Self-assembly of nano-hydroxyapatite on multi-walled carbon nanotubes

Review of the Applications of Biomedical Compositions Containing Hydroxyapatite and Collagen Modified by Bioactive Components

Regenerative medicine is becoming a rapidly evolving technique in today's biomedical progress scenario. Scientists around the world suggest the use of naturally synthesized biomaterials to repair and heal damaged cells. Hydroxyapatite (HAp) has the potential to replace drugs in biomedical engineering and regenerative drugs. HAp is easily biodegradable, biocompatible, and correlated with macromolecules, which facilitates their incorporation into inorganic materials. This review article provides extensive knowledge on HAp and collagen-containing compositions modified with drugs, bioactive components, metals, and selected nanoparticles. Such compositions consisting of HAp and collagen modified with various additives are used in a variety of biomedical applications such as bone tissue engineering, vascular transplantation, cartilage, and other implantable biomedical devices.

In vivo study of conductive 3D printed PCL/MWCNTs scaffolds with electrical stimulation for bone tissue engineering

Critical bone defects are considered one of the major clinical challenges in reconstructive bone surgery. The combination of 3D printed conductive scaffolds and exogenous electrical stimulation (ES) is a potential favorable approach for bone tissue repair. In this study, 3D conductive scaffolds made with biocompatible and biodegradable polycaprolactone (PCL) and multi-walled carbon nanotubes (MWCNTs) were produced using the extrusion-based additive manufacturing to treat large calvary bone defects in rats. Histology results show that the use of PCL/MWCNTs scaffolds and ES contributes to thicker and increased bone tissue formation within the bone defect. Angiogenesis and mineralization are also significantly promoted using high concentration of MWCNTs (3 wt%) and ES. Moreover, scaffolds favor the tartrate-resistant acid phosphatase (TRAP) positive cell formation, while the addition of MWCNTs seems to inhibit the osteoclastogenesis but present limited effects on the osteoclast functionalities (receptor activator of nuclear factor κβ ligand (RANKL) and osteoprotegerin (OPG) expressions). The use of ES promotes the osteoclastogenesis and RANKL expressions, showing a dominant effect in the bone remodeling process. These results indicate that the combination of 3D printed conductive PCL/MWCNTs scaffold and ES is a promising strategy to treat critical bone defects and provide a cue to establish an optimal protocol to use conductive scaffolds and ES for bone tissue engineering.

Aligned multi-walled carbon nanotubes with nanohydroxyapatite in a 3D printed polycaprolactone scaffold stimulates osteogenic differentiation

The development of highly biomimetic scaffolds in terms of composition and structures, to repair or replace damaged bone tissues, is particularly relevant for tissue engineering. This paper investigates a 3D printed porous scaffold containing aligned multi-walled carbon nanotubes (MWCNTs) and nano-hydroxyapatite (nHA), mimicking the natural bone tissue from the nanoscale to macroscale level. MWCNTs with similar dimensions as collagen fibres are coupled with nHA and mixed within a polycaprolactone (PCL) matrix to produce scaffolds using a screw-assisted extrusion-based additive manufacturing system. Scaffolds with different material compositions were extensively characterised from morphological, mechanical and biological points of views. Transmission electron microscopy and polarised Raman spectroscopy confirm the presence of aligned MWCNTs within the printed filaments. The PCL/HA/MWCNTs scaffold are similar to the nanostructure of native bone and shows overall increased mechanical properties, cell proliferation, osteogenic differentiation and scaffold mineralisation, indicating a promising approach for bone tissue regeneration.

