Microwave processing of calcium phosphate and magnesium phosphate based orthopedic bioceramics: A state-of-the-art review

Recent Advances in 3D Printing of Smart Scaffolds for Bone Tissue Engineering and Regeneration

The repair and functional reconstruction of bone defects resulting from severe trauma, surgical resection, degenerative disease, and congenital malformation pose significant clinical challenges. Bone tissue engineering (BTE) holds immense potential in treating these severe bone defects, without incurring prevalent complications associated with conventional autologous or allogeneic bone grafts. 3D printing technology enables control over architectural structures at multiple length scales and has been extensively employed to process biomimetic scaffolds for BTE. In contrast to inert and functional bone grafts, next-generation smart scaffolds possess a remarkable ability to mimic the dynamic nature of native extracellular matrix (ECM), thereby facilitating bone repair and regeneration. Additionally, they can generate tailored and controllable therapeutic effects, such as antibacterial or antitumor properties, in response to exogenous and/or endogenous stimuli. This review provides a comprehensive assessment of the progress of 3D-printed smart scaffolds for BTE applications. It begins with an introduction to bone physiology, followed by an overview of 3D printing technologies utilized for smart scaffolds. Notable advances in various stimuli-responsive strategies, therapeutic efficacy, and applications of 3D-printed smart scaffolds are discussed. Finally, the review highlights the existing challenges in the development and clinical implementation of smart scaffolds, as well as emerging technologies in this field.

Exploration of Whitlockite Nanostructures for Hemostatic Applications

Background Calcium magnesium phosphate (CMP)-based whitlockite is a promising biomaterial for hemostasis and regenerative applications. Regenerative approaches aim to advance tissue repair and recovery in different clinical scenarios. Whitlockite is a biocompatible and biodegradable mineral that has garnered impressive consideration for its interesting properties, making it an appealing candidate for therapeutic applications. Aim This study aimed to evaluate the hemostatic behavior of synthesized whitlockite nanoparticles. Materials and methods Coprecipitation and hydrothermal methods were used to synthesize whitlockite nanoparticles. Calcium nitrate, magnesium nitrate, and diammonium hydrogen phosphate were used as precursors to prepare this material. Results Crystalline phases of whitlockite (Ca3Mg)3(PO4) and calcium magnesium phosphate Ca7Mg2P6O2 were observed through X-ray diffraction (XRD) patterns, along with relevant properties of the phosphate functional group detected through Raman spectra. This study explores the hemostatic adequacy of CMP-based whitlockite using different methodologies. The capacity of the materials to actuate platelet conglomeration and encourage clot arrangement is assessed using in vitro experiments. Moreover, this study investigates the regenerative potential of CMP-based whitlockite in tissue-building applications. Conclusion The structural and morphological parameters provide crucial insights into the proper formation of the material, and the hemoclot assessment aids in understanding its coagulation behavior. Future investigations and clinical trials will be instrumental in fully harnessing the potential of CMP-based whitlockite for advancing hemostasis and regenerative medicine.

Ion incorporation into bone grafting materials

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

Nanotechnology development in surgical applications: recent trends and developments

This paper gives a detailed analysis of nanotechnology's rising involvement in numerous surgical fields. We investigate the use of nanotechnology in orthopedic surgery, neurosurgery, plastic surgery, surgical oncology, heart surgery, vascular surgery, ophthalmic surgery, thoracic surgery, and minimally invasive surgery. The paper details how nanotechnology helps with arthroplasty, chondrogenesis, tissue regeneration, wound healing, and more. It also discusses the employment of nanomaterials in implant surfaces, bone grafting, and breast implants, among other things. The article also explores various nanotechnology uses, including stem cell-incorporated nano scaffolds, nano-surgery, hemostasis, nerve healing, nanorobots, and diagnostic applications. The ethical and safety implications of using nanotechnology in surgery are also addressed. The future possibilities of nanotechnology are investigated, pointing to a possible route for improved patient outcomes. The essay finishes with a comment on nanotechnology's transformational influence in surgical applications and its promise for future breakthroughs.

