Chitosan-based 3D-printed scaffolds for bone tissue engineering

Chitosan-based biomaterials promote bone regeneration by regulating macrophage fate

The development of various osteogenic biomaterials has not only promoted the development of bone tissue engineering but also provided more possibilities for bone defect repair. However, most previous studies have focused on the interaction of biomaterials on endogenous or exogenous stem cells involved in the bone regeneration process while neglecting the effect of changes in the immune microenvironment of bone defect sites on bone regeneration after biomaterial implantation into the host. With the development of bone immunology, the role of various immune cells, especially macrophages, in bone regeneration has gradually attracted the attention of researchers. An increasing number of studies have begun to target macrophages to better promote bone regeneration by modulating the fate of macrophages in a spatiotemporally ordered manner to mimic the changes in the immune microenvironment of bone defect sites during the natural repair process of bone tissue. Chitosan is one of the most abundant natural polysaccharides in the world. In recent years, various chitosan-based biomaterials have been widely used in macrophage fate modulation and bone regeneration. In this review, we review the interaction between macrophages and scaffold materials, general information about chitosan, the modulation of macrophage fate by chitosan-based biomaterials, and their application in bone regeneration.

Utilization of Additive Manufacturing Techniques for the Development of a Novel Scaffolds with Magnetic Properties for Potential Application in Enhanced Bone Regeneration

This study focuses on designing and evaluating scaffolds with essential properties for bone regeneration, such as biocompatibility, macroporous geometry, mechanical strength, and magnetic responsiveness. The scaffolds are made using 3D printing with acrylic resin and iron oxides synthesized through solution combustion. Utilizing triply periodic minimal surfaces (TPMS) geometry and mask stereolithography (MSLA) printing, the scaffolds achieve precise geometrical features. The mechanical properties are enhanced through resin curing, and magnetite particles from synthesized nanoparticles and alluvial magnetite are added for magnetic properties. The scaffolds show a balance between stiffness, porosity, and magnetic responsiveness, with maximum compression strength between 4.8 and 9.2 MPa and Young's modulus between 58 and 174 MPa. Magnetic properties such as magnetic coercivity, remanence, and saturation are measured, with the best results from scaffolds containing synthetic iron oxides at 1% weight. The viscosity of the mixtures used for printing is between 350 and 380 mPas, and contact angles between 90° and 110° are achieved. Biocompatibility tests indicate the potential for clinical trials, though further research is needed to understand the impact of magnetic properties on cellular interactions and optimize scaffold design for specific applications. This integrated approach offers a promising avenue for the development of advanced materials capable of promoting enhanced bone regeneration.

A comprehensive review on recent progress in chitosan composite gels for biomedical uses

Chitosan (CS) composite gels have emerged as promising materials with diverse applications in biomedicine. This review provides a concise overview of recent advancements and key aspects in the development of CS composite gels. The unique properties of CS, such as biocompatibility, biodegradability, and antimicrobial activity, make it an attractive candidate for gel-based composites. Incorporating various additives, such as nanoparticles, polymers, and bioactive compounds, enhances the mechanical, thermal, and biological and other functional properties of CS gels. This review discusses the fabrication methods employed for CS composite gels, including blending and crosslinking, highlighting their influence on the final properties of the gels. Furthermore, the uses of CS composite gels in tissue engineering, wound healing, drug delivery, and 3D printing highlight their potential to overcome a number of the present issues with drug delivery. The biocompatibility, antimicrobial properties, electroactive, thermosensitive and pH responsive behavior and controlled release capabilities of these gels make them particularly suitable for biomedical applications. In conclusion, CS composite gels represent a versatile class of materials with significant potential for a wide range of applications. Further research and development efforts are necessary to optimize their properties and expand their utility in pharmaceutical and biomedical fields.

Innovative technologies for the fabrication of 3D/4D smart hydrogels and its biomedical applications - A comprehensive review

Repairing and regenerating damaged tissues or organs, and restoring their functioning has been the ultimate aim of medical innovations. 'Reviving healthcare' blends tissue engineering with alternative techniques such as hydrogels, which have emerged as vital tools in modern medicine. Additive manufacturing (AM) is a practical manufacturing revolution that uses building strategies like molding as a viable solution for precise hydrogel manufacturing. Recent advances in this technology have led to the successful manufacturing of hydrogels with enhanced reproducibility, accuracy, precision, and ease of fabrication. Hydrogels continue to metamorphose as the vital compatible bio-ink matrix for AM. AM hydrogels have paved the way for complex 3D/4D hydrogels that can be loaded with drugs or cells. Bio-mimicking 3D cell cultures designed via hydrogel-based AM is a groundbreaking in-vivo assessment tool in biomedical trials. This brief review focuses on preparations and applications of additively manufactured hydrogels in the biomedical spectrum, such as targeted drug delivery, 3D-cell culture, numerous regenerative strategies, biosensing, bioprinting, and cancer therapies. Prevalent AM techniques like extrusion, inkjet, digital light processing, and stereo-lithography have been explored with their setup and methodology to yield functional hydrogels. The perspectives, limitations, and the possible prospects of AM hydrogels have been critically examined in this study.

Cell culture on suspended fiber for tissue regeneration: A review

Cell culturing is a cornerstone of tissue engineering, playing a crucial role in tissue regeneration, drug screening, and the study of disease mechanisms. Among various culturing techniques, 3D culture systems, particularly those utilizing suspended fiber scaffolds, offer a more physiologically relevant environment than traditional 2D monolayer cultures. These 3D scaffolds enhance cell growth, differentiation, and proliferation by mimicking the in vivo cellular milieu. This review focuses on the critical role of suspended fiber scaffolds in tissue engineering. We compare the effectiveness of 3D suspended fiber scaffolds with 2D culture systems, discussing their respective benefits and limitations in the context of tissue regeneration. Furthermore, we explore the preparation methods of suspended fiber scaffolds and their potential applications. The review concludes by considering future research directions for optimizing suspended fiber scaffolds to address specific challenges in tissue regeneration, underscoring their significant promise in advancing tissue engineering and regenerative medicine.

Chitosan-based materials for dental implantology: A comprehensive review

Chitosan, a versatile biopolymer, has gained recognition in the discipline of dental implantology due to possessing salient properties. This comprehensive review explores the potential of chitosan in dental implants, focusing on its biocompatibility, bioactivity, and the various chitosan-based materials that have been utilized for dental implant therapy. The review also highlights the importance of surface treatment in dental implants to enhance osseointegration and inhibit bacterial biofilm formation. Additionally, the chemical structure, properties, and sources of chitosan are described, along with its different structural forms. The characteristics of chitosan particularly color, molecular weight, viscosity, and degree of deacetylation are discussed about their influence on its applications. This review provides valuable insights into the promising utilization of polymeric chitosan in enhancing the success and functionality of dental implants. This study highlights the potential applications of chitosan in oral implantology. Chitosan possesses various advantageous properties, including muco-adhesiveness, hemostatic action, biocompatibility, biodegradability, bioactivity, and antibacterial and antifungal activities, which enhance its uses in dental implantology. However, it has limited aqueous solubility at the physiological pH, which sometimes restricts its biological application, but this problem can be overcome by using modified chitosan or chitosan derivatives, which have also shown encouraging results. Recent research suggests that chitosan may act as a promising material for coating titanium-based implants, improving osteointegration together with antibacterial properties.

