Proliferation and bone-related gene expression of osteoblasts grown on hydroxyapatite ceramics sintered at different temperature

The Impact of Hydroxyapatite Sintering Temperature on Its Microstructural, Mechanical, and Biological Properties

Hydroxyapatite (HA), the principal mineral of bone tissue, can be fabricated as an artificial calcium phosphate (CaP) ceramic and potentially used as bioceramic material for bone defect treatment. Nevertheless, the production method (including the applied sintering temperature) of synthetic hydroxyapatite directly affects its basic properties, such as its microstructure, mechanical parameters, bioabsorbability, and osteoconductivity, and in turn influences its biomedical potential as an implantable biomaterial. The wide application of HA in regenerative medicine makes it necessary to explain the validity of the selection of the sintering temperature. The main emphasis of this article is on the description and summarization of the key features of HA depending on the applied sintering temperature during the synthesis process. The review is mainly focused on the dependence between the HA sintering temperature and its microstructural features, mechanical properties, biodegradability/bioabsorbability, bioactivity, and biocompatibility.

Calcium Orthophosphate (CaPO4)-Based Bioceramics: Preparation, Properties, and Applications

Various types of materials have been traditionally used to restore damaged bones. In the late 1960s, a strong interest was raised in studying ceramics as potential bone grafts due to their biomechanical properties. A short time later, such synthetic biomaterials were called bioceramics. Bioceramics can be prepared from diverse inorganic substances, but this review is limited to calcium orthophosphate (CaPO4)-based formulations only, due to its chemical similarity to mammalian bones and teeth. During the past 50 years, there have been a number of important achievements in this field. Namely, after the initial development of bioceramics that was just tolerated in the physiological environment, an emphasis was shifted towards the formulations able to form direct chemical bonds with the adjacent bones. Afterwards, by the structural and compositional controls, it became possible to choose whether the CaPO4-based implants would remain biologically stable once incorporated into the skeletal structure or whether they would be resorbed over time. At the turn of the millennium, a new concept of regenerative bioceramics was developed, and such formulations became an integrated part of the tissue engineering approach. Now, CaPO4-based scaffolds are designed to induce bone formation and vascularization. These scaffolds are usually porous and harbor various biomolecules and/or cells. Therefore, current biomedical applications of CaPO4-based bioceramics include artificial bone grafts, bone augmentations, maxillofacial reconstruction, spinal fusion, and periodontal disease repairs, as well as bone fillers after tumor surgery. Prospective future applications comprise drug delivery and tissue engineering purposes because CaPO4 appear to be promising carriers of growth factors, bioactive peptides, and various types of cells.

Synergistic effect of nanostructure and calcium ions on improving the bioactivity of titanium implants

Surface structure and composition play essential roles in the osseointegration of titanium implants. In the present study, a nanoscale surface structure incorporated with calcium ions was fabricated on a titanium surface by hydrothermal treatment. The characteristics of the surfaces were analysed, and the bioactivity of the samples was evaluated in vitro and in vivo. nm-Ti and nm/Ca-Ti surfaces were significantly more hydrophilic than control-Ti surfaces. nm/Ca-Ti samples showed much faster bone-like apatite precipitation in simulated body fluid than the other samples. The results of MC3T3-E1 cell tests demonstrated that both nm-Ti and nm/Ca-Ti surfaces accelerated cell adhesion and proliferation. The highest level of osteogenesis-related genes (Runx2, bone morphogenetic protein-2, osteopontin and osteocalcin) were observed in nm/Ca-Ti samples, followed by nm-Ti samples. Alizarin red staining experiment showed that the amount of extracellular matrix mineralized nodules in nm/Ca-Ti group was significantly higher than others. In animal experiments using SD rats, nm/Ca-Ti showed the highest value of new bone formation at two and four weeks. The present study suggested that the nanostructure and calcium ions showed synergetic effects on accelerating bone-like apatite precipitation and osteoblast cell growth and differentiation. Animal experiment further indicated that such surface could promote early osteogenesis.

Synergistic effect of nanostructure and calcium ions on improving the bioactivity of titanium implants

Surface structure and composition play essential roles in the osseointegration of titanium implants. In the present study, a nanoscale surface structure incorporated with calcium ions was fabricated on a titanium surface by hydrothermal treatment. The characteristics of the surfaces were analysed, and the bioactivity of the samples was evaluated in vitro and in vivo. nm-Ti and nm/Ca-Ti surfaces were significantly more hydrophilic than control-Ti surfaces. nm/Ca-Ti samples showed much faster bone-like apatite precipitation in simulated body fluid than the other samples. The results of MC3T3-E1 cell tests demonstrated that both nm-Ti and nm/Ca-Ti surfaces accelerated cell adhesion and proliferation. The highest level of osteogenesis-related genes (Runx2, bone morphogenetic protein-2, osteopontin and osteocalcin) were observed in nm/Ca-Ti samples, followed by nm-Ti samples. Alizarin red staining experiment showed that the amount of extracellular matrix mineralized nodules in nm/Ca-Ti group was significantly higher than others. In animal experiments using SD rats, nm/Ca-Ti showed the highest value of new bone formation at two and four weeks. The present study suggested that the nanostructure and calcium ions showed synergetic effects on accelerating bone-like apatite precipitation and osteoblast cell growth and differentiation. Animal experiment further indicated that such surface could promote early osteogenesis.

