In vitro and in vivo evaluation of akermanite bioceramics for bone regeneration

Premixed calcium silicate-based ceramic sealers promote osteogenic/cementogenic differentiation of human periodontal ligament stem cells: A microscopy study

To evaluate the effects of premixed calcium silicate based ceramic sealers on the viability and osteogenic/cementogenic differentiation of human periodontal ligament stem cells (hPDLSCs). The materials evaluated were TotalFill BC Sealer (TFbc), AH Plus Bioceramic Sealer (AHPbc), and Neosealer Flo (Neo). Standardized discs and 1:1, 1:2, and 1:4 eluates of the tested materials were prepared. The following in vitro experiments were carried out: ion release, cell metabolic activity 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, cell migration, immunofluorescence experiment, cell attachment, gene expression, and mineralization assay. Statistical analyses were performed using one-way ANOVA followed by Tukey's post hoc test (p < .05). Increased Ca2+ release was detected in TFbc compared to AHPbc and Neo (*p < .05). Biological assays showed a discrete cell metabolic activity and cell migration in Neo-treated cell, whereas scanning electronic microscopy assay exhibited that TFbc group had a better cell adhesion process of substrate attachment, spreading, and cytoskeleton development on the niche-like structures of the cement than AHPbc and Neo. The sealers tested were able to induce overexpression of the CEMP-1, ALP, and COL1A1 genes in the first days of exposure, particularly in the case of TFbc (***p < .001). All materials tested significantly increased the mineralization of hPDLSCs when compared to the negative control, although more pronounced calcium deposition was observed in the TFbc-treated cells (***p < .001). Our results suggested that TFbc promotes cell differentiation, both by increasing the expression of key osteo/odontogenic genes and by promoting mineralization of the extracellular matrix, whereas this phenomenon was less evident in Neo and AHPbc. RESEARCH HIGHLIGHTS: TFbc group had a better cell adhesion process of substrate attachment, spreading, and cytoskeleton development on the niche-like structures of the cement than AHPbc and Neo. The sealers tested were able to induce overexpression of the CEMP-1, ALP, and COL1A1 genes in the first days of exposure, particularly in the case of TFbc. All materials tested significantly increased the mineralization of hPDLSCs when compared to the negative control, although more pronounced calcium deposition was observed in the TFbc-treated cells.

Smurf1-targeting microRNA-136-5p-modified bone marrow mesenchymal stem cells combined with 3D-printed β-tricalcium phosphate scaffolds strengthen osteogenic activity and alleviate bone defects

Suitable biomaterials with seed cells have promising potential to repair bone defects. However, bone marrow mesenchymal stem cells (BMSCs), one of the most common seed cells used in tissue engineering, cannot differentiate efficiently and accurately into functional osteoblasts. In view of this, a new tissue engineering technique combined with BMSCs and scaffolds is a major task for bone defect repair. Lentiviruses interfering with miR-136-5p or Smurf1 expression were transfected into BMSCs. The effects of miR-136-5p or Smurf1 on the osteogenic differentiation (OD) of BMSCs were evaluated by measuring alkaline phosphatase activity and calcium deposition. Then, the targeting relationship between miR-136-5p and Smurf1 was verified by bioinformatics website analysis and dual luciferase reporter assay. Then, a rabbit femoral condyle bone defect model was established. miR-136-5p/BMSCs/β-TCP scaffold was implanted into the defect, and the repair of the bone defect was detected by Micro-CT and HE staining. Elevating miR-136-5p-3p or suppressing Smurf1 could stimulate OD of BMSCs. miR-136-5p negatively regulated Smurf1 expression. Overexpressing Smurf1 reduced the promoting effect of miR-136-5p on the OD of BMSCs. miR-136-5p/BMSCs/β-TCP could strengthen bone density in the defected area and accelerate bone repair. SmurF1-targeting miR-136-5p-modified BMSCs combined with 3D-printed β-TCP scaffolds can strengthen osteogenic activity and alleviate bone defects.

Role of Adipose-Derived Mesenchymal Stem Cells in Bone Regeneration

Bone regeneration involves multiple factors such as tissue interactions, an inflammatory response, and vessel formation. In the event of diseases, old age, lifestyle, or trauma, bone regeneration can be impaired which could result in a prolonged healing duration or requiring an external intervention for repair. Currently, bone grafts hold the golden standard for bone regeneration. However, several limitations hinder its clinical applications, e.g., donor site morbidity, an insufficient tissue volume, and uncertain post-operative outcomes. Bone tissue engineering, involving stem cells seeded onto scaffolds, has thus been a promising treatment alternative for bone regeneration. Adipose-derived mesenchymal stem cells (AD-MSCs) are known to hold therapeutic value for the treatment of various clinical conditions and have displayed feasibility and significant effectiveness due to their ease of isolation, non-invasive, abundance in quantity, and osteogenic capacity. Notably, in vitro studies showed AD-MSCs holding a high proliferation capacity, multi-differentiation potential through the release of a variety of factors, and extracellular vesicles, allowing them to repair damaged tissues. In vivo and clinical studies showed AD-MSCs favoring better vascularization and the integration of the scaffolds, while the presence of scaffolds has enhanced the osteogenesis potential of AD-MSCs, thus yielding optimal bone formation outcomes. Effective bone regeneration requires the interplay of both AD-MSCs and scaffolds (material, pore size) to improve the osteogenic and vasculogenic capacity. This review presents the advances and applications of AD-MSCs for bone regeneration and bone tissue engineering, focusing on the in vitro, in vivo, and clinical studies involving AD-MSCs for bone tissue engineering.

Sensory Nerve Regulation via H3K27 Demethylation Revealed in Akermanite Composite Microspheres Repairing Maxillofacial Bone Defect

Maxillofacial bone defects exhibit intricate anatomy and irregular morphology, presenting challenges for effective treatment. This study aimed to address these challenges by developing an injectable bioactive composite microsphere, termed D-P-Ak (polydopamine-PLGA-akermanite), designed to fit within the defect site while minimizing injury. The D-P-Ak microspheres biodegraded gradually, releasing calcium, magnesium, and silicon ions, which, notably, not only directly stimulated the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) but also activated sensory nerve cells to secrete calcitonin gene-related peptide (CGRP), a key factor in bone repair. Moreover, the released CGRP enhanced the osteogenic differentiation of BMSCs through epigenetic methylation modification. Specifically, inhibition of EZH2 and enhancement of KDM6A reduced the trimethylation level of histone 3 at lysine 27 (H3K27), thereby activating the transcription of osteogenic genes such as Runx2 and Osx. The efficacy of the bioactive microspheres in bone repair is validated in a rat mandibular defect model, demonstrating that peripheral nerve response facilitates bone regeneration through epigenetic modification. These findings illuminated a novel strategy for constructing neuroactive osteo-inductive biomaterials with potential for further clinical applications.

Understanding Matrix Stiffness in Vinyl Polymer Hydrogels: Implications in Bone Tissue Engineering

Matrix elasticity helps to direct bone cell differentiation, impact healing processes, and modify extracellular matrix deposition, all of which are required for tissue growth and maintenance. In this work, we evaluated the role of inorganic nanocrystals or mineral inducers such as nanohydroxyapatite, alkaline phosphatase, and nanoclay also known as montmorillonite deposited on vinyl-based hydrogels in generating matrices with different stiffness and their role in cell differentiation. Poly-2-(dimethylamino)ethyl methacrylate (PD) and poly-2-hydroxypropylmethacrylamide (PH) are the two types of vinyl polymers chosen for preparing hydrogels via thermal cross-linking. The hydrogels exhibited porosity, which decreased with an increase in stiffness. Each of the compositions is non-cytotoxic and maintains the viability of pre-osteoblasts (MC3T3-E1) and human bone marrow mesenchymal stem cells (hBMSCs). The PD hydrogels in the presence of ALP showed the highest mineralization ability confirmed through the alizarin assay and a better structural environment for their use as scaffolds for tissue engineering. The study reveals that understanding such interactions can generate hydrogels that can serve as efficient 3D models to study biomineralization.