Electrochemical technique to develop surface-controlled polyaniline nano-tulips (PANINTs) on PCL-reinforced chitosan functionalized (CS-f-Fe2O3) scaffolds for stimulating osteoporotic bone regeneration

Bone defects pose significant challenges in orthopedic surgery, often leading to suboptimal outcomes and complications. Addressing these challenges, we employed a three-electrode electrochemical system to fabricate surface-controlled polyaniline nano-tulips (PANINTs) decorated polycaprolactone (PCL) reinforced chitosan functionalized iron oxide nanoparticles (CS-f-Fe2O3) scaffolds. These structures were designed to emulate the natural extracellular matrix (ECM) and promote enhanced osseointegration by establishing a continuous interface between host bone and graft, thereby improving both biological processes and mechanical stability. In vitro experiments demonstrated that PANINTs-PCL/CS-f-Fe2O3 substrates significantly promoted the proliferation, differentiation, and spontaneous outgrowth and extension of MC3T3-E1 cell activity. The nanomaterials exhibited increased cell viability and osteogenic differentiation, as evidenced by elevated expression of bone-related markers such as ALP, ARS, COL-I, RUNX2, and SPP-I, as determined by qRT-PCR. Our findings underscore the regenerative potential of in situ cell culture systems for bone defects, emphasizing the targeted stimulation of essential cell subpopulations to facilitate rapid bone tissue regeneration.

In Vitro Evaluation of Pore Size Graded Bone Scaffolds with Different Material Composition

The demand for biomimetic and biocompatible scaffolds in equivalence of structure and material composition for the regeneration of bone tissue is relevantly high. This article is investigating a novel three-dimensional (3D) printed porous structure called bone bricks with a gradient pore size mimicking the structure of the bone tissue. Poly-ɛ-caprolactone (PCL) combined with ceramics such as hydroxyapatite (HA), β-tricalcium phosphate (TCP), and bioglass 45S5 were successfully mixed using a melt blending method and fabricated with the use of screw-assisted extrusion-based additive manufacturing system. Bone bricks containing the same material concentration (20 wt%) were biologically characterized through proliferation and differentiation tests. Scanning electron microscopy (SEM) was used to investigate the morphology of cells on the surface of bone bricks, whereas energy dispersive X-ray (EDX) spectroscopy was used to investigate the element composition on the surface of the bone bricks. Confocal imaging was used to investigate the number of differentiated cells on the surface of bone bricks. Proliferation results showed that bone bricks containing PCL/HA content are presenting higher proliferation properties, whereas differentiation results showed that bone bricks containing PCL/Bioglass 45S5 are presenting higher differentiation properties. Confocal imaging results showed that bone bricks containing PCL/Bioglass 45S5 are presenting a higher number of differentiated cells on their surface compared with the other material contents.

Recent Developments in Bio-Ink Formulations Using Marine-Derived Biomaterials for Three-Dimensional (3D) Bioprinting

3D bioprinting is a disruptive, computer-aided, and additive manufacturing technology that allows the obtention, layer-by-layer, of 3D complex structures. This technology is believed to offer tremendous opportunities in several fields including biomedical, pharmaceutical, and food industries. Several bioprinting processes and bio-ink materials have emerged recently. However, there is still a pressing need to develop low-cost sustainable bio-ink materials with superior qualities (excellent mechanical, viscoelastic and thermal properties, biocompatibility, and biodegradability). Marine-derived biomaterials, including polysaccharides and proteins, represent a viable and renewable source for bio-ink formulations. Therefore, the focus of this review centers around the use of marine-derived biomaterials in the formulations of bio-ink. It starts with a general overview of 3D bioprinting processes followed by a description of the most commonly used marine-derived biomaterials for 3D bioprinting, with a special attention paid to chitosan, glycosaminoglycans, alginate, carrageenan, collagen, and gelatin. The challenges facing the application of marine-derived biomaterials in 3D bioprinting within the biomedical and pharmaceutical fields along with future directions are also discussed.

Improvement of Osteogenic Differentiation of Mouse Pre-Osteoblastic MC3T3-E1 Cells on Core-Shell Polylactic Acid/Chitosan Electrospun Scaffolds for Bone Defect Repair

Electrospun hybrid scaffolds composed of synthetic and natural polymers have gained increasing interest in tissue engineering applications over the last decade. In this work, scaffolds composed of polylactic acid electrospun fibers, either treated (P-PLA) or non-treated (PLA) with air-plasma, were coated with high molecular weight chitosan to create a core-shell microfibrous structure. The effective thickness control of the chitosan layer was confirmed by gravimetric, spectroscopic (FTIR-ATR) and morphological (SEM) investigations. The chitosan coating increased the fiber diameter of the microfibrous scaffolds while the tensile mechanical tests, conducted in dry and wet environments, showed a reinforcing action of the coating layer on the scaffolds, in particular when deposited on P-PLA samples. The stability of the Chi coating on both PLA and P-PLA substrates was confirmed by gravimetric analysis, while their mineralization capacity was evaluated though scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) after immersing the scaffolds in simulated body fluids (SBF) at 37 °C for 1 week. Sample biocompatibility was investigated through cell viability assay and SEM analysis on mouse pre-osteoblastic MC3T3-E1 cells grown on scaffolds at different times (1, 7, 14 and 21 days). Finally, Alizarin Red assay and qPCR analysis suggested that the combination of plasma treatment and chitosan coating on PLA electrospun scaffolds influences the osteoblastic differentiation of MC3T3-E1 cells, thus demonstrating the great potential of P-PLA/chitosan hybrid scaffolds for bone tissue engineering applications.

Preparation of PDA-GO/CS composite scaffold and its effects on the biological properties of human dental pulp stem cells

Reduced graphene oxide (rGO) is an graphene oxide (GO) derivative of graphene, which has a large specific surface area and exhibited satisfactory physicochemical characteristics. In this experiment, GO was reduced by PDA to generate PDA-GO complex, and then PDA-GO was combined with Chitosan (CS) to synthesize PDA-GO/CS composite scaffold. PDA-GO was added to CS to improve the degradation rate of CS, and it was hoped that PDA-GO/CS composite scaffolds could be used in bone tissue engineering. Physicochemical and antimicrobial properties of the different composite scaffolds were examined to find the optimal mass fraction. Besides, we examined the scaffold's biocompatibility by Phalloidin staining and Live and Dead fluorescent staining.Finally, we applied ALP staining, RT-qPCR, and Alizarin red S staining to detect the effect of PDA-GO/CS on the osteogenic differentiation of human dental pulp stem cells (hDPSCs). The results showed that PDA-GO composite was successfully prepared and PDA-GO/CS composite scaffold was synthesized by combining PDA-GO with CS. Among them, 0.3%PDA-GO/CS scaffolds improves the antibacterial activity and hydrophilicity of CS, while reducing the degradation rate. In vitro, PDA-GO/CS has superior biocompatibility and enhances the early proliferation, migration and osteogenic differentiation of hDPSCs. In conclusion, PDA-GO/CS is a new scaffold materialsuitable for cell culture and has promising application prospect as scaffold for bone tissue engineering.

