Optimisation of lithium-substituted bioactive glasses to tailor cell response for hard tissue repair

Ion incorporation into bone grafting materials

The use of biomaterials in regenerative medicine has expanded to treat various disorders caused by trauma or disease in orthopedics and dentistry. However, the treatment of large and complex bone defects presents a challenge, leading to a pressing need for optimized biomaterials for bone repair. Recent advances in chemical sciences have enabled the incorporation of therapeutic ions into bone grafts to enhance their performance. These ions, such as strontium (for bone regeneration/osteoporosis), copper (for angiogenesis), boron (for bone growth), iron (for chemotaxis), cobalt (for B12 synthesis), lithium (for osteogenesis/cementogenesis), silver (for antibacterial resistance), and magnesium (for bone and cartilage regeneration), among others (e.g., zinc, sodium, and silica), have been studied extensively. This review aims to provide a comprehensive overview of current knowledge and recent developments in ion incorporation into biomaterials for bone and periodontal tissue repair. It also discusses recently developed biomaterials from a basic design and clinical application perspective. Additionally, the review highlights the importance of precise ion introduction into biomaterials to address existing limitations and challenges in combination therapies. Future prospects and opportunities for the development and optimization of biomaterials for bone tissue engineering are emphasized.

Lithiated porous silicon nanowires stimulate periodontal regeneration

Periodontal disease is a significant burden for oral health, causing progressive and irreversible damage to the support structure of the tooth. This complex structure, the periodontium, is composed of interconnected soft and mineralised tissues, posing a challenge for regenerative approaches. Materials combining silicon and lithium are widely studied in periodontal regeneration, as they stimulate bone repair via silicic acid release while providing regenerative stimuli through lithium activation of the Wnt/β-catenin pathway. Yet, existing materials for combined lithium and silicon release have limited control over ion release amounts and kinetics. Porous silicon can provide controlled silicic acid release, inducing osteogenesis to support bone regeneration. Prelithiation, a strategy developed for battery technology, can introduce large, controllable amounts of lithium within porous silicon, but yields a highly reactive material, unsuitable for biomedicine. This work debuts a strategy to lithiate porous silicon nanowires (LipSiNs) which generates a biocompatible and bioresorbable material. LipSiNs incorporate lithium to between 1% and 40% of silicon content, releasing lithium and silicic acid in a tailorable fashion from days to weeks. LipSiNs combine osteogenic, cementogenic and Wnt/β-catenin stimuli to regenerate bone, cementum and periodontal ligament fibres in a murine periodontal defect.

Influence of Lithium- and Zinc-Containing Bioactive Glasses on Pulpal Regeneration

OBJECTIVE

 To evaluate the potential of modified bioactive glasses containing lithium and zinc as pulp capping materials by investigating the odontogenic differentiation and mineralization response in the tooth culture model.

MATERIALS AND METHODS

 Lithium- and zinc-containing bioactive glasses (45S5.1Li, 45S5.5Li, 45S5.1Zn, 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel), fibrinogen-thrombin, and biodentine were prepared to assess Axin2 gene expression at 0, 30 minutes, 1 hour, 12 hours, and 1 day and DSPP gene expression at 0, 3, 7, and 14 days in stem cells from human exfoliated deciduous teeth (SHEDs) using qRT-PCR. The experimental bioactive glasses incorporated with fibrinogen-thrombin and biodentine were placed on the pulpal tissue in the tooth culture model. Histology and immunohistochemistry were analyzed at 2 weeks and 4 weeks.

RESULTS

 Axin2 gene expression for all experimental groups was significantly higher than the control at 12 hours. The DSPP gene expression for all experimental groups was significantly higher than the control at 14 days. The presence of mineralization foci was significantly higher at 4 weeks for the modified bioactive glasses 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel as well as Biodentine compared with the fibrinogen-thrombin control.

CONCLUSION

 Lithium- and zinc-containing bioactive glasses increased Axin2 and DSPP gene expression in SHEDs and can potentially enhance pulp mineralization and regeneration. Zinc-containing bioactive glasses are a promising candidate to be used as pulp capping materials.

