Evolution of bioceramics within the field of biomaterials

Porous phosphate-based bioactive glass /β-TCP scaffold for tooth remineralization

The total or partial loss of teeth in the Mexican population due to periodontal diseases and trauma causes the development of other conditions, such as limitations in chewing and grinding food, pronunciation difficulties, and oral aesthetic alterations. In Mexico, oral diseases have been described to affect 87% of the population, according to reports by the health services, emphasizing that pregnant women and patients with diabetes mellitus have the highest risk of presenting with severe periodontal diseases or tooth loss, according to findings by the Mexican Health Department's Specific Action Program for the prevention, detection, and control of oral health problems (2013-2018). There was a 92.6% prevalence of dental caries in the population examined, and the prevalence of periodontal problems, mainly in 40-year-olds, was above 95%. The objective of this investigation was to manufacture and characterize porous 3D scaffolds with innovative chemical compositions, using phosphate-based bioactive glass, beta-phase tricalcium phosphate, and zirconium oxide, in variable quantities. The scaffold manufacturing method combined two techniques: powder metallurgy and polymer foaming. The results obtained in this research were promising since the mechanically tested scaffolds showed values of compressive strength and modulus of elasticity in the range of human trabecular bone. On the other hand, the in vitro evaluation of the samples immersed in artificial saliva at days 7 and 14 presented the calcium/phosphorus ratio = 1.6; this value is identical to the reported state-of-the-art figure, corresponding to the mineral phase of the bones and teeth. Likewise, the precipitation of the flower-like morphology was observed on the entire surface of the scaffold without zirconia; this morphology is characteristic of hydroxyapatite. On the other hand, the samples with 0.5 and 1.0 mol% zirconia showed less hydroxyapatite formation, with a direct correlation between scaffold dissolution and the amount of zirconia added.

Unraveling the mechanisms of inhibition of silver-doped bioactive glass-ceramic particles

Infections are a major concern in orthopedics. Antibacterial agents such as silver ions are of great interest as broad-spectrum biocides and have been incorporated into bioactive glass-ceramic particles to control the release of ions within a therapeutic concentration and provide tissue regenerative properties. In this work, the antibacterial capabilities of silver-doped bioactive glass (Ag-BG) microparticles were explored to reveal the unedited mechanisms of inhibition against methicillin-resistant Staphylococcus aureus (MRSA). The antibacterial properties were not limited to the delivery of silver ions but rather a combination of antibacterial degradation by-products. For example, nano-sized debris punctured holes in bacteria membranes, osmotic effects, and reactive oxygen species causing oxidative stress and almost 40% of the inhibition. Upon successive Ag-BG treatments, MRSA underwent phenotypic and genomic mutations which were not only insufficient to develop resistance but instead, the clones became more sensitive as the treatment was re-delivered. Additionally, the unprecedented restorative functionality of Ag-BG allowed the effective use of antibiotics that MRSA resists. The synergy mechanism was mainly identified for combinations targeting cell-wall activity and their action was proven in biofilm-like and virulent conditions. Unraveling these mechanisms may offer new insights into how to tailor healthcare materials to prevent or debilitate infections and join the fight against antibiotic resistance in clinical cases.

Achievements in Mesoporous Bioactive Glasses for Biomedical Applications

Nowadays, mesoporous bioactive glasses (MBGs) are envisaged as promising candidates in the field of bioceramics for bone tissue regeneration. This is ascribed to their singular chemical composition, structural and textural properties and easy-to-functionalize surface, giving rise to accelerated bioactive responses and capacity for local drug delivery. Since their discovery at the beginning of the 21st century, pioneering research efforts focused on the design and fabrication of MBGs with optimal compositional, textural and structural properties to elicit superior bioactive behavior. The current trends conceive MBGs as multitherapy systems for the treatment of bone-related pathologies, emphasizing the need of fine-tuning surface functionalization. Herein, we focus on the recent developments in MBGs for biomedical applications. First, the role of MBGs in the design and fabrication of three-dimensional scaffolds that fulfil the highly demanding requirements for bone tissue engineering is outlined. The different approaches for developing multifunctional MBGs are overviewed, including the incorporation of therapeutic ions in the glass composition and the surface functionalization with zwitterionic moieties to prevent bacterial adhesion. The bourgeoning scientific literature on MBGs as local delivery systems of diverse therapeutic cargoes (osteogenic/antiosteoporotic, angiogenic, antibacterial, anti-inflammatory and antitumor agents) is addressed. Finally, the current challenges and future directions for the clinical translation of MBGs are discussed.

Bioactive Inorganic Materials for Dental Applications: A Narrative Review

Over time, much attention has been given to the use of bioceramics for biomedical applications; however, the recent trend has been gaining traction to apply these materials for dental restorations. The bioceramics (mainly bioactive) are exceptionally biocompatible and possess excellent bioactive and biological properties due to their similar chemical composition to human hard tissues. However, concern has been noticed related to their mechanical properties. All dental materials based on bioactive materials must be biocompatible, long-lasting, mechanically strong enough to bear the masticatory and functional load, wear-resistant, easily manipulated, and implanted. This review article presents the basic structure, properties, and dental applications of different bioactive materials i.e., amorphous calcium phosphate, hydroxyapatite, tri-calcium phosphate, mono-calcium phosphate, calcium silicate, and bioactive glass. The advantageous properties and limitations of these materials are also discussed. In the end, future directions and proposals are given to improve the physical and mechanical properties of bioactive materials-based dental materials.