Polysaccharide-based hydrogels for medical devices, implants and tissue engineering: A review

Hydrogels are highly biocompatible biomaterials composed of crosslinked three-dimensional networks of hydrophilic polymers. Owing to their natural origin, polysaccharide-based hydrogels (PBHs) possess low toxicity, high biocompatibility and demonstrate in vivo biodegradability, making them great candidates for use in various biomedical devices, implants, and tissue engineering. In addition, many polysaccharides also show additional biological activities such as antimicrobial, anticoagulant, antioxidant, immunomodulatory, hemostatic, and anti-inflammatory, which can provide additional therapeutic benefits. The porous nature of PBHs allows for the immobilization of antibodies, aptamers, enzymes and other molecules on their surface, or within their matrix, potentiating their use in biosensor devices. Specific polysaccharides can be used to produce transparent hydrogels, which have been used widely to fabricate ocular implants. The ability of PBHs to encapsulate drugs and other actives has been utilized for making neural implants and coatings for cardiovascular devices (stents, pacemakers and venous catheters) and urinary catheters. Their high water-absorption capacity has been exploited to make superabsorbent diapers and sanitary napkins. The barrier property and mechanical strength of PBHs has been used to develop gels and films as anti-adhesive formulations for the prevention of post-operative adhesion. Finally, by virtue of their ability to mimic various body tissues, they have been explored as scaffolds and bio-inks for tissue engineering of a wide variety of organs. These applications have been described in detail, in this review.

Harnessing the power of biological macromolecules in hydrogels for controlled drug release in the central nervous system: A review

Hydrogels have immense potential in revolutionizing central nervous system (CNS) drug delivery, improving outcomes for neurological disorders. They serve as promising tools for controlled drug delivery to the CNS. Available hydrogel types include natural macromolecules (e.g., chitosan, hyaluronic acid, alginate), as well as hybrid hydrogels combining natural and synthetic polymers. Each type offers distinct advantages in terms of biocompatibility, mechanical properties, and drug release kinetics. Design and engineering considerations encompass hydrogel composition, crosslinking density, porosity, and strategies for targeted drug delivery. The review emphasizes factors affecting drug release profiles, such as hydrogel properties and formulation parameters. CNS drug delivery applications of hydrogels span a wide range of therapeutics, including small molecules, proteins and peptides, and nucleic acids. However, challenges like limited biodegradability, clearance, and effective CNS delivery persist. Incorporating 3D bioprinting technology with hydrogel-based CNS drug delivery holds the promise of highly personalized and precisely controlled therapeutic interventions for neurological disorders. The review explores emerging technologies like 3D bioprinting and nanotechnology as opportunities for enhanced precision and effectiveness in hydrogel-based CNS drug delivery. Continued research, collaboration, and technological advancements are vital for translating hydrogel-based therapies into clinical practice, benefiting patients with CNS disorders. This comprehensive review article delves into hydrogels for CNS drug delivery, addressing their types, design principles, applications, challenges, and opportunities for clinical translation.

Chitosan scaffolds: Expanding horizons in biomedical applications

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

Tunicate cellulose nanocrystals reinforced modified calcium sulfate bone cement with enhanced mechanical properties for bone repair

Considering the poor mechanical properties of bone cement, its practical application has always been limited. In this study, we introduced tunicate cellulose nanocrystals (TCNCs) into calcium sulfate bone cement for the first time, and multiple enhanced composite bone cement was prepared by the condensation reflux method. Firstly, high-strength modified calcium sulfate hemihydrate (CSH) bone cement was successfully prepared by using tartaric acid, a crystal modifier with a chiral structure. Secondly, the inclusion of TCNCs not only exhibited significant reinforcement and toughening effects but also stimulated the adhesion, proliferation, and differentiation of related osteoblasts. Furthermore, TCNCs encapsulated the CSH particles, overcoming the limitations of excessive degradation rates in bone cement and enabling sustained release of Ca2+, promoting the healing of bone defects. Overall, this study presents novel ideas and methodologies for designing bone cement with exceptional performance. It also provides a new platform for the development of bone tissue engineering and is expected to become a new type of bone regeneration material. The utilization of oceanic resources in this context holds high-value potential, alleviating environmental burdens and providing clinically applicable bone tissue repair materials with broad application prospects.

Nanomaterials-incorporated hydrogels for 3D bioprinting technology

In the field of tissue engineering and regenerative medicine, various hydrogels derived from the extracellular matrix have been utilized for creating engineered tissues and implantable scaffolds. While these hydrogels hold immense promise in the healthcare landscape, conventional bioinks based on ECM hydrogels face several challenges, particularly in terms of lacking the necessary mechanical properties required for 3D bioprinting process. To address these limitations, researchers are actively exploring novel nanomaterial-reinforced ECM hydrogels for both mechanical and functional aspects. In this review, we focused on discussing recent advancements in the fabrication of engineered tissues and monitoring systems using nanobioinks and nanomaterials via 3D bioprinting technology. We highlighted the synergistic benefits of combining numerous nanomaterials into ECM hydrogels and imposing geometrical effects by 3D bioprinting technology. Furthermore, we also elaborated on critical issues remaining at the moment, such as the inhomogeneous dispersion of nanomaterials and consequent technical and practical issues, in the fabrication of complex 3D structures with nanobioinks and nanomaterials. Finally, we elaborated on plausible outlooks for facilitating the use of nanomaterials in biofabrication and advancing the function of engineered tissues.

Biocomposites containing poly(lactic acid) and chitosan for 3D printing - Assessment of mechanical, antibacterial and in vitro biodegradability properties

New bone repair materials are needed for treatment of trauma- and disease-related skeletal defects as they still represent a major challenge in clinical practice. Additionally, new strategies are required to combat orthopedic device-related infections (ODRI), given the rising incidence of total joint replacement and fracture fixation surgeries in increasingly elderly populations. Recently, the convergence of additive manufacturing (AM) and bone tissue engineering (BTE) has facilitated the development of bone healthcare to achieve personalized three-dimensional (3D) scaffolds. This study focused on the development of a 3D printable bone repair material, based on the biopolymers poly(lactic acid) (PLA) and chitosan. Two different types of PLA and chitosan differing in their molecular weight (MW) were explored. The novel feature of this research was the successful 3D printing using biocomposite filaments composed of PLA and 10 wt% chitosan, with clear chitosan entrapment within the PLA matrix confirmed by Scanning Electron Microscopy (SEM) images. Tensile testing of injection molded samples indicated an increase in stiffness, compared to pure PLA scaffolds, suggesting potential for improved load-bearing characteristics in bone scaffolds. However, the potential benefit of chitosan on the biocomposite stiffness could not be reproduced in compression testing of 3D printed cylinders. The antibacterial assays confirmed antibacterial activity of chitosan when dissolved in acetic acid. The study also verified the biodegradability of the scaffolds, with a process producing an acidic environment that could potentially be neutralized by chitosan. In conclusion, the study indicated the feasibility of the proposed PLA/chitosan biocomposite for 3D printing, demonstrating adequate mechanical strength, antibacterial properties and biodegradability, which could serve as a new material for bone repair.