Sol-gel synthesis of lithium doped mesoporous bioactive glass nanoparticles and tricalcium silicate for restorative dentistry: Comparative investigation of physico-chemical structure, antibacterial susceptibility and biocompatibility

Introduction: The sol-gel method for production of mesoporous bioactive glass nanoparticles (MBGNs) has been adapted to synthesize tricalcium silicate (TCS) particles which, when formulated with other additives, form the gold standard for dentine-pulp complex regeneration. Comparison of TCS and MBGNs obtained by sol-gel method is critical considering the results of the first ever clinical trials of sol-gel BAG as pulpotomy materials in children. Moreover, although lithium (Li) based glass ceramics have been long used as dental prostheses materials, doping of Li ion into MBGNs for targeted dental applications is yet to be investigated. The fact that lithium chloride benefits pulp regeneration in vitro also makes this a worthwhile undertaking. Therefore, this study aimed to synthesize TCS and MBGNs doped with Li by sol-gel method, and perform comparative characterizations of the obtained particles.

Methods: TCS particles and MBGNs containing 0%, 5%, 10% and 20% Li were synthesized and particle morphology and chemical structure determined. Powder concentrations of 15mg/10 mL were incubated in artificial saliva (AS), Hank’s balanced saline solution (HBSS) and simulated body fluid (SBF), at 37°C for 28 days and pH evolution and apatite formation, monitored. Bactericidal effects against S. aureus and E. coli, as well as possible cytotoxicity against MG63 cells were also evaluated through turbidity measurements.

Results: MBGNs were confirmed to be mesoporous spheres ranging in size from 123 nm to 194 nm, while TCS formed irregular nano-structured agglomerates whose size was generally larger and variable. From ICP-OES data, extremely low Li ion incorporation into MBGNs was detected. All particles had an alkalinizing effect on all immersion media, but TCS elevated pH the most. SBF resulted in apatite formation for all particle types as early as 3 days, but TCS appears to be the only particle to form apatite in AS at a similar period. Although all particles had an effect on both bacteria, this was pronounced for undoped MBGNs. Whereas all particles are biocompatible, MBGNs showed better antimicrobial properties while TCS particles were associated with greater bioactivity.

Conclusion: Synergizing these effects in dental biomaterials may be a worthwhile undertaking and realistic data on bioactive compounds targeting dental application may be obtained by varying the immersion media.

Preparation and In Vitro Osteogenic Evaluation of Biomimetic Hybrid Nanocomposite Scaffolds Based on Gelatin/Plasma Rich in Growth Factors (PRGF) and Lithium-Doped 45s5 Bioactive Glass Nanoparticles

Bone tissue engineering is an emerging technique for repairing large bone lesions. Biomimetic techniques expand the use of organic-inorganic spongy-like nanocomposite scaffolds and platelet concentrates. In this study, a biomimetic nanocomposite scaffold was prepared using lithium-doped bioactive-glass nanoparticles and gelatin/PRGF. First, sol-gel method was used to prepare bioactive-glass nanoparticles that contain 0, 1, 3, and 5%wt lithium. The lithium content was then optimized based on antibacterial and MTT testing. By freeze-drying, hybrid scaffolds comprising 5, 10, and 20% bioglass were made. On the scaffolds, human endometrial stem cells (hEnSCs) were cultured for adhesion (SEM), survival, and osteogenic differentiation. Alkaline phosphatase activity and osteopontin, osteocalcin, and Runx2 gene expression were measured. The effect of bioactive-glass nanoparticles and PRGF on nanocomposites' mechanical characteristics and glass-transition temperature (T _g) was also studied. An optimal lithium content in bioactive glass structure was found to be 3% wt. Nanoparticle SEM examination indicated grain deformation due to different sizes of lithium and sodium ions. Results showed up to 10% wt bioactive-glass and PRGF increased survival and cell adhesion. Also, Hybrid scaffolds revealed higher ALP-activity and OP, OC, and Runx2 gene expression. Furthermore, bioactive-glass has mainly increased ALP-activity and Runx2 expression, whereas PRGF increases the expression of OP and OC genes. Bioactive-glass increases scaffold modulus and T _g continuously. Hence, the presence of both bioactive-glass and nanocomposite scaffold improves the expression of osteogenic differentiation biomarkers. Subsequently, it seems that hybrid scaffolds based on biopolymers, Li-doped bioactive-glass, and platelet extracts can be a good strategy for bone repair.