Study of the Resistance to Degradation of Al2O3/Al2TiO5 Composites for Possible Use as Bone Tissue

In this work we studied the response to degradation of Al2O3/Al2TiO5 composites in a Hanks’ solution, which simulates human synovial fluid in contact with bone tissues. Electrochemical impedance study determined that the resistance to polarization of composite rises with increases in the amount of Al2TiO5 and with the sintering time.

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

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

Design Strategies and Biomimetic Approaches for Calcium Phosphate Scaffolds in Bone Tissue Regeneration

Bone is a complex biologic tissue, which is extremely relevant for various physiological functions, in addition to movement, organ protection, and weight bearing. The repair of critical size bone defects is a still unmet clinical need, and over the past decades, material scientists have been expending efforts to find effective technological solutions, based on the use of scaffolds. In this context, biomimetics which is intended as the ability of a scaffold to reproduce compositional and structural features of the host tissues, is increasingly considered as a guide for this purpose. However, the achievement of implants that mimic the very complex bone composition, multi-scale structure, and mechanics is still an open challenge. Indeed, despite the fact that calcium phosphates are widely recognized as elective biomaterials to fabricate regenerative bone scaffolds, their processing into 3D devices with suitable cell-instructing features is still prevented by insurmountable drawbacks. With respect to biomaterials science, new approaches maybe conceived to gain ground and promise for a substantial leap forward in this field. The present review provides an overview of physicochemical and structural features of bone tissue that are responsible for its biologic behavior. Moreover, relevant and recent technological approaches, also inspired by natural processes and structures, are described, which can be considered as a leverage for future development of next generation bioactive medical devices.

Engineering mesoporous silica nanoparticles for drug delivery: where are we after two decades?

The present review details a chronological description of the events that took place during the development of mesoporous materials, their different synthetic routes and their use as drug delivery systems. The outstanding textural properties of these materials quickly inspired their translation to the nanoscale dimension leading to mesoporous silica nanoparticles (MSNs). The different aspects of introducing pharmaceutical agents into the pores of these nanocarriers, together with their possible biodistribution and clearance routes, would be described here. The development of smart nanocarriers that are able to release a high local concentration of the therapeutic cargo on-demand after the application of certain stimuli would be reviewed here, together with their ability to deliver the therapeutic cargo to precise locations in the body. The huge progress in the design and development of MSNs for biomedical applications, including the potential treatment of different diseases, during the last 20 years will be collated here, together with the required work that still needs to be done to achieve the clinical translation of these materials. This review was conceived to stand out from past reports since it aims to tell the story of the development of mesoporous materials and their use as drug delivery systems by some of the story makers, who could be considered to be among the pioneers in this area.

The effects of root canal perforation repair materials on the bond strength of fiber posts

INTRODUCTION

This study aimed to evaluate the effect of calcium hydroxide and bioceramics used in perforation repair on the bonding strength of fiber posts via a push-out test.

METHODOLOGY

This study used 106 extracted single-rooted human mandibular premolar teeth. Root canal preparations were performed with a rotary file system and perforations were created in the middle third of each tooth. The samples were randomized into two main experimental groups, one with calcium hydroxide and one without. Each group had four subgroups in which different bioceramic cements were applied (n = 11) and a control group (n = 9). The root canals perforations were repaired using MTA, Biodentine, Bioaggregate, and Endosequence BC root repair material. A fiber post was applied to each tooth and a push-out test was performed. The samples were examined at 40× magnification with a digital microscope in order to identify fracture type.

RESULTS

Bonding strength was calculated in MPa. A statistical analysis showed that the calcium hydroxide had no effect on the bonding strength of the fiber posts. A comparison of the perforation repair materials revealed that Biodentine in the calcium hydroxide group and Bioaggregate in both groups decreased the bonding strength compared to the other materials (p < 0.05). The most common failure type was adhesive failure between the dentin and resin cement (38.16%).

CONCLUSIONS

The use of different perforation repair materials can affect the bonding strength of fiber posts. Therefore, the choice of perforation repair material should be made on an individual basis.

Laser cladding of bioactive glass coating on pure titanium substrate with highly refined grain structure

Free from toxic elements biomaterial potentially applicable for load bearing biomedical implants was obtained for the first time by laser cladding of S520 bioactive glass onto ultrafine-grained commercially pure titanium. The cladding process affected the refined structure of the substrate inducing martensitic transformation near its surface. The α' acicular martensite gradually passes into relatively large grains with increasing distance from the substrate surface, which subsequently are transformed into smaller grains of about 2 μm in diameter. Both the melted zone, where the martensite crystalline structure was found, and the HAZ are characterised by relatively lower hardness in comparison with that of the substrate core indicating increased ductility. Such a combination of zones with different properties may have a synergistic effect and is beneficial for the obtained biomaterial. A characteristic region in the form of about 3 μm width band was formed in the melted zone at about 10 μm below the titanium surface. The results of EDS analysis indicate that several glass elements moved into the region while the titanium content in the same area was decreased. High bioactivity of the coated S520 glass was revealed by in vitro testing with SBF solution and almost complete reduction of P concentration occurred after 14 days.

