Gel casting of resorbable polymers. 1. Processing and applications

Effect of bioceramic inclusions on gel-cast aliphatic polymer membranes for bone tissue engineering applications: An in vitro study

BACKGROUND

Polylactic acid (PLA) has been extensively used in tissue engineering. However, poor mechanical properties and low cell affinity have limited its pertinence in load bearing bone tissue regeneration (BTR) devices.

OBJECTIVE

Augmenting PLA with β-Tricalcium Phosphate (β-TCP), a calcium phosphate-based ceramic, could potentially improve its mechanical properties and enhance its osteogenic potential.

METHODS

Gels of PLA and β-TCP were prepared of different % w/w ratios through polymer dissolution in acetone, after which polymer-ceramic membranes were synthesized using the gel casting workflow and subjected to characterization.

RESULTS

Gel-cast polymer-ceramic constructs were associated with significantly higher osteogenic capacity and calcium deposition in differentiated osteoblasts compared to pure polymer counterparts. Immunocytochemistry revealed cell spreading over the gel-cast membrane surfaces, characterized by trapezoidal morphology, distinct rounded nuclei, and well-aligned actin filaments. However, groups with higher ceramic loading expressed significantly higher levels of osteogenic markers relative to pure PLA membranes. Rule of mixtures and finite element models indicated an increase in theoretical mechanical strength with an increase in β-TCP concentration.

CONCLUSION

This study potentiates the use of PLA/β-TCP composites in load bearing BTR applications and the ability to be used as customized patient-specific shape memory membranes in guided bone regeneration.

Fabrication of poly(ε-caprolactone) tissue engineering scaffolds with fibrillated and interconnected pores utilizing microcellular injection molding and polymer leaching

Three-dimensional fibrillated interconnected porous poly(ε-caprolactone) scaffolds were prepared by microcellular injection molding and polymer leaching.

Delivery systems and dosing for antipsychotics

Schizophrenia is a devastating illness, affecting approximately 1-2 % of the world population. Age of onset is generally between 20 and 30 years of age with a chronic, unremitting course for the duration of the patient's life. Although schizophrenia is among the most severe and debilitating illnesses known to medicine, its treatment has remained virtually unchanged for over 50 years. This chapter covers several major concepts in experimental drug development and delivery: (1) the concept of "typical" vs. "atypical" classifications for antipsychotic drugs as it relates to dosing; (2) the development of depot formulations for improved medication adherence; and (3) several promising areas for future therapeutic advances related to the methods and duration of drug administration. These areas include sublingual, injectable, and implantable drug delivery strategies that have the potential to effect rapid and dramatic improvements in schizophrenia outcomes.

Porous Polymer-Ceramic Systems for Tissue Engineering Support the Formation of Mineralized Bone Matrix

Osteoblast cell differentiation and bone formation using rat calvaria cells were studied on the surface of a porous 3-dimensional polymer matrix of 50:50 poly (lactide-co-glycolide) (PLAGA)/ hydroxyapatite (HA). Cell proliferation was determined at 24 hr, 3, 7, 14, and 21 days. Exponential growth was observed during the first week and a steady increase in the population continued until 21 days after cells were seeded. Cell growth kinetics on PLAGA/HA showed an exponential pattern. Environmental scanning electron microscopy revealed the formation of multilayers of cells growing throughout the polymer matrices by day 7 and through day 21. Alkaline phosphatase (AP) activity was demonstrated after 21 days of culture on PLAGA/HA using a commercial diagnostic kit. Light microscopy observations of experiment cultures revealed active osteoblastic cells forming a characteristic mineralized matrix in the presence of β-glycerophosphate as a phosphate donor. Mineralization was not seen when the matrix alone was incubated with the reagent, indicating that the mineralization was due to the cells and not the HA in the matrix. These results suggested that the 3-dimensional PLAGA/HA matrix studied provided an excellent matrix for bone cell differentiation and mineralization in vitro and therefore may be a good candidate as a synthetic implant for bone regeneration.