Microenvironment-targeted strategy steers advanced bone regeneration

Treatment of large bone defects represents a great challenge in orthopedic and craniomaxillofacial surgery. Traditional strategies in bone tissue engineering have focused primarily on mimicking the extracellular matrix (ECM) of bone in terms of structure and composition. However, the synergistic effects of other cues from the microenvironment during bone regeneration are often neglected. The bone microenvironment is a sophisticated system that includes physiological (e.g., neighboring cells such as macrophages), chemical (e.g., oxygen, pH), and physical factors (e.g., mechanics, acoustics) that dynamically interact with each other. Microenvironment-targeted strategies are increasingly recognized as crucial for successful bone regeneration and offer promising solutions for advancing bone tissue engineering. This review provides a comprehensive overview of current microenvironment-targeted strategies and challenges for bone regeneration and further outlines prospective directions of the approaches in construction of bone organoids.

A Study of the Properties of Scaffolds for Bone Regeneration Modified with Gel-like Coatings of Chitosan and Folic Acid

The research has been conducted to obtain scaffolds for cancellous bone regeneration. Polylactide scaffolds were made by the phase inversion method with a freeze-extraction variant, including gelling polylactide in its non-solvent. Substitutes made of polylactide are hydrophobic, which limits cell adhesion. For this reason, the scaffolds were modified using chitosan and folic acid by forming gel-like coatings on the surface. The modification aimed to improve the material's surface properties and increase cell adhesion. Analyses of obtained scaffolds confirmed the effectiveness of performed changes. The presence of chitosan and folic acid was confirmed in the modified scaffolds, while all scaffolds retained high open porosity, which is essential for proper cell growth inside the scaffold and the free flow of nutrients. Hydrostatic weighing showed that the scaffolds have high mass absorbability, allowing them to be saturated with biological fluids. There were also cytotoxicity tests performed on 24 h extracts of the materials obtained, which indicated a lack of cytotoxic effect.

Application of chitosan with different molecular weights in cartilage tissue engineering

Cartilage tissue engineering involves the invention of novel implantable cartilage replacement materials to help heal cartilage injuries that do not heal themselves, aiming to overcome the shortcomings of current clinical cartilage treatments. Chitosan has been widely used in cartilage tissue engineering because of its similar structure to glycine aminoglycan, which is widely distributed in connective tissues. The molecular weight, as an important structural parameter of chitosan, affects not only the method of chitosan composite scaffold preparation but also the effect on cartilage tissue healing. Thus, this review identifies methods for the preparation of chitosan composite scaffolds with low, medium and high molecular weights, as well as a range of chitosan molecular weights appropriate for cartilage tissue repair, by summarizing the application of different molecular weights of chitosan in cartilage repair in recent years.

Chitosan and its derivatives in 3D/4D (bio) printing for tissue engineering and drug delivery applications

Tissue engineering research has undergone to a revolutionary improvement, thanks to technological advancements, such as the introduction of bioprinting technologies. The ability to develop suitable customized biomaterial inks/bioinks, with excellent printability and ability to promote cell proliferation and function, has a deep impact on such improvements. In this context, printing inks based on chitosan and its derivatives have been instrumental. Thus, the current review aims at providing a comprehensive overview on chitosan-based materials as suitable inks for 3D/4D (bio)printing and their applicability in creating advanced drug delivery platforms and tissue engineered constructs. Furthermore, relevant strategies to improve the mechanical and biological performances of this biomaterial are also highlighted.

CBCT-Based Design of Patient-Specific 3D Bone Grafts for Periodontal Regeneration

The purpose of this article is to define and implement a methodology for the 3D design of customized patient-specific scaffolds (bone grafts) for the regeneration of periodontal tissues. The prerequisite of the proposed workflow is the three-dimensional (3D) structure of the periodontal defect, i.e., the 3D model of the hard tissues (alveolar bone and teeth) around the periodontal damage, which is proposed to be generated via a segmentation and 3D editing methodology using cone beam computed tomography (CBCT) data. Two types of methodologies for 3D periodontal scaffold (graft) design are described: (i) The methodology of designing periodontal defect customized block grafts and (ii) the methodology of designing extraction socket preservation customized grafts. The application of the proposed methodology for the generation of a 3D model of the hard tissues around periodontal defects of a patient using a CBCT scan and the 3D design of the two aforementioned types of scaffolds for personalized periodontal regenerative treatment shows promising results. The outputs of this work will be used as the basis for the 3D printing of bioabsorbable scaffolds of personalized treatment against periodontitis, which will simultaneously be used as sustained-release drug carriers.

A comprehensive review of chitosan applications in paper science and technologies

Using environmentally friendly biomaterials in different aspects of human life has been considered extensively. In this respect, different biomaterials have been identified and different applications have been found for them. Currently, chitosan, the well-known derivative of the second most abundant polysaccharide in the nature (i.e., chitin), has been receiving a lot of attention. This unique biomaterial can be defined as a renewable, high cationic charge density, antibacterial, biodegradable, biocompatible, non-toxic biomaterial with high compatibility with cellulose structure, where it can be used in different applications. This review takes a deep and comprehensive look at chitosan and its derivative applications in different aspects of papermaking.

Chitosan-Based Membranes as Gentamicin Carriers for Biomedical Applications-Influence of Chitosan Molecular Weight

Over the past decade, much attention has been paid to chitosan as a potential drug carrier because of its non-toxicity, biocompatibility, biodegradability and antibacterial properties. The effect of various chitosan characteristics on its ability to carry different antibiotics is discussed in the literature. In this work, we evaluated the influence of the different molecular weights of this polymer on its potential as an antibacterial membrane after adding gentamicin (1% w/w). Three types of chitosan membranes without and with antibiotic were prepared using a solvent casting process. Their microstructures were analyzed with a 4K digital microscope, and their chemical bonds were studied using FTIR spectroscopy. Furthermore, cytocompatibility on human osteoblasts and fibroblasts as well as antibacterial activity against Staphylococcus aureus (S. aureus.) and Escherichia coli (E. coli) were assessed. We observed that the membrane prepared from medium-molecular-weight chitosan exhibited the highest contact angle (≈85°) and roughness (10.96 ± 0.21 µm) values, and its antibacterial activity was unfavorable. The maximum tensile strength and Young's modulus of membranes improved and elongation decreased with an increase in the molecular weight of chitosan. Membranes prepared with high-molecular-weight chitosan possessed the best antibacterial activity, but mainly against S. aureus. For E. coli, is not advisable to add gentamicin to the chitosan membrane, or it is suggested to deplete its content. None of the fabricated membranes exhibited a full cytotoxic effect on osteoblastic and fibroblast cells. Based on our results, the most favorable membrane as a gentamicin carrier was obtained from high-molecular-weight chitosan.