Chitosan scaffolds: Expanding horizons in biomedical applications

Chitosan, a natural polysaccharide from chitin, shows promise as a biomaterial for various biomedical applications due to its biocompatibility, biodegradability, antibacterial activity, and ease of modification. This review overviews "chitosan scaffolds" use in diverse biomedical applications. It emphasizes chitosan's structural and biological properties and explores fabrication methods like gelation, electrospinning, and 3D printing, which influence scaffold architecture and mechanical properties. The review focuses on chitosan scaffolds in tissue engineering and regenerative medicine, highlighting their role in bone, cartilage, skin, nerve, and vascular tissue regeneration, supporting cell adhesion, proliferation, and differentiation. Investigations into incorporating bioactive compounds, growth factors, and nanoparticles for improved therapeutic effects are discussed. The review also examines chitosan scaffolds in drug delivery systems, leveraging their prolonged release capabilities and ability to encapsulate medicines for targeted and controlled drug delivery. Moreover, it explores chitosan's antibacterial activity and potential for wound healing and infection management in biomedical contexts. Lastly, the review discusses challenges and future objectives, emphasizing the need for improved scaffold design, mechanical qualities, and understanding of interactions with host tissues. In summary, chitosan scaffolds hold significant potential in various biological applications, and this review underscores their promising role in advancing biomedical science.

Modification of titanium orthopedic implants with bioactive glass: a systematic review of in vivo and in vitro studies

Bioactive glasses (BGs) are ideal biomaterials in the field of bio-restoration due to their excellent biocompatibility. Titanium alloys are widely used as a bone graft substitute material because of their excellent corrosion resistance and mechanical properties; however, their biological inertness makes them prone to clinical failure. Surface modification of titanium alloys with bioactive glass can effectively combine the superior mechanical properties of the substrate with the biological properties of the coating material. In this review, the relevant articles published from 2013 to the present were searched in four databases, namely, Web of Science, PubMed, Embase, and Scopus, and after screening, 49 studies were included. We systematically reviewed the basic information and the study types of the included studies, which comprise in vitro experiments, animal tests, and clinical trials. In addition, we summarized the applied coating technologies, which include pulsed laser deposition (PLD), electrophoretic deposition, dip coating, and magnetron sputtering deposition. The superior biocompatibility of the materials in terms of cytotoxicity, cell activity, hemocompatibility, anti-inflammatory properties, bioactivity, and their good bioactivity in terms of osseointegration, osteogenesis, angiogenesis, and soft tissue adhesion are discussed. We also analyzed the advantages of the existing materials and the prospects for further research. Even though the current research status is not extensive enough, it is still believed that BG-coated Ti implants have great clinical application prospects.

Investigation on the physical properties and biocompatibility of zirconia-alumina-silicate@diopside composite materials and its in vivo toxicity study in embryonic zebrafish

Bioceramic materials have a wide range of applications in the biomedical field, such as in the repair of bone defects and dental surgery. Silicate-based bioceramics have attracted biomedical researchers' interest due to their bioactivity and biodegradability. In this study, extended the scope of ZAS utilization in bone tissue engineering by introducing calcium-magnesium-silicate (diopside, CMS) as an interface material aim to develop a machinable bioceramic composite (ZASCMS) by the sol-gel method. The physicochemical characterization, in vitro biological properties and in vivo zebrafish cytotoxicity study of ZAS-based composites as a function of CMS contents, 0, 25, 50, 75 and 100 wt%, were performed. Results showed that the as-prepared ZASCMS possessed porous architecture with well-interconnected pore structure. Results also revealed that the mechanical properties of ZASCMS composite materials were gradually improved with increasing CMS contents. The ZASCMS composites with more than 50 wt% CMS had the highest compressive strength and modulus of 6.78 ± 0.62 MPa and 340.10 ± 16.81 MPa, respectively. Regarding in vitro bioactivities, the composite scaffolds were found to stimulate osteoblast-like UMR-106 cell adhesion, growth, and proliferation. The antibacterial activity of the ZASCMS composite scaffolds was tested against Staphylococcus epidermidis (S. epidermidis) and Escherichia coli (E. coli) also exhibited an antibacterial property. Furthermore, the in vivo studies using embryonic zebrafish were exposed to as-prepared particles (0-500 μg mL-1) and showed that the synthesized ZAS, CMS and ZASCMS composite particles were non-toxic based on the evaluation of survivability, hatching rate and embryonic morphology. In conclusions, our results indicated that the synthesized composite exhibited their biological properties and antibacterial activity, which could well be a promising material with high potential to be applied in orthopaedic and dental tissue engineering.

A Universal Chelation-Induced Selective Demetallization Strategy for Bioceramic Nanosheets (BCene)

The emergence of nanosheet materials like graphene and phosphorene, which are created by breaking the interlayer van der Waals force, has revolutionized multiple fields. Layered inorganic materials are ubiquitous in materials like bioceramics, semiconductors, superconductors, etc. However, the strong interlayer covalent or ionic bonding in these crystals makes it difficult to fabricate nanosheets from them. In this study, we present a simple technique to produce nanosheets from layered crystals by selectively exfoliating their interlayer metal atoms using the metal-chelation reaction. As a proof of concept, we successfully produced bioceramic nanosheets (BCene) by extracting Ca layers from Akermanite (AKT). The 3D-printed BCene scaffolds exhibited superior mechanical strength and in vitro bioactivity compared to the scaffolds made from AKT nanopowders. Our findings demonstrate the outstanding potential of BCene nanosheets in tissue engineering. Additionally, the selective demetallization technique for nanosheet production could be applied to other inorganic layered crystals to optimize their performance.

3D printed pore morphology mediates bone marrow stem cell behaviors via RhoA/ROCK2 signaling pathway for accelerating bone regeneration

Bone bionics and structural engineering have sparked a broad interest in optimizing artificial scaffolds for better bone regeneration. However, the mechanism behind scaffold pore morphology-regulated bone regeneration remains unclear, making the structure design of scaffolds for bone repair challenging. To address this issue, we have carefully assessed diverse cell behaviors of bone mesenchymal stem cells (BMSCs) on the β-tricalcium phosphate (β-TCP) scaffolds with three representative pore morphologies (i.e., cross column, diamond, and gyroid pore unit, respectively). Among the scaffolds, BMSCs on the β-TCP scaffold with diamond pore unit (designated as D-scaffold) demonstrated enhanced cytoskeletal forces, elongated nucleus, faster cell mobility, and better osteogenic differentiation potential (for example, the alkaline phosphatase expression level in D-scaffold were 1.5-2 times higher than other groups). RNA-sequencing analysis and signaling pathway intervention revealed that Ras homolog gene family A (RhoA)/Rho-associated kinase-2 (ROCK2) has in-depth participated in the pore morphology-mediated BMSCs behaviors, indicating an important role of mechanical signaling transduction in scaffold-cell interactions. Finally, femoral condyle defect repair results showed that D-scaffold could effectively promote endogenous bone regeneration, of which the osteogenesis rate was 1.2-1.8 times higher than the other groups. Overall, this work provides insights into pore morphology-mediated bone regeneration mechanisms for developing novel bioadaptive scaffold designs.

