Biocompatibility testing of novel multifunctional polymeric biomaterials for tissue engineering applications in head and neck surgery: an overview

In Vitro Hepatotoxicity of Routinely Used Opioids and Sedative Drugs

A hepatocyte cell line was used to determine the hepatotoxicity of sedatives and opioids, as the hepatotoxicity of these drugs has not yet been well characterized. This might pose a threat, especially to critically ill patients, as they often receive high cumulative doses for daily analgosedation and often already have impaired liver function due to an underlying disease or complications during treatment. A well-established biosensor based on HepG2/C3A cells was used for the determination of the hepatotoxicity of commonly used sedatives and opioids in the intensive care setting (midazolam, propofol, s-ketamin, thiopental, fentanyl, remifentanil, and sufentanil). The incubation time was 2 × 3 days with clinically relevant (Cmax) and higher concentrations (C5× and C10×) of each drug in cell culture medium or human plasma. Afterward, we measured the cell count, vitality, lactate dehydrogenase (LDH), mitochondrial dehydrogenase activity, cytochrome P 450 1A2 (CYP1A2), and albumin synthesis. All tested substances reduced the viability of hepatocyte cells, but sufentanil and remifentanil showed more pronounced effects. The cell count was diminished by sufentanil in both the medium and plasma and by remifentanil only in plasma. Sufentanil and remifentanil also led to higher values of LDH in the cell culture supernatant. A reduction of mitochondrial dehydrogenase activity was seen with the use of midazolam and s-ketamine. Microalbumin synthesis was reduced in plasma after its incubation with higher concentrations of sufentanil and remifentanil. Remifentanil and s-ketamine reduced CYP1A2 activity, while propofol and thiopental increased it. Our findings suggest that none of the tested sedatives and opioids have pronounced hepatotoxicity. Sufentanil, remifentanil, and s-ketamine showed moderate hepatotoxic effects in vitro. These drugs should be given with caution to patients vulnerable to hepatotoxic drugs, e.g., patients with pre-existing liver disease or liver impairment as part of their underlying disease (e.g., hypoxic hepatitis or cholestatic liver dysfunction in sepsis). Further studies are indicated for this topic, which may use more complex cell culture models and global pharmacovigilance reports, addressing the limitation of the used cell model: HepG2/C3A cells have a lower metabolic capacity due to their low levels of CYP enzymes compared to primary hepatocytes. However, while the test model is suitable for parental substances, it is not for toxicity testing of metabolites.

Current Trends in Biomedical Hydrogels: From Traditional Crosslinking to Plasma-Assisted Synthesis

The use of materials to restore or replace the functions of damaged body parts has been proven historically. Any material can be considered as a biomaterial as long as it performs its biological function and does not cause adverse effects to the host. With the increasing demands for biofunctionality, biomaterials nowadays may not only encompass inertness but also specialized utility towards the target biological application. A hydrogel is a biomaterial with a 3D network made of hydrophilic polymers. It is regarded as one of the earliest biomaterials developed for human use. The preparation of hydrogel is often attributed to the polymerization of monomers or crosslinking of hydrophilic polymers to achieve the desired ability to hold large amounts of aqueous solvents and biological fluids. The generation of hydrogels, however, is shifting towards developing hydrogels through the aid of enabling technologies. This review provides the evolution of hydrogels and the different approaches considered for hydrogel preparation. Further, this review presents the plasma process as an enabling technology for tailoring hydrogel properties. The mechanism of plasma-assisted treatment during hydrogel synthesis and the current use of the plasma-treated hydrogels are also discussed.

