Mechanically-competent and cytocompatible polycaprolactone-borophosphosilicate hybrid biomaterials

Sea Cucumber-Inspired Aerogel for Ultrafast Hemostasis of Open Fracture

The symptomatic management of hemorrhagic shock complicated by open fractures is a great challenge, because it is also complicated by complex wound bleeding, bacterial infection, and bone defects. Inspired by the water absorption and cross-sectional microstructure of sea cucumbers, in this study, a new sea cucumber-like aerogel (GCG) is proposed. Its aligned porous structure and composition can stop bleeding rapidly and effectively with a blood clotting index of 3.73 ± 1.8%. More importantly, the data of in vivo hemostasis test in an amputating rat tail hemostatic model (15.69 ± 2.45 s, 26.95 ± 8.43 mg) and liver puncture bleeding model (23.77 ± 2.68 s, 36.22 ± 16.92 mg) also indicate the excellent hemostatic performance of GCG. In addition, GCG also shows a significant inhibitory effect on S. aureus and E. coli, which can prevent the occurrence of postoperative osteomyelitis. Not only that, after filling in the bone defect, it is shown that this GCG aerogel completely degrades eight weeks after surgery and induces new bone ingrowth, achieving functional regeneration after hemostasis of an open fracture defect. Generally, because of its combination of hemostatic, antibacterial, and osteogenic activities, this new aerogel is a promising option for open fractures treatment.

Bioactive glass-based organic/inorganic hybrids: an analysis of the current trends in polymer design and selection

Bioactive glass-based organic/inorganic hybrids are a family of materials holding great promise in the biomedical field. Developed from bioactive glasses following recent advances in sol-gel and polymer chemistry, they can overcome many limitations of traditional composites typically used in bone repair and orthopedics. Thanks to their unique molecular structure, hybrids are often characterized by synergistic properties that go beyond a mere combination of their two components; it is possible to synthesize materials with a wide variety of mechanical and biological properties. The polymeric component, in particular, can be tailored to prepare tough, load-bearing materials, or rubber-like elastomers. It can also be a key factor in the determination of a wide range of interesting biological properties. In addition, polymers can also be used within hybrids as carriers for therapeutic ions (although this is normally the role of silica). This review offers a brief look into the history of hybrids, from the discovery of bioactive glasses to the latest developments, with a particular emphasis on polymer design and chemistry. First the benefits and limitations of hybrids will be discussed and compared with those of alternative approaches (for instance, nanocomposites). Then, key advances in the field will be presented focusing on the polymeric component: its chemistry, its physicochemical and biological advantages, its drawbacks, and selected applications. Comprehensive tables summarizing all the polymers used to date to fabricate sol-gel hybrids for biomedical applications are also provided, to offer a handbook of all the available candidates for hybrid synthesis. In addition to the current trends, open challenges and possible avenues of future development are proposed.

An injectable self-adaptive polymer as a drug carrier for the treatment of nontraumatic early-stage osteonecrosis of the femoral head

Core decompression (CD) with the elimination of osteonecrotic bone is the most common strategy for treating early-stage nontraumatic osteonecrosis of the femoral head (ONFH). Adjuvant treatments are widely used in combination with CD as suitable methods of therapy. Existing augmentations have to be fabricated in advance. Here, we report a novel injectable glycerin-modified polycaprolactone (GPCL) that can adapt to the shape of the CD cavity. GPCL shows great flowability at 52.6 °C. After solidification, its compressive modulus was 120 kPa at body temperature (37 °C). This excellent characteristic enables the polymer to provide mechanical support in vivo. In addition, GPCL acts as a carrier of the therapeutic agent zoledronic acid (ZA), demonstrating sustained release into the CD region. ZA-loaded GPCL was injected into ONFH lesions to treat early-stage nontraumatic cases. Compared to that in the CD group, CD+ZA-loaded GPCL injection preserved bone density and increased the collagen level in the femoral head. At the interface between the GPCL and CD tunnel wall, osteogenesis was significantly promoted. In addition, morphological evaluations revealed that the femoral heads in the CD+ZA-GPCL group exhibited improved pressure resistance. These results suggest a strategy effective to preserve the bone density of the femoral head, thus decreasing the possibility of femoral head collapse. This novel injectable polymer has, therefore, considerable potential in clinical applications.