Comparative assessment of structural and biological properties of biomimetically coated hydroxyapatite on alumina (alpha-Al2O3) and titanium (Ti-6Al-4V) alloy substrates

Previous reports have shown the use of hydroxyapatite (HAp) and related calcium phosphate coatings on metal and nonmetal substrates for preparing tissue-engineering scaffolds, especially for osteogenic differentiation. These studies have revealed that the structural properties of coated substrates are dependent significantly on the method and conditions used for coating and also whether the substrates had been modified prior to the coating. In this article, we have done a comparative evaluation of the structural features of the HAp coatings, prepared by using simulated body fluid (SBF) at 25 degrees C for various time periods, on a nonporous metal substrate titanium-aluminium-vanadium (Ti-6Al-4V) alloy and a bioinert ceramic substrate alpha-alumina (alpha-Al(2)O(3)), with and without their prior treatment with the globular protein bovine serum albumin (BSA). Our analysis of these substrates by scanning electron microscopy (SEM), X-ray diffraction (XRD), and Fourier-transform infrared (FTIR) spectrometry showed significant and consistent differences in the quantitative and qualitative properties of the coatings. Interestingly, the bioactivity of these substrates in terms of supporting in vitro cell adhesion and spreading, and in vivo effects of implanted substrates, showed a predictable pattern, thus indicating that some coated substrates prepared under our conditions could be more suitable for biological/biomedical applications.

Antipsychotic dosing and drug delivery

This chapter addresses the current state of affairs regarding proposed mechanism of action for antipsychotic medications and how this mechanism relates to dosing and delivery strategies. The initial portion describes the history of antipsychotic medication, including key discoveries that contribute to the dopamine hypothesis of schizophrenia and provide evidence that dopamine D2 receptor antagonism remains the most copasetic explanation for both determination of dose and degree of efficacy for current antipsychotic medications. Early observations regarding the unique properties of clozapine and how those observations led to the misconception and misnomer of atypicality are also discussed. Subsequent sections relate the dosing of available medications using chlorpromazine equivalents, with a discussion of non-D2-related mechanisms to antipsychotic effects. The balance of the chapter explores the temporal pattern of receptor occupancy as a key determinant of antipsychotic effectiveness, noting that continuous infusion would present the optimal method of treatment. In addition to the pharmacodynamic benefits of continuous long-term delivery systems, the incidence, causes, and clinical consequences of poor adherence are addressed. These observations are then discussed in the context of clinical studies and meta-analyses, demonstrating superiority of long-term depot preparations over oral administration. However, despite overwhelming evidence in favor of long-term delivery systems, few options are available to provide such ideal medication delivery profiles. Barriers to creating traditional depot preparations for a large number of antipsychotic agents, as well as efforts to address these limitations with polymer-based microspheres are described. The potential extension of current formulations to very long-term delivery implants using biodegradable and nonbiodegradable platforms is then described. Benefits as well as limitations of such systems are discussed with respect to clinical and ethical issues as well as a brief description of potential regulatory and logistic barriers to developing better delivery options. In summary, this chapter describes the basis for relating the dose of all existing antipsychotic medications to dopamine D2 receptor affinity and the potential contribution of continuous occupancy to enhanced efficacy through superior biological effects and improved adherence.

Design, fabrication, and characterization of a composite scaffold for bone tissue engineering

Poly(lactide-co-glycolide) (PLGA) scaffolds have been successfully used in bone tissue engineering, with or without hydroxyapatite (HA) and with a macroporosity given either by simple PLGA sphere packaging and/or by leaching out NaCl. The objective of this work was the optimization of the design parameters for bone tissue engineering scaffolds made by sintering microspheres of PLGA, HA nanocrystals for matrix reinforcement and osteoconduction, and salt crystals for macroporosity and control of matrix pore size. Microsphere fabrication by a single-emulsion and solvent evaporation technique was first optimized to obtain a high yield of PLGA microspheres with a diameter between 80 and 300 microm. The influence of the sintering process and matrix composition on the scaffold structure was then evaluated morphologically and mechanically. Three scaffold types were tested for biocompatibility by culturing with human fibroblasts for up to 14 days. The most important parameters to obtain microspheres with the selected diameter range were the viscosity ratio of the dispersed phase to the continuous phase and the relative volume fraction of the 2 phases. The Young's modulus and the ultimate strength of the sintered matrices ranged between 168-265 MPa and 6-17 MPa, respectively, within the range for trabecular bone. Biocompatibility was demonstrated by fibroblast adhesion, proliferation, and spreading throughout the matrix. This work builds upon previous work of the PLGA/HA sintering technique to give design criteria for fabricating a bone tissue engineered matrix with optimized morphological, functional, and biological properties to fit the requirements of bone replacements.

