1
|
Zhang H, Wang Y, Qiang H, Leng D, Yang L, Hu X, Chen F, Zhang T, Gao J, Yu Z. Exploring the frontiers: The potential and challenges of bioactive scaffolds in osteosarcoma treatment and bone regeneration. Mater Today Bio 2024; 29:101276. [PMID: 39444939 PMCID: PMC11497376 DOI: 10.1016/j.mtbio.2024.101276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 09/16/2024] [Accepted: 09/25/2024] [Indexed: 10/25/2024] Open
Abstract
The standard treatment for osteosarcoma combines surgery with chemotherapy, yet it is fraught with challenges such as postoperative tumor recurrence and chemotherapy-induced side effects. Additionally, bone defects after surgery often surpass the body's regenerative ability, affecting patient recovery. Bioengineering offers a novel approach through the use of bioactive scaffolds crafted from metals, ceramics, and hydrogels for bone defect repair. However, these scaffolds are typically devoid of antitumor properties, necessitating the integration of therapeutic agents. The development of a multifunctional therapeutic platform incorporating chemotherapeutic drugs, photothermal agents (PTAs), photosensitizers (PIs), sound sensitizers (SSs), magnetic thermotherapeutic agents (MTAs), and naturally occurring antitumor compounds addresses this limitation. This platform is engineered to target osteosarcoma cells while also facilitating bone tissue repair and regeneration. This review synthesizes recent advancements in integrated bioactive scaffolds (IBSs), underscoring their dual role in combating osteosarcoma and enhancing bone regeneration. We also examine the current limitations of IBSs and propose future research trajectories to overcome these hurdles.
Collapse
Affiliation(s)
- Huaiyuan Zhang
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, 201508, China
| | - Yu Wang
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, 201508, China
| | - Huifen Qiang
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Dewen Leng
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Luling Yang
- Digestive Endoscopy Center, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Xueneng Hu
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, 201508, China
| | - Feiyan Chen
- Department of Orthopedics, Huashan Hospital, Fudan University Shanghai, 201508, China
| | - Tinglin Zhang
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China
- Shanghai Key Laboratory of Nautical Medicine and Translation of Drugs and Medical Devices, Shanghai, 200336, China
| | - Jie Gao
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China
- Shanghai Key Laboratory of Nautical Medicine and Translation of Drugs and Medical Devices, Shanghai, 200336, China
| | - Zuochong Yu
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, 201508, China
| |
Collapse
|
2
|
Meng B, Zhao X, Wang XL, Wang J, Xu C, Lei W. Does the novel artificial cervical joint complex resolve the conflict between stability and mobility after anterior cervical surgery? a finite element study. Front Bioeng Biotechnol 2024; 12:1400614. [PMID: 38887613 PMCID: PMC11180832 DOI: 10.3389/fbioe.2024.1400614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024] Open
Abstract
Background and objective Our group has developed a novel artificial cervical joint complex (ACJC) as a motion preservation instrument for cervical corpectomy procedures. Through finite element analysis (FEA), this study aims to assess this prosthesis's mobility and stability in the context of physiological reconstruction of the cervical spine. Materials and methods A finite element (FE)model of the subaxial cervical spine (C3-C7) was established and validated. ACJC arthroplasty, anterior cervical corpectomy and fusion (ACCF), and two-level cervical disc arthroplasty (CDA) were performed at C4-C6. Range of motion (ROM), intervertebral disc pressure (IDP), facet joint stress (FJS), and maximum von Mises stress on the prosthesis and vertebrae during loading were compared. Results Compared to the intact model, the ROM in all three surgical groups demonstrated a decline, with the ACCF group exhibiting the most significant mobility loss, and the highest compensatory motion in adjacent segments. ACJC and artificial cervical disc prosthesis (ACDP) well-preserved cervical mobility. In the ACCF model, IDP and FJS in adjacent segments increased notably, whereas the index segments experienced the most significant FJS elevation in the CDA model. The ROM, IDP, and FJS in both index and adjacent segments of the ACJC model were intermediate between the other two. Stress distribution of ACCF instruments and ACJC prosthesis during the loading process was more dispersed, resulting in less impact on the adjacent vertebrae than in the CDA model. Conclusion The biomechanical properties of the novel ACJC were comparable to the ACCF in constructing postoperative stability and equally preserved physiological mobility of the cervical spine as CDA without much impact on adjacent segments and facet joints. Thus, the novel ACJC effectively balanced postoperative stability with cervical motion preservation.