Effect of sintering temperature on the physiochemical properties, microstructure, and compressive strength of a bioceramic root canal sealer reinforced with multi-walled carbon nanotubes and titanium carbide

AIM

Bioceramic root canal sealers like BioRoot RCS have received significant attention for use in endodontics. The addition of a nanophase material like multi-walled carbon nanotubes (MWCNTs) and titanium carbide (TC) to its matrix combined with pressureless sintering might have the potential for improved physiochemical, microstructure, and compressive strength properties.

METHOD

ology: MWCNTs and TC nanomaterials were added at a percentage of 1 wt% to a definite weight of pristine BioRoot RCS. Two composites were prepared by ball milling followed by pressureless sintering in static nitrogen at temperatures 600 °C and 800 °C. The setting time, solubility, pH, compressive strength, and density were determined and compared to pristine BioRoot RCS. The microstructural properties of the composites were investigated by XRD, FTIR, Raman spectroscopy, and SEM.

RESULTS

The final setting time before and after sintering at 600 °C of the composites was accelerated compared to Bioroot RCS (p = 0.016). The solubility of Bioroot/TC sintered at 600 °C was the lowest (p = 0.07) and its compressive strength was the highest among the sintered samples (p = 0.01). The incorporation of MWCNTs and TC had a significant increase in the compressive strength of Bioroot RCS (p < 0.05).

CONCLUSION

The obtained results support the addition of nanomaterials to Bioroot RCS and the use of pressureless sintering.

Borate and Silicate Bioactive Glass Coatings Prepared by Nanosecond Pulsed Laser Deposition

Silicate (13-93) and borate (13-93-B3) bioactive glass coatings were successfully deposited on titanium using the nanosecond Pulsed Laser Deposition technique. The coatings’ microstructural characteristics, compositions and morphologies were examined by a number of physico-chemical techniques. The deposited coatings retain the same functional groups of the targets, are a few microns thick, amorphous, compact and crack free. Their surface is characterized by the presence of micrometric and nanometric particles. The surface topography, investigated by Atomic Force Microscopy, is characterized by spherical or ellipsoidal particles of the 0.2–3 μm size range for the 13-93 silicate bioactive glass film and of the 0.1–1 µm range for the 13-93-B3 borate bioactive glass coating. Equine adipose tissue-derived mesenchymal stem cells (ADMSCs) were applied for biological tests and the osteogenic differentiation activity of cells on the deposited coatings was studied after ADMSCs growth in osteogenic medium and staining with Alizarin Red. Cytocompatibility and osteogenic differentiation tests have shown that thin films retain the biocompatibility properties of the target silicate and borate glass, respectively. On the other hand, no antibacterial activity of the borate glass films was observed, suggesting that ion doping is advisable to inhibit bacterial growth on the surface of borate glass thin films.

Hidrogeles de colágeno acoplados con hidroxiapatita para aplicaciones en ingeniería tisular

Los hidrogeles basados en colágeno son redes tridimensionales (3D) con la capacidad de absorber agua y una alta biocompatibilidad para utilizarlos en la reparación de tejidos dañados. Estos materiales presentan pobres propiedades mecánicas y velocidades de degradación rápidas, limitando su aplicación a estrategias de ingeniería tisular y biomedicina; por ésto, la incorporación de fases inorgánicas en la matriz 3D del colágeno como la hidroxiapatita ha contribuido en la mejora de sus propiedades, incrementado la eficiencia de los hidrogeles híbridos obtenidos. Este trabajo, presenta las contribuciones más relevantes relacionadas con los sistemas de hidrogeles basados en colágeno y partículas de hidroxiapatita dispersas dentro de la matriz colagénica, lo que evidencia que la combinación de los materiales no altera la biocompatibilidad y biodegradabilidad típicas del colágeno, permitiendo la adhesión, proliferación, crecimiento celular y control del metabolismo de las células implicadas en los procesos de una reparación ósea, presentando a los hidrogeles como una estrategia para su uso potencial en la ingeniería tisular.

Multifunctional Copper-Containing Mesoporous Glass Nanoparticles as Antibacterial and Proangiogenic Agents for Chronic Wounds

The physiological wound healing process involves a cascade of events which could be affected by several factors resulting in chronic, non-healing wounds. The latter represent a great burden especially when bacterial biofilms are formed. The rise in antibiotic resistance amongst infectious microorganisms leads to the need of novel approaches to treat this clinical issue. In this context, the use of advanced biomaterials, which can enhance the physiological expression and secretion of the growth factors involved in the wound healing process, is gaining increasing attention as a robust and appealing alternative approach. Among them, mesoporous glasses are of particular interest due to their excellent textural properties and to the possibility of incorporating and releasing specific therapeutic species, such as metallic ions. One of the most attractive therapeutic ions is copper thanks to its proangiogenic and antibacterial effects. In this contribution, copper containing mesoporous glass nanoparticles were proposed as a multifunctional device to treat chronic wounds. The developed nanoparticles evidenced a very high specific surface area (740 m²/g), uniform pores of 4 nm and an almost total release of the therapeutic ion within 72 h of soaking. The produced nanoparticles were biocompatible and, when tested against Gram positive and Gram negative bacterial species, demonstrated antibacterial activity against both planktonic and biofilm bacteria in 2D cell monolayers, and in a 3D human model of infected skin. Their proangiogenic effect was tested with both the aortic ring and the chick chorioallantoic membrane assays and an increase in endothelial cell outgrowth at a concentration range between 30 and 300 ng/mL was shown. Overall, in this study biocompatible, multifunctional Cu-containing mesoporous glass nanoparticles were successfully produced and demonstrated to exert both antibacterial and proangiogenic effects.