Biomaterials in orthopaedics

At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field.

Osteogenic differentiation of dura mater stem cells cultured in vitro on three-dimensional porous scaffolds of poly(epsilon-caprolactone) fabricated via co-extrusion and gas foaming

A novel scaffold fabrication method utilizing both polymer blend extrusion and gas foaming techniques to control pore size distribution is presented. Seventy-five per cent of all pores produced using polymer blend extrusion alone were less than 50microm. Introducing a gas technique provided better control of pore size distribution, expanding the range from 0-50 to 0-350microm. Varying sintering time, annealing temperature and foaming pressure also helped to reduce the percentage of pore sizes below 50microm. Scaffolds chosen for in vitro cellular studies had a pore size distribution of 0-300microm, average pore size 66+/-17microm, 0.54+/-0.02% porosity and 98% interconnectivity, measured by micro-computed tomography (microCT) analysis. The ability of the scaffolds to support osteogenic differentiation for subsequent cranial defect repair was evaluated by static and dynamic (0.035+/-0.006ms(-1) terminal velocity) cultivation with dura mater stem cells (DSCs). In vitro studies showed minimal increases in proliferation over 28 days in culture in osteogenic media. Alkaline phosphatase expression remained constant throughout the study. Moderate increases in matrix deposition, as assessed by histochemical staining and microCT analysis, occurred at later time points, days 21 and 28. Although constructs cultured dynamically showed greater mineralization than static conditions, these trends were not significant. It remains unclear whether bioreactor culture of DSCs is advantageous for bone tissue engineering applications. However, these studies show that polycaprolactone (PCL) scaffolds alone, without the addition of other co-polymers or ceramics, support long-term attachment and mineralization of DSCs throughout the entire porous scaffold.

Optimized bone regeneration based on sustained release from three-dimensional fibrous PLGA/HAp composite scaffolds loaded with BMP-2

Contemporary treatment of critical bone defect remains a significant challenge in the field of orthopedic surgery. Engineered biomaterials combined with growth factors have emerged as a new treatment alternative in bone repair and regeneration. Our approach is to encapsulate bone morphogenetic protein-2 (BMP-2) into a polymeric matrix in different ways and characterize their individual performance in a nude mouse model. The main objective of this study is to examine whether the PLGA/HAp composite fibrous scaffolds loaded with BMP-2 through electrospinning can improve bone regeneration. The hypothesis is that different loading methods of BMP-2 and different HAp contents in scaffolds can alternate the release profiles of BMP-2 in vivo, therefore modify the performance of scaffolds in bone regeneration. Firstly, mechanical strength of scaffolds and HAp nanoparticles distribution in scaffolds were investigated. Secondly, nude mice experiments extended to 6 weeks were carried out to test the in vivo performance of these scaffolds, in which measurements, like serum BMP-2 concentration, ALP activity, X-ray qualification, and H&E/IHC tissue staining were utilized to monitor the growth of new bone and the changes of the corresponding biochemical parameters. The results showed that the PLGA/HAp composite scaffolds developed in this study exhibited good morphology/mechanical strength and HAp nanoparticles were homogeneously dispersed inside PLGA matrix. Results from the animal experiments indicate that the bioactivity of BMP-2 released from the fibrous PLGA/HAp composite scaffolds is well maintained, which further improves the formation of new bone and the healing of segmental defects in vivo. It is concluded that BMP-2 loaded PLGA/HAp composite scaffolds are promising for bone healing.