The Effect of Low-Temperature Thermal Processing on Bovine Hydroxyapatite Bone Substitutes, toward Bone Cell Interaction and Differentiation

Ideal bone grafting scaffolds are osteoinductive, osteoconductive, and encourage osteogenesis through the remodeling processes of bone resorption, new bone formation, and successful integration or replacement; however, achieving this trifecta remains challenging. Production methods of bone grafts, such as thermal processing, can have significant effects on the degree of cell-surface interactions via wide-scale changes in the material properties. Here, we investigated the effects of small incremental changes at low thermal processing temperatures on the degree of osteoclast and osteoblast attachment, proliferation, and differentiation. Bovine bone scaffolds were prepared at 100, 130, 160, 190, and 220 °C and compared with a commercial control, Bio-Oss^®. Osteoclast attachment and activity were significantly higher on lower temperature processed bone and were not present ≥190 °C. The highest osteoblast proliferation and differentiation were obtained from treatments at 130 and 160 °C. Similarly, qRT²-PCR assays highlighted osteoblasts attached to bone processed at 130 and 160 °C as demonstrating the highest osteogenic gene expression. This study demonstrated the significant effects of small-scale processing changes on bone graft materials in vitro, which may translate to a tailored approach of cellular response in vivo.

Synthesized Nanorods Hydroxyapatite by Microwave-Assisted Technology for In Vitro Osteoporotic Bone Regeneration through Wnt/β-Catenin Pathway

This research presents an optimal and inexpensive, without any additives, method for the synthesis and sintering of hydroxyapatite (HA) by microwave-assisted technology (MAT) furnace. The target sintering temperature of the furnace (1100 ℃) was held for one and two hours for conventional sintering. With regard to the microwave hybrid sintering, it was held at 100%MW for 20 and 30 min. FTIR, XRD, TGA, SEM/EDS, and TEM were assessed to determine HA phase composition, and structural as well as thermal decomposition behavior. The in vitro effects of sintered HA discs on cultured aged mice-isolated osteoblast cells and hydrocortisone-induced osteoclast cells were assessed by measuring ALP, osteocalcin, TRAP, calcium, and Alizarin red S staining. Moreover, their effects on cell differentiation (CD90 and CD 105 and PARR- ɣ) and death markers (GSK3b, MAPK, and β-catenin) were evaluated. The results demonstrate the production of ≈35 nm crystal-sized pure hydroxyapatite nanorod-like particles with a high degree of crystallinity and no impurities as required for biomedical application. HA increased osteogenesis (ALP, osteocalcin, and calcium) markers and decreased cell resorption markers. In addition, HA nanorods reversed the effect of cortisone on cell differentiation and death markers. In conclusion, microwave hybrid sintered HA is a potential nanomaterial for osteoporotic bone regeneration as HA reversed the cortisone adverse effect on osteoblast cell death through canonical and non-canonical pathways.

Interplay between surface chemistry and osteogenic behaviour of sulphate substituted nano-hydroxyapatite

Surface potential and chemical compositions of the bioceramics are the core of therapeutic effect and are key factors to trigger the interfacial interactions with surrounding hard and soft tissues to repair and regeneration. Ionic substitution in hydroxyapatite (Hap) lattice significantly influences the zeta potential from -16.46 ± 0.66 mV to -6.01 ± 0.68 mV as well as an average nano-rod length from ~40 nm to ~26 nm with respect to SO₄^2- ion content. Moreover, the surface chemistry of Hap is mainly inter-related to SO₄^2- substitution rate at PO₄^2- site. Specifically, nano-sized feature with lowered negative surface potential influences the protein adsorption via their weak repulsive or attractive forces. Bovine serum albumin (BSA) and lysozyme (LSZ) adsorption studies confirmed the increased affinity to active binding sites of Hap's surface. Further, SO₄^2- ion substituted Hap (SNHA) showed improved in vitro biomineralization activity and alkaline phosphatase activity. Expression of osteogenic biomarkers such as collagen I, V, osteopontin and osteocalcin were evaluated in Saos-2 and MC3T3-E1 cells. Gene expression of these markers was influenced by SO₄^2- ion content in Hap (maximum with 10SNHA). Altogether, these data emphasizes that chemical composition and surface properties are dominant aspect in bioceramic development towards bone regeneration.

Combining local antibiotic delivery with heparinized nanohydroxyapatite/collagen bone substitute: A novel strategy for osteomyelitis treatment

Osteomyelitis is a major challenge in bone surgery and conventional treatment is frequently ineffective to control the infection, with an alternative approach being required. In the present work, a heparinized nanohydroxyapatite/collagen biocomposite was produced in granular form, and loaded with vancomycin, to work as a local drug delivery system for osteomyelitis and as a bone substitute. This strategy involves the local delivery of high concentrations of vancomycin, to eradicate the infection. Additionally, these granules work as a scaffold with regenerative properties, to induce bone regeneration after antibiotic release. The heparinized nanohydroxyapatite/collagen granular bone substitute was produced using two different sintering temperatures to study their effect on granules properties and on vancomycin release profile. Morphological, topographic, chemical and mechanical characterization were carried out for granules sintered at both temperatures and some relevant differences were found. The mechanical strength was increased by several orders of magnitude with increasing sintering temperature, being able to maintain their porous macrostructure and withstand important processes for their commercialization such as packaging, shipping and surgical manipulation. The nanohydroxyapatite/collagen granules were able to release high concentrations of vancomycin, always above MIC, for 19 days. The released antibiotic was able to eradicate both planktonic and sessile methicillin-resistant Staphylococcus aureus. The cytotoxicity was assessed according to ISO 10993-5:2009 and the granules sintered at higher temperature showed no cytotoxic effect. Considering these results nanohydroxyapatite/collagen biocomposite loaded with vancomycin is a promising solution for osteomyelitis treatment.