Poly-ε-Caprolactone-Hydroxyapatite-Alumina (PCL-HA-α-Al2O3) Electrospun Nanofibers in Wistar Rats

Biodegradable polymers of natural origin are ideal for the development of processes in tissue engineering due to their immunogenic potential and ability to interact with living tissues. However, some synthetic polymers have been developed in recent years for use in tissue engineering, such as Poly-ε-caprolactone. The nanotechnology and the electrospinning process are perceived to produce biomaterials in the form of nanofibers with diverse unique properties. Biocompatibility tests of poly-ε-caprolactone nanofibers embedded with hydroxyapatite and alumina nanoparticles manufactured by means of the electrospinning technique were carried out in Wistar rats to be used as oral dressings. Hydroxyapatite as a material is used because of its great compatibility, bioactivity, and osteoconductive properties. The PCL, PCL-HA, PCL-α-Al2O3, and PCL-HA-α-Al2O3 nanofibers obtained in the process were characterized by infrared spectroscopy and scanning electron microscopy. The nanofibers had an average diameter of (840 ± 230) nm. The nanofiber implants were placed and tested at 2, 4, and 6 weeks in the subcutaneous tissue of the rats to give a chronic inflammatory infiltrate, characteristic foreign body reaction, which decreased slightly at 6 weeks with the addition of hydroxyapatite and alumina ceramic particles. The biocompatibility test showed a foreign body reaction that produces a layer of collagen and fibroblasts. Tissue loss and necrosis were not observed due to the coating of the material, but a slight decrease in the inflammatory infiltrate occurred in the last evaluation period, which is indicative of the beginning of the acceptance of the tested materials by the organism.

Innovative Design Methodology for Patient-Specific Short Femoral Stems

The biomechanical performance of hip prostheses is often suboptimal, which leads to problems such as strain shielding, bone resorption and implant loosening, affecting the long-term viability of these implants for articular repair. Different studies have highlighted the interest of short stems for preserving bone stock and minimizing shielding, hence providing an alternative to conventional hip prostheses with long stems. Such short stems are especially valuable for younger patients, as they may require additional surgical interventions and replacements in the future, for which the preservation of bone stock is fundamental. Arguably, enhanced results may be achieved by combining the benefits of short stems with the possibilities of personalization, which are now empowered by a wise combination of medical images, computer-aided design and engineering resources and automated manufacturing tools. In this study, an innovative design methodology for custom-made short femoral stems is presented. The design process is enhanced through a novel app employing elliptical adjustment for the quasi-automated CAD modeling of personalized short femoral stems. The proposed methodology is validated by completely developing two personalized short femoral stems, which are evaluated by combining in silico studies (finite element method (FEM) simulations), for quantifying their biomechanical performance, and rapid prototyping, for evaluating implantability.

On the Biocompatibility and Teat Retention of In Situ Gelling Intramammary Formulations: Cattle Mastitis Prevention and Treatment

Treatment and prevention of cattle mastitis remains a formidable challenge due to the anatomical and physiological constraints of the cow udder. In this study, we investigated polymeric excipients and solvents that can form, (when combined) novel, non-toxic and biocompatible in situ gelling formulations in the mammary gland of bovine cattle. We also report on a new approach to screen intramammary formulations using fresh excised cow teats. Fourteen hydrophilic polymers and six solvents were evaluated for in vitro cytotoxicity and biocompatibility towards cultured bovine mammary epithelial cells (MAC-T), microscopic and macroscopic examination upon contact with excised cow teats. No significant cytotoxicity (p > 0.05) was observed with polyethylene oxides, hydroxypropyl methylcellulose, carboxymethyl cellulose, sodium alginate and xanthan gum. Polycarbophil and carbopol polymers showed significantly higher cytotoxicity (p < 0.05). Concentration-dependent cytotoxicity was observed for glycerin, propylene glycol, polyethylene glycol 400, ethanol, N-methyl-2-pyrrolidone and 2-pyrrolidone, with the 2-pyrrolidone solvents showing higher cytotoxic effects (p < 0.05). In situ gelling formulations comprising hydroxypropyl methylcellulose or carboxymethyl cellulose and solvents in specific ratios were biocompatible at higher concentrations with MAC-T cells compared to alginates. All investigated formulations could undergo in situ sol-to-gel phase transformation, forming non-toxic gels with good biocompatibility in excised cow teats hence, showing potential for use as intramammary carriers for sustained drug delivery.