Mussel-inspired HA@TA-CS/SA biomimetic 3D printed scaffolds with antibacterial activity for bone repair

Bacterial infection is a major challenge that could threaten the patient's life in repairing bone defects with implant materials. Developing functional scaffolds with an intelligent antibacterial function that can be used for bone repair is very important. We constructed a drug delivery (HA@TA-CS/SA) scaffold with curcumin-loaded dendritic mesoporous organic silica nanoparticles (DMON@Cur) via 3D printing for antibacterial bone repair. Inspired by the adhesion mechanism of mussels, the HA@TA-CS/SA scaffold of hydroxyapatite (HA) and chitosan (CS) is bridged by tannic acid (TA), which in turn binds sodium alginate (SA) using electrostatic interactions. The results showed that the HA@TA-CS/SA composite scaffold had better mechanical properties compared with recent literature data, reaching 68.09 MPa. It displayed excellent degradation and mineralization capabilities with strong biocompatibility in vitro. Furthermore, the antibacterial test results indicated that the curcumin-loaded scaffold inhibited S.aureus and E.coli with 99.99% and 96.56% effectiveness, respectively. These findings show that 3D printed curcumin-loaded HA@TA-CS/SA scaffold has considerable promise for bone tissue engineering.

Additive manufacturing of sustainable biomaterials for biomedical applications

Biopolymers are promising environmentally benign materials applicable in multifarious applications. They are especially favorable in implantable biomedical devices thanks to their excellent unique properties, including bioactivity, renewability, bioresorbability, biocompatibility, biodegradability and hydrophilicity. Additive manufacturing (AM) is a flexible and intricate manufacturing technology, which is widely used to fabricate biopolymer-based customized products and structures for advanced healthcare systems. Three-dimensional (3D) printing of these sustainable materials is applied in functional clinical settings including wound dressing, drug delivery systems, medical implants and tissue engineering. The present review highlights recent advancements in different types of biopolymers, such as proteins and polysaccharides, which are employed to develop different biomedical products by using extrusion, vat polymerization, laser and inkjet 3D printing techniques in addition to normal bioprinting and four-dimensional (4D) bioprinting techniques. This review also incorporates the influence of nanoparticles on the biological and mechanical performances of 3D-printed tissue scaffolds. This work also addresses current challenges as well as future developments of environmentally friendly polymeric materials manufactured through the AM techniques. Ideally, there is a need for more focused research on the adequate blending of these biodegradable biopolymers for achieving useful results in targeted biomedical areas. We envision that biopolymer-based 3D-printed composites have the potential to revolutionize the biomedical sector in the near future.

Application of photocrosslinkable hydrogels based on photolithography 3D bioprinting technology in bone tissue engineering

Bone tissue engineering (BTE) has been proven to be an effective method for the treatment of bone defects caused by different musculoskeletal disorders. Photocrosslinkable hydrogels (PCHs) with good biocompatibility and biodegradability can significantly promote the migration, proliferation and differentiation of cells and have been widely used in BTE. Moreover, photolithography 3D bioprinting technology can notably help PCHs-based scaffolds possess a biomimetic structure of natural bone, meeting the structural requirements of bone regeneration. Nanomaterials, cells, drugs and cytokines added into bioinks can enable different functionalization strategies for scaffolds to achieve the desired properties required for BTE. In this review, we demonstrate a brief introduction of the advantages of PCHs and photolithography-based 3D bioprinting technology and summarize their applications in BTE. Finally, the challenges and potential future approaches for bone defects are outlined.

Photothermal and natural activity-based synergistic antibacterial effects of Ti3C2Tx MXene-loaded chitosan hydrogel against methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) has strong resistance to antibiotic therapy. In this regard, developing antibiotic-free antibacterial agents is of great significance to treat MRSA infections. Herein, we loaded Ti₃C₂T_x MXene nanomaterial in the non-crosslinked chitosan (CS) hydrogel. The obtained MX-CS hydrogel is expected to not only adsorb MRSA cells via CS-MRSA interactions, but also gather the MXene-induced photothermal hyperthermia, achieving the efficient and intensive anti-MRSA photothermal therapy. As a result, under NIR irradiation (808 nm, 1.6 W/cm², 5 min), MX-CS showed a greater photothermal effect than MXene alone did (30 μg/mL, 49.9 °C for MX-CS and 46.5 °C for MXene). Importantly, MRSA cells were rapidly adsorbed on MX-CS hydrogel (containing 30 μg/mL MXene) and completely inhibited (99.18 %) under NIR irradiation for 5 min. In contrast, MXene (30 μg/mL) and CS hydrogel alone only inhibited 64.52 % and 23.72 % MRSA, respectively, significantly lower than the inhibition caused by MX-CS (P < 0.001). Interestingly, when the hyperthermia was depleted by a 37 °C water bath, the bacterial inhibition rate of MX-CS significantly decreased to 24.65 %. In conclusion, MX-CS hydrogel has a remarkable synergistic anti-MRSA activity by gathering MRSA cells and MXene-induced hyperthermia, and may have great potentials in treating MRSA-infected diseases.

3D printing of 'green' thermo-sensitive chitosan-hydroxyapatite bone scaffold based on lyophilized platelet-rich fibrin

The critical bone defect is still an urgent problem in the field of bone repair. Here, we reported a new type of chitosan (CS)-hydroxyapatite (HAP) scaffolds based on lyophilized platelet-rich fibrin (L-PRF) for releasing abundant growth factors to realize their respective functions. It also has strong mechanical properties to maintain the stability of the bone repair environment. However, acid-soluble CS hydrogels often contain toxic and organic solvents. Moreover, chemical agents may be used for cross-linking for better mechanical properties, further increasing cytotoxicity. In this study, we used an alkali/urea dissolution system to dissolve CS, which improved its mechanical properties and made it thermo-sensitive. Finally, the L-PRF-CS-HAP (P-C-H) composite scaffold was constructed by extrusion-based printing. The results showed that the printing ink had desirable printability and temperature sensitivity. The compressive properties of the scaffolds exhibited a trend of decline with L-PRF content increasing, but all of them could meet the strength of cancellous bone. Meanwhile, the scaffolds had high hydrophilicity, porosity, and could be degraded stablyin vitro. The antibacterial properties of the scaffolds were also verified, greatly reducing the risk of infection during bone repair. It was also demonstrated that the release time of growth factor from L-PRF was significantly prolonged, and growth factor could still be detected after 35 d of sustained release. The capacity of cells to proliferate increased as the number of L-PRF components increased, indicating that L-PRF still exhibited biological activity after 3D printing.