Structure, mechanical, optical, and imaging contrast features of Yb3+ , Dy3+ , Tb3+ , Gd3+ , Eu3+ , and Nd3+ substituted Y2 O3 -Ln2 O3 solid solution

Bulk ceramic that possess the combined features of structural stability at elevated temperatures, appropriate mechanical stability, luminescence features, magnetic resonance (MR) and computed tomography (CT) imaging capacity in a single platform is considered an exciting prospect in biomedical applications. In this study, six different lanthanides (Ln³⁺ :Yb³⁺ , Dy³⁺ , Tb³⁺ , Gd³⁺ , Eu³⁺ , and Nd³⁺ ) were combined together to yield a Y₂ O₃ :Ln₂ O₃ solid solution and subsequently tested for the proposed application. Three different Y₂ O₃ :Ln₂ O₃ solid solutions were formed by varying the concentrations of Ln³⁺ precursors. A unique cubic crystal structure with Ia-3 (206) space setting is retained until 1500 °C and moreover an expanded lattice is accomplished with the gradual inclusion of six different Ln³⁺ . Optical analysis inferred the characteristic electronic transitions of all the Ln³⁺ and moreover up-conversion and down-conversion emission behavior were also attributed by the material during excitation at 795 and 350 nm. Nanoindentation studies exercised on the material envisaged reasonably enhanced hardness and Young's modulus values. Further, the enhanced CT imaging potential alongside in vitro MRI study deliberating the longitudinal (T₁ ) and transverse (T₂ ) relaxivity ability of the material is also established.

Spectroscopic Methods Used in Implant Material Studies

It is recognized that interactions between most materials are governed by their surface properties and manifest themselves at the interface formed between them. To gain more insight into this thin layer, several methods have been deployed. Among them, spectroscopic methods have been thoroughly evaluated. Due to their exceptional sensitivity, data acquisition speed, and broad material tolerance they have been proven to be invaluable tools for surface analysis, used by scientists in many fields, for example, implant studies. Today, in modern medicine the use of implants is considered standard practice. The past two decades of constant development has established the importance of implants in dentistry, orthopedics, as well as extended their applications to other areas such as aesthetic medicine. Fundamental to the success of implants is the knowledge of the biological processes involved in interactions between an implant and its host tissue, which are directly connected to the type of implant material and its surface properties. This review aims to demonstrate the broad applications of spectroscopic methods in implant material studies, particularly discussing hard implants, surface composition studies, and surface-cell interactions.

Resurrection of antibiotics that methicillin-resistant Staphylococcus aureus resists by silver-doped bioactive glass-ceramic microparticles

This work describes a novel strategy to combat methicillin-resistant Staphylococcus aureus (MRSA) via the reactivation of inert antibiotics. This strategy exploits a multifunctional system consisting of bioactive glass-ceramic microparticles with antibacterial properties combined with various antibiotics to kill MRSA. Specifically, sol-gel derived silver-doped bioactive glass-ceramic microparticles (Ag-BG) combined with antibiotics that MRSA resists such as oxacillin or fosfomycin, significantly decreased the viability of MRSA. Ag-BG also potentiated the activity of vancomycin on static bacteria, which are typically resistant to this antibiotic. Notably, the synergistic activity is restricted to cell-envelope acting antibiotics as Ag-BG supplementation did not increase the efficacy of gentamicin. Bacteria viability assays and electron microscopy images demonstrate that Ag-BG synergizes to restore antibacterial activity to antibiotics that MRSA resists. The low cytotoxicity previously studied against oral bacteria, together with the known regenerative properties presented in previous studies, and the unique antibacterial properties observed in this work when they are combined with antibiotics, make this multifunctional system a promising approach for healing infected tissue. STATEMENT OF SIGNIFICANCE: This study addresses a very significant issue in the field of antibiotic resistance presenting an innovative way to clear MRSA, by utilizing bioactive glass-ceramic microparticles in combination with antibiotics. Multifunctional glass-ceramic microparticles doped with silver ions (Ag-BG) have been previously observed to exhibit bioactive and antibacterial properties. In this study Ag-BG microparticles were observed to synergize with antibiotics restoring their sensitivity against MRSA. This research work presents a novel approach to resurrect ineffective antibiotics and render them effective against MRSA. Cytotoxicity to eukaryotic cells is not anticipated, as it has been previously observed that these microparticles can trigger hard and soft dental tissue regeneration, when they are utilized in certain concentrations. This study opens a new avenue in the treatment of multidrug resistance bacteria.

Bioceramics: from bone substitutes to nanoparticles for drug delivery

Since the second half of the 20th century, bioceramics are used for bone repair and regeneration. Inspired by bones and teeth, and aimed at mimicking their structure and composition, several artificial bioceramics were developed for biomedical applications. And nowadays, in the 21st century, with the increasing prominence of nanoscience and nanotechnology, certain bioceramics are being used to build smart drug delivery systems, among other applications. This minireview will mainly describe both tendencies through the research work carried out by the research team of María Vallet-Regí.