Collapse
Affiliation(s)
- Bing Meng
- Department of Orthopedics, Xijing Hospital, The Air Force Medical University, Xi’an, Shaanxi Province, China
| | - Xiong Zhao
- Department of Orthopedics, Xijing Hospital, The Air Force Medical University, Xi’an, Shaanxi Province, China
| | - Xin-Li Wang
- Department of Orthopedics, Xijing Hospital, The Air Force Medical University, Xi’an, Shaanxi Province, China
| | - Jian Wang
- Department of Orthopedics, Affiliated Hospital of NCO School of Army Medical University, Shijiazhuang, Hebei Province, China
| | - Chao Xu
- Department of Knee Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Health Statistics, Faculty of Preventive Medicine, the Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Wei Lei
- Department of Orthopedics, Xijing Hospital, The Air Force Medical University, Xi’an, Shaanxi Province, China
| |
Collapse
|
3
|
Yu H, Xu M, Duan Q, Li Y, Liu Y, Song L, Cheng L, Ying J, Zhao D. 3D-printed porous tantalum artificial bone scaffolds: fabrication, properties, and applications. Biomed Mater 2024; 19:042002. [PMID: 38697199 DOI: 10.1088/1748-605x/ad46d2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/01/2024] [Indexed: 05/04/2024]
Abstract
Porous tantalum scaffolds offer a high degree of biocompatibility and have a low friction coefficient. In addition, their biomimetic porous structure and mechanical properties, which closely resemble human bone tissue, make them a popular area of research in the field of bone defect repair. With the rapid advancement of additive manufacturing, 3D-printed porous tantalum scaffolds have increasingly emerged in recent years, offering exceptional design flexibility, as well as facilitating the fabrication of intricate geometries and complex pore structures that similar to human anatomy. This review provides a comprehensive description of the techniques, procedures, and specific parameters involved in the 3D printing of porous tantalum scaffolds. Concurrently, the review provides a summary of the mechanical properties, osteogenesis and antibacterial properties of porous tantalum scaffolds. The use of surface modification techniques and the drug carriers can enhance the characteristics of porous tantalum scaffolds. Accordingly, the review discusses the application of these porous tantalum materials in clinical settings. Multiple studies have demonstrated that 3D-printed porous tantalum scaffolds exhibit exceptional corrosion resistance, biocompatibility, and osteogenic properties. As a result, they are considered highly suitable biomaterials for repairing bone defects. Despite the rapid development of 3D-printed porous tantalum scaffolds, they still encounter challenges and issues when used as bone defect implants in clinical applications. Ultimately, a concise overview of the primary challenges faced by 3D-printed porous tantalum scaffolds is offered, and corresponding insights to promote further exploration and advancement in this domain are presented.
Collapse
Affiliation(s)
- Haiyu Yu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Minghao Xu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Qida Duan
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Yada Li
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Yuchen Liu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Liqun Song
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Liangliang Cheng
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Jiawei Ying
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| | - Dewei Zhao
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang St, Dalian, Liaoning 116001, People's Republic of China
| |
Collapse
|
4
|
Li H, Shen S, Wang H, Fu J. Bioinspired, surfactant-free, dual-layer asymmetric structures based on polysaccharides, gelatin, and tannic acid for potential applications in biomedicine. Int J Biol Macromol 2024; 266:130861. [PMID: 38490384 DOI: 10.1016/j.ijbiomac.2024.130861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/29/2024] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
The formation of dual-layer asymmetric porous structures in surfactant-based systems is significantly influenced by emulsions. Surfactants self-assemble to alter the conformational arrangement of polysaccharides, while gravity disrupts the initial uniformity of the established equilibrium droplet concentration gradient in the emulsion, thus achieving delamination. Specifically, high-speed rotation and non-instantaneous freezing allow the gelatin solution to form two different states of foam layers. The integrated dual-layer asymmetric porous structure, composed of polysaccharides and tannic acid, is constructed with gelatin as a skeleton and surfactant. This innovative approach eliminates the need to consider the toxicity of chemically synthesized surfactants and expands the concept of gelatin utilization. This intriguing structure exhibits a variety of desirable characteristics within 30 days (e.g., tailorable performance, ultrarapid antioxidant activity, efficient antibacterial activity, low differential blood clotting index, and good hemocompatibility and cytocompatibility), suggesting its potential as a valuable reference for applying hierarchical porous structures, thereby offering more formulation flexibility for biomaterials with adjustable properties.
