1
|
Wang X, Wang C, Chu C, Xue F, Li J, Bai J. Structure-function integrated biodegradable Mg/polymer composites: Design, manufacturing, properties, and biomedical applications. Bioact Mater 2024; 39:74-105. [PMID: 38783927 PMCID: PMC11112617 DOI: 10.1016/j.bioactmat.2024.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
Mg is a typical biodegradable metal widely used for biomedical applications due to its considerable mechanical properties and bioactivity. Biodegradable polymers have attracted great interest owing to their favorable processability and inclusiveness. However, it is challenging for the degradation rates of Mg or polymers to precisely match tissue repair processes, and the significant changes in local pH during degradation hinder tissue repair. The concept of combining Mg with polymers is proposed to overcome the shortcomings of materials, aiming to meet repair needs from various aspects such as mechanics and biology. Therefore, it is essential to systematically understand the behavior of biodegradable Mg/polymer composite (BMPC) from the design, manufacturing, mechanical properties, degradation, and biological effects. In this review, we elaborate on the design concepts and manufacturing strategies of high-strength BMPC, the "structure-function" relationship between the microstructures and mechanical properties of composites, the variation in the degradation rate due to endogenous and exogenous factors, and the establishment of advanced degradation research platform. Additionally, the interplay among composite components during degradation and the biological function of composites under non-responsive/stimuli-responsive platforms are also discussed. Finally, we hope that this review will benefit future clinical applications of "structure-function" integrated biomaterials.
Collapse
Affiliation(s)
- Xianli Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, 211189, Jiangsu, China
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, 119276, Singapore
| | - Cheng Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, 211189, Jiangsu, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, 211189, Jiangsu, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, 211189, Jiangsu, China
| | - Jun Li
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, 119276, Singapore
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, 211189, Jiangsu, China
| |
Collapse
|
2
|
Demeco A, Foresti R, Frizziero A, Daracchi N, Renzi F, Rovellini M, Salerno A, Martini C, Pelizzari L, Costantino C. The Upper Limb Orthosis in the Rehabilitation of Stroke Patients: The Role of 3D Printing. Bioengineering (Basel) 2023; 10:1256. [PMID: 38002380 PMCID: PMC10669460 DOI: 10.3390/bioengineering10111256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Stroke represents the third cause of long-term disability in the world. About 80% of stroke patients have an impairment of bio-motor functions and over half fail to regain arm functionality, resulting in motor movement control disorder with serious loss in terms of social independence. Therefore, rehabilitation plays a key role in the reduction of patient disabilities, and 3D printing (3DP) has showed interesting improvements in related fields, thanks to the possibility to produce customized, eco-sustainable and cost-effective orthoses. This study investigated the clinical use of 3DP orthosis in rehabilitation compared to the traditional ones, focusing on the correlation between 3DP technology, therapy and outcomes. We screened 138 articles from PubMed, Scopus and Web of Science, selecting the 10 articles fulfilling the inclusion criteria, which were subsequently examined for the systematic review. The results showed that 3DP provides substantial advantages in terms of upper limb orthosis designed on the patient's needs. Moreover, seven research activities used biodegradable/recyclable materials, underlining the great potential of validated 3DP solutions in a clinical rehabilitation setting. The aim of this study was to highlight how 3DP could overcome the limitations of standard medical devices in order to support clinicians, bioengineers and innovation managers during the implementation of Healthcare 4.0.
Collapse
Affiliation(s)
- Andrea Demeco
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Ruben Foresti
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
- Center of Excellence for Toxicological Research (CERT), University of Parma, 43126 Parma, Italy
- Italian National Research Council, Institute of Materials for Electronics and Magnetism (CNR-IMEM), 43124 Parma, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Nicola Daracchi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Francesco Renzi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Margherita Rovellini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Antonello Salerno
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Chiara Martini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Laura Pelizzari
- AUSL Piacenza, Neurorehabilitation and Spinal Unit, Department of Rehabilitative Medicine, 29121 Piacenza, Italy;
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| |
Collapse
|
3
|
Mamo HB, Adamiak M, Kunwar A. 3D printed biomedical devices and their applications: A review on state-of-the-art technologies, existing challenges, and future perspectives. J Mech Behav Biomed Mater 2023; 143:105930. [PMID: 37267735 DOI: 10.1016/j.jmbbm.2023.105930] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/21/2023] [Accepted: 05/21/2023] [Indexed: 06/04/2023]
Abstract
3D printing, also known as Additive manufacturing (AM), has emerged as a transformative technology with applications across various industries, including the medical sector. This review paper provides an overview of the current status of AM technology, its challenges, and its application in the medical industry. The paper covers the different types of AM technologies, such as fused deposition modeling, stereolithography, selective laser sintering, digital light processing, binder jetting, and electron beam melting, and their suitability for medical applications. The most commonly used biomedical materials in AM, such as plastic, metal, ceramic, composite, and bio-inks, are also viewed. The challenges of AM technology, such as material selection, accuracy, precision, regulatory compliance, cost and quality control, and standardization, are also discussed. The review also highlights the various applications of AM in the medical sector, including the production of patient-specific surgical guides, prosthetics, orthotics, and implants. Finally, the review highlights the Internet of Medical Things (IoMT) and artificial intelligence (AI) for regulatory frameworks and safety standards for 3D-printed biomedical devices. The review concludes that AM technology can transform the healthcare industry by enabling patients to access more personalized and reasonably priced treatment alternatives. Despite the challenges, integrating AI and IoMT with 3D printing technology is expected to play a vital role in the future of biomedical device applications, leading to further advancements and improvements in patient care. More research is needed to address the challenges and optimize its use for medical applications to utilize AM's potential in the medical industry fully.