Drug-Loaded Biomimetic Ceramics for Tissue Engineering

The mimesis of biological systems has been demonstrated to be an adequate approach to obtain tissue engineering scaffolds able to promote cell attachment, proliferation, and differentiation abilities similar to those of autologous tissues. Bioceramics are commonly used for this purpose due to their similarities to the mineral component of hard tissues as bone. Furthermore, biomimetic scaffolds are frequently loaded with diverse therapeutic molecules to enhance their biological performance, leading to final products with advanced functionalities. In this review, we aim to describe the already developed bioceramic-based biomimetic systems for drug loading and local controlled release. We will discuss the mechanisms used for the inclusion of therapeutic molecules on the designed systems, paying special attention to the identification of critical parameters that modulate drug loading and release kinetics on these scaffolds.

Effect of surfactant concentration on textural characteristics and biomineralization behavior of mesoporous bioactive glasses

We report mesoporous bioactive glasses (MBGs) with different pore architecture synthesized using the supramolecular chemical approach using acid assisted sol-gel method followed by evaporation induced self-assembly (EISA) process. The surfactant of non-ionic block co-polymer used in the present work act as structure directing agent (SDA) with varying amount, which brings different textural properties. As prepared glasses possess wormhole-like mesostructure with different textural characteristics and it varies with surfactant concentrations. The pristine MBGs have been characterized by various analytical techniques before and after immersing in simulated body fluid (SBF). The textural properties show non-monotonous variations with varying the surfactant concentrations. We have quantified the various structural species present in the glass sample by using local structural probe such as nuclear magnetic resonance technique. Invitro studies on the MBGs revealed the influence of textural characteristics on the formation of nano-crystalline hydroxycarbonated apatite (HCA) layer. The biodegradability is largely related to the pore architecture and it affects the biocompatibility as well as bone formation. In-vitro studies reveals that there are serious negative effects that have been observed in the case of larger pore sized samples due to rapid degradation. We found that MBG with pore sizes of few nano meters exhibit favorable biocompatibility in vitro behavior and found to be promising candidate in the field of biomaterials including tissue regeneration and drug storage.

Micropatterned Silica Films with Nanohydroxyapatite for Y-TZP Implants

This investigation aimed at developing micropatterned silica thin films (MSTFs) containing nanohydroxyapatite (nano-HA) microaggregates that were not completely covered by silica so that they could directly interact with the surrounding cells. The objectives were 1) to evaluate the effect of the presence of 2 films (MSTF with or without nano-HA addition) on the characteristic strength (σ₀) and Weibull modulus ( m) of a yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) and 2) to evaluate the effect of these 2 films, as applied onto the Y-TZP surface, on the morphology, orientation, and proliferation of MG63 cells. Sol-gel process and soft lithography were used to apply the MSTF onto the Y-TZP specimens. Three experimental groups were produced: Y-TZP, Y-TZP + MSTF, and Y-TZP + MSTF + sprayed nano-HA. All surfaces were characterized by scanning electron microscopy and energy-dispersive X-ray spectroscopy and tested for 4-point flexural strength ( n = 30) in water at 37 °C. Weibull analysis was used to determine m and σ₀ (maximum likelihood method). In vitro biological behavior was performed with human osteoblast-like cells (MG63). Y-TZP was successfully coated with MSFT and MSFT + nano-HA. Scanning electron microscopy micrographs indicated that the microaggregates of nano-HA were not entirely covered by the silica. There was no statistically significant difference among the experimental groups for σ₀ and m. In the groups containing the films, the cells were elongated and aligned along the lines. The MSFT + nano-HA group showed significantly higher cell metabolic activity than that obtained for the Y-TZP group at day 7. This investigation was successful in producing an MSTF containing nano-HA microaggregates that remained exposed to the environment. The developed films did not jeopardize the structural reliability of a commercial Y-TZP, as confirmed by the Weibull statistics. The MG63 cells seeded over the films became elongated and aligned along the films' micropatterned lines. Y-TZP specimens coated with MSTF and nano-HA showed a higher cell metabolic activity and proliferation after 7 d of culture when compared with uncoated Y-TZP.

Nanostructured fusiform hydroxyapatite particles precipitated from aquaculture wastewater

The present work represents a new approach for the isolation of uniform nano particulate hydroxyapatite (HAp). The chemical characterization of a calcium phosphate product obtained from industrial trout farm aquaculture wastewater by two different routes, washing either with a basic aqueous medium (wash_NaOH) or followed by a further washing with ethanol (wash_EtOH), is explored. Characterization of the isolated materials includes morphology studies (SEM and TEM), structural (XRD, electron diffraction), compositional (EDX) and thermogravimetric analysis (TGA). The obtained products are a mixture of different compounds, with hydroxyapatite the predominant phase. The morphology is unusually nanometric size with fusiform shaped particles, such characteristics are ordinarily only obtained by synthetic routes. This process of phosphate precipitation represents a unique self-sufficient process to be compared to conventional chemical or biological practices for precipitating phosphate.

