3D plotting in the preparation of newberyite, struvite, and brushite porous scaffolds: using magnesium oxide as a starting material

Research progress on the application of magnesium phosphate bone cement in bone defect repair: A review

BACKGROUND

Bone defects arising from diverse causes, such as traffic accidents, contemporary weapon usage, and bone-related disorders, present significant challenges in clinical treatment. Prolonged treatment cycles for bone defects can result in complications, impacting patients' overall quality of life. Efficient and timely repair of bone defects is thus a critical concern in clinical practice.

OBJECTIVE

This study aims to assess the scientific progress and achievements of magnesium phosphate bone cement (MPC) as an artificial bone substitute material. Additionally, the research seeks to explore the future development path and clinical potential of MPC bone cement in addressing challenges associated with bone defects.

METHODS

The study comprehensively reviews MPC's performance, encompassing e.g. mechanical properties, biocompatibility, porosity, adhesion and injectability. Various modifiers are also considered to broaden MPC's applications in bone tissue engineering, emphasizing drug-loading performance and antibacterial capabilities, which meet clinical diversification requirements.

RESULTS

In comparison to alternatives such as autogenous bone transplantation, allograft, polymethyl methacrylate (PMMA), and calcium phosphate cement (CPC), MPC emerges as a promising solution for bone defects. It addresses limitations associated with these alternatives, such as immunological rejection and long-term harm to patients. MPC can control heat release during the curing process, exhibits superior mechanical strength, and has the capacity to stimulate new bone growth.

CONCLUSION

MPC stands out as an artificial bone substitute with appropriate mechanical strength, rapid degradation, non-toxicity, and good biocompatibility, facilitating bone repair and regeneration. Modification agents can enhance its clinical versatility. Future research should delve into its mechanical properties and formulations, expanding clinical applications to create higher-performing and more medically valuable alternatives in bone defect repair.

Effect of Atmospheric Pressure Plasma Jet Treatments on Magnesium Phosphate Cements: Performance, Characterization, and Applications

Atmospheric pressure plasma treatments are nowadays gaining importance to improve the performance of biomaterials in the orthopedic field. Among those, magnesium phosphate-based cements (MPCs) have recently shown attractive features as bone repair materials. The effect of plasma treatments on such cements, which has not been investigated so far, could represent an innovative strategy to modify MPCs' physicochemical properties and to tune their interaction with cells. MPCs were prepared and treated for 5, 7.5, and 10 min with a cold atmospheric pressure plasma jet. The reactive nitrogen and oxygen species formed during the treatment were characterized. The surfaces of MPCs were studied in terms of the phase composition, morphology, and topography. After a preliminary test in simulated body fluid, the proliferation, adhesion, and osteogenic differentiation of human mesenchymal cells on MPCs were assessed. Plasma treatments induce modifications in the relative amounts of struvite, newberyite, and farringtonite on the surfaces on MPCs in a time-dependent fashion. Nonetheless, all investigated scaffolds show a good biocompatibility and cell adhesion, also supporting osteogenic differentiation of mesenchymal cells.

An Overview of Magnesium-Phosphate-Based Cements as Bone Repair Materials

In the search for effective biomaterials for bone repair, magnesium phosphate cements (MPCs) are nowadays gaining importance as bone void fillers thanks to their many attractive features that overcome some of the limitations of the well-investigated calcium-phosphate-based cements. The goal of this review was to highlight the main properties and applications of MPCs in the orthopedic field, focusing on the different types of formulations that have been described in the literature, their main features, and the in vivo and in vitro response towards them. The presented results will be useful to showcase the potential of MPCs in the orthopedic field and will suggest novel strategies to further boost their clinical application.

Effect of ZnO-doped magnesium phosphate cements on osteogenic differentiation of mBMSCs in vitro