Fabrication and Properties of Biodegradable Akermanite-Reinforced Fe35Mn Alloys for Temporary Orthopedic Implant Applications

As a representative of the biodegradable iron (Fe)-manganese (Mn) alloys, Fe35Mn has been investigated as a promising biodegradable metal biomaterial for orthopedic applications. However, its slow degradation rate, though better than pure Fe, and poor bioactivity are concerns that retard its clinical applications. Akermanite (Ca₂MgSi₂O₇, Ake) is a silicate-based bioceramic, showing desirable degradability and bioactivity for bone repair. In the present work, Fe35Mn/Ake composites were prepared via a powder metallurgy route. The effect of different contents of Ake (0, 10, 30, 50 vol %) on the microstructure, mechanical properties, degradation, and biocompatibility of the composites was investigated. The ceramic phases were found to be evenly distributed in the metal matrix. The Ake reacted with Fe35Mn and generated CaFeSiO₄ during sintering. The addition of Ake increased the relative density of pure Fe35Mn from ∼90 to ∼94-97%. The compressive yield strength (CYS) and elastic modulus (E_c) increased with increasing Ake, with Fe35Mn/50Ake exhibiting the highest CYS of ∼403 MPa and E_c of ∼18 GPa. However, the ductility decreased at higher Ake concentrations (30 and 50%). Microhardness also showed an increasing trend with the addition of Ake. Electrochemical measurements indicated that higher concentrations of Ake (30 and 50%) could potentially increase the corrosion rate of Fe35Mn from ∼0.25 to ∼0.39 mm/year. However, all of the compositions tested did not show measurable weight loss after immersion in simulated body fluid (SBF) for 4 weeks, attributed to the use of prealloyed raw material, high sintered density of the fabricated composites, and the formation of a dense Ca-, P-, and O-rich layer on the surface. Human osteoblasts on Fe35Mn/Ake composites showed increasing viability with increasing Ake content, indicating improved in vitro biocompatibility. These preliminary results suggest that Fe35Mn/Ake can be a potential material for biodegradable bone implant applications, particularly Fe35Mn/30Ake, if the slow corrosion of the composite can be addressed.

Alkaline earth metals for osteogenic scaffolds: From mechanisms to applications

Regeneration of bone defects is a significant challenge today. As alternative approaches to the autologous bone, scaffold materials have remarkable features in treating bone defects; however, the various properties of current scaffold materials still fall short of expectations. Due to the osteogenic capability of alkaline earth metals, their application in scaffold materials has become an effective approach to improving their properties. Furthermore, numerous studies have shown that combining alkaline earth metals leads to better osteogenic properties than applying them alone. In this review, the physicochemical and physiological characteristics of alkaline earth metals are introduced, mainly focusing on their mechanisms and applications in osteogenesis, especially magnesium (Mg), calcium (Ca), strontium (Sr), and barium (Ba). Furthermore, this review highlights the possible cross-talk between pathways when alkaline earth metals are combined. Finally, some of the current drawbacks of scaffold materials are enumerated, such as the high corrosion rate of Mg scaffolds and defects in the mechanical properties of Ca scaffolds. Moreover, a brief perspective is also provided regarding future directions in this field. It is worth exploring that whether the levels of alkaline earth metals in newly regenerated bone differs from those in normal bone. The ideal ratio of each element in the bone tissue engineering scaffolds or the optimal concentration of each elemental ion in the created osteogenic environment still needs further exploration. The review not only summarizes the research developments in osteogenesis but also offers a direction for developing new scaffold materials.

Two Hawks with One Arrow: A Review on Bifunctional Scaffolds for Photothermal Therapy and Bone Regeneration

Despite the significant improvement in the survival rate of cancer patients, the total cure of bone cancer is still a knotty clinical challenge. Traditional surgical resectionof bone tumors is less than satisfactory, which inevitably results in bone defects and the inevitable residual tumor cells. For the purpose of realizing minimal invasiveness and local curative effects, photothermal therapy (PTT) under the irradiation of near-infrared light has made extensive progress in ablating tumors, and various photothermal therapeutic agents (PTAs) for the treatment of bone tumors have thus been reported in the past few years, has and have tended to focus on osteogenic bio-scaffolds modified with PTAs in order to break through the limitation that PTT lacks, osteogenic capacity. These so-called bifunctional scaffolds simultaneously ablate bone tumors and generate new tissues at the bone defects. This review summarizes the recent application progress of various bifunctional scaffolds and puts forward some practical constraints and future perspectives on bifunctional scaffolds for tumor therapy and bone regeneration: two hawks with one arrow.

Multifunctional 3D-printed bioceramic scaffolds: Recent strategies for osteosarcoma treatment

Osteosarcoma is the most prevalent bone malignant tumor in children and teenagers. The bone defect, recurrence, and metastasis after surgery severely affect the life quality of patients. Clinically, bone grafts are implanted. Primary bioceramic scaffolds show a monomodal osteogenesis function. With the advances in three-dimensional printing technology and materials science, while maintaining the osteogenesis ability, scaffolds become more patient-specific and obtain additional anti-tumor ability with functional agents being loaded. Anti-tumor therapies include photothermal, magnetothermal, old and novel chemo-, gas, and photodynamic therapy. These strategies kill tumors through novel mechanisms to treat refractory osteosarcoma due to drug resistance, and some have shown the potential to reverse drug resistance and inhibit metastasis. Therefore, multifunctional three-dimensional printed bioceramic scaffolds hold excellent promise for osteosarcoma treatments. To better understand, we review the background of osteosarcoma, primary 3D-printed bioceramic scaffolds, and different therapies and have a prospect for the future.

Recent advances on bioactive baghdadite ceramic for bone tissue engineering applications: 20 years of research and innovation (a review)

Various artificial bone graft substitutes based on ceramics have been developed over the last 20 years. Among them, calcium-silicate-based ceramics, which are osteoconductive and can attach directly to biological organs, have received great attention for bone tissue engineering applications. However, the degradation rate of calcium-silicate and bone formation is often out of balance, resulting in stress shielding (osteopenia). A new strategy to improve the drawbacks of these ceramics is incorporating trace elements such as Zn, Mg, and Zr into their lattice structures, enhancing their physical and biological properties. Recently, baghdadite (Ca₃ZrSi₂O₉) ceramic, one of the most appealing calcium-silicate-based ceramics, has demonstrated high bioactivity, biocompatibility, biodegradability, and cell interaction. Because of its physical, mechanical, and biological properties and ability to be shaped using various fabrication techniques, baghdadite has found high potential in various biomedical applications such as coatings, fillers, cement, scaffolds, and drug delivery systems. Undoubtedly, there is a high potential for this newly developed ceramic to contribute significantly to therapies to provide a tremendous clinical outcome. This review paper aims to summarize and discuss the most relevant studies performed on baghdadite-based ceramics and composites by focusing on their behavior in vivo and in vitro.

Precisely Tuning the Pore-Wall Surface Composition of Bioceramic Scaffolds Facilitates Angiogenesis and Orbital Bone Defect Repair

Orbital bone damage (OBD) may result in severe post-traumatic enophthalmos, craniomaxillofacial deformities, vision loss, and intracranial infections. However, it is still a challenge to fabricate advanced biomaterials that can match the individual anatomical structure and enhance OBD repair in situ. Herein, we aimed to develop a selective surface modification strategy on bioceramic scaffolds and evaluated the effects of inorganic or organic functional coating on angiogenesis and osteogenesis, ectopically and orthotopically in OBD models. It was shown that the low thermal bioactive glass (BG) modification or layer-by-layer assembly of a biomimetic hydrogel (Biogel) could readily integrate into the pore wall of the bioceramic scaffolds. The BG and Biogel modification showed appreciable enhancement in the initial compressive strength (∼30-75%) or structural stability in vivo, respectively. BG modification could enhance by nearly 2-fold the vessel ingrowth, and the osteogenic capacity was also accelerated, accompanied with a mild scaffold biodegradation after 3 months. Meanwhile, the Biogel-modified scaffolds showed enhanced osteogenic differentiation and mineralization through calcium and phosphorus retention. The potential mechanism of the enhanced bone repair was elucidated via vascular and osteogenic cell responses in vitro, and the cell tests indicated that the Biogel and BG functional layers were both beneficial for in vitro osteoblastic differentiation and mineralization on bioceramics. Totally, these findings demonstrated that the bioactive ions or biomolecules could significantly improve the angiogenic and osteogenic capabilities of conventional bioceramics, and the integration of inorganic or organic functional coating in the pore wall is a highly flexible material toolbox that can be tailored directly to improve orbital bone defect repair.