Fabrication and characterization of toughness-enhanced scaffolds comprising β-TCP/POC using the freeform fabrication system with micro-droplet jetting

A novel elastomeric material, poly(1,8-octanediol-co-citrate) (POC), has demonstrated tremendous versatility because of its advantageous toughness, tunable degradation properties, and efficient drug release capability. In this study, POC was used to improve the mechanical performance of β-tricalcium phosphate (β-Ca3(PO4)2, β-TCP). (3D) β-TCP/POC composite scaffolds were fabricated by a 3D printing technique based on the freeform fabrication system with micro-droplet jetting (FFS-MDJ). The physiochemical properties, compressive modulus, drug release behavior, and cell response of β-TCP/POC composite scaffolds were systematically investigated. The results showed that β-TCP/POC scaffolds had uniform macropores of 300-400 μm, porosity of approximately 45%, biodegradability in phosphate-buffered saline, and high compressive modulus of 50-75 MPa. With the incorporation of POC into β-TCP, the toughness of the composite scaffolds was improved significantly. Moreover, β-TCP/POC scaffolds exhibited sustained drug (ibuprofen (IBU)) release capability. Additionally, β-TCP/POC scaffolds facilitated C2C12 cell attachment and proliferation. It was indicated that the 3D-printed porous β-TCP/POC scaffolds with high compressive modulus and good drug delivery performance might be a promising candidate for bone defect repair.

Parathyroid hormone-related protein (107-111) improves the bone regeneration potential of gelatin-glutaraldehyde biopolymer-coated hydroxyapatite

Biopolymer-coated nanocrystalline hydroxyapatite (HA) made as macroporous foams which are degradable and flexible are promising candidates as orthopaedic implants. The C-terminal (107-111) epitope of parathyroid hormone-related protein (PTHrP) exhibits osteogenic properties. The main aim of this study was to evaluate whether PTHrP (107-111) loading into gelatin-glutaraldehyde biopolymer-coated HA (HAGlu) scaffolds would produce an optimal biomaterial for tissue engineering applications. HAGlu scaffolds with and without PTHrP (107-111) were implanted into a cavitary defect performed in both distal tibial metaphysis of adult rats. Animals were sacrificed after 4 weeks for histological, microcomputerized tomography and gene expression analysis of the callus. At this time, bone healing occurred only in the presence of PTHrP (107-111)-containing HAGlu implant, related to an increase in bone volume/tissue volume and trabecular thickness, cortical thickness and gene expression of osteocalcin and vascular cell adhesion molecule 1, but a decreased gene expression of Wnt inhibitors, SOST and dickkopf homolog 1. The autonomous osteogenic effect of the PTHrP (107-111)-loaded HAGlu scaffolds was confirmed in mouse and human osteoblastic cell cultures. Our findings demonstrate the advantage of loading PTHrP (107-111) into degradable HAGlu scaffolds for achieving an optimal biomaterial that is promising for low load bearing clinical applications.

Antimicrobial activity of thin solid films of silver doped hydroxyapatite prepared by sol-gel method

In this work, the preparation and characterization of silver doped hydroxyapatite thin films were reported and their antimicrobial activity was characterized. Silver doped hydroxyapatite (Ag:HAp) thin films coatings substrate was prepared on commercially pure Si disks by sol-gel method. The silver doped hydroxyapatite thin films were characterized by various techniques such as Scanning electron microscopy (SEM) with energy Dispersive X-ray attachment (X-EDS), Fourier transform infrared spectroscopy (FT-IR), and glow discharge optical emission spectroscopy (GDOES). These techniques have permitted the structural and chemical characterisation of the silver doped hydroxyapatite thin films. The antimicrobial effect of the Ag:HAp thin films on Escherichia coli and Staphylococcus aureus bacteria was then investigated. This is the first study on the antimicrobial effect of Ag:HAp thin films obtained by sol-gel method. The results of this study have shown that the Ag:HAp thin films with x(Ag) = 0.5 are effective against E. coli and S. aureus after 24 h.

Calcium Orthophosphate-Based Bioceramics

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

Characterization of the mechanical and biological properties of a new alumina scaffold

PURPOSE

In this work, an alumina scaffold was produced through a new method to be used in a near future as a bone substitute.

METHODS

In vitro and in vivo studies were performed in order to characterize the mechanical and biological properties of the scaffold.

RESULTS

The results obtained showed that this scaffold has high mechanical resistance and a porous surface that allows human osteoblast cells to adhere and proliferate. The in vivo studies revealed no systemic reaction.

CONCLUSIONS

The alumina scaffold produced herein has the mechanical and biological properties that are compatible with its application in bone therapy.

Mesoporous bioactive scaffolds prepared with cerium-, gallium- and zinc-containing glasses

Mesoporous bioactive glass scaffolds (MBG_Scs), based on 80% SiO(2)-15% CaO-5% P(2)O(5) (in mol.%) mesoporous sol-gel glasses substituted with Ce(2)O(3), Ga(2)O(3) (both 0.2% or 1.0%) and ZnO (0.4% or 2.0%), were synthesized by combination of evaporation-induced self-assembly and rapid prototyping techniques. Cerium, gallium and zinc trace elements were selected because of their inherent beneficial biological properties. Fabricated scaffolds were characterized and compared with unsubstituted scaffold (B_Sc). All of them contained well interconnected ultralarge pores (pores >400 μm) ideal for vascular ingrowth and proliferation of cells. Macropores of size 100-400 μm were present inside the scaffolds. In addition, low-angle X-ray diffraction showed that B_Sc and scaffolds with substituent contents up to 0.4% exhibited ordered mesoporosity useful for hosting molecules with biological activity. The textural properties of B_Sc were a surface area of 398 m(2) g(-1), a pore diameter of 4.3 nm and a pore volume of 0.43 cm(3) g(-1). A slight decrease in surface area and pore volume was observed upon substitution with no distinct effect on pore diameter. In addition, all the MBG_Scs except 2.0% ZnO_Sc showed quite quick in vitro bioactive response. Hence, the present study is a positive addition to ongoing research into preparing bone tissue engineering scaffolds from bioceramics containing elements of therapeutic significance.