Biodegradable Poly(D-L-lactide-co-glycolide) (PLGA)-Infiltrated Bioactive Glass (CAR12N) Scaffolds Maintain Mesenchymal Stem Cell Chondrogenesis for Cartilage Tissue Engineering

Regeneration of articular cartilage remains challenging. The aim of this study was to increase the stability of pure bioactive glass (BG) scaffolds by means of solvent phase polymer infiltration and to maintain cell adherence on the glass struts. Therefore, BG scaffolds either pure or enhanced with three different amounts of poly(D-L-lactide-co-glycolide) (PLGA) were characterized in detail. Scaffolds were seeded with primary porcine articular chondrocytes (pACs) and human mesenchymal stem cells (hMSCs) in a dynamic long-term culture (35 days). Light microscopy evaluations showed that PLGA was detectable in every region of the scaffold. Porosity was greater than 70%. The biomechanical stability was increased by polymer infiltration. PLGA infiltration did not result in a decrease in viability of both cell types, but increased DNA and sulfated glycosaminoglycan (sGAG) contents of hMSCs-colonized scaffolds. Successful chondrogenesis of hMSC-colonized scaffolds was demonstrated by immunocytochemical staining of collagen type II, cartilage proteoglycans and the transcription factor SOX9. PLGA-infiltrated scaffolds showed a higher relative expression of cartilage related genes not only of pAC-, but also of hMSC-colonized scaffolds in comparison to the pure BG. Based on the novel data, our recommendation is BG scaffolds with single infiltrated PLGA for cartilage tissue engineering.

Bioactivity and Antibacterial Behaviors of Nanostructured Lithium-Doped Hydroxyapatite for Bone Scaffold Application

The material for bone scaffold replacement should be biocompatible and antibacterial to prevent scaffold-associated infection. We biofunctionalized the hydroxyapatite (HA) properties by doping it with lithium (Li). The HA and 4 Li-doped HA (0.5, 1.0, 2.0, 4.0 wt.%) samples were investigated to find the most suitable Li content for both aspects. The synthesized nanoparticles, by the mechanical alloying method, were cold-pressed uniaxially and then sintered for 2 h at 1250 °C. Characterization using field-emission scanning electron microscopy (FE-SEM) revealed particle sizes in the range of 60 to 120 nm. The XRD analysis proved the formation of HA and Li-doped HA nanoparticles with crystal sizes ranging from 59 to 89 nm. The bioactivity of samples was investigated in simulated body fluid (SBF), and the growth of apatite formed on surfaces was evaluated using SEM and EDS. Cellular behavior was estimated by MG63 osteoblast-like cells. The results of apatite growth and cell analysis showed that 1.0 wt.% Li doping was optimal to maximize the bioactivity of HA. Antibacterial characteristics against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) were performed by colony-forming unit (CFU) tests. The results showed that Li in the structure of HA increases its antibacterial properties. HA biofunctionalized by Li doping can be considered a suitable option for the fabrication of bone scaffolds due to its antibacterial and unique bioactivity properties.

