Chemical, modulus and cell attachment studies of reactive calcium phosphate filler-containing fast photo-curing, surface-degrading, polymeric bone adhesives

Gelatin-Sodium Alginate Hydrogels Cross-Linked by Squaric Acid and Dialdehyde Starch as a Potential Bio-Ink

Hydrogels as biomaterials possess appropriate physicochemical and mechanical properties that enable the formation of a three-dimensional, stable structure used in tissue engineering and 3D printing. The integrity of the hydrogel composition is due to the presence of covalent or noncovalent cross-linking bonds. Using various cross-linking methods and agents is crucial for adjusting the properties of the hydrogel to specific biomedical applications, e.g., for direct bioprinting. The research subject was mixtures of gel-forming polymers: sodium alginate and gelatin. The polymers were cross-linked ionically with the addition of CaCl2 solutions of various concentrations (10%, 5%, 2.5%, and 1%) and covalently using squaric acid (SQ) and dialdehyde starch (DAS). Initially, the polymer mixture's composition and the hydrogel cross-linking procedure were determined. The obtained materials were characterized by mechanical property tests, swelling degree, FTIR, SEM, thermal analysis, and biological research. It was found that the tensile strength of hydrogels cross-linked with 1% and 2.5% CaCl2 solutions was higher than after using a 10% solution (130 kPa and 80 kPa, respectively), and at the same time, the elongation at break increased (to 75%), and the stiffness decreased (Young Modulus is 169 kPa and 104 kPa, respectively). Moreover, lowering the concentration of the CaCl2 solution from 10% to 1% reduced the final material's toxicity. The hydrogels cross-linked with 1% CaCl2 showed lower degradation temperatures and higher weight losses than those cross-linked with 2.5% CaCl2 and therefore were less thermally stable. Additional cross-linking using SQ and DAS had only a minor effect on the strength of the hydrogels, but especially the use of 1% DAS increased the material's elasticity. All tested hydrogels possess a 3D porous structure, with pores of irregular shape and heterogenic size, and their swelling degree initially increased sharply to the value of approx. 1000% during the first 6 h, and finally, it stabilized at a level of 1200-1600% after 24 h. The viscosity of 6% gelatin and 2% alginate solutions with and without cross-linking agents was similar, and they were only slightly shear-thinning. It was concluded that a mixture containing 2% sodium alginate and 6% gelatin presented optimal properties after gel formation and lowering the concentration of the CaCl2 solution to 1% improved the hydrogel's biocompatibility and positively influenced the cross-linking efficiency. Moreover, chemical cross-linking by DAS or SQ additionally improved the final hydrogel's properties and the mixture's printability. In conclusion, among the tested systems, the cross-linking of 6% gelatin-2% alginate mixtures by 1% DAS addition and 1% CaCl2 solution is optimal for tissue engineering applications and potentially suitable for 3D printing.

Design of Multi-Functional Bio-Safe Dental Resin Composites with Mineralization and Anti-Biofilm Properties

This study aims to develop multi-functional bio-safe dental resin composites with capabilities for mineralization, high in vitro biocompatibility, and anti-biofilm properties. To address this issue, experimental resin composites consisting of UDMA/TEGDMA-based dental resins and low quantities (1.9, 3.8, and 7.7 vol%) of 45S5 bioactive glass (BAG) particles were developed. To evaluate cellular responses of resin composites, MC3T3-E1 cells were (1) exposed to the original composites extracts, (2) cultured directly on the freshly cured resin composites, or (3) cultured on preconditioned composites that have been soaked in deionized water (DI water), a cell culture medium (MEM), or a simple HEPES-containing artificial remineralization promotion (SHARP) solution for 14 days. Cell adhesion, cell viability, and cell differentiation were, respectively, assessed. In addition, the anti-biofilm properties of BAG-loaded resin composites regarding bacterial viability, biofilm thickness, and biofilm morphology, were assessed for the first time. In vitro biological results demonstrated that cell metabolic activity and ALP expression were significantly diminished when subjected to composite extracts or direct contact with the resin composites containing BAG fillers. However, after the preconditioning treatments in MEM and SHARP solutions, the biomimetic calcium phosphate minerals on 7.7 vol% BAG-loaded composites revealed unimpaired or even better cellular processes, including cell adhesion, cell proliferation, and early cell differentiation. Furthermore, resin composites with 1.9, 3.8, and 7.7 vol% BAG could not only reduce cell viability in S. mutans biofilm on the composite surface but also reduce the biofilm thickness and bacterial aggregations. This phenomenon was more evident in BAG7.7 due to the high ionic osmotic pressure and alkaline microenvironment caused by BAG dissolution. This study concludes that multi-functional bio-safe resin composites with mineralization and anti-biofilm properties can be achieved by adding low quantities of BAG into the resin system, which offers promising abilities to mineralize as well as prevent caries without sacrificing biological activity.