Design and development of biodegradable POSS-PCL-Zeolite (β) nano-scaffold for potential applications in bone regeneration

Side effects caused by bone fractures and restrictions on bone regeneration impose an enormous economic burden on the health system of society. To overcome these limitations, tissue engineering and cell-based therapies have been proposed as alternatives to induce and promote bone healing. Still, bone regeneration disadvantages, such as limited and painful surgery, the risk of infection, nerve injury, bleeding, and function damage, have led investigators to find an alternative therapy. In some studies, bone stimulants have prompted scientists to design scaffolds with appropriate physical structure with the possibility of cell adhesion and proliferation, which plays an influential role in the regeneration and repair of bone tissue. PCL nanofiber is an absorbing candidate for the formulation of biocompatible scaffolds used in tissue engineering. To overcome these negative aspects, improve the properties of PCL nanofibers, and based on the biocompatibility and superior mechanical properties of POSS, Polyhedral Oligomeric Silsesquioxane-Polycaprolactone-Zeolite (POSS-PCL-Zeolite) nanocomposite electrospun nanofiber scaffolds were fabricated in the present study. Nanohybrids and nanofibers structures were characterized by FTIR, HNMR, XRD, SEM, EDX, and DSC techniques. We used cellular and molecular assays, including DCFH ROS detection system, gene expression (RUNX-2, Osteocalcin, Nrf2, BAX, VEGF gens), and apoptotic to demonstrate the biocompatibility and induce bone differentiation of formulated POSS-PCL-Zeolite scaffolds. The results showed the biodegradability of POSS-PCL-Zeolite Nano-scaffold and supported the nesting of mesenchymal stem cells (MSCs) and induced bone differentiation by POSS-PCL-Zeolite Nano-scaffold.

Phosphoserine-loaded chitosan membranes promote bone regeneration by activating endogenous stem cells

Bone defects that result from trauma, infection, surgery, or congenital malformation can severely affect the quality of life. To address this clinical problem, a phosphoserine-loaded chitosan membrane that consists of chitosan membranes serving as the scaffold support to accommodate endogenous stem cells and phosphoserine is synthesized. The introduction of phosphoserine greatly improves the osteogenic effect of the chitosan membranes via mutual crosslinking using a crosslinker (EDC, 1-ethyl-3-(3-dimethyl aminopropyl)-carbodiimide). The morphology of PS-CS membranes was shown by scanning electron microscopy (SEM) to have an interconnected porous structure. The incorporation of phosphoserine into chitosan membranes was confirmed by energy dispersive spectrum (EDS), Fourier Transforms Infrared (FTIR), and X-ray diffraction (XRD) spectrum. The CCK8 assay and Live/Dead staining, Hemolysis analysis, and cell adhesion assay demonstrated that PS-CS membranes had good biocompatibility. The osteogenesis-related gene expression of BMSCs was higher in PS-CS membranes than in CS membranes, which was verified by alkaline phosphatase (ALP) activity, immunofluorescence staining, and real-time quantitative PCR (RT-qPCR). Furthermore, micro-CT and histological analysis of rat cranial bone defect demonstrated that PS-CS membranes dramatically stimulated bone regeneration in vivo. Moreover, H&E staining of the main organs (heart, liver, spleen, lung, or kidney) showed no obvious histological abnormalities, revealing that PS-CS membranes were no additional systemic toxicity in vivo. Collectively, PS-CS membranes may be a promising candidate for bone tissue engineering.

Bioresorbable Chitosan-Based Bone Regeneration Scaffold Using Various Bioceramics and the Alteration of Photoinitiator Concentration in an Extended UV Photocrosslinking Reaction

Bone tissue engineering (BTE) is an ongoing field of research based on clinical needs to treat delayed and non-union long bone fractures. An ideal tissue engineering scaffold should have a biodegradability property matching the rate of new bone turnover, be non-toxic, have good mechanical properties, and mimic the natural extracellular matrix to induce bone regeneration. In this study, biodegradable chitosan (CS) scaffolds were prepared with combinations of bioactive ceramics, namely hydroxyapatite (HAp), tricalcium phosphate-α (TCP- α), and fluorapatite (FAp), with a fixed concentration of benzophenone photoinitiator (50 µL of 0.1% (w/v)) and crosslinked using a UV curing system. The efficacy of the one-step crosslinking reaction was assessed using swelling and compression testing, SEM and FTIR analysis, and biodegradation studies in simulated body fluid. Results indicate that the scaffolds had comparable mechanical properties, which were: 13.69 ± 1.06 (CS/HAp), 12.82 ± 4.10 (CS/TCP-α), 13.87 ± 2.9 (CS/HAp/TCP-α), and 15.55 ± 0.56 (CS/FAp). Consequently, various benzophenone concentrations were added to CS/HAp formulations to determine their effect on the degradation rate. Based on the mechanical properties and degradation profile of CS/HAp, it was found that 5 µL of 0.1% (w/v) benzophenone resulted in the highest degradation rate at eight weeks (54.48% degraded), while maintaining compressive strength between (4.04 ± 1.49 to 10.17 ± 4.78 MPa) during degradation testing. These results indicate that incorporating bioceramics with a suitable photoinitiator concentration can tailor the biodegradability and load-bearing capacity of the scaffolds.

Enhanced In Vitro Biocompatible Polycaprolactone/Nano-Hydroxyapatite Scaffolds with Near-Field Direct-Writing Melt Electrospinning Technology

Polycaprolactone (PCL) scaffold is a common biological material for tissue engineering, owing to its good biocompatibility, biodegradability and plasticity. However, it is not suitable for osteoblast adhesion and regeneration of bone tissue due to its non-biological activity, poor mechanical strength, slow degradation speed, smooth surface and strong hydrophobicity. To improve the mechanical properties and biocompatibility of PCL scaffold, the PCL/nHA scaffolds were prepared by melting and blending different proportions of nano-hydroxyapatite (nHA) with PCL by the near-field direct-writing melt electrospinning technology in this study. The morphology, porosity, mechanical properties and in vitro biocompatibility of the PCL/nHA scaffolds were studied. The results showed that when the proportion of nHA was less than or equal to 25%, PCL/nHA composite scaffolds were easily formed in which bone marrow mesenchymal stem cells proliferated successfully. When the proportion of nHA was 15%, the PCL/nHA composite scaffolds had excellent structural regularity, good fiber uniformity, outstanding mechanical stability and superior biocompatibility. The PCL/nHA composite scaffolds were ideal scaffold materials, which would broaden their applications for bone tissue engineering.