Collapse
Affiliation(s)
- Hana Beyene Mamo
- Faculty of Mechanical Engineering, Silesian University of Technology, Konarskiego 18A, 44-100, Gliwice, Poland.
| | - Marcin Adamiak
- Faculty of Mechanical Engineering, Silesian University of Technology, Konarskiego 18A, 44-100, Gliwice, Poland
| | - Anil Kunwar
- Faculty of Mechanical Engineering, Silesian University of Technology, Konarskiego 18A, 44-100, Gliwice, Poland
| |
Collapse
|
4
|
Han L, Zhang Z, Dai J, Li X, Bai J, Huang Z, Guo C, Xue F, Chu C. The influence of alternating cyclic dynamic loads with different low frequencies on the bio-corrosion behaviors of AZ31B magnesium alloy in vitro. Bioact Mater 2021; 7:263-274. [PMID: 34466732 PMCID: PMC8379482 DOI: 10.1016/j.bioactmat.2021.05.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/11/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
The real physiological environment of human body is complicated with different degrees and forms of dynamic loads applied to implanted medical devices due to the daily activities of the patients, which would have impacts on the degradation behaviors of magnesium alloy implants. In this work, the bio-corrosion behaviors of AZ31B magnesium alloy under alternating cyclic dynamic loads with different low frequencies (0.1–2.5 Hz) were specially investigated. It was found that the bio-degradation performances under external dynamic stressed conditions were much severer than those under unstressed conditions and static loads. The corrosion rates were generally accelerated as the rise of cyclic frequency. Hereby a numerical model for the degradation process of Mg alloy was established. The corrosion current density icorr of Mg alloy and the applied loading frequency f matches a linear relationship of ln icorr∝ f, which is the result of interactions between the cyclic alternating load and corrosive environment. This work could provide a theoretical reference and an experimental basis for further researches on the biodegradation behaviors of biomedical materials under dynamic conditions. Biocorrosion of Mg alloy under dynamic load with different frequencies were studied. A stress apparatus was designed to achieve in-situ evaluation under dynamic loads. The rising dynamic loading frequency resulted in an increase in the corrosion rate. Theoretical corrosion mechanism under dynamic load was systematically discussed. A numerical relationship between corrosion rate and load frequency was determined.
Collapse
Affiliation(s)
- Linyuan Han
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Zhenwei Zhang
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Jianwei Dai
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Xuan Li
- School of Materials Engineering, Nanjing Institute of Technology, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory of Advanced Structural Materials and Application Technology, Nanjing, 211189, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Zhihai Huang
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Chao Guo
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory for Advanced Metallic Materials, Southeast University, Nanjing, 211189, Jiangsu, China.,Jiangsu Key Laboratory of Advanced Structural Materials and Application Technology, Nanjing, 211189, China
| |
Collapse
|
5
|
Khalaj Amnieh S, Mosaddegh P, Mashayekhi M, Kharaziha M. Biodegradation evaluation of poly (lactic acid) for stent application: Role of mechanical tension and temperature. J Appl Polym Sci 2020. [DOI: 10.1002/app.50389] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Sasan Khalaj Amnieh
- Department of Mechanical Engineering Isfahan University of Technology Isfahan Iran
| | - Peiman Mosaddegh
- Department of Mechanical Engineering Isfahan University of Technology Isfahan Iran
| | - Mohammad Mashayekhi
- Department of Mechanical Engineering Isfahan University of Technology Isfahan Iran
| | - Mahshid Kharaziha
- Department of Materials Engineering Isfahan University of Technology Isfahan Iran
| |
Collapse
|
6
|
Biodegradable Magnesium Alloy (ZK60) with a Poly(l-lactic)-Acid Polymer Coating for Maxillofacial Surgery. METALS 2020. [DOI: 10.3390/met10060724] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The purpose of this study was to evaluate the mechanical strength and biodegradation of a ZK60 plate coated with poly(l-lactic)-acid polymer (PLLA) in a LeFort I osteotomy canine model for maxillofacial applications. The PLLA-coated ZK60 plate and screw were evaluated using a LeFort I osteotomy canine model based on five beagles. The presence of wound dehiscence, plate exposure, gas formation, inflammation, pus formation, occlusion, food intake, and fistula formation were evaluated. After 12 weeks, these dogs were sacrificed, and an X-ray micro-computed tomography (µCT) was conducted. Plate exposure, gas formation, and external fistula were not observed, and the occlusion remained stable. Wound dehiscence did not heal for 12 weeks. CT images did not show plates in all the five dogs. A few screw bodies fixed in the bone remained, and screw heads were completely absorbed after 12 weeks. These findings may be attributed to the inability to optimize the absorption rate with PLLA coating. Rapid biodegradation of the PLLA-coated ZK60 occurred due to the formation of microcracks during the bending process. Further improvement to the plate system with PLLA-coated ZK60 is required using other surface coating methods or alternative Mg alloys.
Collapse
|