Collapse
Affiliation(s)
- Huimin Li
- Jiangsu Engineering Technology Research Centre for Functional Textiles, Jiangnan University, No.1800 Lihu Avenue, Wuxi, China
| | - Shen Shen
- Jiangsu Engineering Technology Research Centre for Functional Textiles, Jiangnan University, No.1800 Lihu Avenue, Wuxi, China
| | - Hongbo Wang
- Jiangsu Engineering Technology Research Centre for Functional Textiles, Jiangnan University, No.1800 Lihu Avenue, Wuxi, China.
| | - Jiajia Fu
- Jiangsu Engineering Technology Research Centre for Functional Textiles, Jiangnan University, No.1800 Lihu Avenue, Wuxi, China; China National Textile and Apparel Council Key Laboratory of Natural Dyes, Soochow University, Suzhou 215123, China.
| |
Collapse
|
5
|
Wang Y, Qin X, Lv N, Gao L, Sun C, Tong Z, Li D. Microstructure Optimization for Design of Porous Tantalum Scaffolds Based on Mechanical Properties and Permeability. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7568. [PMID: 38138710 PMCID: PMC10744872 DOI: 10.3390/ma16247568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
Porous tantalum (Ta) implants have important clinical application prospects due to their appropriate elastic modulus, and their excellent bone growth and bone conduction ability. However, porous Ta microstructure designs generally mimic titanium (Ti) implants commonly used in the clinic, and there is a lack of research on the influence of the microstructure on the mechanical properties and penetration characteristics, which will greatly affect bone integration performance. This study explored the effects of different microstructure parameters, including the fillet radius of the middle plane and top planes, on the mechanics and permeability properties of porous Ta diamond cells through simulation, and put forward an optimization design with a 0.5 mm midplane fillet radius and 0.3 mm top-plane fillet radius in order to significantly decrease the stress concentration effect and improve permeability. On this basis, the porous Ta structures were prepared by Laser Powder Bed Fusion (LPBF) technology and evaluated before and after microstructural optimization. The elastic modulus and the yield strength were increased by 2.31% and 10.39%, respectively. At the same time, the permeability of the optimized structure was also increased by 8.25%. The optimized microstructure design of porous Ta has important medical application value.
Collapse
Affiliation(s)
- Yikai Wang
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an 710054, China; (Y.W.); (X.Q.); (N.L.); (Z.T.); (D.L.)
- National Medical Products Administration (NMPA), Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi’an Jiaotong University, Xi’an 710054, China
| | - Xiao Qin
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an 710054, China; (Y.W.); (X.Q.); (N.L.); (Z.T.); (D.L.)
- National Medical Products Administration (NMPA), Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi’an Jiaotong University, Xi’an 710054, China
| | - Naixin Lv
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an 710054, China; (Y.W.); (X.Q.); (N.L.); (Z.T.); (D.L.)
- National Medical Products Administration (NMPA), Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi’an Jiaotong University, Xi’an 710054, China
| | - Lin Gao
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an 710054, China; (Y.W.); (X.Q.); (N.L.); (Z.T.); (D.L.)
- National Medical Products Administration (NMPA), Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi’an Jiaotong University, Xi’an 710054, China
| | - Changning Sun
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an 710054, China; (Y.W.); (X.Q.); (N.L.); (Z.T.); (D.L.)
- National Medical Products Administration (NMPA), Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi’an Jiaotong University, Xi’an 710054, China
| | - Zhiqiang Tong
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an 710054, China; (Y.W.); (X.Q.); (N.L.); (Z.T.); (D.L.)
- National Medical Products Administration (NMPA), Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi’an Jiaotong University, Xi’an 710054, China
| | - Dichen Li
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an 710054, China; (Y.W.); (X.Q.); (N.L.); (Z.T.); (D.L.)
- National Medical Products Administration (NMPA), Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi’an Jiaotong University, Xi’an 710054, China
| |
Collapse
|
6
|
Kiselevskiy MV, Anisimova NY, Kapustin AV, Ryzhkin AA, Kuznetsova DN, Polyakova VV, Enikeev NA. Development of Bioactive Scaffolds for Orthopedic Applications by Designing Additively Manufactured Titanium Porous Structures: A Critical Review. Biomimetics (Basel) 2023; 8:546. [PMID: 37999187 PMCID: PMC10669447 DOI: 10.3390/biomimetics8070546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
We overview recent findings achieved in the field of model-driven development of additively manufactured porous materials for the development of a new generation of bioactive implants for orthopedic applications. Porous structures produced from biocompatible titanium alloys using selective laser melting can present a promising material to design scaffolds with regulated mechanical properties and with the capacity to be loaded with pharmaceutical products. Adjusting pore geometry, one could control elastic modulus and strength/fatigue properties of the engineered structures to be compatible with bone tissues, thus preventing the stress shield effect when replacing a diseased bone fragment. Adsorption of medicals by internal spaces would make it possible to emit the antibiotic and anti-tumor agents into surrounding tissues. The developed internal porosity and surface roughness can provide the desired vascularization and osteointegration. We critically analyze the recent advances in the field featuring model design approaches, virtual testing of the designed structures, capabilities of additive printing of porous structures, biomedical issues of the engineered scaffolds, and so on. Special attention is paid to highlighting the actual problems in the field and the ways of their solutions.