Fabrication and characterization of novel polyhydroxybutyrate-keratin/nanohydroxyapatite electrospun fibers for bone tissue engineering applications

The role of scaffolds in bone regeneration is of great importance. Here, the electrospun scaffolds of poly (3-hydroxybutyrate)-keratin (PHB-K)/nanohydroxyapatite (nHA) with different morphologies (long nanorods (HAR) and very short nanorods (HAP)) and weight percentages (up to 10 w/w%) of nHA were fabricated and characterized. The fibers integrity, the porosity of above 80%, and increase in pore size up to 16 μm were observed by adding nHA. The nanofibers crystallinity increased by 13.5 and 22.8% after the addition of HAR and HAP, respectively. The scaffolds contact angle decreased by almost 20° and 40° after adding 2.5 w/w% HAR and HAP, respectively. The tensile strength of the scaffolds increased from 2.99 ± 0.3 MPa for PHB-K to 6.44 ± 0.16 and 9.27 ± 0.04 MPa for the scaffolds containing 2.5 w/w% HAR and HAP, respectively. After immersing the scaffolds into simulated body fluid (SBF), the Ca concentration decreased by 55% for HAR- and 73% for HAP-containing scaffolds, showing the bioactivity of nHA-containing scaffolds. The results of cell attachment, proliferation, and viability of MG-63 cells cultured on the nanocomposites showed the positive effects of nHA. The results indicate that the nanocomposite scaffolds, especially HAP-containing ones, can be suitable for bone tissue engineering applications.

Chitosan-Based Biomaterials for Bone Tissue Engineering Applications: A Short Review

Natural bone tissue is composed of calcium-deficient carbonated hydroxyapatite as the inorganic phase and collagen type I as the main organic phase. The biomimetic approach of scaffold development for bone tissue engineering application is focused on mimicking complex bone characteristics. Calcium phosphates are used in numerous studies as bioactive phases to mimic natural bone mineral. In order to mimic the organic phase, synthetic (e.g., poly(ε-caprolactone), polylactic acid, poly(lactide-co-glycolide acid)) and natural (e.g., alginate, chitosan, collagen, gelatin, silk) biodegradable polymers are used. However, as materials obtained from natural sources are accepted better by the human organism, natural polymers have attracted increasing attention. Over the last three decades, chitosan was extensively studied as a natural polymer suitable for biomimetic scaffold development for bone tissue engineering applications. Different types of chitosan-based biomaterials (e.g., molded macroporous, fiber-based, hydrogel, microspheres and 3D-printed) with specific properties for different regenerative applications were developed due to chitosan's unique properties. This review summarizes the state-of-the-art of biomaterials for bone regeneration and relevant studies on chitosan-based materials and composites.

Influences of Process Parameters of Near-Field Direct-Writing Melt Electrospinning on Performances of Polycaprolactone/Nano-Hydroxyapatite Scaffolds

In this paper, near-field direct-writing melt electrospinning technology was employed to fabricate a polycaprolactone/nano-hydroxyapatite (PCL/nHA) scaffold for future applications in tissue engineering. The influences of different fabrication parameters on the structural characteristics, mechanical properties, and thermal stability of the scaffolds were discussed. It was found that the moving speed of the receiving plate had the most significant effect on the scaffold performance, followed by the receiving distance and spinning voltage. The results also showed that these process parameters affected the fiber diameter, corresponding coefficient of variation, porosity of the composite scaffolds, and mechanical properties of the samples, including the tensile strength and fiber peeling strength. Moreover, the process parameters could influence the thermal degradation performance and melting process. Although the mass loss of the composite scaffolds was not obvious after degradation, the mechanical performance degraded severely. It was concluded that the more appropriate process parameters for preparing PCL/nHA scaffolds were a spinning voltage of -4 kV, receiving distance of 4 mm, moving speed of receiving plate of 5 mm/s, and melt temperature of 130 °C. This study proved that near-field direct-writing melt electrospinning technology is a good method to obtain PCL/nHA composite scaffolds with an excellent mechanical properties and desired morphology for future tissue engineering applications.

Recent advances in 3D-printed polylactide and polycaprolactone-based biomaterials for tissue engineering applications

The three-dimensional printing (3DP) also known as the additive manufacturing (AM), a novel and futuristic technology that facilitates the printing of multiscale, biomimetic, intricate cytoarchitecture, function-structure hierarchy, multi-cellular tissues in the complicated micro-environment, patient-specific scaffolds, and medical devices. There is an increasing demand for developing 3D-printed products that can be utilized for organ transplantations due to the organ shortage. Nowadays, the 3DP has gained considerable interest in the tissue engineering (TE) field. Polylactide (PLA) and polycaprolactone (PCL) are exemplary biomaterials with excellent physicochemical properties and biocompatibility, which have drawn notable attraction in tissue regeneration. Herein, the recent advancements in the PLA and PCL biodegradable polymer-based composites as well as their reinforcement with hydrogels and bio-ceramics scaffolds manufactured through 3DP are systematically summarized and the applications of bone, cardiac, neural, vascularized and skin tissue regeneration are thoroughly elucidated. The interaction between implanted biodegradable polymers, in-vivo and in-vitro testing models for possible evaluation of degradation and biological properties are also illustrated. The final section of this review incorporates the current challenges and future opportunities in the 3DP of PCL- and PLA-based composites that will prove helpful for biomedical engineers to fulfill the demands of the clinical field.

Functionalization of Electrospun Nanofiber for Bone Tissue Engineering

Bone-tissue engineering is an alternative treatment for bone defects with great potential in which scaffold is a critical factor to determine the effect of bone regeneration. Electrospun nanofibers are widely used as scaffolds in the biomedical field for their similarity with the structure of the extracellular matrix (ECM). Their unique characteristics are: larger surface areas, porosity and processability; these make them ideal candidates for bone-tissue engineering. This review briefly introduces bone-tissue engineering and summarizes the materials and methods for electrospining. More importantly, how to functionalize electrospun nanofibers to make them more conducive for bone regeneration is highlighted. Finally, the existing deficiencies of functionalized electrospun nanofibers for promoting osteogenesis are proposed. Such a summary can lay the foundation for the clinical practice of functionalized electrospun nanofibers.

Chitosan-based biomaterials for the treatment of bone disorders

Bone is an alive and dynamic organ that is well-differentiated and originated from mesenchymal tissues. Bone undergoes continuous remodeling during the lifetime of an individual. Although knowledge regarding bones and their disorders has been constantly growing, much attention has been devoted to effective treatments that can be used, both from materials and medical performance points of view. Polymers derived from natural sources, for example polysaccharides, are generally biocompatible and are therefore considered excellent candidates for various biomedical applications. This review outlines the development of chitosan-based biomaterials for the treatment of bone disorders including bone fracture, osteoporosis, osteoarthritis, arthritis rheumatoid, and osteosarcoma. Different examples of chitosan-based formulations in the form of gels, micro/nanoparticles, and films are discussed herein. The work also reviews recent patents and important developments related to the use of chitosan in the treatment of bone disorders. Although most of the cited research was accomplished before reaching the clinical application level, this manuscript summarizes the latest achievements within chitosan-based biomaterials used for the treatment of bone disorders and provides perspectives for future scientific activities.