The role of calcium phosphate surface structure in osteogenesis and the mechanisms involved

Calcium phosphate (CaP) ceramics have been widely used for bone regeneration because of their ability to induce osteogenesis. Surface properties, including chemical composition and surface structure, are known to play a crucial role in osteoconduction and osteoinduction. This review systematically analyzes the effects of surface properties, in particular the surface structure, of CaP scaffolds on cell behavior and new bone formation. We also summarize the possible signaling pathways involved in the osteogenic differentiation of bone-related cells when cultured on surfaces with various structures in vitro. The significant immune response initiated by surface structure involved in osteogenic differentiation of cells is also discussed in this review. Taken together, the new biological principle for advanced biomaterials is not only to directly stimulate osteogenic differentiation of bone-related cells but also to modulate the immune response in vivo. Although the reaction mechanism responsible for bone formation induced by CaP surface structure is not clear yet, the insights on surface structure-mediated osteogenic differentiation and osteoimmunomodulation could aid the optimization of CaP-based biomaterials for bone regeneration. STATEMENT OF SIGNIFICANCE: CaP ceramics have similar inorganic composition with natural bone, which have been widely used for bone tissue scaffolds. CaP themselves are not osteoinductive; however, osteoinductive properties could be introduced to CaP materials by surface engineering. This paper systematically summarizes the effects of surface properties, especially surface structure, of CaP scaffolds on bone formation. Additionally, increasing evidence has proved that the bone healing process is not only affected by the osteogenic differentiation of bone-related cells, but also relevant to the the cooperation of immune system. Thus, we further review the possible signaling pathways involved in the osteogenic differentiation and immune response of cells cultured on scaffold surface. These insights into surface structure-mediated osteogenic differentiation and osteoimmunomodulated-based strategy could aid the optimization of CaP-based biomaterials.

Preparation and properties of a biodegradable poly(lactide-co-glycolide)/poly(trimethylene carbonate) porous composite scaffold for bone tissue engineering

New biodegradable PLGA/PTMC composite porous scaffold with high porosity, mechanical properties, significant homogeneous, interconnected pore network and good biocompatibility.

Insights into the apatite mineralization potential of thermally processed nanocrystalline Ca10−xFex(PO4)6(OH)2

The thermal treatment of Ca_10−xFe_x(PO₄)₆(OH)₂ at different temperatures had an effect on the mineralization potential under non-cellular and cellular conditions by releasing its bioactive ions at optimal or excessive levels.

In vitro response of mesenchymal stem cells to biomimetic hydroxyapatite substrates: A new strategy to assess the effect of ion exchange

Biomaterials can interact with cells directly, that is, by direct contact of the cells with the material surface, or indirectly, through soluble species that can be released to or uptaken from the surrounding fluids. However, it is difficult to characterise the relevance of this fluid-mediated interaction separately from the topography and composition of the substrate, because they are coupled variables. These fluid-mediated interactions are amplified in the case of highly reactive calcium phosphates (CaPs) such as biomimetic calcium deficient hydroxyapatite (CDHA), particularly in static in vitro cultures. The present work proposes a strategy to decouple the effect of ion exchange from topographical features by adjusting the volume ratio between the cell culture medium and biomaterial (V_CM/V_B). Increasing this ratio allowed mitigating the drastic ionic exchanges associated to the compositional changes experienced by the material exposed to the cell culture medium. This strategy was validated using rat mesenchymal stem cells (rMSCs) cultured on CDHA and beta-tricalcium phosphate (β-TCP) discs using different V_CM/V_B ratios. Whereas in the case of β-TCP the cell response was not affected by this ratio, a significant effect on cell adhesion and proliferation was found for the more reactive CDHA. The ionic exchange, produced by CDHA at low V_CM/V_B, altered cell adhesion due to the reduced number of focal adhesions, caused cell shrinkage and further rMCSs apoptosis. This was mitigated when using a high V_CM/V_B, which attenuated the changes of calcium and phosphate concentrations in the cell culture medium, resulting in rMSCs spreading and a viability over time. Moreover, rMSCs showed an earlier expression of osteogenic genes on CDHA compared to sintered β-TCP when extracellular calcium fluctuations were reduced.

STATEMENT OF SIGNIFICANCE

Fluid mediated interactions play a significant role in the bioactivity of calcium phosphates. Ionic exchange is amplified in the case of biomimetic hydroxyapatite, which makes the in vitro characterisation of cell-material interactions especially challenging. The present work proposes a novel and simple strategy to explore the mechanisms of interaction of biomimetic and sintered calcium phosphates with mesenchymal stem cells. The effects of topography and ion exchange are analysed separately by modifying the volume ratio between cell culture medium and biomaterial. High ionic fluctuations interfered in the maturation of focal adhesions, hampering cell adhesion and leading to increased apoptosis and reduced proliferation rate.

Bioceramics for Clinical Application in Regenerative Dentistry

Bioceramics represent functional ceramics with significant interest in regenerative medicine area. In orthopedics as well as in oral and maxillofacial surgery, bioceramics have been widely used as bone reconstructive materials. The most common one is hydroxyapatite which have been in the market and clinical applications since the mid of 1970s. Nowadays, a lot of works have been being in the pipeline to develop bioceramics for various clinical applications in regenerative medicine area, including dentistry. Bioceramics have been used and considered promising candidate for periodontal treatment, prevention of relapse, nerve regeneration, vaccine adjuvant, drug delivery technology, even for esthetic medicine and cosmetics. In this chapter, the advantages of bioceramics for regenerative therapy especially in dentistry is discussed. The overview of bioceramics classification is also explained. The future perspective and challenges on the use of bioceramics for next generation regenerative therapy is also discussed.