Synthetic electrospun nanofibers as a supportive matrix in osteogenic differentiation of induced pluripotent stem cells

Continuous remodeling is not able to repair large bone defects. Bone tissue engineering is aimed to repair these defects by creating bone grafts. To do this, several technologies and biomaterials have been employed to fabricate an in vivo-like supportive matrix. Electrospinning is a versatile technique to fabricate porous matrices with interconnected pores and high surface area, replicating in vivo microenvironment. Electrospun scaffolds have been used in a large number of studies to provide a matrix for bone regeneration and osteogenic differentiation of stem cells such as induced pluripotent stem cells (iPSCs). Electrospinning uses both natural and synthetic polymers, either alone or in combination, to fabricate scaffolds. Among them, synthetic polymers have had a great promise in bone regeneration and repair. They allow the fabrication of biocompatible and biodegradable scaffolds with high mechanical properties, suitable for bone engineering. Furthermore, several attempts have done to increase the osteogenic properties of these scaffolds. This paper reviewed the potential of synthetic electrospun scaffolds in osteogenic differentiation of iPSCs. In addition, the approaches to improve the osteogenic differentiation of these scaffolds are addressed.

Additive manufacturing of bioactive and biodegradable porous iron-akermanite composites for bone regeneration

Advanced additive manufacturing techniques have been recently used to tackle the two fundamental challenges of biodegradable Fe-based bone-substituting materials, namely low rate of biodegradation and insufficient bioactivity. While additively manufactured porous iron has been somewhat successful in addressing the first challenge, the limited bioactivity of these biomaterials hinder their progress towards clinical application. Herein, we used extrusion-based 3D printing for additive manufacturing of iron-matrix composites containing silicate-based bioceramic particles (akermanite), thereby addressing both of the abovementioned challenges. We developed inks that carried iron and 5, 10, 15, or 20 vol% of akermanite powder mixtures for the 3D printing process and optimized the debinding and sintering steps to produce geometrically-ordered iron-akermanite composites with an open porosity of 69-71%. The composite scaffolds preserved the designed geometry and the original α-Fe and akermanite phases. The in vitro biodegradation rates of the composites were improved as much as 2.6 times the biodegradation rate of geometrically identical pure iron. The yield strengths and elastic moduli of the scaffolds remained within the range of the mechanical properties of the cancellous bone, even after 28 days of biodegradation. The composite scaffolds (10-20 vol% akermanite) demonstrated improved MC3T3-E1 cell adhesion and higher levels of cell proliferation. The cellular secretion of collagen type-1 and the alkaline phosphatase activity on the composite scaffolds (10-20 vol% akermanite) were, respectively higher than and comparable to Ti6Al4V in osteogenic medium. Taken together, these results clearly show the potential of 3D printed porous iron-akermanite composites for further development as promising bone substitutes. STATEMENT OF SIGNIFICANCE: : Porous iron matrix composites containing akermanite particles were produced by means of multi-material additive manufacturing to address the two fundamental challenges associated with biodegradable iron-based biomaterials, namely very low rate of biodegradation and insufficient bioactivity. Our porous iron-akermanite composites exhibited enhanced biodegradability and superior bioactivity compared to porous monolithic iron scaffolds. The murine bone cells proliferated on the composite scaffolds, and secreted the collagen type-1 matrix that stimulated bony-like mineralization. The results show the exceptional potential of the developed porous iron-based composite scaffolds for application as bone substitutes.

Developing a novel calcium magnesium silicate/graphene oxide incorporated silk fibroin porous scaffold with enhanced osteogenesis, angiogenesis and inhibited osteoclastogenesis

Recently, biofunctional ions (Mg2+, Si4+, etc.) and graphene derivatives are proved to be promising in stimulating bone formation. In this study, a novel inorganic/organic composite porous scaffold based on silk fibroin (SF), graphene oxide (GO), and calcium magnesium silicate (CMS) was developed for bone repair. The porous scaffolds obtained by lyophilization showed a little difference in pore structure while GO and CMS displayed a good interaction with SF matrix. The addition of CMS with good mineralization potential and sustainedly release ability of biofunctional ions (Ca2+, Mg2+ and Si4+) increased the strength of SF scaffolds a little and facilitated the osteogenic differentiation of bone mesenchymal stem cells (BMSCs) by upregulating bone formation-related genes (ALP, COL1, OC and Runx2). The further incorporation of GO in SF scaffolds enhanced the compressive strength and water retention, and also remarkably promoted the osteogenic differentiation of BMSCs. Besides, the angiogenesis of human umbilical vein endothelial cells was significantly promoted by CMS/GO/SF scaffold extract through the upregulation of angiogenesis genes (eNOs and bFGF). Moreover, the osteoclastic formation ability of RAW264.7 cells was suppressed by the released ions from CMS/GO/SF scaffold through the down-regulation of CAK, MMP9 and TRAP. The promoted osteogenesis, angiogenesis and inhibited osteoclastogenesis functions of CMS/GO/SF composite scaffold may enable it as a novel therapy for bone repair and regeneration.

Molybdenum disulfide (MoS2)-based nanostructures for tissue engineering applications: prospects and challenges

Molybdenum disulfide (MoS₂) nanostructures have recently earned substantial thoughts from the scientific communities owing to their unique physicochemical, optical and electrical properties. Although MoS₂ has been mostly highlighted for its industrial applications, its biological applicability has not been extensively explored. The introduction of nanotechnology in the field of tissue engineering has significantly contributed to human welfare by displaying advancement in tissue regeneration. Assimilation of MoS₂ nanostructures into the polymer matrix has been considered a persuasive material of choice for futuristic tissue engineering applications. The current review provides a general discussion on the structural properties of different MoS₂ nanostructures. Further, this article focuses on the interactions of MoS₂ with biological systems in terms of its cellular toxicity, and biocompatibility along with its capability for cell proliferation, adhesion, and immunomodulation. The article continues to confer the utility of MoS₂ nanostructure-based scaffolds for various tissue engineering applications. The article also highlights some emerging prospects and possibilities of the applicability of MoS₂-based nanostructures in large organ tissue engineering. Finally, the article concludes with a brief annotation on the challenges and limitations that need to be overcome in order to make plentiful use of this wonderful material for tissue engineering applications.

Effects of Mg-Nd-Gd-Sr alloy on bone marrow mesenchymal stem cell function derived from SD rats

Introduction

The aim of this study was to determine the effect of a new type of Mg-3Nd-1Gd-0.3Sr-0.2Zn-0.4Zr (abbreviated to Mg-Nd-Gd-Sr) alloy on bone marrow mesenchymal stem cell (BMSCs) function derived from SD rats.

Methods

BMSCs were first isolated and cultured in vitro using the whole bone marrow adherence method, and identified by BMSC surface biomarkers and osteogenic induction. The in vitro biological safety of the Mg-Nd-Gd-Sr alloy was studied by cytotoxicity and apoptosis experiments, and the in vitro biological functions were studied by cell adhesion and cell proliferation experiments.