Collapse
Affiliation(s)
- Mikhail V. Kiselevskiy
- N.N. Blokhin National Medical Research Center of Oncology (N.N. Blokhin NMRCO), Ministry of Health of the Russian Federation, 115478 Moscow, Russia;
- Department of Casting Technologies and Artistic Processing of Materials, National University of Science and Technology “MISIS”, 119049 Moscow, Russia
| | - Natalia Yu. Anisimova
- N.N. Blokhin National Medical Research Center of Oncology (N.N. Blokhin NMRCO), Ministry of Health of the Russian Federation, 115478 Moscow, Russia;
- Department of Casting Technologies and Artistic Processing of Materials, National University of Science and Technology “MISIS”, 119049 Moscow, Russia
| | - Alexei V. Kapustin
- Laboratory for Metals and Alloys under Extreme Impacts, Ufa University of Science and Technology, 450076 Ufa, Russia (A.A.R.); (D.N.K.); (V.V.P.); (N.A.E.)
| | - Alexander A. Ryzhkin
- Laboratory for Metals and Alloys under Extreme Impacts, Ufa University of Science and Technology, 450076 Ufa, Russia (A.A.R.); (D.N.K.); (V.V.P.); (N.A.E.)
| | - Daria N. Kuznetsova
- Laboratory for Metals and Alloys under Extreme Impacts, Ufa University of Science and Technology, 450076 Ufa, Russia (A.A.R.); (D.N.K.); (V.V.P.); (N.A.E.)
| | - Veronika V. Polyakova
- Laboratory for Metals and Alloys under Extreme Impacts, Ufa University of Science and Technology, 450076 Ufa, Russia (A.A.R.); (D.N.K.); (V.V.P.); (N.A.E.)
| | - Nariman A. Enikeev
- Laboratory for Metals and Alloys under Extreme Impacts, Ufa University of Science and Technology, 450076 Ufa, Russia (A.A.R.); (D.N.K.); (V.V.P.); (N.A.E.)
- Laboratory for Dynamics and Extreme Characteristics of Promising Nanostructured Materials, Saint Petersburg State University, 199034 St. Petersburg, Russia
| |
Collapse
|
7
|
Cai A, Yin H, Wang C, Chen Q, Song Y, Yin R, Yuan X, Kang H, Guo H. Bioactivity and antibacterial properties of zinc-doped Ta 2O 5nanorods on porous tantalum surface. Biomed Mater 2023; 18:065011. [PMID: 37729922 DOI: 10.1088/1748-605x/acfbd0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/20/2023] [Indexed: 09/22/2023]
Abstract
This paper focuses on the preparation of Zn2+-doped Ta2O5nanorods on porous tantalum using the hydrothermal method. Porous tantalum is widely used in biomedical materials due to its excellent elastic modulus and biological activity. Porous tantalum has an elastic modulus close to that of human bone, and its large specific surface area is conducive to promoting cell adhesion. Zinc is an important component of human bone, which not only has spectral bactericidal properties, but also has no cytotoxicity. The purpose of this study is to provide a theoretical basis for the surface modification of porous tantalum and to determine the best surface modification method. The surface structure of the sample was characterized by x-ray diffractometer, x-ray photoelectron spectroscopy, scanning electron microscope, transmission electron microscope, and the Zn-doped Ta2O5nanorods are characterized by antibacterial test, MTT test, ICP and other methods. The sample has good antibacterial properties and no cytotoxicity. The results of this study have potential implications for the development of new and improved biomedical materials.