Mechanical Properties and Hydration Degree of Magnesium Potassium Phosphate Cement Modified by Sintered Silt Ash

The effective utilization rate of river-dredged silt was extremely low, and common disposal methods such as dumping it into the ocean have already threatened the ecological environment. To demonstrate that dredged silt can be used as a mineral admixture to modify magnesium potassium phosphate cement (MKPC), the mechanical properties and hydration degree of sintered silt ash (SSA)-blended MKPC in the early stage of hydration were studied systematically in this paper, with MKPC as the reference group. The mechanical experiment results showed that in the process of increasing the SSA content to 25%, the compressive strength first increased and then decreased. Among the samples, the compressive strength of cement aged by 1d and 3d with 15% content was the highest, which increased by 11.5% and 17.2%, respectively, compared with the reference group. The setting time experiment found that with the increase in SSA content, the hydration reaction rate of MKPC slowed down significantly. Its effect of delaying hydration was most obvious when the SSA content was 10-15%. The X-ray diffraction pattern showed that there was no large amount of new crystalline substances formed in the hydration product. The results obtained by scanning electron microscopy show that the microstructure tended to be denser and the hydration products tended to be plump when the SSA content was in the range of 0-15%. The non-contact electrical resistivity experiment showed that the addition of SSA delayed the early hydration of MKPC. Combined with the above experiment results, it was found that when the content of SSA was less than 15%, it not only delayed the early hydration of MKPC, but also deepened its hydration degree.

Calcium Phosphate-Based Nanomaterials: Preparation, Multifunction, and Application for Bone Tissue Engineering

Calcium phosphate is the main inorganic component of bone. Calcium phosphate-based biomaterials have demonstrated great potential in bone tissue engineering due to their superior biocompatibility, pH-responsive degradability, excellent osteoinductivity, and similar components to bone. Calcium phosphate nanomaterials have gained more and more attention for their enhanced bioactivity and better integration with host tissues. Additionally, they can also be easily functionalized with metal ions, bioactive molecules/proteins, as well as therapeutic drugs; thus, calcium phosphate-based biomaterials have been widely used in many other fields, such as drug delivery, cancer therapy, and as nanoprobes in bioimaging. Thus, the preparation methods of calcium phosphate nanomaterials were systematically reviewed, and the multifunction strategies of calcium phosphate-based biomaterials have also been comprehensively summarized. Finally, the applications and perspectives of functionalized calcium phosphate biomaterials in bone tissue engineering, including bone defect repair, bone regeneration, and drug delivery, were illustrated and discussed by presenting typical examples.

Copper-doped zeolitic imidazolate frameworks-8/hydroxyapatite composite coating endows magnesium alloy with excellent corrosion resistance, antibacterial ability and biocompatibility

Magnesium (Mg) and its alloys exhibit an excellent prospect for orthopedic clinical application due to their outstanding biodegradability and mechanical adaptability. However, the rapid corrosion rate/latent device-associated infections may lead to a failed internal fixation of Mg-based implants. Herein, a novel composite coating consisted of outer copper-doped zeolitic imidazolate frameworks-8 and inner hydroxyapatite (Cu@ZIF-8/HA) was in situ constructed on AZ31B Mg alloy via a two-step approach of hydrothermal treatment and seeded solvothermal method. The results verified that the electrochemical impedance of the obtained Cu45@ZIF-8/HA composite coating increased by two orders of magnitude to 6.6013 × 104 Ω·cm2 compared to that of bare Mg alloy. This was attributed to the reduced particle size of ZIF-8 nanoparticles due to the doped copper ions, which could be effectively grown in situ on the micro-nano flower-like structure of the HA-coated Mg alloy. Meanwhile, the Cu@ZIF-8/HA coating exhibited excellent antibacterial properties due to the release of copper ions and zinc ions from Cu@ZIF-8 dissolved in bacterial culture solution. The ICP results unraveled that the released concentration of copper and zinc ions could enhance the activity of alkaline phosphatase in the appropriate range during MC3T3-E1 cell culture in vitro for 7 days. This research revealed that the preparation of multifunctional metal-organic frameworks coating doped with antimicrobial metal ions via the seed layer solvothermal method was significant for studying the antimicrobial properties, osteogenic performance and corrosion resistance of Mg-based bioactive coatings.