Degradation behavior of hydrophilized PLGA scaffolds prepared by melt-molding particulate-leaching method: comparison with control hydrophobic one

Porous PLGA/PVA scaffolds as hydrophilized PLGA scaffolds for tissue engineering applications were fabricated by a novel melt-molding particulate leaching method (non-solvent method). The prepared scaffolds exhibited highly porous and open-cellular pore structures with almost same surface and interior porosities (pore size, 200-300 microm; porosity, about 90%). The in vitro degradation behavior of the PLGA and PLGA/PVA scaffolds was compared at 37 degrees C in PBS (pH 7.4) with and without the solution change everyday to see the effect of solution pH as well as scaffold hydrophilicity on the degradation behavior. The changes in dimension, molecular weight, mechanical properties (maximum load and modulus), and morphology of the scaffolds were examined with degradation time. The degradation behavior of the PLGA and PLGA/PVA scaffolds was further investigated in vivousing a rat model (subcutaneously implantation). It was observed that both PLGA and PLGA/PVA scaffolds in decreasing pH condition (PBS no change) showed faster degradation than those in constant pH condition (PBS change everyday), owing to the enhanced intramolecular depolymerization by the increment of chain hydrophilicity caused by carboxylate groups as well as the autocatalysis of carboxylic acids accumulated in the solution by the cleavage of PLGA backbone ester bonds. The scaffolds in vivo condition also showed faster degradation than those in vitro, probably due to the aid of foreign body giant cells or enzymes. The PLGA/PVA scaffold showed slightly faster degradation than the PLGA scaffold for both in vitro and in vivo conditions.

Incorporation of growth factors into medical devices via biomimetic coatings

Orthopaedic and dental surgeons are fully aware of the need for implants to bond well with the surrounding living bone if long-lasting clinical success is to be achieved. For example, well-bonded hip implants have a 10 year failure rate, which is lowered fivefold if bonding is poor or absent. The techniques that are currently available to impart implant surfaces with the desired osteoconductive properties are essentially limited. To overcome the inherent difficulties, we have developed a 'biomimetic' coating process. By this means, implants with complex surface geometries, such as porous spinal implants, can be furnished with a bone-bonding surface. Furthermore, these coatings can be rendered osteoinductive as well as osteoconductive (by incorporating osteogenic agents). Using this facility, we have induced bone formation at an ectopic site in rats, and have accelerated osseointegration (bone bonding) at an orthotopic dental site in adult miniature pigs. Our preliminary results indicated that these osteoinductive dental implants bond with surrounding bone within one week instead of the usual three weeks. We believe that surfaces coated with biomimetic coatings into which osteogenic growth factors are incorporated hold great potential for use in clinical orthopaedics and dentistry.

Bone regeneration through transplantation of genetically modified cells

To the author's knowledge, the rabbit is the largest animal model used to explore bone regeneration with genetically modified cells. This technology needs to be expanded to larger animal models that represent a more clinically relevant application in which cells are isolated from the animal, expanded ex vivo, genetically modified, and implanted in a critical-size bone defect in the donor animal. Furthermore, optimization of the vector type, vector dose, cell dose, and carrier material choice must be accomplished in animal models before clinical investigation is initiated. Most research has focused on a single osteoinductive protein; however, multiple proteins may synergize to further enhance bone formation. In conclusion, transplantation of genetically modified cells provides a new opportunity to improve bone tissue regeneration.

Performance of degradable composite bone repair products made via three-dimensional fabrication techniques

This study analyzed the in vivo performance of composite degradable bone repair products fabricated using the TheriForm process, a solid freeform fabrication (SFF) technique, in a rabbit calvarial defect model at 8 weeks. Scaffolds were composed of polylactic-co-glycolic acid (PLGA) polymer with 20% w/w beta-tricalcium phosphate (beta-TCP) ceramic with engineered macroscopic channels, a controlled porosity gradient, and a controlled pore size for promotion of new bone ingrowth. Scaffolds with engineered macroscopic channels and a porosity gradient had higher percentages of new bone area compared to scaffolds without engineered channels. These scaffolds also had higher percentages of new bone area compared to unfilled control defects, suggesting that scaffold material and design combinations could be tailored to facilitate filling of bony defects. This proof-of-concept study demonstrated that channel size, porosity, and pore size can be controlled and used to influence new bone formation and calvarial defect healing.