Results

The results showed that high-purity BMSCs were isolated using the whole bone marrow adherence method. Flow cytometry showed high expression of CD44 and CD90, and low expression of CD31 and CD45 in the BMSCs. Osteogenic induction showed that the BMSCs differentiated into osteoblasts, and mineralized nodules were observed. The cytotoxicity of the Mg-Nd-Gd-Sr alloy to SD rat BMSCs was 0–1 grade, suggesting that the Mg-Nd-Gd-Sr alloy had no significant cytotoxic effect on SD rat BMSCs; compared with the control group, there was no significant cell apoptosis in any of the experimental groups ( p > 0.05). Cell adhesion experiments showed that the number of adherent cells increased with the duration of culture with the exception of the 100% concentration group; compared with the control group, the 75% concentration group had the highest number of adherent cells at the 1st, 3rd, 5th, and 7th hours ( p < 0.05). Cell proliferation experiments showed that the number of cells in all experiment groups was higher than the control group ( p < 0.05) on the 1st, 3rd, 5th, and 7th days, with the highest number of cells in the 75% concentration group ( p < 0.05).

Conclusion

Our data indicate that the extracts of new type of Mg-Nd-Gd-Sr alloy has no apparent cytotoxicity to BMSCs, does not affect cell apoptosis, and has good biocompatibility. Different concentrations of Mg-Nd-Gd-Sr alloy extracts promoted the adhesion and proliferation of BMSCs. The alloy had good biological functions, and is thus a promising bone repair material.

3D-printed bioceramic scaffolds with Fe3S4microflowers for magnetothermal and chemodynamic therapy of bone tumor and regeneration of bone defects

Elimination of residual osteosarcoma cells and repair of bone defects remain major challenges for osteosarcoma in clinic. To address this problem, it is required that multifunctional therapeutic platform possess high tumor-killing efficiency and simultaneous bone regeneration capabilities. In this work, an intelligent therapeutic platform was developed to achieve highly-efficient tumor therapy and simultaneous significantly improved bone defect repairing ability, which was realized byin situgrowing ferromagnetic Fe₃S₄layers with tuned microstructures on the surface of 3D-printed akermanite bioceramic scaffolds via hydrothermal method. The Fe₃S₄layers exploited magnetic thermal energy to enhance chemodynamic treatment, thus achieving a synergistic effect between magnetothermal and chemodynamic therapy on the elimination of residual tumor cells. Moreover, the micro-structured surface of the 3D-printed bioceramic scaffolds further enhanced the osteogenic activityin vitroand accelerated the bone regenerationin vivo. The scaffolds with multi-mode tumor-killing and bone repairing capabilities indicated that such a therapeutic platform is applicable for a stepwise treatment strategy of osteosarcoma and provides inspiration for the design of multifunctional biomaterials.

Biomineralization potential and biological properties of a new tantalum oxide (Ta2O5)-containing calcium silicate cement

Objective

The present study evaluated the biological effects and biomineralization potential of a new tantalum oxide (Ta₂O₅)–containing material designed for vital pulp therapy or perforation repair (NeoMTA 2), compared to NeoMTA Plus and Bio-C Repair.

Material and methods

Human dental pulp stem cells (hDPSCs) were exposed to different eluates from NeoMTA Plus, NeoMTA 2, and Bio-C Repair. Ion release from each material was determined using inductively coupled plasma-optical emission spectrometry (ICP-MS). The biological experiments performed were MTT assays, apoptosis/necrosis assays, adhesion assays, migration assays, morphology evaluation, and reactive oxygen species (ROS) production analysis. Biomineralization was assessed by Alizarin red S staining. Finally, osteo/odontogenic gene expression was determined by real-time quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR). Data were analyzed using one-way ANOVA followed by Tukey’s multiple comparison test.

Results

NeoMTA 2 displayed a significantly higher calcium release compared to the other materials (p < 0.05). When hDPSCs were cultured in presence of the different material eluates, all groups exhibited similar hDPSC viability and migration rates when compared to untreated cells. Substantial cell attachment and spreading were observed in all materials’ surfaces, without significant differences. hDPSCs treated with NeoMTA 2 displayed an upregulation of ALP, Col1A1, RUNX2 (p < 0.001), ON, and DSPP genes (p < 0.05), and showed the highest mineralization potential compared to other groups (p < 0.001). Finally, the more concentrated eluates from these materials, specially NeoMTA Plus and NeoMTA 2, promoted higher ROS production in hDPSCs compared to Bio-C Repair and control cells (p < 0.001), although these ROS levels did not result in increased cell death.

Conclusions

The new tantalum oxide (Ta₂O₅)–containing material shows an adequate cytocompatibility and the ability to promote biomineralization without using chemical osteogenic inducers, showing great potential as a new material for vital pulp therapy.

Clinical relevance

NeoMTA 2 seems to be a promising material for vital pulp therapy. Further studies considering its biocompatibility and biomineralization potential are necessary.

The in vivo dissolution of tricalcium silicate bone cement

This study aimed to investigate the in vivo dissolution of tricalcium silicate (Ca₃ SiO₅ , C₃ S) bone cement in the rabbit femoral defect. Results indicated that C₃ S paste directly integrated with the bone tissue without the protection of the bone-like apatite. Calcium silicate hydrate gel (C-S-H gel) and Ca(OH)₂ were the main components of C₃ S paste. The dissolution model of C₃ S paste was a mass loss rather than a decrease in volume. The initial dissolution of C₃ S paste (0 ~ 6 weeks) was greatly attributed to the release of Ca(OH)₂ , and the later dissolution (>6 weeks) was attributed to the decalcification of C-S-H gel. Although the mass of C₃ S paste could decrease by more than 19 wt % after 6 weeks of implantation, the created pores (<1 μm) were not large enough for the bone tissue to migrate into C₃ S paste. The loss of Ca ions also resulted in the transformation of SiO₄ tetrahedrons from Q¹ and Q² to Q⁰ , Q³ , and Q⁴ in C-S-H gel. Because only isolated SiO₄ tetrahedrons (Q⁰ ) and Ca ions could be absorbed by the bone tissue, C₃ S paste gradually transformed into a silica-rich gel. The fundamental reason for no decrease in volume of C₃ S paste was that the SiO₄ tetrahedron network still maintained the frame structure of C₃ S paste during the implantation.

Manganese-Doped Calcium Silicate Nanowire Composite Hydrogels for Melanoma Treatment and Wound Healing

Melanoma is a serious malignant skin tumor. Effectively eliminating melanoma and healing after-surgical wounds are always challenges in clinical studies. To address these problems, we propose manganese-doped calcium silicate nanowire-incorporated alginate hydrogels (named MCSA hydrogels) for in situ photothermal ablation of melanoma followed by the wound healing process. The proposed MCSA hydrogel had controllable gelation properties, reasonable strength, and excellent bioactivity due to the incorporated calcium silicate nanowires as the in situ cross-linking agents and bioactive components. The doping of manganese into calcium silicate nanowires gave them excellent photothermal effects for eradicating melanoma effectively under near infrared (NIR) irradiation. Moreover, the synergistic effect of manganese and silicon in the MCSA hydrogel effectively promotes migration and proliferation of vascular endothelial cells and promotes angiogenesis. Hence, such bifunctional bioactive hydrogels could achieve combined functions of photothermal therapy and wound healing, showing great promise for melanoma therapy and tissue regeneration.

Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material

Root canal treatment has been the treatment of choice for carious pulp exposures. In the perspective of minimally invasive dentistry and preventive endodontics, a direct pulp capping procedure with a reliable bioactive material may be considered an alternative approach provided that the pulp status is favorable. However, the treatment of pulp exposure by pulp capping is still a controversial issue with no clear literature available on this topic, leaving the concerned practitioner more confused than satisfied. Biodentine is a relatively new bioactive material explored for vital pulp therapy procedures. This article discusses its role in direct pulp capping procedures. A thorough literature search of the database was done using PubMed, Google Scholar, and Scopus using the keywords preventive endodontics, calcium silicate cement, direct pulp capping, Biodentine, and vital pulp therapy. Reference mining of the articles that were identified was used to locate other papers and enrich the findings. No limits were imposed on the year of publication, but only articles in English were considered. This paper is aimed at reviewing the current literature on Biodentine as a direct pulp capping material. The review will provide a better understanding of Biodentine's properties and can aid in the decision-making process for maintaining the vitality of exposed dental pulp with minimal intervention.