Hydoxyapatite/beta-tricalcium phosphate biphasic ceramics as regenerative material for the repair of complex bone defects

Bone is a composite material composed of collagen and calcium phosphate (CaP) mineral. The collagen gives bone its flexibility while the inorganic material gives bone its resilience. The CaP in bone is similar in composition and structure to the mineral hydroxyapatite (HA) and is bioactive, osteoinductive and osteoconductive. Therefore synthetic versions of bone apatite (BA) have been developed to address the demand for autologous bone graft substitutes. Synthetic HA (s-HA) are stiff and strong, but brittle. These lack of physical attributes limit the use of synthetic apatites in situations where no physical loading of the apatite occurs. s-HA chemical properties differ from BA and thus change the physical and mechanical properties of the material. Consequently, s-HA is more chemically stable than BA and thus its resorption rate is slower than the rate of bone regeneration. One solution to this problem is to introduce a faster resorbing CaP, such as β-tricalcium phosphate (β-TCP), when synthesizing the material creating a biphasic (s-HA and β-TCP) formulation of calcium phosphate (BCP). The focus of this review is to introduce the major differences between BCP and biological apatites and how material scientists have overcome the inadequacies of the synthetic counterparts. Examples of BCP performance in vitro and in vivo following structural and chemical modifications are provided as well as novel ultrastructural data. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2493-2512, 2018.

Attributes of Bio-Oss® and Moa-Bone® graft materials in a pilot study using the sheep maxillary sinus model

BACKGROUND AND OBJECTIVE

The aim of this pilot study was to characterize surface morphology and to evaluate resorption and osseous healing of two deproteinated bovine bone graft materials after sinus grafting in a large animal model.

MATERIAL AND METHODS

Surfaces of a novel particulate bovine bone graft, Moa-Bone^® were compared with Bio-Oss^® using scanning electron microscopy. Six sheep then had maxillary sinus grafting bilaterally, covered with BioGide^® . Grafted maxillae were harvested after 4, 6 and 12 weeks. Healing was described for half of each site using resin-embedded ground sections. For the other half, paraffin-embedded sections were examined using tartrate resistant acid phosphatase staining for osteoclast activity, runt-related transcription factor2 immunohistochemistry for pre-osteoblasts and osteoblasts and proliferating cell nuclear antigen for proliferative cells.

RESULTS

Moa-Bone^® had a smoother, more porous fibrous structure with minimal globular particles compared with Bio-Oss^® . After 4 weeks, woven bone formed on both grafts and the Moa-Bone^® particles also showed signs of resorption. After 12 weeks, Moa-Bone^® continued to be resorbed, however Bio-Oss^® did not; both grafts were surrounded by maturing lamellar bone. Moa-Bone^® was associated with earlier evidence of runt-related transcription factor 2-positive cells. Moa-Bone^® but not Bio-Oss^® was associated with strong tartrate resistant acid phosphatase-positive osteoclasts on the graft surface within resorption lacunae at both 4 and 6 weeks post-grafting.

CONCLUSION

Both materials supported osseous healing and maturation without inflammation. Moa-Bone^® showed marked osteoclast activity after 4 and 6 weeks and demonstrated positive attributes for grafting, if complete remodeling of the graft within the site is desired. Further optimization of Moa-Bone^® for maxillofacial applications is warranted.

Calcium Plasma Implanted Titanium Surface with Hierarchical Microstructure for Improving the Bone Formation

Introducing hierarchical microstructure and bioactive trace elements simultaneously onto the surface of titanium implant is a very effective way to improve the osseointegration between bone and implant. In this work, hierarchical topography was prepared on Ti surface via acid etching and sandblasting (SLA) to form micropits and microcavities then underwent Ca plasma immersion ion implantation (Ca-PIII) process. The surface wettability and roughness did not change obviously before and after Ca-PIII process. The in vitro evaluations including cell adhesion, activity, alkaline phosphatase (ALP), osteogenic genes (Runx2, OSX, ALP, BSP, Col1a1, OPN, and OC), and protein (BSP, Col1a1, OPN, and OC) expressions revealed that the introduction of Ca ions onto the surface of SLA-treated Ti can promote greater osteoblasts adhesion, spread and proliferation, which in return further accelerated the maturation and mineralization of osteoblasts. More importantly, in vivo evaluations including Micro-CT evaluation, histological observations, push-out test, sequential fluorescent labeling and histological observations verified that Ca-SLA-treated Ti implants could efficiently promote new bone formation in early times. These promising results suggest that Ca-SLA-treated Ti has the potential for future application in orthopedic field.

Structural and phase characterization of bioceramics prepared from tetracalcium phosphate-monetite cement and in vitro osteoblast response

Biphasic porous calcium phosphate ceramics was prepared by sintering of transformed tetracalcium phosphate-monetite cement. After annealing hydroxyapatite, β- or α-TCP were found as main phases in ceramic substrates and a highly microporous microstructure of cement ceramics was created without an addition of porosifier. The origin microstructure features characteristic by the presence of hollow particle agglomerates in cement were preserved in microstructure of cement ceramics after annealing but the hydroxyapatite particles rose in size up to 2 µm and obtained a more regular shape. A small decrease in compressive strength was demonstrated in ceramics sintered up to 1150 °C and enhanced osteoblast proliferation was revealed on cement ceramic substrates in comparison with cement sample and conventional ceramics. The ALP activity of osteoblasts decreased with rise in sintering temperature. The prepared cement microporous ceramics could be utilized as carrier for antibiotics, drugs, growth factors, enzymes or other substances stimulating healing process.

Effect of microstructure characteristics on tetracalcium phosphate-nanomonetite cement in vitro cytotoxicity

MC3T3E1 murine pre-osteoblastic cells were used to evaluate the cytotoxicity of tetracalcium phosphate (TTCP)-nanomonetite (DCPA) cement. The starting cement powder mixture was prepared by the in situ reaction between TTCP and a diluted solution of orthophosphoric acid in a planetary ball mill. The cements in the form of pressed cement powder mixture discs differ from each other by the method of pre-treatment and degree of the transformation of cement components in phosphate-buffered saline (PBS). For the evaluation of TTCP-DCPA cement to be non-cytotoxic, it was sufficient to apply the short-time soaking in PBS solution, regardless of whether the cement components were completely transformed or not. If the texture motif and hydroxyapatite particle morphology were properly developed during the initial stage of hardening, the cement cytotoxicity or osteoblast proliferation were insignificantly influenced by the soaking time or the texture stability during cell cultivation, but the lattice ordering enhanced cell proliferation. Results showed that the surface texture and the hydroxyapatite particle morphology are crucial for in vitro cement cytotoxicity evaluation.