Role of bioglass in enamel remineralization: Existing strategies and future prospects-A narrative review

Enamel, once formed, loses the ability to regenerate due to the loss of the formative ameloblasts. It is subjected to constant damaging events due to exposure to external agents and oral microbiomes. An enamel remineralization process targets to replenish the lost ionic component of the enamel through a multitude of methods. Enamel remineralization is highly challenging as it has a complex organized hierarchical microstructure. Hydroxyapatite nanocrystals of the enamel vary in size and orientation along alignment planes inside the enamel rod. The inability of the enamel to remodel unlike other mineralized tissues is another substantial deterrent. One of the well-known biomaterials, bioglass (BG) induces apatite formation on the external surface of the enamel in the presence of saliva or other physiological fluids. Calcium, sodium, phosphate, and silicate ions in BG become responsive in the presence of body fluids, leading to the precipitation of calcium phosphate. Studies have also demonstrated the bactericidal potential of BG against Streptococcus mutans biofilms. The anticariogenicity and antibacterial activity were found to be enhanced when BG was doped with inorganic ions such as F, Ag, Mg, Sr, and Zn. Due to the versatility of BG, it has been combined with a variety of agents such as chitosan, triclosan, and amelogenin to biomimic remineralization process. Key strategies that can aid in the development of contemporary enamel remineralization agents are also included in this review.

A modified glass ionomer cement to mediate dentine repair

OBJECTIVES

Glass ionomer cements (GIC) can be used to protect dentine following caries removal. However, GIC have little biological activity on biological repair processes, which means that neo-dentine formation remains reliant on limited endogenous regenerative processes. Wnt/β-catenin signalling is known to play a central role in stimulating tertiary dentine formation following tooth damage and can be stimulated by a range of glycogen synthase kinase (GSK3) antagonists, including lithium ions.

METHODS

Here, we created lithium-containing bioactive glass (BG) by substituting lithium for sodium ions in 45S5 BG. We then replaced between 10 and 40% of the powder phase of a commercial GIC with the lithium-substituted BG to create a range of formulations of 'LithGlassGIC'. In vitro physical properties of the resulting glasses were characterised and their ability to stimulate reactionary dentine formation in mouse molars in vivo was tested.

RESULTS

Lithium release from LithGlassGIC increased with increasing lithium content in the cement. In common with unmodified commercial GIC, all formations of LithGlassGIC showed in vitro toxicity when measured using an indirect cell culture assay based on ISO10993:5, precluding direct pulp contact. However, in a murine non-exposed pulp model of tooth damage, LithGlassGIC quickly released lithium ions, which could be transiently detected in the saliva and blood. LithGlassGIC also enhanced the formation of tertiary dentine, resulting in a thickening of the dentine at the damage site that restored lost dentine volume. Dentine regeneration was likely mediated by upregulation of Wnt/β-catenin activity, as LithGlassGIC placed in TCF/Lef:H2B-GFP reporter mice showed enhanced GFP activity.

SIGNIFICANCE

We conclude that LithGlassGIC acts as a biological restorative material that promotes tertiary dentine formation and restores tooth structure.

Role of alkali metal oxide type on the degradation and in vivo biocompatibility of soda-lime-borate bioactive glass

In this work, it is the first time to study the effect of replacing of Na₂ O by a fixed amount of Li₂ O or K₂ O in soda-lime-borate glass on its in vivo biocompatibility. The glass composition was based on xM₂ O-20x Na₂ O20 CaO60 B₂ O₃ , (wt %), where, M₂ OLi₂ O and K₂ O, and consequently, samples encoded BN100, BK50, and BL50. The degradation test was carried out in 0.25 M K₂ HPO₄ solution. The in vivo test was performed in the femoral bone defect of Sprague-Dawley adult male rat. Following up bone formation was conducted by the histological analyses and bone formation markers (alkaline phosphatase [ALP] and osteocalcin [OCN]). Furthermore, the glass effect on the liver and kidney functions was addressed in this study using (alanine transaminase [ALT] and aspartate transaminase [AST]) and (urea and creatinine), respectively. The results of the degradation test showed that the glass dissolution rate was increased by incorporating of K₂ O, and its ion release was occurred by a diffusion-controlled process. Moreover, in vivo bioactivity test showed that serum activity of ALP, OCN level, and the newly formed bone was higher in BL50-implanted group than that of BN100 andBK50at 3 w and 6 w post-surgery. As well as, implantation of all glass samples in the femoral bone defect did not alter the liver and kidney functions. In conclusion, the synthesized borate glass was well served as a controlled delivery system for Li⁺ ion release, which enhanced bone formation as shown from the bone formation markers (ALP and OCN).