In Vitro Osteogenesis Stimulation via Nano-Hydroxyapatite/Carbon Nanotube Thin Films on Biomedical Stainless Steel

We evaluated the electrophoretic deposition of nanohydroxyapatite/superhydrop hilic multiwalled carbon nanotube composites (nHAp/MWCNT) onto stainless steel biomedical alloys for applications in bone tissue engineering. First, nHAp/MWCNT composites were dispersed into 0.042 mol·L⁻¹ of Ca(NO₃)₂·4H₂O + 0.025 mol·L⁻¹ NH₄H₂PO₄ electrolytes (pH = 4.8) at two different concentrations. Next, a voltage of −2 V was applied using 316L stainless steel as a working electrode (0.27 cm²), a high-purity platinum coil wire was used as the auxiliary electrode, and an Ag/AgCl (3 M) electrode was used as the reference electrode. The nHAp/MWCNT composites were characterized by transmission electron microscopy. The deposited nHAp and nHAp/MWCNT films were characterized by profilometry, scanning electron microscopy, X-ray diffractometry and Raman spectroscopy. Human osteoblast cells were cultivated with the different materials and in vitro cytotoxicity was evaluated using lactate dehydrogenase (LDH) assay. The osteogenesis process was evaluated by mRNA levels of the three genes that are directly related to bone repair: Alkaline Phosphatase, Osteopontin and Osteocalcin. We showed that rough, crystalline apatite thin films containing phases of nHAp were successfully deposited onto 316L stainless steel alloys. Also, we noticed that nHAp/MWCNT thin films deposited onto 316L stainless steel alloys upregulated the expression of important genes related to bone mineralization and maturation. Our results strongly support the possibility of this new alternative to modify the surface of metallic biomedical alloys to promote bone tissue regeneration.

Graphene oxide/multi-walled carbon nanotubes as nanofeatured scaffolds for the assisted deposition of nanohydroxyapatite: characterization and biological evaluation

Nanohydroxyapatite (nHAp) is an emergent bioceramic that shows similar chemical and crystallographic properties as the mineral phase present in bone. However, nHAp presents low fracture toughness and tensile strength, limiting its application in bone tissue engineering. Conversely, multi-walled carbon nanotubes (MWCNTs) have been widely used for composite applications due to their excellent mechanical and physicochemical properties, although their hydrophobicity usually impairs some applications. To improve MWCNT wettability, oxygen plasma etching has been applied to promote MWCNT exfoliation and oxidation and to produce graphene oxide (GO) at the end of the tips. Here, we prepared a series of nHAp/MWCNT-GO nanocomposites aimed at producing materials that combine similar bone characteristics (nHAp) with high mechanical strength (MWCNT-GO). After MWCNT production and functionalization to produce MWCNT-GO, ultrasonic irradiation was employed to precipitate nHAp onto the MWCNT-GO scaffolds (at 1-3 wt%). We employed various techniques to characterize the nanocomposites, including transmission electron microscopy (TEM), Raman spectroscopy, thermogravimetry, and gas adsorption (the Brunauer-Emmett-Teller method). We used simulated body fluid to evaluate their bioactivity and human osteoblasts (bone-forming cells) to evaluate cytocompatibility. We also investigated their bactericidal effect against Staphylococcus aureus and Escherichia coli. TEM analysis revealed homogeneous distributions of nHAp crystal grains along the MWCNT-GO surfaces. All nanocomposites were proved to be bioactive, since carbonated nHAp was found after 21 days in simulated body fluid. All nanocomposites showed potential for biomedical applications with no cytotoxicity toward osteoblasts and impressively demonstrated a bactericidal effect without the use of antibiotics. All of the aforementioned properties make these materials very attractive for bone tissue engineering applications, either as a matrix or as a reinforcement material for numerous polymeric nanocomposites.

Synthesis and bioactivity of gelatin/multiwalled carbon nanotubes/hydroxyapatite nanofibrous scaffolds towards bone tissue engineering

The in vitro bioactivity of scaffolds, and the adhesion, mineralization, viability and proliferation of hFOBs on gelatin/MWNTs/HA nanofibrous scaffolds.