Bone adhesive materials: From bench to bedside

Biodegradable bone adhesives represent a highly sought-after type of biomaterial which would enable replacement of traditional metallic devices for fixation of bone. However, these biomaterials should fulfil an extremely large number of requirements. As a consequence, bone-adhesive biomaterials which meet all of these requirements are not yet commercially available. Therefore, this comprehensive review provides an extensive overview of the development of bone adhesives from a translational perspective. First, the definition, classification, and chemistry of various types of bone adhesives are highlighted to provide a detailed overview of this emerging class of biomaterials. In this review we particularly focused studies which describe the use of materials that are capable of gluing two pieces of bone together within a time frame of minutes to days. Second, this review critically reflects on i) the experimental conditions of commonly employed adhesion tests to assess bone adhesion and ii) the current state-of-the-art regarding their preclinical and clinical applicability.

Biocompatibility and Antibiofilm Properties of Calcium Silicate-Based Cements: An In Vitro Evaluation and Report of Two Clinical Cases

Simple Summary

Calcium silicate-based cements are successfully applied in the different fields of endodontics and vital pulp therapy. To better assess the properties of these bioactive materials, the present in vitro and in vivo study aimed to compare the biocompatibility and antibiofilm properties of ProRoot MTA and Biodentine. Human osteogenic sarcoma (Saos-2) cells were cultured in the presence of both materials and evaluated. Moreover, the bioactive cements were in vivo applied to perform vital pulp therapy on immature permanent teeth affected by reversible pulpitis. Saos-2 cells’ viability was slightly greater in the presence of ProRootMTA than Biodentine and cells would grow in a better way on ProRootMTA disks than on Biodentine ones. Moreover, ProRootMTA showed a powerful antibiofilm effect towards Streptococcus mutans. The in vitro results were clinically supported by a 100% success rate after 2 years of follow-up.

Abstract

Calcium silicate-based cements have reached excellent levels of performance in endodontics, providing predictable and successful results. To better assess the properties of these bioactive materials, the present study aimed to compare the biocompatibility and antibiofilm properties of ProRoot MTA and Biodentine. Human osteogenic sarcoma (Saos-2) cells were cultured on ProRoot MTA and Biodentine samples or in the presence of both cement extracts. Cell viability assay, measurement of reactive oxygen species (ROS), immunofluorescence analysis, as well as morphological evaluations were conducted. Moreover, Streptococcus mutans was used to assess the biofilm forming ability on ProRoot MTA and Biodentine disks. Finally, both cements were applied in vivo to treat immature permanent teeth affected by reversible pulpitis. Results: Cell viability assay demonstrated that Saos-2 cells had a dose- and time-dependent cytotoxicity to both analyzed cements, although cells exposed to ProRoot MTA showed a better cell vitality than those exposed to Biodentine (p < 0.001). Both cements demonstrated ROS production while this was greater in the case of Biodentine than ProRoot MTA (p < 0.001). Immunofluorescence images of the cytoskeleton and focal adhesions showed no differences in Saos-2 cells grown in the presence of ProRoot MTA eluate; whereas in the Biodentine groups, cells showed a morphology and focal adhesions more similar to that of the control sample, as the eluate concentration decreased. Morphological analysis revealed that Saos-2 cells were more flattened and exhibited better spreading when attached to ProRoot MTA disks than to Biodentine ones. The antibiofilm properties showed a time-dependent powerful inhibition of S. mutans superficial colonization and an antibiofilm effect of both cements. Clinically, complete root formation of the treated elements was achieved using the two studied cements, showing stable results over time. ProRoot MTA and Biodentine was demonstrated to be biocompatible and to possess antibiofilm properties. Their clinical application in vital pulp therapy provided successful outcomes after 2 years of follow-up.

A Systematic Study of the Effect of pH on the Initialization of Ca-deficient Hydroxyapatite to β-TCP Nanoparticles

The formation of β-tricalcium phosphate (β-TCP) nanoparticles via a wet precipitation technique was studied in a systematical way, taking reaction pH and sintering temperature parameters into account. A full transformation of Ca-deficient hydroxyapatite (CDHA) to β-TCP at 750 °C in under 3 hours from Ca++ and PO₄3- precursor solutions prepared under a pH of 5.5 was observed. For pH values higher than 6.5, CDHA can only partially transform into β-TCP and only at temperatures higher than 750 °C confirmed using X-Ray diffraction and Raman spectroscopy. The morphologies of the particles were also examined by Transmission electron microscopy. The lower temperatures and the shorter sintering time allow for a fine needle-like morphology, but with a high crystallinity, likely eliminating the possibility of excessive grain growth that is otherwise expected to occur under high-temperature treatment with long process times. We show that sintering of nanostructured, high crystallinity β-TCP at relatively low temperatures is possible via adjustment of the precursor solution parameters. Such an outcome is important for the use of β-TCP with a fine morphology imitating that of the skeletal tissues, enhancing the osteointegration of a base, load-bearing alloy to the host tissue. MTT analysis was used to test the effect of the obtained β-TCP particles on the viability of MG-63 human osteoblast-like cells.