Three-Dimensional Printing of Scaffolds with Synergistic Effects of Micro-Nano Surfaces and Hollow Channels for Bone Regeneration

The 3D printing technology with unique strategies for accurate fabrication of biomaterials in regenerative medicine has been widely applied in bone regeneration. However, the traditional 3D printing scaffolds are only stacked by solid struts without any hollow channel structures, which limits the new bone tissue formation. In this study, a special 3D scaffold with hollow channels and a micro-nano surface was prepared by a modified 3D printing strategy combined with the hydrothermal treatment approach. By regulating the reaction solution of hydrothermal treatment, the micro-nano structures formed on the surface of scaffolds can be successfully controlled. Moreover, the scaffolds have the ability to facilitate the attachment and proliferation of BMSCs after culturing for 1, 3, and 7 days in vitro. Interestingly, the in vivo results demonstrated that the hollow channels and the micro-nano surface present synergistic effects on bone regeneration. They both boost the new bone formation in femur defects in rabbits for 12 weeks after operation. The study demonstrates a 3D scaffold with special surface microstructures and hollow struts that can overcome the shortages of most traditional scaffolds and meanwhile improve the bioactivity of biomaterials for bone tissue engineering.

Reinforced Supramolecular Hydrogels from Attapulgite and Cyclodextrin Pseudopolyrotaxane for Sustained Intra-Articular Drug Delivery

Injectable hydrogels for nonsteroidal anti-inflammatory drugs' (NSAIDs) delivery to minimize the side effects of NSAIDs and achieve long-term sustained release at the targeted site of synovial joint are attractive for osteoarthritis therapy, but how to improve its mechanical strength remains a challenge. In this work, a kind of 1D natural clay mineral material, attapulgite (ATP), is introduced to a classical cyclodextrin pseudopolyrotaxane (PPR) system to form a reinforced supramolecular hydrogel for sustained release of diclofenac sodium (DS) due to its rigid, rod-like morphology, and unique structure, which has great potential in tissue regeneration, repair, and engineering. Investigation on the interior morphology and rheological property of the obtained hydrogel points out that the ATP distributed in PPR hydrogel plays a role similar to the "reinforcement in concrete" and exhibits a positive effect on improving the mechanical properties of PPR hydrogel by regulating their interior morphology from a randomly distributed style to the well-ordered porous frame structure. The hybrid hydrogels demonstrate good shear-thinning and thixotropic properties, excellent biocompability, and sustained release behavior both in vitro and in vivo. Furthermore, preliminary in vivo treatment in an acute inflammatory rat model reveals that the ATP hybrid hydrogels present sustained anti-inflammatory effect.

Early Odontogenic Differentiation of Dental Pulp Stem Cells Treated with Nanohydroxyapatite-Silica-Glass Ionomer Cement

This study aimed to investigate the effects of nanohydroxyapatite–silica–glass ionomer cement (nanoHA–silica–GIC) on the differentiation of dental pulp stem cells (DPSCs) into odontogenic lineage. DPSCs were cultured in complete Minimum Essential Medium Eagle—Alpha Modification (α-MEM) with or without nanoHA–silica–GIC extract and conventional glass ionomer cement (cGIC) extract. Odontogenic differentiation of DPSCs was evaluated by real-time reverse transcription polymerase chain reaction (rRT–PCR) for odontogenic markers: dentin sialophosphoprotein (DSPP), dentin matrix protein 1 (DMP1), osteocalcin (OCN), osteopontin (OPN), alkaline phosphatase (ALP), collagen type I (COL1A1), and runt-related transcription factor 2 (RUNX2) on day 1, 7, 10, 14, and 21, which were normalized to the house keeping gene glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Untreated DPSCs were used as a control throughout the study. The expressions of DSPP and DMP1 were higher on days 7 and 10, that of OCN on day 10, those of OPN and ALP on day 14, and that of RUNX2 on day 1; COL1A1 exhibited a time-dependent increase from day 7 to day 14. Despite the above time-dependent variations, the expressions were comparable at a concentration of 6.25 mg/mL between the nanoHA–silica–GIC and cGIC groups. This offers empirical support that nanoHA–silica–GIC plays a role in the odontogenic differentiation of DPSCs.

A Magnesium-Incorporated Nanoporous Titanium Coating for Rapid Osseointegration

Purpose

Micro-arc oxidation (MAO) is a fast and effective method to prepare nanoporous coatings with high biological activity and bonding strength. Simple micro/nano-coatings cannot fully meet the requirements of osteogenesis. To further improve the biological activity of a titanium surface, we successfully added biological magnesium (Mg²⁺) to a coating by micro-arc oxidation and evaluated the optimal magnesium concentration in the electrolyte, biocompatibility, cell adhesion, proliferation, and osteogenesis in vitro.

Methods

Nanoporous titanium coatings with different concentrations of magnesium were prepared by micro-arc oxidation and characterized by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). The Mg²⁺ release ability of the magnesium-incorporated nanoporous titanium coatings was determined by inductively coupled plasma emission spectrometry (ICP-OES). The cytotoxicity of the magnesium-incorporated nanoporous titanium coatings was detected with live/dead double-staining tests. A CCK-8 assay was employed to evaluate cell proliferation, and FITC-phalloidin was used to determine the structure of the cytoskeleton by staining β-actin. Alkaline phosphatase (ALP) activity was evaluated by alizarin red S (ARS) staining to determine the effect of the coatings on osteogenic differentiation in vitro. The mRNA expression of osteogenic differentiation-related markers was measured using qRT-PCR.

Results

EDS analyses revealed the successful addition of magnesium to the microporous coatings. The best magnesium concentration of the electrolyte for preparing the new coating was determined. The results showed that the nano-coatings prepared using the electrolyte with 2 g/L magnesium acetate best promoted the adhesion, proliferation, and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs).

Conclusion

These results suggest that the new titanium metal coating with a dual effect of promoting bone morphology and supplying the biological ion Mg²⁺ can be beneficial for rapid osseointegration.

Tissue Engineering and Regenerative Medicine: Achievements, Future, and Sustainability in Asia

Exploring innovative solutions to improve the healthcare of the aging and diseased population continues to be a global challenge. Among a number of strategies toward this goal, tissue engineering and regenerative medicine (TERM) has gradually evolved into a promising approach to meet future needs of patients. TERM has recently received increasing attention in Asia, as evidenced by the markedly increased number of researchers, publications, clinical trials, and translational products. This review aims to give a brief overview of TERM development in Asia over the last decade by highlighting some of the important advances in this field and featuring major achievements of representative research groups. The development of novel biomaterials and enabling technologies, identification of new cell sources, and applications of TERM in various tissues are briefly introduced. Finally, the achievement of TERM in Asia, including important publications, representative discoveries, clinical trials, and examples of commercial products will be introduced. Discussion on current limitations and future directions in this hot topic will also be provided.

Osteogenic Differentiation of Adipose-Derived Stromal Cells: From Bench to Clinics

In addition to mesenchymal stem cells, adipose-derived stem/stromal cells (ASCs) are an attractive source for a large variety of cell-based therapies. One of their most important potential applications is related to the regeneration of bone tissue thanks to their capacity to differentiate in bone cells. However, this requires a proper control of their osteogenic differentiation, which depends not only on the initial characteristics of harvested cells but also on the conditions used for their culture. In this review, we first briefly describe the preclinical and clinical trials using ASCs for bone regeneration and present the quantitative parameters used to characterize the osteogenic differentiation of ASCs. We then focus on the soluble factors influencing the osteogenic differentiation of ACS, including the steroid hormones and various growth factors, notably the most osteoinductive ones, the bone morphogenetic proteins (BMPs). Impact statement Adipose-derived stromal/stem cells are reviewed for their use in bone regeneration.