A novel method to obtain protein release from porous polymer scaffolds: emulsion coating

To obtain the controlled release of proteins from macro-porous polymeric scaffolds, a novel emulsion-coating method has been developed. In this process, a water-in-oil emulsion, from an aqueous protein solution and a polymer solution, is forced through a prefabricated scaffold by applying a vacuum. After solvent evaporation, a polymer film, containing the protein, is then deposited on the porous scaffold surface. This paper reports the effect of processing parameters on the emulsion coating characteristics, scaffold structure, and protein release and stability. Poly(ether-ester) multiblock copolymers were chosen as the polymer matrix for both scaffolds and coating. Macro-porous scaffolds, with a porosity of 77 vol% and pores of approximately 500 microm were prepared by compression moulding/salt leaching. A micro-porous, homogeneous protein-loaded coating could be obtained on the scaffold surface. Due to the coating, the scaffold porosity was decreased, whereas the pore interconnection was increased. A model protein (lysozyme) could effectively be released in a controlled fashion from the scaffolds. Complete lysozyme release could be achieved within 3 days up to more than 2 months by adjusting the coated emulsion parameters. In addition, the coating process did not reduce the enzymatic activity. This new method appears to be promising for tissue engineering applications.

Indirect solid free form fabrication of local and global porous, biomimetic and composite 3D polymer-ceramic scaffolds

Precise control over scaffold material, porosity, and internal pore architecture is essential for tissue engineering. By coupling solid free form (SFF) manufacturing with conventional sponge scaffold fabrication procedures, we have developed methods for casting scaffolds that contain designed and controlled locally porous and globally porous internal architectures. These methods are compatible with numerous bioresorbable and non-resorbable polymers, ceramics, and biologic materials. Phase separation, emulsion-solvent diffusion, and porogen leaching were used to create poly(L)lactide (PLA) scaffolds containing both computationally designed global pores (500, 600, or 800 microm wide channels) and solvent fashioned local pores (50-100 microm wide voids or 5-10 microm length plates). Globally porous PLA and polyglycolide/PLA discrete composites were made using melt processing. Biphasic scaffolds with mechanically interdigitated PLA and sintered hydroxyapatite regions were fabricated with 500 and 600 microm wide global pores. PLA scaffolds with complex internal architectures that mimicked human trabecular bone were produced. Our indirect fabrication using casting in SFF molds provided enhanced control over scaffold shape, material, porosity and pore architecture, including size, geometry, orientation, branching, and interconnectivity. These scaffolds that contain concurrent local and global pores, discrete material regions, and biomimetic internal architectures may prove valuable for multi-tissue and structural tissue interface engineering.

Proteins incorporated into biomimetically prepared calcium phosphate coatings modulate their mechanical strength and dissolution rate

In a previous investigation, we demonstrated that when bovine serum albumin (BSA) is biomimetically co-precipitated with Ca(2+) and PO(4)(3-) ions upon titanium-alloy implants, it becomes incorporated into the crystal lattice and is not merely deposited on its surface. Moreover, the protein elicited a change in crystal structure from an octacalcium phosphate type to a carbonated apatite one, which bears a closer resemblance to natural bone mineral. In the present study, we investigated the dissolution rate and mechanical strength of such BSA-containing coatings as a function of protein concentration within the bathing medium (10 ng/ml to 1.0 mg/ml). BSA-containing coatings released Ca(2+) ions more slowly (5 ppm/min) than did non-BSA-containing ones (10 ppm/min), but this rate did not change as a function of protein concentration within the bathing medium. In contrast, the strength of coatings increased almost linearly as a function of protein concentration within the bathing medium, indicating that BSA incorporated into the crystal lattice enhances its mechanical strength in a concentration-dependent manner.

Fabrication of poly(alpha-hydroxy acid) foam scaffolds using multiple solvent systems

The present studies describe the fabrication and characterization of highly porous and interconnected poly(alpha-hydroxy acid) foam scaffolds produced using a phase separation multisolvent system, followed by a sublimation process. Fabrication parameters, including solvent composition, polymer concentration, freezing temperature, polymer type, and polymer molecular weight, were optimized to produce the desired foam microstructure. Analyses of selected samples with scanning electron microscopic images and mercury intrusion porosimetry indicated polymer foams with pore size ranges of 100-350 microm, a porosity >90%, and an interconnecting open-pore foam structure. Scaffold degradation profiles varied according to the type and molecular weight of the polymers. Cytocompatibility assays demonstrated that the preferred foam structures were nontoxic and osteoprecursor cells seeded into the scaffolds exhibited the ability to attach, propagate, and differentiate into a calcified structure.