The insufficient osteogenesis of magnesium phosphate cements (MPCs) limits its further application. It is significant to develop a bioactive MPC with osteogenic properties. In this work, MPCs were reinforced by zinc oxide nanoparticles (ZnO-NPs). The composition, microstructure, setting time, compressive strength and degradation of ZnO-NPs/MPCs (ZNMPCs) were evaluated. The results showed that the setting times of MPCs were prolonged from 8.2 to 25.3 min (5.0ZNMPC). The exothermic temperatures were reduced from 45.8 ± 0.4℃ (MPCs) to 39.3 ± 0.5℃ (1.0ZNMPC). The compressive strength of ZNMPC composite cement with 1 wt. % ZnO-NPs (1.0ZNMPC) was the highest (42.9 MPa) among all the composite cements. Furthermore, the ZNMPCs were cultured with mouse bone marrow mesenchymal stem cells (mBMSCs). The results yielded that the ZNMPCs exhibited good cytocompatibility with enhanced differentiation, proliferation, and mineralization on mBMSCs, and it also pronouncedly elevated the expressions of genes and proteins involving osteogenesis. These findings suggested that ZNMPCs could drive the differentiation toward osteogenesis and mineralization of mBMSCs, providing a simple way to the MPC with enhanced osteogenesis for further orthopedic applications.

Rapid Fabrication of MgNH4PO4·H2O/SrHPO4 Porous Composite Scaffolds with Improved Radiopacity via 3D Printing Process

Although bone repair scaffolds are required to possess high radiopacity to be distinguished from natural bone tissues in clinical applications, the intrinsic radiopacity of them is usually insufficient. For improving the radiopacity, combining X-ray contrast agents with bone repair scaffolds is an effective method. In the present research, MgNH₄PO₄·H₂O/SrHPO₄ 3D porous composite scaffolds with improved radiopacity were fabricated via the 3D printing technique. Here, SrHPO₄ was firstly used as a radiopaque agent to improve the radiopacity of magnesium phosphate scaffolds. X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive spectroscopy (EDS) were used to characterize the phases, morphologies, and element compositions of the 3D porous composite scaffolds. The radiography image showed that greater SrHPO₄ contents corresponded to higher radiopacity. When the SrHPO₄ content reached 9.34%, the radiopacity of the composite scaffolds was equal to that of a 6.8 mm Al ladder. The porosity and in vitro degradation of the porous composite scaffolds were studied in detail. The results show that magnesium phosphate scaffolds with various Sr contents could sustainably degrade and release the Mg, Sr, and P elements during the experiment period of 28 days. In addition, the cytotoxicity on MC3T3-E1 osteoblast precursor cells was evaluated, and the results show that the porous composite scaffolds with a SrHPO₄ content of 9.34% possessed superior cytocompatibility compared to that of the pure MgNH₄PO₄·H₂O scaffolds when the extract concentration was 0.1 g/mL. Cell adhesion experiments showed that all of the scaffolds could support MC3T3-E1 cellular attachment well. This research indicates that MgNH₄PO₄·H₂O/SrHPO₄ porous composite scaffolds have potential applications in the bone repair fields.

Fused Filament Fabrication (Three-Dimensional Printing) of Amorphous Magnesium Phosphate/Polylactic Acid Macroporous Biocomposite Scaffolds

The ultimate goal of this paper is to develop novel ceramic-polymer-based biocomposite orthopedic scaffolds with the help of additive manufacturing. Specifically, we incorporate a bioceramic known as amorphous magnesium phosphate (AMP) into polylactic acid (PLA) with the help of the melt-blending technique. Magnesium phosphate (MgP) was chosen as the bioactive component as previous studies have confirmed its favorable biomaterial properties, especially in orthopedics. Special care was taken to develop constant diameter AMP-PLA composite filaments, which would serve as feedstock for a fused filament fabrication (FFF)-based three-dimensional (3D) printer. Before the filaments were used for FFF, a thorough set of characterization protocols comprising of phase analysis, microstructure evaluations, thermal analysis, rheological analysis, and in vitro degradation determinations was performed on the biocomposites. Scanning electron microscopy (SEM) results confirmed a homogenous dispersion of AMP particles in the PLA matrix. Rheological studies demonstrated good printability behavior of the AMP-PLA filaments. In vitro degradation studies indicated a faster degradation rate in the case of AMP-PLA filaments as compared to the single phase PLA filaments. Subsequently, the filaments were fed into an FFF setup, and tensile bars and design-specific macroporous AMP-PLA scaffolds were printed. The biocomposite exhibited favorable mechanical properties. Furthermore, in vitro cytocompatibility results revealed higher pre-osteoblast cell attachment and proliferation on AMP-PLA scaffolds as compared to single-phase PLA scaffolds. Altogether, this study provides a proof of concept that design-specific bioactive AMP-PLA biocomposite scaffolds fabricated by FFF can be potential candidates as medical implants in orthopedics.