The Development of Design and Manufacture Techniques for Bioresorbable Coronary Artery Stents

Coronary artery disease (CAD) is the leading killer of humans worldwide. Bioresorbable polymeric stents have attracted a great deal of interest because they can treat CAD without producing long-term complications. Bioresorbable polymeric stents (BMSs) have undergone a sustainable revolution in terms of material processing, mechanical performance, biodegradability and manufacture techniques. Biodegradable polymers and copolymers have been widely studied as potential material candidates for bioresorbable stents. It is a great challenge to find a reasonable balance between the mechanical properties and degradation behavior of bioresorbable polymeric stents. Surface modification and drug-coating methods are generally used to improve biocompatibility and drug loading performance, which are decisive factors for the safety and efficacy of bioresorbable stents. Traditional stent manufacture techniques include etching, micro-electro discharge machining, electroforming, die-casting and laser cutting. The rapid development of 3D printing has brought continuous innovation and the wide application of biodegradable materials, which provides a novel technique for the additive manufacture of bioresorbable stents. This review aims to describe the problems regarding and the achievements of biodegradable stents from their birth to the present and discuss potential difficulties and challenges in the future.

Biodegradable Shape Memory Polymers in Medicine

Shape memory materials have emerged as an important class of materials in medicine due to their ability to change shape in response to a specific stimulus, enabling the simplification of medical procedures, use of minimally invasive techniques, and access to new treatment modalities. Shape memory polymers, in particular, are well suited for such applications given their excellent shape memory performance, tunable materials properties, minimal toxicity, and potential for biodegradation and resorption. This review provides an overview of biodegradable shape memory polymers that have been used in medical applications. The majority of biodegradable shape memory polymers are based on thermally responsive polyesters or polymers that contain hydrolyzable ester linkages. These materials have been targeted for use in applications pertaining to embolization, drug delivery, stents, tissue engineering, and wound closure. The development of biodegradable shape memory polymers with unique properties or responsiveness to novel stimuli has the potential to facilitate the optimization and development of new medical applications.

On-command on/off switching of progenitor cell and cancer cell polarized motility and aligned morphology via a cytocompatible shape memory polymer scaffold

In vitro biomaterial models have enabled advances in understanding the role of extracellular matrix (ECM) architecture in the control of cell motility and polarity. Most models are, however, static and cannot mimic dynamic aspects of in vivo ECM remodeling and function. To address this limitation, we present an electrospun shape memory polymer scaffold that can change fiber alignment on command under cytocompatible conditions. Cellular response was studied using the human fibrosarcoma cell line HT-1080 and the murine mesenchymal stem cell line C3H/10T1/2. The results demonstrate successful on-command on/off switching of cell polarized motility and alignment. Decrease in fiber alignment causes a change from polarized motility along the direction of fiber alignment to non-polarized motility and from aligned to unaligned morphology, while increase in fiber alignment causes a change from non-polarized to polarized motility along the direction of fiber alignment and from unaligned to aligned morphology. In addition, the findings are consistent with the hypothesis that increased fiber alignment causes increased cell velocity, while decreased fiber alignment causes decreased cell velocity. On-command on/off switching of cell polarized motility and alignment is anticipated to enable new study of directed cell motility in tumor metastasis, in cell homing, and in tissue engineering.

Cytotoxicity Evaluation of Anatase and Rutile TiO₂ Thin Films on CHO-K1 Cells in Vitro

Cytotoxicity of titanium dioxide (TiO₂) thin films on Chinese hamster ovary (CHO-K1) cells was evaluated after 24, 48 and 72 h of culture. The TiO₂ thin films were deposited using direct current magnetron sputtering. These films were post-deposition annealed at different temperatures (300, 500 and 800 °C) toward the anatase to rutile phase transformation. The root-mean-square (RMS) surface roughness of TiO₂ films went from 2.8 to 8.08 nm when the annealing temperature was increased from 300 to 800 °C. Field emission scanning electron microscopy (FESEM) results showed that the TiO₂ films’ thickness values fell within the nanometer range (290–310 nm). Based on the results of the tetrazolium dye and trypan blue assays, we found that TiO₂ thin films showed no cytotoxicity after the aforementioned culture times at which cell viability was greater than 98%. Independently of the annealing temperature of the TiO₂ thin films, the number of CHO-K1 cells on the control substrate and on all TiO₂ thin films was greater after 48 or 72 h than it was after 24 h; the highest cell survival rate was observed in TiO₂ films annealed at 800 °C. These results indicate that TiO₂ thin films do not affect mitochondrial function and proliferation of CHO-K1 cells, and back up the use of TiO₂ thin films in biomedical science.