Calcium phosphate coated Keratin-PCL scaffolds for potential bone tissue regeneration

The incorporation of hydroxyapatite (HA) nanoparticles within or on the surface of electrospun polymeric scaffolds is a popular approach for bone tissue engineering. However, the fabrication of osteoconductive composite scaffolds via benign processing conditions still remains a major challenge to date. In this work, a new method was developed to achieve a uniform coating of calcium phosphate (CaP) onto electrospun keratin-polycaprolactone composites (Keratin-PCL). Keratin within PCL was crosslinked to decrease its solubility, before coating of CaP. A homogeneous coating was achieved within a short time frame (~10min) by immersing the scaffolds into Ca(2+) and (PO4)(3-) solutions separately. Results showed that the incorporation of keratin into PCL scaffolds not only provided nucleation sites for Ca(2+) adsorption and subsequent homogeneous CaP surface deposition, but also facilitated cell-matrix interactions. An improvement in the mechanical strength of the resultant composite scaffold, as compared to other conventional coating methods, was also observed. This approach of developing a biocompatible bone tissue engineering scaffold would be adopted for further in vitro osteogenic differentiation studies in the future.

Biomaterials for in situ tissue regeneration: development and perspectives

Biomaterials are of fundamental importance to in situ tissue regeneration, which has emerged as a powerful method to treat tissue defects. The development and perspectives of biomaterials for in situ tissue regeneration were summarized.

The Osteoprint: a bioinspired two-photon polymerized 3-D structure for the enhancement of bone-like cell differentiation

The need for a better understanding of cell behavior and for exploiting cell functions in various healthcare applications has driven biomedical research to develop increasingly complex fabrication strategies to reproduce the natural biological microenvironment in vitro. Different approaches have led to the development of refined examples of 2- and 3-D structures able to sustain cellular proliferation, differentiation and functionality very similar to those normally occurring in living organisms. One such approach is two-photon polymerization. In this paper, we present a trabecula-like structure (which we have named "Osteoprint") that resembles to the typical microenvironment of trabecular bone cells. Starting from microtomography images of the trabecular bone, we prepared several Osteoprints through two-photon polymerization and tested the behavior of SaOS-2 bone-like cells cultured on our structures. Interestingly, we found that Osteoprints deeply affect cellular behavior, determining an exit from the cell cycle and an enhancement of osteogenic differentiation. Indeed, we found an up-regulation of the genes involved in SaOS-2 cell maturation and an increase in hydroxyapatite production and accumulation upon SaOS-2 culture on the Osteoprints. The findings we obtained are extremely interesting, and open up new perspectives in "bioinspired" approaches for tissue engineering and regenerative medicine.

Scaffold-based regeneration of skeletal tissues to meet clinical challenges

The management and reconstruction of damaged or diseased skeletal tissues have remained a significant global healthcare challenge. The limited efficacy of conventional treatment strategies for large bone, cartilage and osteochondral defects has inspired the development of scaffold-based tissue engineering solutions, with the aim of achieving complete biological and functional restoration of the affected tissue in the presence of a supporting matrix. Nevertheless, significant regulatory hurdles have rendered the clinical translation of novel scaffold designs to be an inefficient process, mainly due to the difficulties of arriving at a simple, reproducible and effective solution that does not rely on the incorporation of cells and/or bioactive molecules. In the context of the current clinical situation and recent research advances, this review will discuss scaffold-based strategies for the regeneration of skeletal tissues, with focus on the contribution of bioactive ceramic scaffolds and silk fibroin, and combinations thereof, towards the development of clinically viable solutions.

Effect of Control-released Basic Fibroblast Growth Factor Incorporated in β-Tricalcium Phosphate for Murine Cranial Model

BACKGROUND

β-Tricalcium phosphate (β-TCP) is used clinically as a bone substitute, but complete osteoinduction is slow. Basic fibroblast growth factor (bFGF) is important in bone regeneration, but the biological effects are very limited because of the short half-life of the free form. Incorporation in gelatin allows slow release of growth factors during degradation. The present study evaluated whether control-released bFGF incorporated in β-TCP can promote bone regeneration in a murine cranial defect model.

METHODS

Bilateral cranial defects of 4 mm in diameter were made in 10-week-old male Sprague-Dawley rats treated as follows: group 1, 20 μl saline as control; group 2, β-TCP disk in 20 μl saline; group 3, β-TCP disk in 50 μg bFGF solution; and group 4, β-TCP disk in 50 μg bFGF-containing gelatin hydrogel (n = 6 each). Histological and imaging analyses were performed at 1, 2, and 4 weeks after surgery.

RESULTS

The computed tomography value was lower in groups 3 and 4, whereas the rate of osteogenesis was higher histologically in group 4 than in the other groups. The appearance of tartrate-resistant acid phosphate-positive cells and osteocalcin-positive cells and disappearance of osteopontin-positive cells occurred earlier in group 4 than in the other groups.

CONCLUSIONS

These findings suggest that control-released bFGF incorporated in β-TCP can accelerate bone regeneration in the murine cranial defect model and may be promising for the clinical treatment of cranial defects.