Generation of a Porous Scaffold with a Starting Composition in the CaO–SiO2–MgO–P2O5 System in a Simulated Physiological Environment

Magnesium-based ceramics are involved in orthopedic applications such as bone scaffolds or implant coatings. They provide structural support to cells for bone ingrowth, but highly porous matrices cannot resist severe mechanical stress during implantation. In this study, the laser floating zone (LFZ) technique is used to prepare a dense crystalline material with composition in the CaO–SiO2–MgO–P2O5 system. This material, under physiological conditions, is able to generate a porous scaffold controlled by the dissolution of the MgO phase, meeting the mechanical advantages of a dense material and the biological features of a porous scaffold. FESEM (Field emission scanning electron microscopy), XRD (X-ray Diffraction), EDS (Energy Dispersive X-rays spectroscopy), and ICP ((Inductively Coupled Plasma) analysis were carried out in order to characterize the samples before and after immersion in simulated body fluid (SBF).

Three-Dimensional-Printed Bioceramic Scaffolds with Osteogenic Activity for Simultaneous Photo/Magnetothermal Therapy of Bone Tumors

For the postoperative treatment of bone cancer, biomaterials should possess an antitumor effect and simultaneous repair ability of bone defects. Compared with single photothermal treatment or magnetothermal treatment, photo/magnetothermal joint treatment represents a more high-efficient strategy to kill tumor cells. In this work, a 3D-printed bioceramic scaffold with a photo/magnetothermal effect was successfully designed and fabricated, which exhibited the function of killing tumor cells and excellent osteogenic bioactivity, via incorporating an Fe element into akermanite (AKT) bioceramics. After doping with ferric elements, the AKT scaffolds possessed significantly enhanced compressive strength and desirable ferromagnetic property. The ferric elements endowed the AKT scaffolds with excellent photo/magnetothermal effects, and hence the scaffolds could efficiently kill tumor cells in vitro under mild laser power density and magnetic field. In addition, the Fe-doped AKT bioceramic scaffolds significantly promoted cell proliferation and osteogenic differentiation of rabbit bone mesenchymal stem cells as compared with the original AKT scaffolds without Fe elements. The results suggest that Fe-doped bioceramic scaffolds with both photo/magnetothermal effect and in vitro osteogenic bioactivity could be a promising biomaterial for the synergistic therapy of bone cancers.

In-vivo performance of plasma-sprayed CaO-MgO-SiO2-based bioactive glass-ceramic coating on Ti-6Al-4V alloy for bone regeneration

The CaO-MgO-SiO₂-based bioactive glass-ceramic coating (named M2) on Ti-6Al-4V alloy has been proven to behave well in vitro. But how to make full sense of its performances in terms of osteogenesis and osseointegration in vivo matters very much. For this, the M2-coated Ti-6Al-4V cylinders were prepared by atmospheric plasma spraying (APS) and implanted into New Zealand rabbit for 1, 2 and 3 months, respectively, by setting commercial HA-coated Ti-6Al-4V as the control. It is encouraging that, the two groups bonded with the surrounding tissues stably and newly formed bone grew towards or around the implants after 3-month implantation according to radiographic images. From the histological sections, it is obvious that, compared to the control, the M2-coated implant was more favorable for the osteogenesis and neo-vascularisation in the whole experimental process and demonstrated a better osseointegration with the host bone, indicating the former possessed better osteoconductivity, osteoinductivity and osteogenic ability. The study indicated that the M2-coated Ti-6Al-4V implant exerted a great potential to substitute the commercial HA-coated Ti-6Al-4V implant in repairing load-bearing bone defects.

3D Printing of Hot Dog-Like Biomaterials with Hierarchical Architecture and Distinct Bioactivity

Hierarchical structure has exhibited an important influence in the fields of supercapacitors, catalytic applications, and tissue engineering. The hot dog, a popular food, is composed of bread and sausage with special structures. In this study, inspired by the structure of a hot dog, the strategy of combining direct ink writing 3D printing with bidirectional freezing is devised to prepare hot dog-like scaffolds with hierarchical structure. The scaffolds are composed of hollow bioceramic tubes (mimicking the "bread" in hot dogs, pore size: ≈1 mm) embedded by bioceramic rods (mimicking the "sausage" in hot dogs, diameter: ≈500 µm) and the sausage-like bioceramic rods possess uniformly aligned lamellar micropores (lamellar pore size: ≈30 µm). By mimicking the functions of hierarchical structure of bone tissues for transporting and storing nutrients, the prepared hot dog-like scaffolds show excellent properties for loading and releasing drugs and proteins as well as for improving the delivery and differentiation of tissue cells. The in vivo study further demonstrates that both the hierarchical structure itself and the controlled drug delivery in hot dog-like scaffolds significantly contribute to the improved bone-forming bioactivity. This study suggests that the prepared hot dog-like scaffolds are a promising biomaterial for drug delivery, tissue engineering, and regenerative medicine.

Inhibition of the negative effect of high glucose on osteogenic differentiation of bone marrow stromal cells by silicon ions from calcium silicate bioceramics

Human bone marrow stem cells (hBMSCs) are exploited for miscellaneous applications in bone tissue engineering where they are mainly used as seed cells. However, high glucose (HG) environment has negative impacts on the proliferation and osteogenic differentiation of hBMSCs, thus reducing the bone formation in diabetic patients. In our former research works, we discovered that silicon (Si) ions extracted from silicate-based bioceramics are able to stimulate the proliferation and osteogenic differentiation of hBMSCs under normal culture condition. This study aimed to investigate if Si ions could prevent HG-induced inhibition of proliferation and osteogenesis of hBMSCs. We found that 2.59 ppm concentration of Si ions promoted the proliferation of hBMSCs under HG condition. The results from alkaline phosphatase (ALP) activity assay, Alizarin red S staining and quantitative real-time PCR analysis of osteogenic genes (BMP2, RUNX2, ALP, COL1 and OCN) demonstrated that the 15.92 ppm concentration of Si ions prevented HG-induced inhibition of the osteogenic differentiation of hBMSCs. Moreover, application of Si ions reduced the level of reactive oxygen species in HG-treated hBMSCs. In HG-treated hBMSCs following 15.92 ppm Si ions treatment, activation of BMP2/SMAD signaling pathway was detected, as indicated by the increased expression of BMP2 receptors and its downstream genes such as SMAD1, SMAD4 and SMAD5. Taken together, we provide evidence that the specific concentration of Si ions compensated HG-induced inhibition of proliferation and osteogenic differentiation of hBMSCs through antioxidant effect and modulation of BMP2/SMAD pathway. The results suggest that silicate-based bioceramics might be good scaffold biomaterials for bone engineering applications in diabetes patients.

Nanobiomaterials: from 0D to 3D for tumor therapy and tissue regeneration

Nanobiomaterials have attracted tremendous attention in the biomedical field. Especially in the past few years, a large number of low dimensional nanobiomaterials, including 0D nanostructures, 1D nanotubes and 2D nanosheets, were employed for tumor therapy due to their optically triggered tumor therapy effects and drug loading capacities. However, these low dimensional nanobiomaterials cannot support cell adhesion and possess poor tissue regeneration ability, thus they are not suitable for application in regenerative medicine. Three dimensional (3D) nanofiber scaffolds have attracted extensive attention in tissue regeneration, including bone, skin, nerve and cardiac tissues, due to their similar extracellular matrix structures. Additionally, many 3D scaffolds displayed bone and cartilage regeneration abilities. Therefore, to obtain materials with both tumor therapy and tissue regeneration abilities, it is meaningful and necessary to develop 3D nanobiomaterials with multifunctions. In this review, we systematically review the research progress of nanobiomaterials with varied dimensional structures including 0D, 1D, 2D and 3D, as well as evolutional functions from single tumor therapy to simultaneous tumor therapy and tissue regeneration. This review may pave the way for developing an interdisciplinary research of nanobiomaterials in combination of tumor therapy and regenerative medicine.