Tissue engineering: orthopedic applications

Because of an aging population and increased occurrence of sports-related injuries, musculoskeletal disorders have become one of the major health concerns in the United States. Current treatments, although fairly successful, do not provide the optimum therapy. These treatments typically rely on donor tissues obtained either from the patient or from another source. The former raises the issue of supply, whereas the latter poses the risk of rejection and disease transfer. This has prompted orthopedic surgeons and scientists to look for viable alternatives. In recent years, tissue engineering has gained increasing support as a method to treat orthopedic disorders. Because it uses principles of engineering, biology, and chemistry, tissue engineering may provide a more effective approach to the treatment of musculoskeletal disorders than traditional methods. This chapter presents a review of current methods and new tissue-engineering techniques for the treatment of disorders affecting bone, ligament, and cartilage.

Biomimetic coprecipitation of calcium phosphate and bovine serum albumin on titanium alloy

Titanium alloy implants were precoated biomimetically with a thin and dense layer of calcium phosphate and then incubated either in a supersaturated solution of calcium phosphate or in phosphate-buffered saline, each containing bovine serum albumin (BSA) at various concentrations, under physiological conditions for 48 h. Coated implants then underwent scanning electron microscopy, immunohistochemical evaluation, Fourier transform infrared spectroscopy, and X-ray diffraction. The quantity of BSA taken up by coatings and the kinetics of protein release were monitored colorimetrically. In coatings prepared by the coprecipitation of calcium phosphate and BSA, protein had become incorporated into the mineral crystal latticework. With increasing BSA concentration, matrices decreased in thickness, became more dense, showed lower crystallinity, and underwent a change in crystal geometry. The octacalcium phosphate structure manifested in the absence of protein was gradually transformed into a carbonated apatite form. Preformed mineral coatings became only superficially mantled with a layer of BSA, and the morphology of the mineral matrices themselves remained unchanged. At equivalent protein concentrations, coatings prepared by the coprecipitation of calcium phosphate released only a minute fraction of its protein component under physiological conditions, whereas preformed mineral matrices showed a "burst" release of their associated protein within a single 2-h period. The biomimetic coating can be a carrier for osteoinductive agents.

Biodegradable polymeric scaffolds for musculoskeletal tissue engineering

Biodegradable scaffolds have played an important role in a number of tissue engineering attempts over the past decade. The goal of this review article is to provide a brief overview of some of the important issues related to scaffolds fabricated from synthetic biodegradable polymers. Various types of such materials are available; some are commercialized and others are still in the laboratories. The properties of the most common of these polymers are discussed here. A variety of fabrication techniques were developed to fashion polymeric materials into porous scaffolds, and a selection of these is presented. The very important issue of scaffold architecture, including the topic of porosity and permeability, is discussed. Other areas such as cell growth on scaffolds, surface modification, scaffold mechanics, and the release of growths factors are also reviewed. A summary outlining the common themes in scaffold-related science that are found in the literature is presented.

Engineering new bone tissue in vitro on highly porous poly(alpha-hydroxyl acids)/hydroxyapatite composite scaffolds

Engineering new bone tissue with cells and a synthetic extracellular matrix (scaffolding) represents a new approach for the regeneration of mineralized tissues compared with the transplantation of bone (autografts or allografts). In the present work, highly porous poly(L-lactic acid) (PLLA) and PLLA/hydroxyapatite (HAP) composite scaffolds were prepared with a thermally induced phase separation technique. The scaffolds were seeded with osteoblastic cells and cultured in vitro. In the pure PLLA scaffolds, the osteoblasts attached primarily on the outer surface of the polymer. In contrast, the osteoblasts penetrated deep into the PLLA/HAP scaffolds and were uniformly distributed. The osteoblast survival percentage in the PLLA/HAP scaffolds was superior to that in the PLLA scaffolds. The osteoblasts proliferated in both types of the scaffolds, but the cell number was always higher in the PLLA/HAP composite scaffolds during 6 weeks of in vitro cultivation. Bone-specific markers (mRNAs encoding bone sialoprotein and osteocalcin) were expressed more abundantly in the PLLA/HAP composite scaffolds than in the PLLA scaffolds. The new tissue increased continuously in the PLLA/HAP composite scaffolds, whereas new tissue formed only near the surface of pure PLLA scaffolds. These results demonstrate that HAP imparts osteoconductivity and the highly porous PLLA/HAP composite scaffolds are superior to pure PLLA scaffolds for bone tissue engineering.