Carbon nanotubes: their potential and pitfalls for bone tissue regeneration and engineering

The extracellular environment which supports cell life is composed of a hierarchy of maintenance, force and regulatory systems which integrate from the nano- through to macroscale. For this reason, strategies to recreate cell supporting environments have been investigating the use of nanocomposite biomaterials. Here, we review the use of carbon nanotubes as part of a bottom-up approach for use in bone tissue engineering. We evaluate the properties of carbon nanotubes in the context of synthetic tissue substrates and contrast them with the nanoscale features of the extracellular environment. Key studies are evaluated with an emphasis on understanding the mechanisms through which carbon nanotubes interact with biological systems. This includes an examination of how the different properties of carbon nanotubes affect tissue growth, how these properties and variation to them might be leveraged in regenerative tissue therapies and how impurities or contaminates affect their toxicity and biological interaction.

FROM THE CLINICAL EDITOR

In this comprehensive review, the authors describe the status and potential applications of carbon nanotubes in bone tissue engineering.

Electrospun fibrous scaffolds with continuous gradations in mineral contents and biological cues for manipulating cellular behaviors

Challenges remain in the generation of heterogeneous tissues and the repairing of interfacial tissue between soft and hard tissues. The development of tissue engineering scaffolds with gradients in composition, structure, mechanical and chemical properties is essential to modulate cellular behaviors in a graded way and potentially support the growth of functionally graded tissues. Integrated with the three-dimensional (3-D) nanofibrous skeletal structure of native extracellular matrix, electrospun fibers with gradients in amino groups were generated in the current study through an aminolysis process by using a microinfusion pump. Gelatin grafts were constructed to create fibrous scaffolds with gradients in hydroxyapatite (HA) contents, crystal size and mechanical properties through in situ mineralization. Plasmid DNA (pDNA) was included during the mineralization process, and gradations in pDNA loading contents were created on fibrous scaffolds on the basis of HA gradients. Obvious gradients in cell density, osteoblastic differentiation and collagen deposition were demonstrated along the long axis of fibrous mats after cell seeding. Gradients in the amount of pDNA released and the expression of target proteins were indicated on the fibrous mats, which offered a temporally and spatially controlled delivery of growth factors in scaffolds. The creation of gradient futures on 3-D fibrous scaffolds may provide physical, chemical and biological cues and result in efficient regeneration of tissues with spatial distributions of the cell proliferation, differentiation, and matrix secretion.

Biomineralization of superhydrophilic vertically aligned carbon nanotubes

Vertically aligned carbon nanotubes (VACNT) promise a great role for the study of tissue regeneration. In this paper, we introduce a new biomimetic mineralization routine employing superhydrophilic VACNT films as highly stable template materials. The biomineralization was obtained after VACNT soaking in simulated body fluid solution. Detailed structural analysis reveals that the polycrystalline biological apatites formed due to the -COOH terminations attached to VACNT tips after oxygen plasma etching. Our approach not only provides a novel route for nanostructured materials, but also suggests that COOH termination sites can play a significant role in biomimetic mineralization. These new nanocomposites are very promising as nanobiomaterials due to the excellent human osteoblast adhesion.

Tantalum oxide/carbon nanotubes composite coatings on titanium, and their functionalization with organophosphonic molecular films: a high quality scaffold for hydroxyapatite growth

Nowadays, titanium is a very commonly used biomaterial for the preparation of orthopedic and dental implants. Its excellent mechanical and biochemical bulk properties are nevertheless counterbalanced by its propensity to long term degradation in physiological conditions and its weak osseointegrative capacities. In this context, surface modifications can significantly hinder titanium weaknesses. The approach considered in this work relies on the preparation of thin composite coatings based on tantalum oxide and carbon nanotubes by sol-gel process. Tantalum is particularly interesting for its high biocompatibility and bioactivity, as well as its strong resistance to bio-corrosion. Carbon nanotubes are exploited to reinforce the compactness and homogeneity of the coatings, and can act as a favorable factor to strengthen the interaction with bone components by biomimicry. The composite layers are further modified with specific organophosphonic acid molecular films, able to chemically bind the tantalum oxide surface and improve the hydroxyapatite formation process. The characteristics and the qualities of these hybrid inorganic/organic coatings are evaluated by XPS, SEM, TEM, peeling tests, contact angle measurements, and electrochemical characterizations (free potential, polarization curves).