Synthesis of Ti6Al4V/SrFHA Composites by Microwave-Assisted Liquid Phase Deposition and Calcination

The feasibility of synthesis of Ti6Al4V/SrFHA (Ca_9.37Sr_0.63(PO₄)₆F₂) composites via coating strontium and fluorine co-doped HA to Ti6Al4V substrate by microwave-assisted liquid phase deposition and calcination was evaluated, with a focus on the effect of the deposition temperature from 30 °C to 70 °C. The outcomes demonstrate that strontium and fluorine can be successfully doped into HA to form a SrFHA coating with modified micromorphology which is deposited on the alloy. When the deposition temperature was 50 °C, the coating with the largest uniform continuous SrFHA coverage was obtained. After calcination, the adhesion strength and Vickers microhardness of the Ti6Al4V/SrFHA composite increased from 0.68 MPa and 323 HV to 2.41 MPa and 329 HV, respectively, with a decrease in the water contact angle from 10.88° to 7.24°, exhibiting enhancement of both mechanical properties and wettability. Moreover, the composite obtained at the deposition temperature of 50 °C exhibited good bioactivity based on the simulate body fluid (SBF) test. On account of the above features primarily as a result of the combined effect of the co-doping of strontium and fluorine, high crystallinity of SrFHA, large surface roughness, and formation of the titanium oxide transition layer, the Ti6Al4V/SrFHA composite shows great potential in dental implantology.

Rapid Synthesis of Multifunctional Apatite via the Laser-Induced Hydrothermal Process

Synthetic biomaterials are used to overcome the limited quantity of human-derived biomaterials and to impart additional biofunctionality. Although numerous synthetic processes have been developed using various phases and methods, currently commonly used processes have some issues, such as a long process time and difficulties with extensive size control and high-concentration metal ion substitution to achieve additional functionality. Herein, we introduce a rapid synthesis method using a laser-induced hydrothermal process. Based on the thermal interaction between the laser pulses and titanium, which was used as a thermal reservoir, hydroxyapatite particles ranging from nanometer to micrometer scale could be synthesized in seconds. Further, this method enabled selective metal ion substitution into the apatite matrix with a controllable concentration. We calculated the maximum temperature achieved by laser irradiation at the surface of the thermal reservoir based on the validation of three simplification assumptions. Subsequent linear regression analysis showed that laser-induced hydrothermal synthesis follows an Arrhenius chemical reaction. Hydroxyapatite and Mg²⁺-, Sr²⁺-, and Zn²⁺-substituted apatite powders promoted bone cell attachment and proliferation ability due to ion release from the hydroxyapatite and the selective ion-substituted apatite powders, which had a low crystallinity and relatively high solubility. Laser-induced hydrothermal synthesis is expected to become a powerful ceramic material synthesis technology.

Development, In-Vitro Characterization and In-Vivo Osteoinductive Efficacy of a Novel Biomimetically-Precipitated Nanocrystalline Calcium Phosphate With Internally-Incorporated Bone Morphogenetic Protein-2