Preparation of Monodomain Liquid Crystal Elastomers and Liquid Crystal Elastomer Nanocomposites

LCEs are shape-responsive materials with fully reversible shape change and potential applications in medicine, tissue engineering, artificial muscles, and as soft robots. Here, we demonstrate the preparation of shape-responsive liquid crystal elastomers (LCEs) and LCE nanocomposites along with characterization of their shape-responsiveness, mechanical properties, and microstructure. Two types of LCEs - polysiloxane-based and epoxy-based - are synthesized, aligned, and characterized. Polysiloxane-based LCEs are prepared through two crosslinking steps, the second under an applied load, resulting in monodomain LCEs. Polysiloxane LCE nanocomposites are prepared through the addition of conductive carbon black nanoparticles, both throughout the bulk of the LCE and to the LCE surface. Epoxy-based LCEs are prepared through a reversible esterification reaction. Epoxy-based LCEs are aligned through the application of a uniaxial load at elevated (160 °C) temperatures. Aligned LCEs and LCE nanocomposites are characterized with respect to reversible strain, mechanical stiffness, and liquid crystal ordering using a combination of imaging, two-dimensional X-ray diffraction measurements, differential scanning calorimetry, and dynamic mechanical analysis. LCEs and LCE nanocomposites can be stimulated with heat and/or electrical potential to controllably generate strains in cell culture media, and we demonstrate the application of LCEs as shape-responsive substrates for cell culture using a custom-made apparatus.

Bio-based (co)polylactide-urethane networks with shape memory behavior at body temperature

The novel bio-based polymer networks with shape memory behavior were synthesized from polylactide-based tetraols and hexamethylene diisocyanate trimer.

Bio-based polyurethanes with shape memory behavior at body temperature: effect of different chain extenders

The chain extenders are used to adjust the transition temperatures and shape memory properties of bio-based shape memory polyurethanes.

Advanced biomaterials and their potential applications in the treatment of periodontal disease

Periodontal disease is considered as a widespread infectious disease and the most common cause of tooth loss in adults. Attempts for developing periodontal disease treatment strategies, including drug delivery and regeneration approaches, provide a useful experimental model for the evaluation of future periodontal therapies. Recently, emerging advanced biomaterials including hydrogels, films, micro/nanofibers and particles, hold great potential to be utilized as cell/drug carriers for local drug delivery and biomimetic scaffolds for future regeneration therapies. In this review, first, we describe the pathogenesis of periodontal disease, including plaque formation, immune response and inflammatory reactions caused by bacteria. Second, periodontal therapy and an overview of current biomaterials in periodontal regenerative medicine have been discussed. Third, the roles of state-of-the-art biomaterials, including hydrogels, films, micro/nanofibers and micro/nanoparticles, developed for periodontal disease treatment and periodontal tissue regeneration, and their fabrication methods, have been presented. Finally, biological properties, including biocompatibility, biodegradability and immunogenicity of the biomaterials, together with their current applications strategies are given. Conclusive remarks and future perspectives for such advanced biomaterials are discussed.

Shape-memory surfaces for cell mechanobiology

Shape-memory polymers (SMPs) are a new class of smart materials, which have the capability to change from a temporary shape 'A' to a memorized permanent shape 'B' upon application of an external stimulus. In recent years, SMPs have attracted much attention from basic and fundamental research to industrial and practical applications due to the cheap and efficient alternative to well-known metallic shape-memory alloys. Since the shape-memory effect in SMPs is not related to a specific material property of single polymers, the control of nanoarchitecture of polymer networks is particularly important for the smart functions of SMPs. Such nanoarchitectonic approaches have enabled us to further create shape-memory surfaces (SMSs) with tunable surface topography at nano scale. The present review aims to bring together the exciting design of SMSs and the ever-expanding range of their uses as tools to control cell functions. The goal for these endeavors is to mimic the surrounding mechanical cues of extracellular environments which have been considered as critical parameters in cell fate determination. The untapped potential of SMSs makes them one of the most exciting interfaces of materials science and cell mechanobiology.