A novel fabrication method of macroporous biodegradable polymer scaffolds using gas foaming salt as a porogen additive

Highly open porous biodegradable poly(L-lactic acid) ¿PLLA scaffolds for tissue regeneration were fabricated by using ammonium bicarbonate as an efficient gas foaming agent as well as a particulate porogen salt. A binary mixture of PLLA-solvent gel containing dispersed ammonium bicarbonate salt particles, which became a paste state, was cast in a mold and subsequently immersed in a hot water solution to permit the evolution of ammonia and carbon dioxide within the solidifying polymer matrix. This resulted in the expansion of pores within the polymer matrix to a great extent, leading to well interconnected macroporous scaffolds having mean pore diameters of around 300-400 microm, ideal for high-density cell seeding. Rat hepatocytes seeded into the scaffolds exhibited about 95% seeding efficiency and up to 40% viability at 1 day after the seeding. The novelty of this new method is that the PLLA paste containing ammonium bicarbonate salt particles can be easily handled and molded into any shape, allowing for fabricating a wide range of temporal tissue scaffolds requiring a specific shape and geometry.

Porous biodegradable polymeric scaffolds prepared by thermally induced phase separation

Poly(L-lactic acid) and its copolymers with D-lactic and glycolic acid were used to fabricate various porous biodegradable scaffolds suitable for tissue engineering and drug delivery based on a thermally induced phase separation (TIPS) technique. A variety of parameters involved in TIPS process, such as types of polymers, polymer concentration, solvent/nonsolvent ratio, and quenching temperature, were examined in detail to produce a wide array of micro- and macroporous structures. A mixture of dioxane and water was used for a binary composition of solvent and nonsolvent, respectively. In particular, the coarsening effect of pore enlargement affected by controlling the quenching temperature was used for the generation of a macroporous open cellular structure with pore diameters above 100 microm. The use of amorphous polymers with a slow cooling rate resulted in a macroporous open cellular structure, whereas that of semicrystalline polymers with a fast cooling rate generated a microporous closed cellular structure. The fabricated porous devices loaded with recombinant human growth hormone (rhGH) were tested for the controlled delivery of rhGH, as a potential additional means to cell delivery.

Polylactide macroporous biodegradable implants for cell transplantation. II. Preparation of polylactide foams by liquid-liquid phase separation

Potential of thermally induced phase separation as a porogen technique has been studied in an effort to produce a surgical implant suitable for cell transplantation. Emphasis has been placed on the liquid-liquid phase separation of solutions of amorphous poly DL-lactide and semicrystalline poly L-lactide in an 87/13 dioxane/water mixture. The related temperature/composition phase diagrams have been set up by turbidimetry, and the possible occurrence of a gel has been discussed. Freeze-drying of some phase-separated polylactide solutions can produce flexible and tough foams with an isotropic morphology. Interconnected pores of 1-10 microns in diameter are expected to result from the spinodal decomposition of the polylactide solutions with formation of co-continuous phases. Thermodynamics of the polymer/solvent pair has a decisive effect on the final macroporous foams, as shown by the dependence of their porosity, density, porous morphology, and mechanical behavior on molecular weight and crystallinity of polylactide and concentration of the original solutions. On the basis of the foam characteristics, potential of the liquid-liquid phase separation (spinodal decomposition) has been compared with the solid/liquid phase separation (solvent crystallization) as a porogen technique.