Collapse
Affiliation(s)
- Anqi Cai
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Hairong Yin
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Cuicui Wang
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Qian Chen
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Yingxuan Song
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Ruixue Yin
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Xin Yuan
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Haoran Kang
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| | - Hongwei Guo
- School of Materials Science and Engineering, Shaanxi Key Laboratory of Green Preparation and Functionalization for Inorganic Materials, Shaanxi University of Science and Technology, Xi'an 710021, People's Republic of China
| |
Collapse
|
8
|
Wen J, Song M, Zeng Y, Dong X. Effect of different HA/β-TCP coated 3D printed bioceramic scaffolds on repairing large bone defects in rabbits. J Orthop Surg (Hong Kong) 2023; 31:10225536231222121. [PMID: 38118163 DOI: 10.1177/10225536231222121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Treatment of large segmental bone defects is still a major clinical challenge, and bone grafting is the main method. The development of novel bone graft substitutes will help solve this problem. METHODS Porous bioceramics hydroxyapatite (HA) scaffolds coated with different ratios of HA/β-tricalcium phosphate (β-TCP) were prepared by 3D printing. The scaffolds were sampled and tested in large segmental bone defect rabbit models. X-ray, micro-computed tomography (CT), hematoxylin and eosin (HE) staining, Van-Gieson staining, and type I collagen staining were performed to find the best scaffolds for large segmental bone defect treatment. RESULTS The average length, diameter, compressive strength, and porosity of the bioceramics scaffolds were 15.05 ± 0.10 mm, 4.98 ± 0.06 mm, 11.11 ± 0.77 MPa, and 54.26 ± 5.38%, respectively. Postoperative lateral radiographs suggested the scaffold group got better bone healing and stability than the blank group. Micro-CT showed new bones grew into the scaffold from the two ends of the fracture along the scaffold and finally achieved bony union. The new bone volume around the scaffolds suggested the 3:7 HA/β-TCP-coated bioceramic scaffolds were more favorable for the healing of large segmental bone defects. The results of HE, Van-Gieson, and type I collagen staining also suggested more new bone formation in 3:7 HA/β-TCP-coated bioceramic scaffolds. CONCLUSION 3:7 HA/β-TCP-coated porous bioceramics scaffolds are more conducive to the repair of large bone defects in rabbits. The results of this study can provide some reference and theoretical support in this area.
Collapse
Affiliation(s)
- Jian Wen
- Jiangxi Medical College, Nanchang University, Nanchang, China
- Department of Orthopedics, JXHC Key Laboratory of Digital Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Meiling Song
- Department of Orthopedics, JXHC Key Laboratory of Digital Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Graduate School, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Yu Zeng
- Department of Orthopedics, JXHC Key Laboratory of Digital Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Xieping Dong
- Jiangxi Medical College, Nanchang University, Nanchang, China
- Department of Orthopedics, JXHC Key Laboratory of Digital Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| |
Collapse
|
9
|
Zhang C, Zhou Z, Liu N, Chen J, Wu J, Zhang Y, Lin K, Zhang S. Osteogenic differentiation of 3D-printed porous tantalum with nano-topographic modification for repairing craniofacial bone defects. Front Bioeng Biotechnol 2023; 11:1258030. [PMID: 37671184 PMCID: PMC10475942 DOI: 10.3389/fbioe.2023.1258030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/09/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction: Congenital or acquired bone defects in the oral and cranio-maxillofacial (OCMF) regions can seriously affect the normal function and facial appearance of patients, and cause great harm to their physical and mental health. To achieve good bone defect repair results, the prosthesis requires good osteogenic ability, appropriate porosity, and precise three-dimensional shape. Tantalum (Ta) has better mechanical properties, osteogenic ability, and microstructure compared to Ti6Al4V, and has become a potential alternative material for bone repair. The bones in the OCMF region have unique shapes, and 3D printing technology is the preferred method for manufacturing personalized prosthesis with complex shapes and structures. The surface characteristics of materials, such as surface morphology, can affect the biological behavior of cells. Among them, nano-topographic surface modification can endow materials with unique surface properties such as wettability and large surface area, enhancing the adhesion of osteoblasts and thereby enhancing their osteogenic ability. Methods: This study used 3D-printed porous tantalum scaffolds, and constructed nano-topographic surface through hydrothermal treatment. Its osteogenic ability was verified through a series of in vitro and in vivo experiments. Results: The porous tantalum modified by nano-topographic surface can promote the proliferation and osteogenic differentiation of BMSCs, and accelerate the formation of new bone in the Angle of the mandible bone defect of rabbits. Discussion: It can be seen that 3D-printed nano-topographic surface modified porous tantalum has broad application prospects in the repair of OCMF bone defects.