The repair of large-volume bone defects (LVBDs) remains a great challenge in the fields of orthopedics and maxillofacial surgery. Most clinically available bone-defect-filling materials lack proper degradability and efficient osteoinductivity. In this study, we synthesized a novel biomimetically-precipitated nanocrystalline calcium phosphate (BpNcCaP) with internally incorporated bone morphogenetic protein-2 (BpNcCaP + BMP-2) with an aim to develop properly degradable and highly osteoinductive granules to repair LVBDs. We first characterized the physicochemical properties of the granules with different incorporation amounts of BMP-2 using scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. We evaluated the cytotoxicity and cytocompatibility of BpNcCaP by assessing the viability and adhesion of MC3T3-E1 pre-osteoblasts using PrestoBlue assay, Rhodamine-Phalloidin and DAPI staining, respectively. We further assessed the in-vivo osteoinductive efficacy in a subcutaneous bone induction model in rats. In-vitro characterization data showed that the BpNcCaP + BMP-2 granules were comprised of hexagonal hydroxyapatite with an average crystallite size ranging from 19.7 to 25.1 nm and a grain size at 84.13 ± 28.46 nm. The vickers hardness of BpNcCaP was 32.50 ± 3.58 HV 0.025. BpNcCaP showed no obvious cytotoxicity and was favorable for the adhesion of pre-osteoblasts. BMP-2 incorporation rate could be as high as 65.04 ± 6.01%. In-vivo histomorphometric analysis showed that the volume of new bone induced by BpNcCaP exhibited a BMP-2 amount-dependent increasing manner. The BpNcCaP+50 μg BMP-2 exhibited significantly more degradation and fewer foreign body giant cells in comparison with BpNcCaP. These data suggested a promising application potential of BpNcCaP + BMP-2 in repairing LVBDs.

Microwave Treatment of Calcium Phosphate/Titanium Dioxide Composite to Improve Protein Adsorption

Calcium phosphate has attracted enormous attention as a bone regenerative material in biomedical fields. In this study, we investigated the effect of microwave treatment on calcium phosphate deposited TiO₂ nanoflower to improve protein adsorption. Hierarchical rutile TiO₂ nanoflowers (TiNF) fabricated by a hydrothermal method were soaked in modified simulated body fluid for 3 days to induce calcium phosphate (CAP) formation, followed by exposure to microwave radiation (MW). Coating the dental implants with CAP/TiNF provides a means of improving the biological properties, as the structure, morphology, and thickness of the composites can be controlled. The composites were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), field emission transmission electron microscopy (TEM), and Fourier-transform infrared spectroscopy (FTIR), respectively. The composites were identified to be composed of aggregated nano-sized particles with sphere-like shapes, and the calcium phosphate demonstrated low crystallinity. The ability of bovine serum albumin (BSA) to adsorb on MW-treated CAP/TiNF composites was studied as a function of BSA concentration. The Sips isotherm was used to analyze the BSA adsorption on MW-treated CAP/TiNF composites. The MW-treated samples showed high protein adsorption capacity, thereby indicating their potential in various biomedical applications.

Biodegradable magnesium phosphates in biomedical applications

As an essential element, magnesium is involved in a variety of physiological processes. Magnesium is the second most abundant cation in cells and the fourth most abundant cation in living...

Mesoporous Mn-doped hydroxyapatite nanorods obtained via pyridinium chloride enabled microwave-assisted synthesis by utilizing Donax variabilis seashells for implant applications

Manganese-doped mesoporous hydroxyapatite (MnHAp) nanorods, a bio-apatite were synthesized via pyridinium chloride mediated microwave approach using bio-waste Donax variabilis seashells to treat orthopedic infections. This is the first report on using pyridinium chloride mediated mesoporous MnHAp nanorods synthesis. Pure and Mn doped HAp samples were examined using Raman spectroscopy, X-ray powder diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) studies to confirm the prepared HAp nanorods. Furthermore, the fabrication of manganese-doped HAp was successful with the formation of a hexagonal crystal lattice without disturbing the HAp phase. It is because, at the time of synthesis, PO₄^3- ions form an electrostatic interaction with the Mn ions. Furthermore, Mn-doped HAp samples showed a reduction in their sizes of 15, 10-15, 5-10 nm width, and 80-100, 10-15, 20-30 nm length with varied pore diameters and surface area. The pure HAp, MnHAp-1, MnHAp-2, and MnHAp-3 nanorods disclose the surface area of 39.4, 18.0, 49.2, and 80.4 m² g^-1, with a pore volume of 0.0102, 0.0047, 0.0143, and 0.0447 cm³ g^-1, the corresponding pore diameter was estimated to be 6, 7, 6, and 4 nm, respectively. Moreover, antibacterial activity reveals effective bactericidal action against infections causing pathogens whereas cytotoxicity examination (MTT assay), and zebrafish results reveal their non-toxic behavior. Therefore, it is evident from the study, that rapid fabrication of mesoporous and diverse structured MnHAp nanorods could be convenient with pyridinium chloride enabled microwave-assisted method as a bactericidal biomaterial for implant applications.