Influence of low amounts of zinc or magnesium substitution on ion release and apatite formation of Bioglass 45S5

Magnesium and zinc ions play various key roles in the human body, being involved, among others, in skeletal development and wound healing. Zinc is also known to have antimicrobial properties. While low concentrations can stimulate cells in vitro, high concentrations of magnesium or zinc introduced into bioactive glasses significantly reduce glass degradation and ion release and inhibit apatite precipitation. On the other hand, magnesium and zinc ions improve the high temperature processing of bioactive glasses, even when present at low concentrations only. Results here show that by substituting small amounts of Mg or Zn for Ca, ion release remains high enough to allow for apatite precipitation. In addition, magnesium and zinc containing bioactive glasses are shown to be very susceptible to changes in particle size and relative surface area. For a given magnesium or zinc content in the glass, ion release and apatite formation can be enhanced dramatically by reducing the particle size, reaching comparable levels as Bioglass 45S5 of the same particle size range. Taken together, these findings suggest that when introducing these ions into bioactive glasses, ideally low Mg or Zn for Ca substitution as well as small particle sizes are used. This way, bioactive glasses combining good high temperature processing with fast ion release and apatite precipitation can be obtained, providing the potential additional benefit of releasing magnesium or zinc ions in therapeutic concentrations.

A comparison of lithium-substituted phosphate and borate bioactive glasses for mineralised tissue repair

OBJECTIVES

Wnt/β-catenin signalling plays important roles in regeneration, particularly in hard tissues such as bone and teeth, and can be regulated by small molecule antagonists of glycogen synthase kinase 3 (GSK3); however, small molecules can be difficult to deliver clinically. Lithium (Li) is also a GSK3 antagonist and can be incorporated into bioactive glasses (BG), which can be used clinically in dental and bone repair applications and tuned to quickly release their constituent ions.

METHODS

Here, we created phosphate (P)- and borate (B)-based BG that also contained Li (LiPBG and LiBBG) and examined their ion release kinetics and the toxicity of their dissolution ions on mouse 17IA4 dental pulp cells.

RESULTS

We found that although LiPBG and LiBBG can both quickly release Li at concentrations known to regulate Wnt/β-catenin signalling, the P and B ions they concomitantly release are highly toxic to cells. Only when relatively low concentrations of LiPBG and LiBBG were placed in cell culture medium were their dissolution products non-toxic. However, at these concentrations, LiPBG and LiBBG's ability to regulate Wnt/β-catenin signalling was limited.

SIGNIFICANCE

These data suggest that identifying a BG composition that can both quickly deliver high concentrations of Li and is non-toxic remains a challenge.

Single-Chain Atomic Crystals as Extracellular Matrix-Mimicking Material with Exceptional Biocompatibility and Bioactivity

In this study, Mo₃Se₃^- single-chain atomic crystals (SCACs) with atomically small chain diameters of ∼0.6 nm, large surface areas, and mechanical flexibility were synthesized and investigated as an extracellular matrix (ECM)-mimicking scaffold material for tissue engineering applications. The proliferation of L-929 and MC3T3-E1 cell lines increased up to 268.4 ± 24.4% and 396.2 ± 8.1%, respectively, after 48 h of culturing with Mo₃Se₃^- SCACs. More importantly, this extremely high proliferation was observed when the cells were treated with 200 μg mL^-1 of Mo₃Se₃^- SCACs, which is above the cytotoxic concentration of most nanomaterials reported earlier. An ECM-mimicking scaffold film prepared by coating Mo₃Se₃^- SCACs on a glass substrate enabled the cells to adhere to the surface in a highly stretched manner at the initial stage of cell adhesion. Most cells cultured on the ECM-mimicking scaffold film remained alive; in contrast, a substantial number of cells cultured on glass substrates without the Mo₃Se₃^- SCAC coating did not survive. This work not only proves the exceptional biocompatible and bioactive characteristics of the Mo₃Se₃^- SCACs but also suggests that, as an ECM-mimicking scaffold material, Mo₃Se₃^- SCACs can overcome several critical limitations of most other nanomaterials.