In vitro osteoclast-like and osteoblast cells' response to electrospun calcium phosphate biphasic candidate scaffolds for bone tissue engineering

Successful long term bone replacement and repair remain a challenge today. Nanotechnology has made it possible to alter materials' characteristics and therefore possibly improve on the material itself. In this study, biphasic hydroxyapatite/β-tricalcium phosphate nanobioceramic scaffolds were prepared by the electrospinning technique in order to mimic the extracellular matrix. Scaffolds were characterised by scanning electron microscopy (SEM) and attenuated total reflectance-fourier transform infrared. Osteoblasts as well as monocytes that were differentiated into osteoclast-like cells, were cultured separately on the biphasic bioceramic scaffolds for up to 6 days and the proliferation, adhesion and cellular response were determined using lactate dehydrogenase cytotoxicity assay, nucleus and cytoskeleton dynamics, analysis of the cell cycle progression, measurement of the mitochondrial membrane potential and the detection of phosphatidylserine expression. SEM analysis of the biphasic bioceramic scaffolds revealed nanofibers spun in a mesh-like scaffold. Results indicate that the biphasic bioceramic electrospun scaffolds are biocompatible and have no significant negative effects on either osteoblasts or osteoclast-like cells in vitro.

Infection of orthopedic implants with emphasis on bacterial adhesion process and techniques used in studying bacterial-material interactions

Staphylococcus comprises up to two-thirds of all pathogens in orthopedic implant infections and they are the principal causative agents of two major types of infection affecting bone: septic arthritis and osteomyelitis, which involve the inflammatory destruction of joint and bone. Bacterial adhesion is the first and most important step in implant infection. It is a complex process influenced by environmental factors, bacterial properties, material surface properties and by the presence of serum or tissue proteins. Properties of the substrate, such as chemical composition of the material, surface charge, hydrophobicity, surface roughness and the presence of specific proteins at the surface, are all thought to be important in the initial cell attachment process. The biofilm mode of growth of infecting bacteria on an implant surface protects the organisms from the host immune system and antibiotic therapy. The research for novel therapeutic strategies is incited by the emergence of antibiotic-resistant bacteria. This work will provide an overview of the mechanisms and factors involved in bacterial adhesion, the techniques that are currently being used studying bacterial-material interactions as well as provide insight into future directions in the field.

In vivo osteointegration of three-dimensional crosslinked gelatin-coated hydroxyapatite foams

The main requirement of bone regenerative scaffolds is to enhance the chemical reactions leading to the formation of new bone while providing a proper surface for tissue in-growth as well as a suitable degradation rate. Calcium phosphate ceramics are conformed by different shaping methods. One requirement is to design implants and scaffolds with suitable shapes and sizes, but also with interconnected porosity to ensure bone oxygenation and angiogenesis. In this work we present the in vivo performance of hierarchically arranged glutaraldehyde crosslinked, gelatin-coated nanocrystalline hydroxyapatite (HABP) scaffolds (1-400 μm), with high potential as bone regenerators and excellent osteointegration performance, as well as an appropriate bioresorption rate. 6×10 mm bone defects were made in the lateral aspect of both distal femoral epiphysis of 15 mature (9 months old) male New Zealand rabbits. The bone defect in the left femur was then filled by using HABP foam cylinders, allowing the surgeon to carve the appropriate shape for a particular bone defect with high stability intra-operatively. The foam becomes swollen with body fluid and fills the cavity, ensuring good fixation without the need for a cement. Histological and radiographical studies after 4 months implantation showed healing of all treated bone defects, with bone integration of the HABP foam cylinders and bone conduction over the surface. This in vivo behaviour offers promising results as a scaffold for clinical applications, mainly in orthopaedics and dentistry.

Structure and functionalization of mesoporous bioceramics for bone tissue regeneration and local drug delivery

This review article describes the importance of structure and functionalization in the performance of mesoporous silica bioceramics for bone tissue regeneration and local drug delivery purposes. Herein, we summarize the pivotal features of mesoporous bioactive glasses, also known as 'templated glasses' (TGs), which present chemical compositions similar to those of conventional bioactive sol-gel glasses and the added value of an ordered mesopore arrangement. An in-depth study concerning the possibility of tailoring the structural and textural characteristics of TGs at the nanometric scale and their influence on bioactive behaviour is discussed. The highly ordered mesoporous arrangement of cavities allows these materials to confine drugs to be subsequently released, acting as drug delivery devices. The functionalization of mesoporous silica walls has been revealed as the cornerstone in the performance of these materials as controlled release systems. The synergy between the improved bioactive behaviour and local sustained drug release capability of mesostructured materials makes them suitable to manufacture three-dimensional macroporous scaffolds for bone tissue engineering. Finally, this review tackles the possibility of covalently grafting different osteoinductive agents to the scaffold surface that act as attracting signals for bone cells to promote the bone regeneration process.