Bioactive fluorescent hybrid microparticles as a stand-alone osteogenic differentiation inducer

Osteogenic differentiation of stem cells is one of the essential steps in bone regeneration. While supplementing exogenous factors using differentiation media is the established method to differentiate stem cells into osteoblasts on biomaterials, designing biomaterials that can act as a stand-alone differentiation inducer and promote bone regeneration is preferred for clinical translation. In this work, we report dexamethasone-loaded organic-inorganic hybrid microparticles synthesized from an intrinsically fluorescent poly (ester amide) and tertiary bioactive glass (PEA-BG) as a stand-alone osteogenic differentiation inducer. The mechanical properties data indicated that the compressive modulus of fluorescent hybrid microparticles could be modulated by its composition. The hybrid fluorescent microparticles supported the adhesion and proliferation of 10T1/2 ​cells in culture for up to seven days. Both pristine and dexamethasone-loaded PEA-BG microparticles were able to induce osteogenic differentiation of 10T1/2 ​cells in the absence of any media supplement, to a level even higher than standard osteogenic media, as evidenced by the expression of osteogenic markers on gene and protein levels and matrix mineralization. Taken together, the fluorescent PEA-BG hybrid microparticles have the potential to be used as a stand-alone biomaterial for osteogenic differentiation and bone regeneration.

Original implementation of low-temperature SPS for bioactive glass used as a bone biomaterial

Alkali borated bioactive glasses powders with compositions based on the SiO₂-Na₂O-CaO-P₂O₅-x B₂O₃ system (0 < x < 20 wt%); have been consolidated at low temperature using Spark Plasma Sintering (SPS). Through SPS technique under 50 MPa, it was possible to achieve fully dense and completely amorphous borated glasses at temperatures as low as 420 °C. By increasing the sintering temperature up to 430 °C, the dense samples crystallized which is mostly achieved at higher temperatures. This study reveals that the mechanical properties of these new borated biomaterials are suitable to be used as a promising candidate for repairing defects in non-load-bearing bones as well as for coating on the metallic surface implants to improve the bioactivity process bone/implant. The pressure had a weak effect on the crystallization and densification of the glass compared to the temperature during the powder consolidation by SPS. Moreover, by increasing the boron content, the compressive strength and the elastic modulus of the elaborated glasses decreased for being close to those of the natural.

Improvement of mechanical properties of zein porous scaffold by quenching/electrospun fiber reinforcement

As a novel bone substitute material, zein-based scaffolds (ZS) should have suitable mechanical properties and porosity. ZS has shown good compressive properties matching cancellous bone, but there is still a demand to improve its mechanical properties, especially tensile and bending properties without adding plasticizers. The present study explored two simple and environment-friendly factors for this purpose: fiber reinforcement and quenching. Addition of electrospun zein fibers enhanced all mechanical properties significantly including compressive, tensile, and bending moduli; compressive and bending strengths of ZS with both higher (70-80%) and lower (50-60%) porosities, no matter whether heating treated or not treated. Especially, all these parameters were further enhanced significantly by addition of heating treated fibers. AFM provided evidence that high temperature modification could significantly alter the micro-elastic properties of zein electrospun fibers, i.e., increased stiffness of fibers. Quenching treatment also enhanced compressive, tensile, and bending strengths significantly. Finally, quenching treated ZS were implanted into critical-sized bone defects (15 mm) of the rabbit model to compare the repair efficacy with a commercial β-tricalcium phosphate product. The results demonstrated that there were no remarkable differences in bone reconstructions between these two materials.

Intrinsically fluorescent bioactive glass-poly(ester amide) hybrid microparticles for dual drug delivery and bone repair

The bone extracellular matrix (ECM) is a composite scaffold having inorganic hydroxyapatite and organic collagen fibers. Synthetic bone repair scaffolds that mimic the chemical composition of the native ECM and capable of delivering therapeutics are beneficial. In this study, we prepared intrinsically fluorescent organic-inorganic hybrid microparticle biomaterials by sol-gel process. Unlike the conventional Stöber process which requires an alkaline condition for microparticle formation, an acidic condition in the presence of a biodegradable poly(ester amide) (PEA) polymer was used to prepare silica and tertiary bioactive glass hybrids. During their preparation, one or two model drugs were loaded in the microparticles. Our results showed that a gelation temperature between 40 °C-60 °C and the inclusion of PEA were critical for microparticle formation. Unexpectedly, the hybrid microparticles were fluorescent with tunable emission by changing the excitation wavelengths ranging from 300 to 565 nm for potential multiplex imaging. Gene expression studies showed that the hybrid materials induce osteogenic differentiation of 10T1/2 cells without adding exogenous biochemical factors. The bioactivity of the inorganic phase and the dual drug release from homogenous, biodegradable, biocompatible, osteoinductive, and intrinsically fluorescent microparticles may offer a unique platform for bone regeneration and therapy.