Monetite, an important calcium phosphate compound-Its synthesis, properties and applications in orthopedics

This review recognizes a unique calcium phosphate (CaP) phase known as monetite or dicalcium phosphate anhydrous (DCPA, CaHPO₄), and presents an overview of its properties, processing, and applications in orthopedics. The motivation for the present effort is to highlight the state-of-the-art research and development of monetite and propel the research community to explore more of its potentials in orthopedics. After a brief introduction of monetite, we provide a summary of its various synthesis routes like dehydration, solvent-based, energy-assisted processes and also discuss the formation of different crystal structures with respect to the synthesis conditions. Subsequently, we discuss the material's noteworthy physico-chemical properties including the crystal structure, vibrational spectra, solubility, thermal decomposition, and conversion to other phases. Of note, we focus on the biological (in vitro and in vivo) properties of monetite, given its ever-increasing popularity as a biomaterial for medical implants. Appropriately, we discuss various orthopedic applications of monetite as bone cement, implant coatings, granules for defect fillers, and scaffolds. Many in vitro and in vivo studies confirmed the favorable osteointegration and osteoconduction properties of monetite products, along with a better balance between implant resorption and new bone formation as compared to other CaP phases. The review ends with translational aspects of monetite and presents thoughts about its possible future research directions. Further research may explore but not limited to improvements in mechanical strength of monetite-based scaffolds, using monetite particles as a therapeutic agent delivery, and tissue engineering strategies where monetite serves as the biomaterial. STATEMENT OF SIGNIFICANCE: This is the first review that focusses on the favorable potential of monetite for hard tissue repair and regeneration. The article accurately covers the "Synthesis-Structure-Property-Applications" correlations elaborating on monetite's diverse material properties. Special focus is put on the in vitro and in vivo properties of the material highlighting monetite as an orthopedic material-of-choice. The synthesis techniques are discussed which provide important information about the different fabrication routes for monetite. Most importantly, the review provides comprehensive knowledge about the diverse biomedical applications of monetite as granules, defect--specific scaffolds, bone cements and implant coatings. This review will help to highlight monetite's potential as an effective regenerative medicine and catalyze the continuing translation of this bioceramic from the laboratory to clinics.

Magnetic Calcium Phosphate Cement for Hyperthermia Treatment of Bone Tumors

This article reports, for the first time, the 'proof-of-concept' results on magnetic monetite (CaHPO4)-based calcium phosphate cements (CPCs) compositions developed for the hyperthermia treatment of bone tumors. Hyperthermia involves the heating of a tumor within a temperature range of 40-45 °C, inducing apoptosis in the tumor cells. This process holds promising potential in the field of cancer treatment and has been proven to be more effective than conventional therapeutics. Hence, we aimed to develop cement compositions that are capable of the hyperthermia treatment of bone tumors. To achieve that central goal, we incorporated iron oxide (Fe3O4), a ferromagnetic material, into monetite and hypothesized that, upon the application of a magnetic field, magnetite will generate heat and ablate the tumor cells near the implantation site. The results confirmed that an optimized content of magnetite incorporation in monetite can generate heat in the range of 40-45 °C upon the application of a magnetic field. Furthermore, the compositions were bioactive and cytocompatible with an osteoblastic cell line.