3D-Printed Hydrogels in Orthopedics: Developments, Limitations, and Perspectives

Three-dimensional (3D) printing has been used in medical research and practice for several years. Various aspects can affect the finished product of 3D printing, and it has been observed that the impact of the raw materials used for 3D printing is unique. Currently, hydrogels, including various natural and synthetic materials, are the most biologically and physically advantageous biological raw materials, and their use in orthopedics has increased considerably in recent years. 3D-printed hydrogels can be used in the construction of extracellular matrix during 3D printing processes. In addition to providing sufficient space structure for osteogenesis and chondrogenesis, hydrogels have shown positive effects on osteogenic and chondrogenic signaling pathways, promoting tissue repair in various dimensions. 3D-printed hydrogels are currently attracting extensive attention for the treatment of bone and joint injuries owing to the above-mentioned significant advantages. Furthermore, hydrogels have been recently used in infection prevention because of their antiseptic impact during the perioperative period. However, there are a few shortcomings associated with hydrogels including difficulty in getting rid of the constraints of the frame, poor mechanical strength, and burst release of loadings. These drawbacks could be overcome by combining 3D printing technology and novel hydrogel material through a multi-disciplinary approach. In this review, we provide a brief description and summary of the unique advantages of 3D printing technology in the field of orthopedics. In addition, some 3D printable hydrogels possessing prominent features, along with the key scope for their applications in bone joint repair, reconstruction, and antibacterial performance, are discussed to highlight the considerable prospects of hydrogels in the field of orthopedics.

Magnesium Oxide Nanoparticle Coordinated Phosphate-Functionalized Chitosan Injectable Hydrogel for Osteogenesis and Angiogenesis in Bone Regeneration

Natural polysaccharide (NPH)-based injectable hydrogels have shown great potential for critical-sized bone defect repair. However, their osteogenic, angiogenic, and mechanical properties are insufficient. Here, MgO nanoparticles (NPs) were incorporated into a newly synthesized water-soluble phosphocreatine-functionalized chitosan (CSMP) water solution to form an injectable hydrogel (CSMP-MgO) via supramolecular combination between phosphate groups in CSMP and magnesium in MgO NPs to circumvent these drawbacks of chitosan-based injectable hydrogels. Water-soluble chitosan deviate CSMP was first synthesized by grafting methacrylic anhydride and phosphocreatine into a chitosan chain in a one-step lyophilization process. The phosphocreatine in this hydrogel not only provides sites to combine with MgO NPs to form supramolecular binding but also serves as the reservoir to control Mg²⁺ release. As a result, the lyophilized CSMP-MgO hydrogels presented a porous structure with some small holes in the pore wall, and the pore diameters ranged from 50 to 100 μm. The CSMP-MgO injectable hydrogels were restricted from swelling in DI water (lowest swelling ratio was 16.0 ± 1.1 g/g) and presented no brittle failure during compression even at a strain above 85% (maximum compressive strength was 195.0 kPa) versus the control groups (28.0 and 41.3 kPa for CSMP and CSMP-MgO (0.5) hydrogels), with regulated Mg²⁺ release in a stable and sustained manner. The CSMP-MgO injectable hydrogels promoted in vitro calcium phosphate (hydroxyapatite (HA) and tetracalcium phosphate (TTCP)) deposition in supersaturated calcium phosphate solution and presented no cytotoxicity to MC3T3-E1 cells; the CSMP-MgO hydrogel promoted MC3T3-E1 cell osteogenic differentiation with upregulation of BSP, OPN, and Osterix osteogenic gene expression and mineralization and HUVEC tube formation. Among them, CSMP-MgO (5) presented most of these properties. Moreover, this hydrogel (CSMP-MgO (5)) showed an excellent ability to promote new bone formation in critical-sized calvarial defects in rats. Thus, the CSMP-MgO injectable hydrogel shows great promise for bone regeneration.

Polysaccharide 3D Printing for Drug Delivery Applications

3D printing, or additive manufacturing, has gained considerable interest due to its versatility regarding design as well as in the large choice of materials. It is a powerful tool in the field of personalized pharmaceutical treatment, particularly crucial for pediatric and geriatric patients. Polysaccharides are abundant and inexpensive natural polymers, that are already widely used in the food industry and as excipients in pharmaceutical and cosmetic formulations. Due to their intrinsic properties, such as biocompatibility, biodegradability, non-immunogenicity, etc., polysaccharides are largely investigated as matrices for drug delivery. Although an increasing number of interesting reviews on additive manufacturing and drug delivery are being published, there is a gap concerning the printing of polysaccharides. In this article, we will review recent advances in the 3D printing of polysaccharides focused on drug delivery applications. Among the large family of polysaccharides, the present review will particularly focus on cellulose and cellulose derivatives, chitosan and sodium alginate, printed by fused deposition modeling and extrusion-based printing.

Decellularized Scaffold-based Poly(ethylene glycol) Biomimetic Vascular Patches Modified with Polyelectrolyte Multilayer of Heparin and Chitosan: Preparation and Vascular Tissue Engineering Applications in a Porcine Model

The mechanical property mismatch between vascular patches and native blood vessels can result in post-operation failure, so it is important to develop vascular patches that mimic the biomechanical properties of...

Enhanced Bone Regeneration via PHA Scaffolds Coated with Polydopamine-Captured BMP2

The hierarchical three-dimensional (3D)-printing scaffolds based on microbial polyester poly(3-hydrxoybutyrate-co-4-hydroxybutyrate) (P34HB) were designed and used for bone tissue engineering via surface functionalization on the 3D-printed (P34HB) scaffolds using polydopamine (PDA)-mediated...

Electron-Beam-Induced Grafting of Chitosan onto HDPE/ATZ Composites for Biomedical Applications

The surface functionalisation of high-density polyethylene (HDPE) and HDPE/alumina-toughened zirconia (ATZ) surfaces with chitosan via electron-beam (EB) irradiation technique was exploited for preparing materials suitable for biomedical purposes. ATR–FTIR analysis and wettability measurements were employed for monitoring the surface changes after both irradiation and chitosan grafting reaction. Interestingly, the presence of ATZ loadings beyond 2 wt% influenced both the EB irradiation process and the chitosan functionalisation reaction, decreasing the oxidation of the surface and the chitosan grafting. The EB irradiation induced an increase in Young’s modulus and a decrease in the elongation at the break of all analysed systems, whereas the tensile strength was not affected in a relevant way. Biological assays indicated that electrostatic interactions between the negative charges of the surface of cell membranes and the –NH₃⁺ sites on chitosan chains promoted cell adhesion, while some oxidised species produced during the irradiation process are thought to cause a detrimental effect on the cell viability.