Tooth Repair and Regeneration

PURPOSE OF REVIEW

Current dental treatments are based on conservative approaches, using inorganic materials and appliances.This report explores and discusses the newest achievements in the field of "regenerative dentistry," based on the concept of biological repair as an alternative to the current conservative approach.

RECENT FINDINGS

The review covers and critically analyzes three main approaches of tooth repair: the re-mineralization of the enamel, the biological repair of dentin, and whole tooth engineering.

SUMMARY

The development of a concept of biological repair based on the role of the Wnt signaling pathway in reparative dentin formation offers a new translational approach into development of future clinical dental treatments.In the field of bio-tooth engineering, the current focus of the researchers remains the establishment of odontogenic cell-sources that would be viable and easily accessible for future bio-tooth engineering.

Highly dispersed lithium doped mesoporous silica nanospheres regulating adhesion, proliferation, morphology, ALP activity and osteogenesis related gene expressions of BMSCs

Lithium (Li) doped mesoporous silica nanospheres (LMSNs) were synthesized by incorporation of 5 wt% Li into mesoporous silica nanospheres (MSNs) using sol-gel method. The results showed that LMSNs with a mean size of approximate 300 nm exhibited uniform and highly dispersed spherical morphology, which was similar to the morphology of MSNs. Moreover, the degradability of MSNs was significantly increased after the incorporation of Li, and LMSNs could release both silicon (Si) and Li ions in a sustained manner. Due to the release of Li ions, LMSNs showed higher stimulatory effects on the attachment and proliferation of bone marrow mesenchymal stem cells (BMSCs) than MSNs. In addition, LMSNs could also enhance the ALP activity of BMSCs as well as improving osteogenesis related genes (OPN, ALP, Runx2 and OCN) expression of BMSCs. In summary, LMSNs have shown the capability of being a carrier of biologically active ions, which exhibit great potential in bone repair/regeneration applications.

Porous lithium-doped hydroxyapatite scaffold seeded with hypoxia-preconditioned bone-marrow mesenchymal stem cells for bone-tissue regeneration

Hydroxyapatite (HA) is a commonly used biomaterial in bone-tissue engineering, but pure HA is deficient in osteoinduction. In this study, we fabricated scaffolds of lithium-doped HA (Li-HA) and assess the bone generation enhancement of Li-HA scaffolds seeded with hypoxia-preconditioned bone-marrow mesenchymal stem cells (BMMSCs). We found that 1.5%Li-HA obtained optimal cell proliferation activity in vitro. In an in vivo study, Li-HA/BMSCs enhanced new bone formation, reducing the GSK-3β and increasing the β-catenin, but the angiogenic effect was not modified significantly. However, when the seeded BMMSCs had been preconditioned in hypoxia condition, the new bone formation was increased, with lower GSK-3β and higher β-catenin amounts detected. The HIF-1α secretion was up-regulated, and the vascular endothelial growth factor and CD31 expression increased. In conclusion, the bone scaffold developed from Li-doped HA seeded with hypoxia-preconditioned BMMSCs exerted positive effect on activating the Wnt and HIF-1α signal pathway, and showed good osteogenesis and angiogenesis potential. The composited scaffold contributed to an encouraging result in bone regeneration.