Preparation and properties of calcium-silicate filled resins for dental restoration. Part I: chemical-physical characterization and apatite-forming ability

OBJECTIVE

The aim of this study was to measure dimensional changes due to hygroscopic expansion and the bioactivity of two experimental methacrylate-based dental adhesives either incorporating Bioglass 45S5 (3-E&RA/BG) or MTA (3-E&RA/WMTA).

MATERIALS AND METHODS

3-E&RA/BG, 3-E&RA/WMTA and a control filler-free resin blend (3-E&RA) were formulated from commercially available monomers. Water sorption (WS) and solubility (SL) behaviour were evaluated by weighing material disks at noted intervals; the relationship between degree of hydration and the glass transition temperature (Tg) was investigated by using differential scanning calorimetry (DSC). In vitro apatite-forming ability as a function of soaking time in phosphate-containing solutions was also determined. Kruskal-Wallis analysis of variance (ANOVA) was used to evaluate differences between groups for maximum WS, SL, net water uptake and the percentage change in Tg values. Post-ANOVA pair-wise comparisons were conducted using Mann-Whitney-U tests.

RESULTS

3-E&RA/BG and 3-E&RA/WMTA exhibited values of maximum WS and net water uptake that were significantly higher when compared to 3-E&RA. However, no statistically significant differences were observed in terms of SL between all the adhesives. The addition of the Bioglass 45S5 and MTA to the 3-E&RA showed no reduction of the Tg after 60 days of storage in deionized water. ATR Fourier Transform Infrared Spectroscopy (ATR-FTIR) of the filled resin disks soaked in DPBS for 60 days showed the presence of carbonate ions in different chemical phases.

CONCLUSION

Dentine bonding agents comprising calcium-silicates are not inert materials in a simulated oral environment and apatite formation may occur in the intra-oral conditions.

CLINICAL SIGNIFICANCE

A bioactive dental material which forms apatite on the surface would have several benefits including closure of gaps forming at the resin-dentine interface and potentially better bond strength over time (less degradation of bond).

Influence of Calcium Ions on Cell Survival and Proliferation in the Context of an Alginate Hydrogel

One goal of biofabrication is to incorporate living cells into artificial scaffolds in order to repair damaged tissues or organs. Although there are many studies on various biofabrication techniques, the maintenance of cell viability during the biofabrication process and cell proliferation after the process is still a challenging issue. Construction of scaffolds using hydrogels composed of natural materials can avoid exposure of cells to harsh chemicals or temperature extremes but can still entail exposure to non-physiological conditions, causing cell damage or even death. This paper presents an experimental investigation into the influence on Schwann cell survival and proliferation of calcium used for ionic crosslinking of alginate hydrogel during the biofabrication process. The experimental results obtained show the viability and proliferation capacity of cells, either suspended in cell culture medium or encapsulated in hydrogel, and vary with the calcium concentration and the time period of cells exposed to the calcium environment. The experimental results also show the alginate concentration and cell density, that have profound influence on cell survival and proliferation, and solution viscosity as well. This study suggests the incorporation of living cells in calcium-crosslinked hydrogel in the biofabrication process can be regulated for controlled cell survival and proliferation.

Dicalcium phosphate cements: brushite and monetite

Dicalcium phosphate cements were developed two decades ago and ever since there has been a substantial growth in research into improving their properties in order to satisfy the requirements needed for several clinical applications. The present paper presents an overview of the rapidly expanding research field of the two main dicalcium phosphate bioceramics: brushite and monetite. This review begins with a summary of all the different formulae developed to prepare dicalcium phosphate cements, and their setting reaction, in order to set the scene for the key cement physical and chemical properties, such as compressive and tensile strength, cohesion, injectability and shelf-life. We address the issue of brushite conversion into either monetite or apatite. Moreover, we discuss the in vivo behavior of the cements, including their ability to promote bone formation, biodegradation and potential clinical applications in drug delivery, orthopedics, craniofacial surgery, cancer therapy and biosensors.