Biocompatibility and Surface Properties of TiO₂ Thin Films Deposited by DC Magnetron Sputtering

We present the study of the biocompatibility and surface properties of titanium dioxide (TiO₂) thin films deposited by direct current magnetron sputtering. These films are deposited on a quartz substrate at room temperature and annealed with different temperatures (100, 300, 500, 800 and 1100 °C). The biocompatibility of the TiO₂ thin films is analyzed using primary cultures of dorsal root ganglion (DRG) of Wistar rats, whose neurons are incubated on the TiO₂ thin films and on a control substrate during 18 to 24 h. These neurons are activated by electrical stimuli and its ionic currents and action potential activity recorded. Through X-ray diffraction (XRD), the surface of TiO₂ thin films showed a good quality, homogeneity and roughness. The XRD results showed the anatase to rutile phase transition in TiO₂ thin films at temperatures between 500 and 1100 °C. This phase had a grain size from 15 to 38 nm, which allowed a suitable structural and crystal phase stability of the TiO₂ thin films for low and high temperature. The biocompatibility experiments of these films indicated that they were appropriated for culture of living neurons which displayed normal electrical behavior.

Delivery of growth factors using a smart porous nanocomposite scaffold to repair a mandibular bone defect

Implantation of a porous scaffold with a large volume into the body in a convenient and safe manner is still a challenging task in the repair of bone defects. In this study, we present a porous smart nanocomposite scaffold with a combination of shape memory function and controlled delivery of growth factors. The shape memory function enables the scaffold with a large volume to be deformed into its temporal architecture with a small volume using hot-compression and can subsequently recover its original shape upon exposure to body temperature after it is implanted in the body. The scaffold consists of chemically cross-linked poly(ε-caprolactone) (c-PCL) and hydroxyapatite nanoparticles. The highly interconnected pores of the scaffold were obtained using the sugar leaching method. The shape memory porous scaffold loaded with bone morphogenetic protein-2 (BMP-2) was also fabricated by coating the calcium alginate layer and BMP-2 on the surface of the pore wall. Under both in vitro and in vivo environmental conditions, the porous scaffold displays good shape memory recovery from the compressed shape with deformed pores of 33 μm in diameter to recover its porous shape with original pores of 160 μm in diameter. In vitro cytotoxicity based on the MTT test revealed that the scaffold exhibited good cytocompatibility. The in vivo micro-CT and histomorphometry results demonstrated that the porous scaffold could promote new bone generation in the rabbit mandibular bone defect. Thus, our results indicated that this shape memory porous scaffold demonstrated great potential for application in bone regenerative medicine.

Application of the chick embryo chorioallantoic membrane in neurosurgery disease

The chick embryo chorioallantoic membrane (CAM) is a highly vascularized extraembryonic membrane. Because of its ease of accessibility, extensive vascularization and immunodeficient environment, the CAM has been broadly used in the oncology, biology, pharmacy, and tissue regeneration research. The present review summarizes the application of the CAM in neurosurgery disease research. We focused on the use of the CAM as an assay for the research of glioma, vascular anomalies, Moyamoya Disease, and the blood-brain barrier.

Shape-memory-actuated change in scaffold fiber alignment directs stem cell morphology

Tissue engineering scaffolds have traditionally been static physical structures poorly suited to mimicking the complex dynamic behavior of in vivo microenvironments. Here we present a thermoresponsive scaffold that can be programmed to change macroscopic shape and microscopic architecture during cell culture. The scaffold, which was prepared by electrospinning a shape memory polymer (SMP), was used to test the hypothesis that a shape-memory-actuated change in scaffold fiber alignment could be used to control the behavior of attached and viable cells. To test this hypothesis, we stretched an SMP scaffold of randomly oriented fibers and fixed the scaffold in a temporary but stable elongated shape in which fibers were aligned by the strain. Following seeding and culture of human adipose-derived stem cells on the strain-aligned scaffold, the scaffold was triggered to transition back to its initial shape and random fiber orientation via shape memory actuation using a cytocompatible temperature increase. We found that cells preferentially aligned along the fiber direction of the strain-aligned scaffold before shape memory actuation. After shape memory actuation, cells remained attached and viable but lost preferential alignment. These results demonstrate that shape-memory-actuated changes in scaffold fiber alignment can be achieved with attached and viable cells and can control cell morphological behavior. The incorporation of shape memory into cytocompatible scaffolds is anticipated to facilitate the development, delivery and functionality of tissue engineering scaffolds and the in vitro and in vivo study and application of mechanobiology.