Collapse
Affiliation(s)
- Chuxi Zhang
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral and Cranio-Maxillofacial Surgery, National Clinical Research Center, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongwei Zhou
- Ningxia Key Laboratory of Oral Diseases Research, Department of Oral and Maxillofacial Surgery, General Hospital of Ningxia Medical University, Institute of Medical Sciences, Yinchuan, Ningxia, China
| | - Nian Liu
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral and Cranio-Maxillofacial Surgery, National Clinical Research Center, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangping Chen
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral and Cranio-Maxillofacial Surgery, National Clinical Research Center, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinyang Wu
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral and Cranio-Maxillofacial Surgery, National Clinical Research Center, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Zhang
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral and Cranio-Maxillofacial Surgery, National Clinical Research Center, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kaili Lin
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral and Cranio-Maxillofacial Surgery, National Clinical Research Center, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shilei Zhang
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral and Cranio-Maxillofacial Surgery, National Clinical Research Center, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
10
|
Bandzerewicz A, Niebuda K, Gadomska-Gajadhur A. Synthesis and Cytotoxicity Studies of Poly(1,4-butanediol citrate) Gels for Cell Culturing. Gels 2023; 9:628. [PMID: 37623083 PMCID: PMC10453459 DOI: 10.3390/gels9080628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Abstract
One of the main branches of regenerative medicine is biomaterials research, which is designed to develop and study materials for regenerative therapies, controlled drug delivery systems, wound dressings, etc. Research is continually being conducted to find biomaterials-especially polymers-with better biocompatibility, broader modification possibilities and better application properties. This study describes a potential biomaterial, poly(1,4-butanediol citrate). The gelation time of poly(1,4-butanediol citrate) was estimated. Based on this, the limiting reaction time and temperature were determined to avoid gelling of the reaction mixture. Experiments with different process conditions were carried out, and the products were characterised through NMR spectra analysis. Using statistical methods, the functions were defined, describing the dependence of the degree of esterification of the acid groups on the following process parameters: temperature and COOH/OH group ratio. Polymer films from the synthesised polyester were prepared and characterised. The main focus was assessing the initial biocompatibility of the materials.
Collapse
|
11
|
Xiao L, Sun Y, Liao L, Su X. Response of mesenchymal stem cells to surface topography of scaffolds and the underlying mechanisms. J Mater Chem B 2023; 11:2550-2567. [PMID: 36852826 DOI: 10.1039/d2tb01875f] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Mesenchymal stem/stromal cells (MSCs) serve as essential components of regenerative medicine. Their destiny is influenced by the interaction of the cells with the external environment. In addition to the biochemical cues in a microenvironment, physical cues of the topography of the surrounding materials such as the extracellular matrix emerge as a crucial regulator of stem cell destiny and function. With recent advances in technologies of materials production and surface modification, surfaces with micro/nanotopographical characteristics can be fabricated to mimic the micro/nanoscale mechanical stimuli of the extracellular matrix environment and regulate the biological behavior of cells. Understanding the interaction of cells with the topography of a surface is conducive to the control of stem cell fate for application in regenerative medicine. However, the mechanisms by which topography affects the biological behavior of stem cells have not been fully elucidated. This review will present the effects of surface topography at the nano/micrometer scale on stem cell adhesion, morphology, proliferation, migration, and differentiation. It also focuses on discussing current theories about the sensing and recognition of surface topology cues, the transduction of the extracellular cues into plasma, and the final activation of related signaling pathways and downstream gene expression in MSCs. These insights will provide a theoretical basis for the future design of biomaterial scaffolds for application in regenerative medicine and tissue engineering.
Collapse
Affiliation(s)
- Li Xiao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Pediatrics & Engineering Research Center of Oral Translational Medicine, Ministry of Education, West China Hospital of Stomatology, Sichuan University, 610041, Chengdu, China.
| | - Yanping Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Pediatrics & Engineering Research Center of Oral Translational Medicine, Ministry of Education, West China Hospital of Stomatology, Sichuan University, 610041, Chengdu, China.
| | - Li Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Pediatrics & Engineering Research Center of Oral Translational Medicine, Ministry of Education, West China Hospital of Stomatology, Sichuan University, 610041, Chengdu, China.
| | - Xiaoxia Su
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Pediatrics & Engineering Research Center of Oral Translational Medicine, Ministry of Education, West China Hospital of Stomatology, Sichuan University, 610041, Chengdu, China.