A comparative study on the in vitro formation of hydroxyapatite, cytotoxicity and antibacterial activity of 58S bioactive glass substituted by Li and Sr

Lithium and strontium up to 10 mol% have been substituted for calcium in 58S bioactive glasses in order to enhance specific biological properties such as proliferation, alkaline phosphatase (ALP) activity of cells as well as antibacterial activity. In-vitro formation of hydroxyapatite was studied using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), inductively coupled plasma atomic emission spectrometry (ICP-AES) and scanning electron microscopy (SEM). Substitution of either Li or Sr for Ca in the composition had a retarding effect on the bioactivity while Li decreased and Sr increased the rate of ion release in the simulated body fluid solution. The dissolution rate showed to be inversely proportional to oxygen density of the bioactive glasses. The proposed mechanisms for the lowered bioactivity are a lower supersaturation degree for nucleation of apatite in Li substituted bioactive glasses and blocking of the active growth sites of calcium phosphate by Sr²⁺ in Sr substituted bioactive glasses. The proliferation rate and alkaline phosphate activity of osteoblast cell line MC3T3-E1 treated with Li and Sr bioactive glasses were studied. 3-(4,5dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and alkaline phosphate assay showed that all synthesized bioactive glasses with exception of 58S with 10 mol% SrO, exhibited statistically significant increase in both cell proliferation and alkaline phosphatase activity. Finally, 58S bioactive glass with 5 mol% Li₂O substitution for CaO was considered as a potential biomaterial in bone repair/regeneration therapies with enhanced biocompatibility, and alkaline phosphate activity, with a negligible loss in the bioactivity compared to the 58S bioglass. At the same time this composition had the highest antibacterial activity against methicillin-resistant Staphylococcus aureus bacteria among all synthesized Li and Sr substituted bioactive glasses.

Applications of Metals for Bone Regeneration

The regeneration of bone tissue is the main purpose of most therapies in dental medicine. For bone regeneration, calcium phosphate (CaP)-based substitute materials based on natural (allo- and xenografts) and synthetic origins (alloplastic materials) are applied for guiding the regeneration processes. The optimal bone substitute has to act as a substrate for bone ingrowth into a defect, as well as resorb in the time frame needed for complete regeneration up to the condition of restitution ad integrum. In this context, the modes of action of CaP-based substitute materials have been frequently investigated, where it has been shown that such materials strongly influence regenerative processes such as osteoblast growth or differentiation and also osteoclastic resorption due to different physicochemical properties of the materials. However, the material characteristics needed for the required ratio between new bone tissue formation and material degradation has not been found, until now. The addition of different substances such as collagen or growth factors and also of different cell types has already been tested but did not allow for sufficient or prompt application. Moreover, metals or metal ions are used differently as a basis or as supplement for different materials in the field of bone regeneration. Moreover, it has already been shown that different metal ions are integral components of bone tissue, playing functional roles in the physiological cellular environment as well as in the course of bone healing. The present review focuses on frequently used metals as integral parts of materials designed for bone regeneration, with the aim to provide an overview of currently existing knowledge about the effects of metals in the field of bone regeneration.

In Vitro Human Umbilical Vein Endothelial Cells Response to Ionic Dissolution Products from Lithium-Containing 45S5 Bioactive Glass

Since lithium (Li⁺) plays roles in angiogenesis, the localized and controlled release of Li⁺ ions from bioactive glasses (BGs) represents a promising alternative therapy for the regeneration and repair of tissues with a high degree of vascularization. Here, microparticles from a base 45S5 BG composition containing (wt %) 45% SiO₂, 24.5% Na₂O, 24.5% CaO, and 6% P₂O₅, in which Na₂O was partially substituted by 5% Li₂O (45S5.5Li), were obtained. The results demonstrate that human umbilical vein endothelial cells (HUVECs) have greater migratory and proliferative response and ability to form tubules in vitro after stimulation with the ionic dissolution products (IDPs) of the 45S5.5Li BG. The results also show the activation of the canonical Wnt/β-catenin pathway and the increase in expression of proangiogenic cytokines insulin like growth factor 1 (IGF1) and transforming growth factor beta (TGFβ). We conclude that the IDPs of 45S5.5Li BG would act as useful inorganic agents to improve tissue repair and regeneration, ultimately stimulating HUVECs behavior in the absence of exogenous growth factors.