Effects of low-temperature hydrogen peroxide gas plasma sterilization on in vitro cytotoxicity of poly(ϵ-caprolactone) (PCL)

Our objective was to determine whether low-temperature hydrogen peroxide (H2O2) gas plasma sterilization of porous three-dimensional poly(ϵ-caprolactone) (PCL) constructs significantly inhibits cellular metabolism of canine chondrocytes. Porous cylindrical constructs were fabricated using fused deposition modeling and divided into four sterilization groups. Two groups were sterilized with low-temperature H2O2 gas plasma (LTGP) and constructs from one of those groups were subsequently rinsed with Dulbecco's Modified Essential Media (LTGPDM). Constructs in the other two groups were disinfected with either 70% isopropyl alcohol or exposure to UV light. Canine chondrocytes were seeded in 6-well tissue-culture plates and allowed to adhere prior to addition of PCL. Cellular metabolism was assessed by adding resazurin to the tissue-culture wells and assessing conversion of this substrate by viable cells to the fluorescent die resorufin. This process was performed at three times prior to addition of PCL and at four times after addition of PCL to the tissue-culture wells. Metabolism was not significantly different among the different tissue-culture wells at any of the 3 times prior to addition of PCL. Metabolism was significantly different among the treatment groups at 3 of 4 times after addition of PCL to the tissue culture wells. Metabolism was significantly lower with constructs sterilized by LTGP than all other treatment groups at all 3 of these times. We conclude that LTGP sterilization of PCL constructs resulted in significant cytotoxicity to canine chondrocytes when compared to PCL constructs disinfected with either UV light exposure or 70% isopropyl alcohol.

Polymeric implant materials for the reconstruction of tracheal and pharyngeal mucosal defects in head and neck surgery

The existing therapeutical options for the tracheal and pharyngeal reconstruction by use of implant materials are described. Inspite of a multitude of options and the availability of very different materials none of these methods applied for tracheal reconstruction were successfully introduced into the clinical routine. Essential problems are insufficiencies of anastomoses, stenoses, lack of mucociliary clearance and vascularisation. The advances in Tissue Engineering (TE) offer new therapeutical options also in the field of the reconstructive surgery of the trachea. In pharyngeal reconstruction far reaching developments cannot be recognized at the moment which would allow to give a prognosis of their success in clinical application. A new polymeric implant material consisting of multiblock copolymers was applied in our own work which was regarded as a promising material for the reconstruction of the upper aerodigestive tract (ADT) due to its physicochemical characteristics. In order to test this material for applications in the ADT under extreme chemical, enzymatical, bacterial and mechanical conditions we applied it for the reconstruction of a complete defect of the gastric wall in an animal model. In none of the animals tested either gastrointestinal complications or negative systemic events occurred, however, there was a multilayered regeneration of the gastric wall implying a regular structured mucosa.

In future the advanced stem cell technology will allow further progress in the reconstruction of different kind of tissues also in the field of head and neck surgery following the principles of Tissue Engineering.