Nanoscale hydroxyapatite particles for bone tissue engineering

Hydroxyapatite (HAp) exhibits excellent biocompatibility with soft tissues such as skin, muscle and gums, making it an ideal candidate for orthopedic and dental implants or components of implants. Synthetic HAp has been widely used in repair of hard tissues, and common uses include bone repair, bone augmentation, as well as coating of implants or acting as fillers in bone or teeth. However, the low mechanical strength of normal HAp ceramics generally restricts its use to low load-bearing applications. Recent advancements in nanoscience and nanotechnology have reignited investigation of nanoscale HAp formation in order to clearly define the small-scale properties of HAp. It has been suggested that nano-HAp may be an ideal biomaterial due to its good biocompatibility and bone integration ability. HAp biomedical material development has benefited significantly from advancements in nanotechnology. This feature article looks afresh at nano-HAp particles, highlighting the importance of size, crystal morphology control, and composites with other inorganic particles for biomedical material development.

Carbon nanotubes in nanocomposites and hybrids with hydroxyapatite for bone replacements

Hydroxyapatite (HA), as a bone mineral component, has been an attractive bioceramic for the reconstruction of hard tissues. However, its poor mechanical properties, including low fracture toughness and tensile strength, have been a significant challenge to the application of HA for the replacement of load-bearing and/or large bone defects. Among materials studied to reinforce HA, carbon nanotubes (CNTs: single-walled or multiwalled) have recently gained significant attention because of their unprecedented mechanical properties (high strength and toughness) and physicochemical properties (high surface area, electrical and thermal conductivity, and low weight). Here, we review recent studies of the organization of HA-CNTs at the nanoscale, with a particular emphasis on the functionalization of CNTs and their dispersion within an HA matrix and induction of HA mineralization. The organization of CNTs and HA implemented at the nanoscale can further be developed in the form of coatings, nanocomposites, and hybrid powders to enable potential applications in hard tissue reconstruction.

Synthesis and characterization of biomimetic hydroxyapatite/sepiolite nanocomposites

Natural fibrous sepiolite with a high surface area, negative surface charge and porous structure is promising for hydroxyapatite (HAp) mineralization since the clay is naturally abundant and biocompatible. In this paper, the use of fibrous sepiolite as a template for growth of HAp nanocrystals was reported for the first time. Carbonated HAp nanorods with dimensions of 20-60 nm in length and 10-20 nm in diameter were successfully grown on the sepiolite surface with a preferred orientation to the c-axis. The critical nucleus radius of HAp in the presence of natural sepiolite was estimated as 0.296-0.312 nm. Strong acid-activation increased the specific surface area of the sepiolite by 205% and also transformed the sepiolite to silica fiber with an elastic modulus being 395% of the original value. The novel HAp/acid-activated sepiolite biocomposite has a specific surface area of 182 m2 g(-1) and an elastic modulus of over 20 GPa, considerably higher than those of the HAp synthesized without sepiolite. Such hierarchically assembled HAp/sepiolite biocomposites with controlled size and improved modulus open a new way to expand the applications of naturally abundant clays in biological load-bearing devices.

Fast preparation of hydroxyapatite/superhydrophilic vertically aligned multiwalled carbon nanotube composites for bioactive application

A method for the electrodeposition of hydroxyapatite films on superhydrophilic vertically aligned multiwalled carbon nanotubes is presented. The formation of a thin homogeneous film with high crystallinity was observed without any thermal treatment and with bioactivity properties that accelerate the in vitro biomineralization process and osteoblast adhesion.