Three-dimensional degradable porous polymer-ceramic matrices for use in bone repair

A degradable polymer-ceramic matrix for use as a bone graft material is described. The fabrication method used produces 3-dimensional macroporous matrices which are structurally similar to cancellous bone in their porosity, mechanically similar to cancellous bone in compressive elastic modulus and chemically comparable to the mineral matrix of bone in that they contain hydroxyapatite (HA). A 50:50 copolymer of poly(lactide/glycolide) (PLAGA) reinforced by a particulate calcium phosphate ceramic, HA, was used to create a matrix composed of polymeric microspheres. The channels between these spheres were pores approximately 100 microns in diameter. Four polymer/ceramic ratios were used in matrix fabrication: 1:0, 1:1, 2.5:1, and 5:1. The mechanical behavior of the material was found to vary with ceramic content. Increased levels of HA resulted in increased compressive elastic moduli. Prior to polymer degradation, moduli ranged from a high of 1459 MPa (50% HA) to a low of 293 MPa (0% HA). Degradation studies over a 6-week period showed that 0 and 16.7% HA-containing matrices lost up to 50% of their original weight, while the 28.6 and 50% IIA-containing matrices lost up to 20% of their original weight. Increased HA matrix content translated into decreased rates of matrix degradation. Environmental scanning electron microscopy (ESEM) confirmed that the polymer matrix contained pores that were interconnected during degradation. Viewed via ESEM, 10% HA containing matrices completely degraded by 6 weeks, while 50% HA matrices remained relatively stable. These studies indicate that the porous 3-dimensional polymer/ceramic matrix may potentially be useful as a synthetic material for bone repair.

Protein release kinetics of a biodegradable implant for fracture non-unions

Non-union of long bone fractures is often a serious complication of fracture healing. It is estimated that 100 000 non-unions occur in the united States annually and result in the loss of function of the involved limb. The present study was performed to develop a microporous polylactic acid-polyglycolic acid (PLA-PGA) implant for the delivery of bone morphogenetic protein (BMP) to sites of fracture non-unions, and to characterize the protein release kinetics of such an implant in vitro. A 50:50 copolymer of PLA-PGA was used to fabricate the implants using a gel formation technique. The implants were subjected to hydrolytic degradation in phosphate-buffered saline at 37 degrees C for up to 72 d. The protein release and the polymer degradation were monitored during this time period. The release kinetics of these implants were studied using a model protein, soybean trypsin inhibitor (TI), as well as BMP. The results indicate that there is a burst release of the proteins in the initial 48 h followed by a lower elution rate. The release of both the proteins followed similar trends. The molecular weight of the polymer decreased at a faster rate compared to its mass.

Resorbable synthetic polymers as replacements for bone graft

The potential of resorbable synthetic polymers derived from the poly(alpha-hydroxy acids), poly(lactide) and poly(glycolide), to fulfill a role as bone graft substitutes is reviewed. The various elements of the relationship between the degradation behaviour of resorbable implants and polymer synthesis and chain structure, implant morphology, processing and dimensions have been defined. The production of resorbable polymeric implants has been extensively documented so as to provide a wide basis for selection of an appropriate manufacturing technique. The key requirement of implant dimensional stability over the early stages of bone healing is emphasised so as to provide a stable surface on which osteoblasts and/or their precursor cells may migrate and secrete bone matrix. Minimisation of the content of slow resorbing polymers such as poly(L-lactide) is recommended, consistent with retention of an adequate implant degradation characteristic. The review concludes with a summary of alternative resorbable polymers such as the polyphosphazines which are interesting candidate materials for bone repair and reconstruction.

Gel casting of resorbable polymers. 2. In-vitro degradation of bone graft substitutes

Gel cast microporous materials produced from: slow resorbing, poly(L-lactide); fast resorbing, 50:50 poly(DL lactide coglycolide); and blends of these polymers have been characterized by weight loss, compression testing and thermal analysis after immersion in phosphate buffered saline (37 degrees C, pH 7.4) for times up to 6 months. Increasing weight loss and reduction in compressive properties with immersion time were measured. Blending reduces the rate of weight loss and material shrinkage relative to the copolymer. Thermal analysis of degraded samples revealed evidence of reorganization of the crystalline phase in poly(L-lactide) and a crystalline component in the 50:50 copolymer, estimated at 5-7% of the original material content, which is probably responsible for gel formation. Thermograms of the blend are effectively a superposition of thermograms of the individual components. Gel casting shows potential for varying the resorption rate, form stability and compressive properties of micro/macroporous bone graft substitutes.