| |
Collapse
|
12
|
Jin P, Liu L, Cheng L, Chen X, Xi S, Jiang T. Calcium-to-phosphorus releasing ratio affects osteoinductivity and osteoconductivity of calcium phosphate bioceramics in bone tissue engineering. Biomed Eng Online 2023; 22:12. [PMID: 36759894 PMCID: PMC9912630 DOI: 10.1186/s12938-023-01067-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/16/2023] [Indexed: 02/11/2023] Open
Abstract
Calcium phosphate (Ca-P) bioceramics, including hydroxyapatite (HA), biphasic calcium phosphate (BCP), and beta-tricalcium phosphate (β-TCP), have been widely used in bone reconstruction. Many studies have focused on the osteoconductivity or osteoinductivity of Ca-P bioceramics, but the association between osteoconductivity and osteoinductivity is not well understood. In our study, the osteoconductivity of HA, BCP, and β-TCP was investigated based on the osteoblastic differentiation in vitro and in situ as well as calvarial defect repair in vivo, and osteoinductivity was evaluated by using pluripotent mesenchymal stem cells (MSCs) in vitro and heterotopic ossification in muscles in vivo. Our results showed that the cell viability, alkaline phosphatase activity, and expression of osteogenesis-related genes, including osteocalcin (Ocn), bone sialoprotein (Bsp), alpha-1 type I collagen (Col1a1), and runt-related transcription factor 2 (Runx2), of osteoblasts each ranked as BCP > β-TCP > HA, but the alkaline phosphatase activity and expression of osteogenic differentiation genes of MSCs each ranked as β-TCP > BCP > HA. Calvarial defect implantation of Ca-P bioceramics ranked as BCP > β-TCP ≥ HA, but intramuscular implantation ranked as β-TCP ≥ BCP > HA in vivo. Further investigation indicated that osteoconductivity and osteoinductivity are affected by the Ca/P ratio surrounding the Ca-P bioceramics. Thus, manipulating the appropriate calcium-to-phosphorus releasing ratio is a critical factor for determining the osteoinductivity of Ca-P bioceramics in bone tissue engineering.
Collapse
Affiliation(s)
- Pan Jin
- grid.410654.20000 0000 8880 6009Health Science Center, Yangtze University, Jingzhou, 434023 Hubei China ,Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-Constructed By the Province and MinistryGuangxi Medical University, Nanning, 530021 Guangxi China
| | - Lei Liu
- grid.452877.b0000 0004 6005 8466Articular Surgery, The Second Nanning People’s Hospital, Third Affiliated Hospital of Guangxi Medical University), Nanning, 530031 Guangxi China
| | - Lin Cheng
- grid.410654.20000 0000 8880 6009Health Science Center, Yangtze University, Jingzhou, 434023 Hubei China
| | - Xichi Chen
- grid.410654.20000 0000 8880 6009Health Science Center, Yangtze University, Jingzhou, 434023 Hubei China
| | - Shanshan Xi
- Health Science Center, Yangtze University, Jingzhou, 434023, Hubei, China.
| | - Tongmeng Jiang
- Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, 571199, China. .,Key Laboratory of Emergency and Trauma, Ministry of Education, Engineering Research Center for Hainan Bio-Smart Materials and Bio-Medical Devices, Key Laboratory of Hainan Functional Materials and Molecular Imaging, College of Emergency and Trauma, Hainan Medical University, Haikou, 571199, China.
| |
Collapse
|
13
|
Jiao J, Hong Q, Zhang D, Wang M, Tang H, Yang J, Qu X, Yue B. Influence of porosity on osteogenesis, bone growth and osteointegration in trabecular tantalum scaffolds fabricated by additive manufacturing. Front Bioeng Biotechnol 2023; 11:1117954. [PMID: 36777251 PMCID: PMC9911888 DOI: 10.3389/fbioe.2023.1117954] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Porous tantalum implants are a class of materials commonly used in clinical practice to repair bone defects. However, the cumbersome and problematic preparation procedure have limited their widespread application. Additive manufacturing has revolutionized the design and process of orthopedic implants, but the pore architecture feature of porous tantalum scaffolds prepared from additive materials for optimal osseointegration are unclear, particularly the influence of porosity. We prepared trabecular bone-mimicking tantalum scaffolds with three different porosities (60%, 70% and 80%) using the laser powder bed fusing technique to examine and compare the effects of adhesion, proliferation and osteogenic differentiation capacity of rat mesenchymal stem cells on the scaffolds in vitro. The in vivo bone ingrowth and osseointegration effects of each scaffold were analyzed in a rat femoral bone defect model. Three porous tantalum scaffolds were successfully prepared and characterized. In vitro studies showed that scaffolds with 70% and 80% porosity had a better ability to osteogenic proliferation and differentiation than scaffolds with 60% porosity. In vivo studies further confirmed that tantalum scaffolds with the 70% and 80% porosity had a better ability for bone ingrowh than the scaffold with 60% porosity. As for osseointegration, more bone was bound to the material in the scaffold with 70% porosity, suggesting that the 3D printed trabecular tantalum scaffold with 70% porosity could be the optimal choice for subsequent implant design, which we will further confirm in a large animal preclinical model for better clinical use.