In vitro calcification of chemically functionalized carbon nanotubes

Bone is composed of two phases. The organic phase is made of collagen fibrils assembled in broad fibers acting as a template for mineralization. The mineral phase comprises hydroxyapatite (HAP) crystals grown between and inside the collagen fibers. We have developed a biomimetic material using functionalized carbon nanotubes as scaffold to initiate in vitro mineralization. Biomimetic formation of HAP was performed on single-walled carbon nanotubes (SWCNTs) which have been grafted with carboxylic groups. Two types of nanotubes, HiPco(R) and Carbon Solutions(R), were oxidized via various acidic processes, leading to five different groups of carboxylated nanotubes, fully characterized by physical methods (thermogravimetric analysis, attenuated total reflectance infrared spectroscopy and X-ray photoelectron spectroscopy). All samples were dispersed in ultra-pure water and incubated for 2weeks in a synthetic body fluid, in order to induce the calcification of the SWCNTs. Scanning electron microscopy (SEM) and energy-dispersive X-ray analysis studies showed that Ca(2+) and PO(4)(3-) ions were deposited as round-shaped nodules (calcospherites) on the carboxylated SWCNTs. Fourier transform infrared and Raman spectroscopic studies confirmed the HAP formation, and image analysis made on SEM pictures showed that calcospherites and carboxylated SWCNTs were packed together. The size of calcospherites thus obtained in vitro from the HiPco(R) series was close to that issued from calcospherites observed in vivo. Functionalization of SWCNTs with carboxylic groups confers the capacity to induce calcification similar to woven bone.

MWCNTs as reinforcing agent to the hap-gel nanocomposite for artificial bone grafting

The essence of this investigation is to explore MWCNTs as reinforcing agents to strengthen Hap-Gel nanocomposites for artificial bone grafting applications without significantly compromising their biocompatibility. Hap-Gelatin composites, reinforced with various proportions of MWCNTs, were synthesized to optimize the MWCNT content in the composites which yield commendable improvement in the strength. The morphological studies reveal that the MWCNTs act as templates for nucleation of Hap crystals. The biocompatibility of MWCNT reinforced Hap-Gelatin composites were evaluated in animal model through the histopathological investigation of tissues from skin, kidney, and liver. On histopathological examination, no noticeable alteration due to toxicity was found for lower concentration of MWCNTs. Mild reversible changes in the liver and tubular damage in kidney have been observed for higher concentration (4 wt % of MWCNTs). It can be inferred from the findings that MWCNTs, in proportions less than 4%, can successfully be used to reinforce the Hap-Gel nanocomposite to improve its mechanical properties. However, how safe would these CNT reinforced bone implants would be when used for prolonged period in actual physiological conditions needs to be investigated further.

The functionalization of multi-walled carbon nanotubes by in situ deposition of hydroxyapatite

A simple and effective approach was introduced to functionalize multi-walled carbon nanotubes (MWNTs) by in situ deposition of hydroxyapatite (HA) to improve their hydrophilicity and biocompatibility. Firstly, we prepared two types of pre-functionalized MWNTs: acid-oxidated MWNTs and covalently modified MWNTs by poly (ethylene glycol) (PEG). The influences of the acid-oxidated time, pre-phosphorylation, and PEGylation of MWNTs on in situ growth of HA were further investigated in simulated body fluid (SBF) with ionic concentration: 2, 5 and 10 times, respectively, at 37 degrees C for 24h. The results exhibited that all these factors have positive effects on the HA crystals growth, especially the PEGylation of MWNTs plays a key role during the deposition. Finally, the methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate their cytotoxicity, which showed that the PEGylated MWNTs wrapped by HA crystals have the best biocompatibility.