Synthesis, toxicology and potential of ordered mesoporous materials in nanomedicine

Although ordered mesoporous silica materials have been studied for almost 20 years, their utilization within life science applications is relatively new and unexplored. An increasing number of researchers are transcending their respective fields in order to bridge the knowledge gap between materials chemistry and biotechnology, and to exploit the potential of mesoporous materials. Their intricate porosity with order in the nanoscale translates into high surface areas above 1000 m(2)/g, high selectivity for the encapsulation of biorelevant molecules as well as controlled surface chemistry. Their uses in pharmaceutics to improve drug formulation, drug bioavailability, mitigate drug toxicity and in cellular targeting, through controlled drug delivery strategies, have been shown. The incorporation of a high concentration of fluorescent and nuclear markers within their pores, whilst retaining good diffusion through their porous matrix, has shown them to be ideal candidates for sensing devices, in immunoassays such as flow cytometry and for their use in novel theranostic applications. This article aims to bring to the forefront some of the most important properties of mesoporous materials, which prove advantageous for their use in nanomedical applications and to highlight some of the potential areas into which the field may now emerge.

Bioceramics: from bone regeneration to cancer nanomedicine

Research on biomaterials has been growing in the last few years due to the clinical needs in organs and tissues replacement and regeneration. In addition, cancer nanomedicine has recently appeared as an effective means to combine nanotechnology developments towards a clinical application. Ceramic materials are suitable candidates to be used in the manufacturing of bone-like scaffolds. Bioceramic materials may also be designed to deliver biologically active substances aimed at repairing, maintaining, restoring or improving the function of organs and tissues in the organism. Several materials such as calcium phosphates, glasses and glass ceramics able to load and subsequently release in a controlled fashion drugs, hormones, growth factors, peptides or nucleic acids have been developed. In particular, to prevent post surgical infections bioceramics may be surface modified and loaded with certain antibiotics, thus preventing the formation of bacterial biofilms. Remarkably, mesoporous bioactive glasses have shown excellent characteristics as drug carrying bone regeneration materials. These bioceramics are not only osteoconductive and osteoproductive, but also osteoinductive, and have therefore been proposed as ideal components for the fabrication of scaffolds for bone tissue engineering. A recent promising development of bioceramic materials is related to the design of magnetic mediators against tumors. Magnetic composites are suitable thermoseeds for cancer treatment by hyperthermia. Moreover, magnetic nanomaterials offer a wide range of possibilities for diagnosis and therapy. These nanoparticles may be conjugated with therapeutic agents and heat the surrounding tissue under the action of alternating magnetic fields, enabling hyperthermia of cancer as an effective adjunct to chemotherapy regimens.

Control of the pore architecture in three-dimensional hydroxyapatite-reinforced hydrogel scaffolds

Hydrogels (gellan or agarose) reinforced with nanocrystalline carbonated hydroxyapatite (nCHA) were prepared by the GELPOR3D technique. This simple method is characterized by compositional flexibility; it does not require expensive equipment, thermal treatment, or aggressive or toxic solvents, and yields a three-dimensional (3D) network of interconnected pores 300-900 μm in size. In addition, an interconnected porosity is generated, yielding a hierarchical porous architecture from the macro to the molecular scale. This porosity depends on both the drying/preservation technology (freeze drying or oven drying at 37 ^○C) and on the content and microstructure of the reinforcing ceramic. For freeze-dried samples, the porosities were approximately 30, 66 and below 3% for pore sizes of 600-900 μm, 100-200 μm and 50-100 nm, respectively. The pore structure depends much on the ceramic content, so that higher contents lead to the disappearance of the characteristic honeycomb structure observed in low-ceramic scaffolds and to a lower fraction of the 100-200-μm-sized pores. The nature of the hydrogel did not affect the pore size distribution but was crucial for the behavior of the scaffolds in a hydrated medium: gellan-containing scaffolds showed a higher swelling degree owing to the presence of more hydrophilic groups.

Compression behaviour of biphasic calcium phosphate and biphasic calcium phosphate-agarose scaffolds for bone regeneration

There is an acknowledged need for shaping 3-D scaffolds with adequate porosity and mechanical properties for biomedical applications. The mechanical properties under static and cyclic compressive testing of dense and designed porous architecture bioceramic scaffolds based on the biphasic calcium phosphate (BCP) systems and BCP-agarose systems have been evaluated. The dense and designed porous architecture scaffolds in BCP systems exhibited a brittle behaviour. Agarose, a biocompatible and biodegradable hydrogel, has been used to shape designed architecture ceramic-agarose scaffolds following a low-temperature shaping method. Agarose conferred toughness, ductility and a rubbery consistency for strains of up to 60% of in ceramic BCP-agarose systems. This combination of ceramic and organic matrix helps to avoid the inherent brittleness of the bioceramic and enhances the compression resistance of hydrogel. The presence of mechanical hysteresis, permanent deformation after the first cycle and recovery of the master monotonous curve indicate a Mullins-like effect such as that observed in carbon-filled rubber systems. We report this type of mechanical behaviour, the Mullins effect, for the first time in bioceramics and bioceramic-agarose systems.

Calcium orthophosphates as bioceramics: state of the art

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