regulate the gene expression of inflammatory factors such as IL-1β, TNF-α and MCP-1, while increasing the gene expression of IL-6, a cytokine known for its osteogenic effect. These results were further confirmed by ELISA test of the respective protein concentrations. When exposed to supernatants of macrophage culture in the presence of strontium and G3-K PS, osteoblast viability was promoted with elevated osteogenic gene markers, in terms of OPG, ALP, OCN and COL-I. In vivo implantation experiments using an osteoporotic rat model with bone defect further confirmed that the addition of G3-K PS to HA could dramatically promote new bone regeneration. Although the introduction of strontium improved the degradation properties of the injectable materials, no positive effect on promoting in vivo bone regeneration was observed.

Graphene Family Materials in Bone Tissue Regeneration: Perspectives and Challenges

We have witnessed abundant breakthroughs in research on the bio-applications of graphene family materials in current years. Owing to their nanoscale size, large specific surface area, photoluminescence properties, and antibacterial activity, graphene family materials possess huge potential for bone tissue engineering, drug/gene delivery, and biological sensing/imaging applications. In this review, we retrospect recent progress and achievements in graphene research, as well as critically analyze and discuss the bio-safety and feasibility of various biomedical applications of graphene family materials for bone tissue regeneration.

Gelatin/nano-hydroxyapatite hydrogel scaffold prepared by sol-gel technology as filler to repair bone defects

This study reports on the development of a scaffold with a gradient of bioactive solid signal embedded in the biodegradable polymer matrix by combining a sol-gel approach and freeze-drying technology. The chemical approach based on the sol-gel transition of calcium phosphates ensures the particles dispersion into the gelatin matrix and a direct control of interaction among COOH_gelatin /Ca²⁺ ions. Morphological analysis demonstrated that on the basis of the amount of inorganic component and by using specific process conditions, it is possible to control the spatial distribution of nanoparticles around the gelatin helix. In fact, methodology and formulations were able to discriminate between the different hydroxyapatite concentrations and their respective morphology. The good biological response represented by good cell attachment, proliferation and increased levels of alkaline phosphatase as an indicator of osteoblastic differentiation of human mesenchymal stem cells toward the osteogenic lineage, demonstrating the effect of bioactive solid signals on cellular behavior. Furthermore, the inhibition of reactive oxygen species production by composite materials predicted potential anti-inflammatory properties of scaffolds thus confirming their biocompatibility. Indeed, these interesting biological results suggest good potential application of this scaffold as filler to repair bone defects. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 2007-2019, 2018.

An overview of graphene-based hydroxyapatite composites for orthopedic applications

Hydroxyapatite (HA) is an attractive bioceramic for hard tissue repair and regeneration due to its physicochemical similarities to natural apatite. However, its low fracture toughness, poor tensile strength and weak wear resistance become major obstacles for potential clinical applications. One promising method to tackle with these problems is exploiting graphene and its derivatives (graphene oxide and reduced graphene oxide) as nanoscale reinforcement fillers to fabricate graphene-based hydroxyapatite composites in the form of powders, coatings and scaffolds. The last few years witnessed increasing numbers of studies on the preparation, mechanical and biological evaluations of these novel materials. Herein, various preparation techniques, mechanical behaviors and toughen mechanism, the in vitro/in vivo biocompatible analysis, antibacterial properties of the graphene-based HA composites are presented in this review.

Graphene coating on the surface of CoCrMo alloy enhances the adhesion and proliferation of bone marrow mesenchymal stem cells

The objective was to investigate whether a graphene coating could improve the surface bioactivity of a cobalt-chromium-molybdenum-based alloy (CoCrMo). Graphene was produced by chemical vapor deposition and transferred to the surface of the CoCrMo alloy using an improved wet transfer approach. The morphology of the samples was observed, and the adhesion force and stabilization of graphene coating were analyzed by a nanoscratch test and ultrasonication test. In an in vitro study, the adhesion and proliferation of bone marrow mesenchymal stem cells (BMSCs) cultured on the samples were quantified via an Alamar Blue assay and cell counting kit-8 (CCK-8) assay. The results showed that it is feasible to apply graphene to modify the surface of a CoCrMo alloy, and the enhancement of the adhesion and proliferation of BMSCs was also shown in the present study. In conclusion, graphene exhibits considerable potential for enhancing the surface bioactivity of CoCrMo alloy.

Biocompatibility and fabrication of RGO/chitosan film for cartilage tissue recovery

Graphene oxide (GO) has been successfully deoxygenated via an environmental friendly approach using chitosan. The prepared RGO was characterized using several microscopic and spectroscopic techniques. Also, the synthesized RGO is used to develop a highly compatible film with chitosan. Further, the in-vitro cytotoxicity results showed the biocompatible nature of prepared RGO/chitosan composite towards the human articular chondrocytes indicating their use in future cartilage tissue engineering applications.