Calcium Orthophosphate-Based Bioceramics

Various types of grafts have been traditionally used to restore damaged bones. In the late 1960s, a strong interest was raised in studying ceramics as potential bone grafts due to their biomechanical properties. A bit later, such synthetic biomaterials were called bioceramics. In principle, bioceramics can be prepared from diverse materials but this review is limited to calcium orthophosphate-based formulations only, which possess the specific advantages due to the chemical similarity to mammalian bones and teeth. During the past 40 years, there have been a number of important achievements in this field. Namely, after the initial development of bioceramics that was just tolerated in the physiological environment, an emphasis was shifted towards the formulations able to form direct chemical bonds with the adjacent bones. Afterwards, by the structural and compositional controls, it became possible to choose whether the calcium orthophosphate-based implants remain biologically stable once incorporated into the skeletal structure or whether they were resorbed over time. At the turn of the millennium, a new concept of regenerative bioceramics was developed and such formulations became an integrated part of the tissue engineering approach. Now calcium orthophosphate scaffolds are designed to induce bone formation and vascularization. These scaffolds are often porous and harbor different biomolecules and/or cells. Therefore, current biomedical applications of calcium orthophosphate bioceramics include bone augmentations, artificial bone grafts, maxillofacial reconstruction, spinal fusion, periodontal disease repairs and bone fillers after tumor surgery. Perspective future applications comprise drug delivery and tissue engineering purposes because calcium orthophosphates appear to be promising carriers of growth factors, bioactive peptides and various types of cells.

Fabrication and characterization of novel nano hydroxyapatite/β-tricalcium phosphate scaffolds in three different composition ratios

The biphasic calcium phosphate (BCP) concept was introduced to overcome disadvantages of single phase biomaterials. Different composition ratios of BCP bioceramics have been studied, yet controversies regarding the effects of ratio on biomaterial behavior still exist. In this study, BCP scaffolds were prepared from nano hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) that were synthesized via a solid state reaction. Three different composition ratios of pure BCP and collagen-based BCP scaffolds (%HA/%β-TCP; 30/70, 40/60, and 50/50) were produced using a polymeric sponge method. Physical and mechanical properties of all materials and scaffolds were investigated. SEM showed overall distribution of both macropores (80-200 μm) and micropores (0.5-2 μm) with high interconnected porosities. Total porosity of pure BCP (90% ± 3%) was found to be higher than collagen-based BCP (85% ± 2%). It was observed that following sintering process, dimensional shrinkage of large scaffolds (39% ± 4%) was lower than small ones (42% ± 5%) and scaffolds with high HA ratios (50%) experienced higher dimensional changes than those with higher β-TCP (70%) ratios (45% ± 3% and 36% ± 1%, respectively). Compressive strength of both groups was less than 0.1 MPa and collagen coating had almost no influence on mechanical behavior. Further studies may improve the physical properties of these scaffolds and investigate their exact biological behaviors.

IN VITRO EXPERIMENTS ON LASER SINTERED POROUS PCL SCAFFOLDS WITH POLYMER HYDROGEL FOR BONE REPAIR

Bone defects caused by tumors, diseased infection, trauma or abnormal bone development create a lot of serious health problems. Tissue engineering aims to fabricate tissues or organs using patients' cells for repairing the damaged tissues or organs in clinic. The aim of this study was to design and fabricate polycaprolactone (PCL) scaffolds using the inhouse-built selective laser sintering (SLS) rapid prototyping (RP) machine and combining with polymer hydrogel for in vitro study for bone repair. In this study, three configurations of scaffolds structure (0/45/0/45°, 0/90/0/90°, and 0/45/90/135° patterns) were designed and produced. The compressive modulus, porosity and pore size of porous scaffolds were first determined. In addition, polymer hydrogel was combined with PCL scaffolds with three loading methods (i.e., immersion method, injection method and titration method) to enhance scaffolds surface hydrophilicity for cell proliferation. Mesenchymal stem cells from New Zealand White rabbits were loaded on PCL scaffolds and induced to osteoblasts in vitro. Bone formation was determined by MTS assays, von Kossa stains and ALP activities. The experimental results showed the compressive moduli of scaffolds with 0/45/0/45°, 0/90/0/90°, and 0/45/90/135° patterns was 2 MPa, 3.4 MPa, and 3.75 MPa, respectively. The porosity of scaffolds was 72%, 76%, and 83%, respectively. The ranges of pore size of scaffolds were 350–400 μm, 400–500 μm, and 350–400 μm, respectively. By comparing three kinds of polymer hydrogel loading methods, titration method had the best result. The in vitro experimental results revealed that OD values of MTS tests and ALP activities increased from day 7 to day 21 and von Kossa stain revealed dark brown mineralized tissue, indicating cells could proliferate and differentiate in polymer hydrogel and scaffolds.

Thin-layer hydroxyapatite deposition on a nanofiber surface stimulates mesenchymal stem cell proliferation and their differentiation into osteoblasts

Pulsed laser deposition was proved as a suitable method for hydroxyapatite (HA) coating of coaxial poly-ɛ-caprolactone/polyvinylalcohol (PCL/PVA) nanofibers. The fibrous morphology of PCL/PVA nanofibers was preserved, if the nanofiber scaffold was coated with thin layers of HA (200 nm and 400 nm). Increasing thickness of HA, however, resulted in a gradual loss of fibrous character. In addition, biomechanical properties were improved after HA deposition on PCL/PVA nanofibers as the value of Young's moduli of elasticity significantly increased. Clearly, thin-layer hydroxyapatite deposition on a nanofiber surface stimulated mesenchymal stem cell viability and their differentiation into osteoblasts. The optimal depth of HA was 800 nm.