Bone allografts combined with adipose-derived stem cells in an optimized cell/volume ratio showed enhanced osteogenesis and angiogenesis in a murine femur defect model

Critical sized defects, especially in long bones, pose one of the biggest problems in orthopedic surgery. By definition, these defects do not heal without further treatment. Different therapeutic options range from autologous bone grafts, for example, free vascularized bone grafts, to commercially available bone allografts. Disadvantages of these bone allografts are related to reduced osteogenesis, since they are solely composed of cell-free bone matrix. The purpose of this study was to investigate the cell seeding efficiency of human adipose-derived stem cells (hASCs) on human bone allografts in vitro and furthermore analyze these optimized seeded allografts in a critical sized defect model in vivo. Cancellous human bone allografts were colonized with human ASCs in vitro. Cell seeding efficiency was evaluated by Cell Counting Kit-8 assay. Thereafter, optimized hASC-seeded bone scaffolds were examined in a murine femur defect model, stabilized with the MouseExFix system. Subsequently, x-ray analysis and histology were performed. Examination of cell seeding efficiency revealed an optimum starting population of 84,600 cells per 100 mm³ scaffold. In addition, scaffolds seeded with hASCs showed increased osteogenesis compared with controls. Histological analysis revealed increased remodeling and elevated new bone formation within hASC-seeded scaffolds. Moreover, immunohistochemical stainings revealed increased proliferation, osteogenesis, and angiogenesis. In this study, we systemically optimized cell/volume ratio of two promising components of tissue engineering: hASCs and human bone allografts. These findings may serve as a basis for future translational studies. KEY MESSAGES: Bone tissue engineering. Mesenchymal stem cells derived from human adipose tissue (hASCs). Optimal cell/volume ratio of cell-seeded scaffolds. Increased osteogenesis and angiogenesis in vivo.

Akermanite bioceramic enhances wound healing with accelerated reepithelialization by promoting proliferation, migration, and stemness of epidermal cells

Reepithelialization is an important step of wound healing, which is mainly completed by proliferation and migration of epidermal cells. Akermanite is a Ca-, Mg-, and Si-containing bioceramic. This study evaluated the effects of Akermanite on wound healing and investigated the mechanisms. Using scald burn mice models, we demonstrated that local Akermanite treatment significantly accelerated wound healing by increasing reepithelialization and the stemness of epidermal cells. Epidermal cells were cultured in medium containing Akermanite extracts to explore the cellular mechanism of reepithelialization. Akermanite promoted the cell proliferation and migration, maintaining more cells in the S and G₂ /M phases of the cell cycle. An additional study showed that Akermanite enhanced the expressions of integrinβ1, Lgr4, Lgr5, and Lgr6, which are specific molecular markers of epidermal stem cells, accompanied by the activation of the Wnt/β-catenin pathway. These results suggested that Akermanite accelerated reepithelialization by increasing the proliferation, migration, and stemness of epidermal cells in a manner related to the Wnt/β-catenin pathway, which might contribute, at least partially, to accelerated wound healing by Akermanite therapy.

Mechanical properties of bioactive glasses, ceramics, glass-ceramics and composites: State-of-the-art review and future challenges

The repair and restoration of bone defects in orthopaedic and dental surgery remains a major challenge despite advances in surgical procedures and post-operative treatments. Bioactive glasses, ceramics, glass-ceramics and composites show considerable potential for such applications as they can promote bone tissue regeneration. This paper presents an overview of the mechanical properties of various bioactive materials, which have the potential for bone regeneration. It also identifies current strategies for improving the mechanical properties of these novel materials, as these are rarely ideal as direct replacements for human bone. For this reason bioactive organic-inorganic composites and hybrids that have tailorable mechanical properties are of particular interest. The inorganic component (bioactive glass, ceramic or glass-ceramic) can provide both strength and bioactivity, while the organic component can add structural reinforcement, toughness and processability. Another topic presented in this paper includes 3D porous scaffolds that act as a template for cell attachment, proliferation and bone growth. Mechanical limitations of existing glass and ceramic scaffolds are discussed, along with the relevant challenges and strategies for further improvement. Advantages and disadvantages of different bioactive materials are critically examined. This paper is focused on optimization of biomaterials properties, in particular mechanical properties and bioactivity.

Physical, mechanical and in vitro evaluation of a novel cement based on akermantite and dicalcium phosphate dihydrate phase

Magnesium containing calcium silicates have recently shown that they are promising materials for various biomedical application with potential use in the form of bulk ceramic, composite scaffold or coatings on metallic substrates. A novel akermanite (AK; Ca₂MgSi₂O₇)/dicalcium phosphate dihydrate (DCPD, CaHPO₄. H₂O) cement mixture was tested in this work in order to produce an alternative AK/DCPD biocement for orthopedic applications. For comparison, we have prepared two cements mixed with 2.5 wt% NaH₂PO₄ solution (labeled as NaH₂PO₄ cement) and with the solution composed of organic 2.5 wt% citric acid a 2.5 wt% trisodium citrate (citrate cement) respectively. The results demonstrated only a partial dissolution of AK, regardless of the type of liquid used. On the other hand, the DCPD was completely hydrolyzed much faster in the citrate cement. The final hydration product was an amorhous quarternary phase of CaO-MgO-SiO₂-P₂O₅ composition with the remaining unreacted akermanite embeded in the cement matrix. The highest early compressive strength was observed in the citrate cement (33 MPa), but much lower value was measured in NaH₂PO₄ cement (7 MPa) after 1 d setting. Different cell responses have been observed when the cells were cultured on the surfaces of cement substrates. While the NaH₂PO₄ cement demonstrated high proliferation activity of osteoblast, the citrate cement showed strong cytotoxic cell response, probably as a result of higher concentration of citrates on the cement surface, which can negatively affect the attachment and proliferation of osteoblastic cells.

Comparative study of hydroxyapatite, fluor-hydroxyapatite and Si-substituted hydroxyapatite nanoparticles on osteogenic, osteoclastic and antibacterial ability

This study compared the effects of hydroxyapatite (HA), fluor-hydroxyapatite (FHA) and Si-substituted hydroxyapatite (SiHA) on osteogenic differentiation, osteoclastic activity and antibacterial properties. HA, FHA and SiHA were prepared via a sol-gel reaction and characterized by scanning electron microscopic analysis (SEM), transmission electron microscopic analysis (TEM), and X-ray photoelectron spectrometry. Cell proliferation was evaluated using an MTT assay and cytoskeletal morphology was observed by fluorescence microscopy. Osteogenic differentiation was evaluated using alkaline phosphatase activity and Alizarin red staining. Quantitative real-time PCR was used to evaluate the mRNA expression of runt-related transcription factor 2 (Runx2) and osteopontin (OPN). New bone formation was tested using μCT, haematoxylin and eosin staining and TRAP staining. The antibacterial actions against Porphyromonas gingivalis (P. g) were evaluated through plate counting and live-dead bacterial staining. The results demonstrated that HA, FHA and SiHA can promote proliferation of bone mesenchymal stem cells (BMSCs). ALP activity in FHA extract with a concentration of 625 μg mL-1 was the highest after 14 days osteogenic induction; similar results were observed for Runx2 and OPN mRNA expression. HA, FHA and SiHA decreased trabecular space in bone defects, but FHA reduced osteoclastic activity and inhibited P. g growth. In conclusion, FHA can promote osteogenic activity, reduce osteoclastic activity and enhance antibacterial effects.