Hydroxyapatite nucleation and growth mechanism on electrospun fibers functionalized with different chemical groups and their combinations

Controlled nucleation and growth of hydroxyapatite (HA) crystals on electrospun fibers should play important roles in fabrication of composite scaffolds for bone tissue engineering, but no attempt has been made to clarify the effects of chemical group densities and the cooperation of two and more groups on the biomineralization process. The aim of the current study was to investigate into HA nucleation and growth on electrospun poly(dl-lactide) fibers functionalized with carboxyl, hydroxyl and amino groups and their combinations. Electrospun fibers with higher densities of carboxyl groups, combination of hydroxyl and carboxyl groups with the ratio of 3/7, and combination of amino, hydroxyl and carboxyl groups with the ratio of 2/3/5 were favorable for HA nucleation and growth, resulting in higher content and lower crystal size of formed HA. Carboxyl groups were initially combined with calcium ions through electrostatic attraction, and the introduction of hydroxyl groups could modulate the distance between carboxyl groups. The introduction of amino groups may lead to the inner ionic bonding with carboxyl groups, but can accelerate phosphate ions to form HA through a chelate ring with the calcium ion and carbonyl oxygen. The biological evaluation indicated that the mineralized scaffolds acted as an excellent cell support to maintain desirable cell-substrate interactions, to provide favorable conditions for cell proliferation and to stimulate the osteogenic differentiation.

Nanosized and nanocrystalline calcium orthophosphates

Recent developments in biomineralization have already demonstrated that nanosized crystals and particles play an important role in the formation of hard tissues of animals. Namely, it is well established that the basic inorganic building blocks of bones and teeth of mammals are nanosized and nanocrystalline calcium orthophosphates in the form of apatites. In mammals, tens to hundreds nanocrystals of a biological apatite have been found to be combined into self-assembled structures under the control of bioorganic matrixes. Therefore, application and prospective use of the nanosized and nanocrystalline calcium orthophosphates for a clinical repair of damaged bones and teeth are also well known. For example, greater viability and better proliferation of various types of cells have been detected on smaller crystals of calcium orthophosphates. Thus, the nanosized and nanocrystalline forms of calcium orthophosphates have great potential to revolutionize the hard tissue-engineering field, starting from bone repair and augmentation to controlled drug delivery systems. This paper reviews the current state of art and recent developments of various nanosized and nanocrystalline calcium orthophosphates, starting from synthesis and characterization to biomedical and clinical applications. The review also provides possible directions for future research and development.

Nanodimensional and Nanocrystalline Apatites and Other Calcium Orthophosphates in Biomedical Engineering, Biology and Medicine

Recent developments in biomineralization have already demonstrated that nanosized particles play an important role in the formation of hard tissues of animals. Namely, the basic inorganic building blocks of bones and teeth of mammals are nanodimensional and nanocrystalline calcium orthophosphates (in the form of apatites) of a biological origin. In mammals, tens to hundreds nanocrystals of a biological apatite were found to be combined into self-assembled structures under the control of various bioorganic matrixes. In addition, the structures of both dental enamel and bones could be mimicked by an oriented aggregation of nanosized calcium orthophosphates, determined by the biomolecules. The application and prospective use of nanodimensional and nanocrystalline calcium orthophosphates for a clinical repair of damaged bones and teeth are also known. For example, a greater viability and a better proliferation of various types of cells were detected on smaller crystals of calcium orthophosphates. Thus, the nanodimensional and nanocrystalline forms of calcium orthophosphates have a great potential to revolutionize the field of hard tissue engineering starting from bone repair and augmentation to the controlled drug delivery devices. This paper reviews current state of knowledge and recent developments of this subject starting from the synthesis and characterization to biomedical and clinical applications. More to the point, this review provides possible directions of future research and development.

Various Nanotube Scaffolds for Cell Proliferation

Carbon nanotubes (CNT) and their derivatives with different structure and compositions have unique features. In the present study, cell proliferation was performed on various nanotubes such as single walled CNTs, multiwalled CNTs and imogolite which is nanotubes of aluminosilicate. SEM observation of the growth of osteoblast-like cells cultured on CNTs showed the morphology fully developed for the whole direction, which was different from that extended to the one direction on the usual scaffold. Numerous filopodia were grown from cell edge, extended far long and combined with CNT meshwork. Apatite precipitation in simulated body fluid, affinity for proteins and saccharides, and nanosize meshwork structure with large porosity would be the properties responsible for these cell adhesion and growth. Imogolite showed the similar properties to CNTs. Nanotubes could be the favorable materials for biomedical applications.