Osteoinduction by Ca-P biomaterials implanted into the muscles of mice

The osteoinduction of porous biphasic calcium phosphate ceramics (BCP) has been widely reported and documented, but little research has been performed on rodent animals, e.g., mice. In this study, we report osteoinduction in a mouse model. Thirty mice were divided into two groups. BCP materials (Sample A) and control ceramics (Sample B) were implanted into the leg muscle, respectively. Five mice in each group were killed at 15, 30, and 45 d after surgery. Sample A and Sample B were harvested and used for hematoxylin and eosin (HE) staining, immunohistochemistry (IHC) staining, and Alizarin Red S staining to check bone formation in the biomaterials. Histological analysis showed that no bone tissue was formed 15 d after implantation (0/5) in either of the two groups. Newly-formed bone tissues were observed in Sample A at 30 d (5/5) and 45 d (5/5) after implantation; the average amounts of newly-formed bone tissues were approximately 5.2% and 8.6%, respectively. However, we did not see any bone tissue in Sample B until 45 d after implantation. Bone-related molecular makers such as bone morphogenesis protein-2 (BMP-2), collagen type I, and osteopontin were detected by IHC staining in Sample A 30 d after implantation. In addition, the newly-formed bone was also confirmed by Alizarin Red S staining. Because this is the report of osteoinduction in the rodent animal on which all the biotechnologies were available, our results may contribute to further mechanism research.

In vitro cell performance on hydroxyapatite particles/poly(L-lactic acid) nanofibrous scaffolds with an excellent particle along nanofiber orientation

Highly porous hydroxyapatite (HA)/poly(L-lactide) (PLLA) nanofibrous scaffolds were prepared by incorporating needle-shaped nano- or micro-sized HA particles into PLLA nanofibers using electrospinning. The scaffolds had random or aligned fibrous assemblies and both types of HA particles were perfectly oriented along the fiber long axes. The biocompatibility and cell signaling properties of these scaffolds were evaluated by in vitro culture of rat osteosarcoma ROS17/2.8 cells on the scaffold surface. Cell morphology, viability and alkaline phosphatase (ALP) activity on each scaffold were examined at different time points. The HA/PLLA scaffolds exhibited higher cell viability and ALP activity than a pure PLLA scaffold. In addition, micro-sized HA particles supported cell proliferation and differentiation better than nano-sized ones in random scaffolds through a 10 day culture period and in aligned scaffolds at an early culture stage. The fibrous assembly of the scaffold had a pronounced impact on the morphology of the cells in direct contact with the scaffold surface, but not on cell proliferation and differentiation. Thus, HA/PLLA nanofibrous scaffolds could be good candidates for bone tissue engineering.

Osteogenic differentiation of human adipose-derived stem cells induced by osteoinductive calcium phosphate ceramics

Microstructure is indispensable for the osteoinduction of calcium phosphate ceramics. To study how microstructure takes its role and explore the mechanism of the osteoinduction, we evaluated attachment, proliferation, alkaline phosphatase (ALP)/DNA, protein/DNA, and mineralization of human adipose-derived stem cells cultured on two kinds of biphasic calcium phosphate (BCP) ceramic discs with the same chemistry and dimension, but different microporosity and surface area. BCP-A had been found osteoinductive in vivo while BCP-B was not. During the conventional culture, ALP/DNA and protein/DNA of the cell on BCP-A with larger surface area were significantly higher than those of the cells on BCP-B. With the adsorption of the proteins in culture medium with 50% fetal bovine serum (FBS) in advance, the increments of the ALP/DNA and protein/DNA for the BCP-A were found respectively significantly more than the increments of those for BCP-B, suggesting that the larger amount of protein adsorbed on the BCP-A was crucial. More results showed that ALP/DNA and protein/DNA of the cells on the two kinds of discs presoaked in culture medium having additional rhBMP-2 were found to be both higher than those of the cells on the discs resoaked in culture medium with 50% FBS, and that those values for BCP-A increased much more. Furthermore, larger mineral content was found on BCP-A than on BCP-B at day 7. The results indicated that by increasing microporosity and thus surface areas, osteoinductive calcium phosphate ceramics concentrate more proteins, including bone-inducing proteins, and thereafter stimulate inducible cells in soft tissues to form inductive bone.

Calcium orthophosphates as bioceramics: state of the art

In the late 1960s, much interest was raised in regard to biomedical applications of various ceramic materials. A little bit later, such materials were named bioceramics. This review is limited to bioceramics prepared from calcium orthophosphates only, which belong to the categories of bioactive and bioresorbable compounds. There have been a number of important advances in this field during the past 30-40 years. Namely, by structural and compositional control, it became possible to choose whether calcium orthophosphate bioceramics were biologically stable once incorporated within the skeletal structure or whether they were resorbed over time. At the turn of the millennium, a new concept of calcium orthophosphate bioceramics-which is able to promote regeneration of bones-was developed. Presently, calcium orthophosphate bioceramics are available in the form of particulates, blocks, cements, coatings, customized designs for specific applications and as injectable composites in a polymer carrier. Current biomedical applications include artificial replacements for hips, knees, teeth, tendons and ligaments, as well as repair for periodontal disease, maxillofacial reconstruction, augmentation and stabilization of the jawbone, spinal fusion and bone fillers after tumor surgery. Exploratory studies demonstrate potential applications of calcium orthophosphate bioceramics as scaffolds, drug delivery systems, as well as carriers of growth factors, bioactive peptides and/or various types of cells for tissue engineering purposes.

Influence of crystallite size of nanophased hydroxyapatite on fibronectin and osteonectin adsorption and on MC3T3-E1 osteoblast adhesion and morphology

The characteristic topographical features (crystallite dimensions, surface morphology and roughness) of bioceramics may influence the adsorption of proteins relevant to bone regeneration. This work aims at analyzing the influence of two distinct nanophased hydroxyapatite (HA) ceramics, HA725 and HA1000 on fibronectin (FN) and osteonectin (ON) adsorption and MC3T3-E1 osteoblast adhesion and morphology. Both substrates were obtained using the same hydroxyapatite nanocrystals aggregates and applying the sintering temperatures of 725°C and 1000°C, respectively. The two proteins used in this work, FN as an adhesive glycoprotein and ON as a counter-adhesive protein, are known to be involved in the early stages of osteogenesis (cell adhesion, mobility and proliferation). The properties of the nanoHA substrates had an important role in the adsorption behavior of the two studied proteins and clearly affected the MC3T3-E1 morphology, distribution and metabolic activity. HA1000 surfaces presenting slightly larger grain size, higher root-mean-square roughness (Rq), lower surface area and porosity, allowed for higher amounts of both proteins adsorbed. These substrates also revealed increased number of exposed FN cell-binding domains as well as higher affinity for osteonectin. Regarding the osteoblast adhesion results, improved viability and cell number were found for HA1000 surfaces as compared to HA725 ones, independently of the presence or type of adsorbed protein. Therefore the osteoblast adhesion and metabolic activity seemed to be more sensitive to surfaces morphology and roughness than to the type of adsorbed proteins.