Collapse
Affiliation(s)
- Juyang Jiao
- Department of Bone and Joint Surgery, Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qimin Hong
- Department of Bone and Joint Surgery, Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dachen Zhang
- Shenzhen Dazhou Medical Technology Co., Ltd., Shenzhen, Guangdong, China
- Center of Biomedical Materials 3D Printing, National Engineering Laboratory for Polymer Complex Structure Additive Manufacturing, Baoding, Hebei, China
| | - Minqi Wang
- Department of Bone and Joint Surgery, Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haozheng Tang
- Department of Bone and Joint Surgery, Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingzhou Yang
- Shenzhen Dazhou Medical Technology Co., Ltd., Shenzhen, Guangdong, China
- Center of Biomedical Materials 3D Printing, National Engineering Laboratory for Polymer Complex Structure Additive Manufacturing, Baoding, Hebei, China
- School of Mechanical and Automobile Engineering, Qingdao University of Technology, Qingdao, Shandong, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Yue
- Department of Bone and Joint Surgery, Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
14
|
Tantalum as Trabecular Metal for Endosseous Implantable Applications. Biomimetics (Basel) 2023; 8:biomimetics8010049. [PMID: 36810380 PMCID: PMC9944482 DOI: 10.3390/biomimetics8010049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
During the last 20 years, tantalum has known ever wider applications for the production of endosseous implantable devices in the orthopedic and dental fields. Its excellent performances are due to its capacity to stimulate new bone formation, thus improving implant integration and stable fixation. Tantalum's mechanical features can be mainly adjusted by controlling its porosity thanks to a number of versatile fabrication techniques, which allow obtaining an elastic modulus similar to that of bone tissue, thus limiting the stress-shielding effect. The present paper aims at reviewing the characteristics of tantalum as a solid and porous (trabecular) metal, with specific regard to biocompatibility and bioactivity. Principal fabrication methods and major applications are described. Moreover, the osteogenic features of porous tantalum are presented to testify its regenerative potential. It can be concluded that tantalum, especially as a porous metal, clearly possesses many advantageous characteristics for endosseous applications but it presently lacks the consolidated clinical experience of other metals such as titanium.
Collapse
|
15
|
Gu Y, Sun Y, Shujaat S, Braem A, Politis C, Jacobs R. 3D-printed porous Ti6Al4V scaffolds for long bone repair in animal models: a systematic review. J Orthop Surg Res 2022; 17:68. [PMID: 35109907 PMCID: PMC8812248 DOI: 10.1186/s13018-022-02960-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/21/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Titanium and its alloys have been widely employed for bone tissue repair and implant manufacturing. The rapid development of three-dimensional (3D) printing technology has allowed fabrication of porous titanium scaffolds with controllable microstructures, which is considered to be an effective method for promoting rapid bone formation and decreasing bone absorption. The purpose of this systematic review was to evaluate the osteogenic potential of 3D-printed porous Ti6Al4V (Ti64) scaffold for repairing long bone defects in animal models and to investigate the influential factors that might affect its osteogenic capacity. METHODS Electronic literature search was conducted in the following databases: PubMed, Web of Science, and Embase up to September 2021. The SYRCLE's tool and the modified CAMARADES list were used to assess the risk of bias and methodological quality, respectively. Due to heterogeneity of the selected studies in relation to protocol and outcomes evaluated, a meta-analysis could not be performed. RESULTS The initial search revealed 5858 studies. Only 46 animal studies were found to be eligible based on the inclusion criteria. Rabbit was the most commonly utilized animal model. A pore size of around 500-600 µm and porosity of 60-70% were found to be the most ideal parameters for designing the Ti64 scaffold, where both dodecahedron and diamond pores optimally promoted osteogenesis. Histological analysis of the scaffold in a rabbit model revealed that the maximum bone area fraction reached 59.3 ± 8.1% at weeks 8-10. Based on micro-CT assessment, the maximum bone volume fraction was found to be 34.0 ± 6.0% at weeks 12. CONCLUSIONS Ti64 scaffold might act as a promising medium for providing sufficient mechanical support and a stable environment for new bone formation in long bone defects. Trail registration The study protocol was registered in the PROSPERO database under the number CRD42020194100.
Collapse
Affiliation(s)
- Yifei Gu
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Yi Sun
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Annabel Braem
- Department of Materials Engineering, Biomaterials and Tissue Engineering Research Group, KU Leuven, 3000, Leuven, Belgium
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. .,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium. .,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|