Collagen/silk fibroin bi-template induced biomimetic bone-like substitutes

A novel bi-template induced co-assembly method was employed to fabricate biomimetic bone substitute materials, collagen (COL)-fibroin/hydroxyapatite (COL-SF/HA) composite by using a combination of Type I COL and silk fibroin (SF) molecular templates. As a control, COL/HA and SF/HA composites were also synthesized via single-template assembly technology. The structure and morphology of the resulting assembly composites were investigated by X-ray diffractometer, Fourier transform infrared spectra, transmission electron microscope, and thermogravimetric analysis. Their sizes and size distributions were measured by DLS. The results indicated that the mineral phases in COL-SF/HA, COL-HA, and SF-HA composites were needle-like nano-HA crystals. In comparison to those in COL-HA and SF-HA, the mineral phase in COL-SF/HA displayed smaller size and more narrow distribution. Of all above biomimetic composites, the HA was well assembled with molecular template(s), and the organic content of the composite was about 12%-20%, which was quite similar to the natural bone in composition. CD and SDS-PAGE were used to examine the secondary structure and subunit composition of template proteins. The results revealed that the spatial structure of co-assembly template proteins played a pivotal role in controlling and regulating HA crystal nucleation and growth. Based on the experimental results above, a possible co-assembly mechanism for the HA growing on fibrous bi-template proteins was suggested.

Material nanosizing effect on living organisms: non-specific, biointeractive, physical size effects

Nanosizing effects of materials on biological organisms was investigated by biochemical cell functional tests, cell proliferation and animal implantation testing. The increase in specific surface area causes the enhancement of ionic dissolution and serious toxicity for soluble, stimulative materials. This effect originates solely from materials and enhances the same functions as those in a macroscopic size as a catalyst. There are other effects that become prominent, especially for non-soluble, biocompatible materials such as Ti. Particle size dependence showed the critical size for the transition of behaviour is at approximately 100 microm, 10 microm and 200 nm. This effect has its origin in the biological interaction process between both particles and cells/tissue. Expression of superoxide anions, cytokines tumour necrosis factor-alpha and interleukin-1 beta from neutrophils was increased with the decrease in particle size and especially pronounced below 10 microm, inducing phagocytosis to cells and inflammation of tissue, although inductively coupled plasma chemical analysis showed no dissolution from Ti particles. Below 200 nm, stimulus decreases, then particles invade into the internal body through the respiratory or digestive systems and diffuse inside the body. Although macroscopic hydroxyapatite, which exhibits excellent osteoconductivity, is not replaced with natural bone, nanoapatite composites induce both phagocytosis of composites by osteoclasts and new bone formation by osteoblasts when implanted in bone defects. The progress of this bioreaction results in the conversion of functions to bone substitution. Although macroscopic graphite is non-cell adhesive, carbon nanotubes (CNTs) are cell adhesive. The adsorption of proteins and nano-meshwork structure contribute to the excellent cell adhesion and growth on CNTs. Non-actuation of the immune system except for a few innate immunity processes gives the non-specific nature to the particle bioreaction and restricts reaction to the size-sensitive phagocytosis. Materials larger than cell size, approximately 10 microm, behave inertly, but those smaller become biointeractive and induce the intrinsic functions of living organisms. This bioreaction process causes the conversion of functions such as from biocompatibility to stimulus in Ti-abraded particles, from non-bone substitutional to bone substitutional in nanoapatite and from non-cell adhesive to cell adhesive CNTs. The insensitive nature permits nanoparticles that are less than 200 nm to slip through body defence systems and invade directly into the internal body.