Viscoelastic and biological performance of low-modulus, reactive calcium phosphate-filled, degradable, polymeric bone adhesives

The aim of this study was to investigate the effect of reactive mono- and tricalcium phosphate addition on the mechanical, surface free energy, degradation and cell compatibility properties of poly(lactide-co-propylene glycol-co-lactide) dimethacrylate (PPGLDMA) thin films. Dry composites containing up to 70 wt.% filler were in a flexible rubber state at body temperature. Filler addition increased the initial strength and Young’s modulus and reduced the elastic and permanent deformation under load. The polymer had high polar surface free energy, which might enable greater spread upon bone. This was significantly reduced by filler addition but not by water immersion for 7 days. The samples exhibited reduced water sorption and associated bulk degradation when compared with previous work with thicker samples. Their cell compatibility was also improved. Filler raised water sorption and degradation but improved cell proliferation. The materials are promising bone adhesive candidates for low-load-bearing areas.

Cell attachment and response to photocured, degradable bone adhesives containing tricalcium phosphate and purmorphamine

The aim of this study was to quantify and provide evidence as to how addition of tricalcium phosphate (β-TCP) and the Hedgehog agonist purmorphamine to a degradable bone adhesive affects cell attachment/proliferation and Hedgehog pathway activation. Fourier transform infrared spectroscopy demonstrated that high levels (75 wt.%) of β-TCP addition reduced the photocure rate of the chosen poly(propylene glycol-co-lactide) dimethacrylate (PPLM) bone adhesive, but this problem was overcome by increased light exposure. In phosphate-buffered saline the total surface mass loss of set 15 mm diameter PPLM films was ∼3.2 mg in 12 weeks, irrespective of thickness (200 or 400 μm) or β-TCP level (50 or 75 wt.%). With 400 μm samples there was additional bulk material loss. Proliferation of pre-osteoblast cells (MC3T3-E1) on the set adhesive surfaces was enhanced by decreased sample thickness or filler content increase. Degradation evidence suggested that both effects were due to reduced acidic polymeric degradation products. Activation of the Hedgehog pathway was quantified by measuring Gli expression in Light II reporter cells. The 0.01 and 0.1 wt.% purmorphamine in composite discs (400 μm, 75 wt.% β-TCP) enhanced Gli expression of attached cells 2- and 5-fold, respectively, without influencing their number. Pre-storage of the composite samples in culture medium had no detrimental effect on this response. Furthermore, sample storage medium gave no enhanced Gli expression in cells on tissue culture plastic. This suggests drug release levels were very low. Purmorphamine and β-TCP incorporation in PPLM adhesives might, therefore, provide prolonged enhancement of in vivo bone repair without systemic drug side-effects.

Stereolithographic bone scaffold design parameters: osteogenic differentiation and signal expression

Scaffold design parameters including porosity, pore size, interconnectivity, and mechanical properties have a significant influence on osteogenic signal expression and differentiation. This review evaluates the influence of each of these parameters and then discusses the ability of stereolithography (SLA) to be used to tailor scaffold design to optimize these parameters. Scaffold porosity and pore size affect osteogenic cell signaling and ultimately in vivo bone tissue growth. Alternatively, scaffold interconnectivity has a great influence on in vivo bone growth but little work has been done to determine if interconnectivity causes changes in signaling levels. Osteogenic cell signaling could be also influenced by scaffold mechanical properties such as scaffold rigidity and dynamic relationships between the cells and their extracellular matrix. With knowledge of the effects of these parameters on cellular functions, an optimal tissue engineering scaffold can be designed, but a proper technology must exist to produce this design to specification in a repeatable manner. SLA has been shown to be capable of fabricating scaffolds with controlled architecture and micrometer-level resolution. Surgical implantation of these scaffolds is a promising clinical treatment for successful bone regeneration. By applying knowledge of how scaffold parameters influence osteogenic cell signaling to scaffold manufacturing using SLA, tissue engineers may move closer to creating the optimal tissue engineering scaffold.

Study of microscale hydraulic jump phenomenon for hydrodynamic trap-and-release of microparticles

Easy trap-and-release of microparticles is necessary to study biological cellular behavior. The hydraulic jump phenomenon inspired us to conceive a microfluidic device for the hydrodynamic trap-and-release of microparticles. A sudden height increase in a microfluidic channel leads to a dramatic decrease in flow velocity, allowing effective trapping of the microparticles by energy conversion. The trapped particles can be released by stronger inertial force based on simply increasing the flow velocity. We present a systematic, numerical study of trap-and-release of the microparticles using multiphase Navier-Stokes equations. Effect of geometry flow velocity, particle diameter, and adhesion force on trap-and-release was studied.