In vitro evaluation of elastic multiblock co-polymers as a scaffold material for reconstruction of blood vessels

There is a need to create cell- and histocompatible implant materials, which might temporarily replace the mechanical function of a native tissue for regenerative therapies. To match the elastic behavior of the native tissue two different multiblock co-polymers were investigated: PDC, consisting of poly(p-dioxanone) (PPDO)/poly(ε-caprolactone) (PCL), and PDD, based on PPDO/poly((adipinate-alt-1,4-butanediol)-co-(adipinate-alt-ethylene glycol)-co-adipinate-alt-diethylene glycol) (Diorez). PDC is capable of a shapememory effect. Both multiblock co-polymers show an improved elasticity compared to materials applied in established vascular prosthesis. PDD is softer than PDC at 20°C, while PDC maintains its elasticity at 37°C. Thermodynamic characteristics indicate a more polar surface of PDD. Low cell adhesion was found on surfaces with low molar free energy of hysteresis (ΔG) derived from contact angle measurements in wetting and dewetting mode and high cell adhesion on high-ΔG surfaces. An increasing content of PCL in PDC improved cell adhesion and spreading of human umbilical vein endothelial cells. The prothrombotic potential of PDD is higher than PDC. Finally, it is concluded that PDC is a promising material for vascular tissue engineering because of its improved elastic properties, as well as balanced prothrombotic and anti-thrombotic properties with endothelial cells.

Multifunctional shape-memory polymers

The thermally-induced shape-memory effect (SME) is the capability of a material to change its shape in a predefined way in response to heat. In shape-memory polymers (SMP) this shape change is the entropy-driven recovery of a mechanical deformation, which was obtained before by application of external stress and was temporarily fixed by formation of physical crosslinks. The high technological significance of SMP becomes apparent in many established products (e.g., packaging materials, assembling devices, textiles, and membranes) and the broad SMP development activities in the field of biomedical as well as aerospace applications (e.g., medical devices or morphing structures for aerospace vehicles). Inspired by the complex and diverse requirements of these applications fundamental research is aiming at multifunctional SMP, in which SME is combined with additional functions and is proceeding rapidly. In this review different concepts for the creation of multifunctionality are derived from the various polymer network architectures of thermally-induced SMP. Multimaterial systems, such as nanocomposites, are described as well as one-component polymer systems, in which independent functions are integrated. Future challenges will be to transfer the concept of multifunctionality to other emerging shape-memory technologies like light-sensitive SMP, reversible shape changing effects or triple-shape polymers.

Biomedical applications of thermally activated shape memory polymers

Shape memory polymers (SMPs) are smart materials that can remember a primary shape and can return to this primary shape from a deformed secondary shape when given an appropriate stimulus. This property allows them to be delivered in a compact form via minimally invasive surgeries in humans, and deployed to achieve complex final shapes. Here we review the various biomedical applications of SMPs and the challenges they face with respect to actuation and biocompatibility. While shape memory behavior has been demonstrated with heat, light and chemical environment, here we focus our discussion on thermally stimulated SMPs.

Cartilage replacement by use of hybrid systems of autologous cells and polyethylene: an experimental study

This study used porous polyethylene (PE) as a scaffold in an animal model system. The surface of the scaffolds was either modified with collagen II coating or first functionalized by oxygen plasma treatment and then coated with collagen II. The specimens were inoculated with autologous chondrocytes and transplanted into the concha of guinea pigs. Bare scaffolds were used as controls. Periods of 1, 6, and 12 months after implantation, samples of cells containing specimens and control samples were evaluated microscopically. As a result, the pre-seeded specimens were better integrated into the surrounding tissue than cell-free PE-specimens. Also a weaker immune reaction and an improved cartilage generation could be detected in the pre-seeded specimen. Compared to the other surface modifications, no further improvement of cartilage development was observed in the long term in vivo animal experimental study.

A review of the biocompatibility of implantable devices: current challenges to overcome foreign body response

In recent years, a variety of devices (drug-eluting stents, artificial organs, biosensors, catheters, scaffolds for tissue engineering, heart valves, etc.) have been developed for implantation into patients. However, when such devices are implanted into the body, the body can react to these in a number of different ways. These reactions can result in an unexpected risk for patients. Therefore, it is important to assess and optimize the biocompatibility of implantable devices. To date, numerous strategies have been investigated to overcome body reactions induced by the implantation of devices. This review focuses on the foreign body response and the approaches that have been taken to overcome this. The biological response following device implantation and the methods for biocompatibility evaluation are summarized. Then the risks of implantable devices and the challenges to overcome these problems are introduced. Specifically, the challenges used to overcome the functional loss of glucose sensors, restenosis after stent implantation, and calcification induced by implantable devices are discussed.