Sol-Gel Derived Tertiary Bioactive Glass-Ceramic Nanorods Prepared via Hydrothermal Process and Their Composites with Poly(Vinylpyrrolidone-Co-Vinylsilane)

Bioactive glass (BG) nanoparticles have wide applications in bone repair due to their bone-bonding and biodegradable nature. In this work, nanometric rod-shaped ternary SiO2-CaO-P2O5 bioactive glass particles were prepared through sol-gel chemistry followed by a base-induced hydrothermal process at 130 °C and 170 °C for various times up to 36 h. This facile, low-temperature and surfactant-free hydrothermal process has shown to be capable of producing uniform nanorods and nanowires. One-dimensional growth of nanorods and the characteristics of siloxane bridging networks were dependent on the hydrothermal temperature and time. Hardened bioactive composites were prepared from BG nanorods and cryo-milled poly(vinylpyrrolidone-co-triethoxyvinylsilane) in the presence of ammonium phosphate as potential bone graft biomaterials. Covalent crosslinking has been observed between the organic and inorganic components within these composites. The ultimate compressive strength and modulus values increased with increasing co-polymer content, reaching 27 MPa and 500 MPa respectively with 30% co-polymer incorporation. The materials degraded in a controlled non-linear manner when incubated in phosphate-buffered saline from 6 h to 14 days. Fibroblast cell attachment and spreading on the composite were not as good as the positive control surfaces and suggested that they may require protein coating in order to promote favorable cell interactions.

Bone Repair and Regenerative Biomaterials: Towards Recapitulating the Microenvironment

Biomaterials and tissue engineering scaffolds play a central role to repair bone defects. Although ceramic derivatives have been historically used to repair bone, hybrid materials have emerged as viable alternatives. The rationale for hybrid bone biomaterials is to recapitulate the native bone composition to which these materials are intended to replace. In addition to the mechanical and dimensional stability, bone repair scaffolds are needed to provide suitable microenvironments for cells. Therefore, scaffolds serve more than a mere structural template suggesting a need for better and interactive biomaterials. In this review article, we aim to provide a summary of the current materials used in bone tissue engineering. Due to the ever-increasing scientific publications on this topic, this review cannot be exhaustive; however, we attempted to provide readers with the latest advance without being redundant. Furthermore, every attempt is made to ensure that seminal works and significant research findings are included, with minimal bias. After a concise review of crystalline calcium phosphates and non-crystalline bioactive glasses, the remaining sections of the manuscript are focused on organic-inorganic hybrid materials.

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

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

Optimized Bioactive Glass: the Quest for the Bony Graft

Technological advances have provided surgeons with a wide range of biomaterials. Yet improvements are still to be made, especially for large bone defect treatment. Biomaterial scaffolds represent a promising alternative to autologous bone grafts but in spite of the numerous studies carried out on this subject, no biomaterial scaffold is yet completely satisfying. Bioactive glass (BAG) presents many qualifying characteristics but they are brittle and their combination with a plastic polymer appears essential to overcome this drawback. Recent advances have allowed the synthesis of organic-inorganic hybrid scaffolds combining the osteogenic properties of BAG and the plastic characteristics of polymers. Such biomaterials can now be obtained at room temperature allowing organic doping of the glass/polymer network for a homogeneous delivery of the doping agent. Despite these new avenues, further studies are required to highlight the biological properties of these materials and particularly their behavior once implanted in vivo. This review focuses on BAG with a particular interest in their combination with polymers to form organic-inorganic hybrids for the design of innovative graft strategies.

Bioactivity, Degradation, and Mechanical Properties of Poly(vinylpyrrolidone-co-triethoxyvinylsilane)/Tertiary Bioactive Glass Hybrids

Currently, composite and class I hybrid biomaterials are used for tissue regeneration applications. To improve and better control biomaterial properties, we synthesized class II organic/inorganic (O/I) hybrids, in which organic polymers and inorganic tertiary bioactive glass (TBG) were covalently cross-linked. To tailor their microstructure, bioactivity, degradation, and mechanical properties, we altered the degree of cross-linking by varying the amount of functional groups in the polymer that mediate covalent bonding to the TBG. We synthesized class II hybrids in a two-step process: first, vinylpyrrolidone (VP) and triethoxyvinylsilane (TEVS) were copolymerized at various molar ratios to obtain different amounts of silane functional groups in the copolymer; second, TBG and the copolymer were mixed and allowed to undergo hydrolysis and polycondensation forming Si-O-Si- and Si-O-P-bridging networks between the organic and inorganic phases. Higher amounts of functional groups increased copolymer-TBG covalent bonding and decreased  degradation and the release of TBG dissolution products. Incubation in simulated body fluid led to biomimetic apatite deposition on the hybrid biomaterial surfaces, which was primarily dependent on O/I weight ratios. A higher TBG content improved apatite deposition and biocompatibility. Porous and interconnected three-dimensional scaffolds, fabricated by indirect 3D printing using polycaprolactone as a sacrificial template, had intriguing yield and compressive strengths, compressive moduli, and toughness. These studies demonstrate, for the first time, that the functionality of our synthesized copolymers greatly affects the nature of O/I matrix formation and degradation behavior of the class II hybrid biomaterials, creating possibilities for tailoring the physical, biochemical, and mechanical properties of scaffold biomaterials for tissue regeneration and related applications.