Mechanical properties and osteocompatibility of novel biodegradable alanine based polyphosphazenes: Side group effects

The versatility of polymers for tissue regeneration lies in the feasibility to modulate the physical and biological properties by varying the side groups grafted to the polymers. Biodegradable polyphosphazenes are high-molecular-weight polymers with alternating nitrogen and phosphorus atoms in the backbone. This study is the first of its kind to systematically investigate the effect of side group structure on the compressive strength of novel biodegradable polyphosphazene based polymers as potential materials for tissue regeneration. The alanine polyphosphazene based polymers, poly(bis(ethyl alanato) phosphazene) (PNEA), poly((50% ethyl alanato) (50% methyl phenoxy) phosphazene) (PNEA(50)mPh(50)), poly((50% ethyl alanato) (50% phenyl phenoxy) phosphazene) (PNEA(50)PhPh(50)) were investigated to demonstrate their mechanical properties and osteocompatibility. Results of mechanical testing studies demonstrated that the nature and the ratio of the pendent groups attached to the polymer backbone play a significant role in determining the mechanical properties of the resulting polymer. The compressive strength of PNEA(50)PhPh(50) was significantly higher than poly(lactide-co-glycolide) (85:15 PLAGA) (p<0.05). Additional studies evaluated the cellular response and gene expression of primary rat osteoblast cells on PNEA, PNEA(50)mPh(50) and PNEA(50)PhPh(50) films as candidates for bone tissue engineering applications. Results of the in vitro osteocompatibility evaluation demonstrated that cells adhere, proliferate, and maintain their phenotype when seeded directly on the surface of PNEA, PNEA(50)mPh(50), and PNEA(50)PhPh(50). Moreover, cells on the surface of the polymers expressed type I collagen, alkaline phosphatase, osteocalcin, osteopontin, and bone sialoprotein, which are characteristic genes for osteoblast maturation, differentiation, and mineralization.

Effects of low-amplitude, high-frequency vibrations on proliferation and differentiation of SAOS-2 human osteogenic cell line

The aim of the work was to understand the consequences of low-amplitude, high-frequency vibrations on proliferation and differentiation of SAOS-2 cells (sarcoma osteogenetic), an osteoblastic and tumorigenic cell line. We realized a bioreactor composed of an eccentric motor that produces a displacement of 11 mm at frequencies between 1 and 120 Hz on a plate connected to the motor. The cultures of SAOS-2 cells were fixed on the plate, and the linear acceleration provoked by the motor to the cultures was measured. We used 30 Hz as stimulating frequency after a preliminary test on the effect of different frequencies on differentiation of cells. Afterward, SAOS-2 cells were stimulated with 30 Hz for different durations, every day for 4 days. The expression of some genes involved in the differentiation process was analyzed first with a reverse transcriptase-polymerase chain reaction and afterward with a real-time polymerase chain reaction on the most expressed genes. Moreover, the proliferation of cells was evaluated. The results suggest a strong increase in the expression of the genes involved in tissue differentiation in the treated groups with respect to the controls. On the other hand, the proliferation seems to be slowed down, so probably the acceleration perceived by the mechanosensors of the cells changes the cellular cycle by blocking the duplication to early differentiate toward bone tissue.

The effects of silicate ions on human osteoblast adhesion, proliferation, and differentiation

Silicon has been shown to have important effects on skeletal development and repair, and soluble silicate ions have been found to stimulate the expression of type-I collagen in osteoblast-like cell cultures. Furthermore, silicon has been incorporated into the hydroxyapatite lattice and enhanced metabolic activity of human osteosarcoma cells was observed when cells were cultured on this material. In vivo assessments have demonstrated enhanced bioactivity of silicon-substituted hydroxyapatite (Si-HA) over pure HA. However, detailed mechanisms for the stimulative effects of Si-HA have not been described. In this study, we found that silicon substitution into hydroxyapatite affects the adhesion of human osteoblast-like cells (HOBs) in culture, with 0.8 wt % silicon substitution being optimal. In addition, metabolic activity and proliferation of HOBs were increased by supplementation of the growth medium with 30 microM silicon. It was determined that this response may depend on the proportion of cells at different stages of differentiation within the cultures.

Bone growth is enhanced by novel bioceramic coatings on Ti alloy implants

Calcium phosphate ceramics are widely used as coating materials to orthopedic implants and are found to enhance initial bony ingrowth by stimulating osseous apposition to the implant surface. In this study, two novel calcium orthophosphate materials were selected for coating onto the commonly used orthopedic implant material Ti-6Al- 4V. One was calcium alkali orthophosphate with the crystalline phase Ca10[K/Na](PO4)7 with a small addition of SiO2 (AW-Si) and the other was calcium orthophosphate composed of 70 mol % fluorapatite, Ca10(PO4)6F2 and 30 mol % CaZr4(PO4)6 (FA7Z). The coated implants were placed in cortical and cortico-cancellous bone of sheep femur for six weeks. Retrieved samples were tested for osseointegration and mechanical strength. It was found that both coatings produced enhanced bone/implant contact rate compared to the control when implanted in cortico-cancellous bone. This study demonstrates that the two coatings have the capability of encouraging bone growth, and hence the potential for being used as coating materials on Ti implants.