Binary bioactive glass composite scaffolds for bone tissue engineering-Structure and mechanical properties in micro and nano scale. A preliminary study

Productizing Nano-Bioactive Glass-Based Bilayer Scaffolds: A Graft for Reconstruction of Mandibular and Femoral Bone Defects

This investigation aimed to construct a bilayer scaffold integrating alginate and gelatin with nanobioactive glass (BG), recognized for their efficacy in tissue regeneration and drug delivery. Scaffolds, namely, alginate/gelatin (AG), alginate-/actonel gelatin (AGD), alginate actenol/gelatin-45S5 BG (4AGD), and alginate-actonel/gelatin-59S BG (5AGD), were assembled using a cost-effective freeze-drying method, followed by detailed structural investigation via powder X-ray diffraction as well as morphological characterization using field emission scanning electron microscopy (FESEM). FESEM revealed a honeycomb-like morphology with distinct pore sizes for nutrient, oxygen, and drug transport. The scaffolds evidently exhibited hemocompatibility, high porosity, good swelling capacity, and biodegradability. In vitro studies demonstrated sustained drug release, particularly for scaffolds containing actonel. In vivo tests showed that the bilayer scaffold promoted new bone formation, surpassing the control group in bone area increase. The interaction of the scaffold with collagen and released ions improved the osteoblastic function and bone volume fraction. The findings suggest that this bilayer scaffold could be beneficial for treating critical-sized bone defects, especially in the mandibular and femoral regions.

Initial Clinical Experience with the Biodegradable AbsnowTM Device for Percutaneous Closure of Atrial Septal Defect: A 3-Year Follow-Up

Objective

We reported the 3-year follow-up results of initial clinical experience with the Absnow^TM device, a novel biodegradable occluder for percutaneous closure of atrial septal defect (ASD).

Background

The Absnow^TM device is a total biodegradable septal occluder with double-disc poly-L-lactic acid (PLLA) framework and PLLA membranes intergraded into the device to ensure its biodegradability, clinical safety, and efficacy.

Methods

Five pediatric patients were enrolled from May to June 2018 in our institution and were followed up for 3 years. A clinical evaluation and transthoracic echocardiography were performed at 24 hr, 1 month, 3 months, 6 months, 12 months, and yearly after implantation. Primary endpoints were a composite clinical success, comprising of clinical closure success and safety at the 36-month follow-up evaluation. Secondary endpoints included technical success, procedure success, closure success, and safety at each of the follow-up visits.

Results

The median subject age was 3.6 years (range 3.1-6.5 years). The mean ASD diameter was (13.7 ± 2.9) mm. The median device size was 20 mm (range 14 to 24 mm). Technical and procedure success was achieved in 100% (5/5) of the patients. At 2-year follow-up, 3 of the 5 patients developed new-onset residual shunts and 2 of them reached a moderate degree. At 3-year follow-up, the residual shunt size increased over time in all the 3 patients, and 1 of them had right ventricular enlargement. All of the 5 patients were free from serious adverse events during the 3-year follow-up, with no device embolization, thromboembolization, or reintervention to the target defect.

Conclusion

This 3-year follow-up result of initial experience with the biodegradable Absnow^TM device has demonstrated acceptable safety with no procedural complications. Notably, the high rate of residual shunt significantly affected its efficacy. The long-term safety and efficacy of the device should be further evaluated in a large cohort of patients in future studies.

Bioactive Regeneration Potential of the Newly Developed Uncalcined/Unsintered Hydroxyapatite and Poly-l-Lactide-Co-Glycolide Biomaterial in Maxillofacial Reconstructive Surgery: An In Vivo Preliminary Study

Uncalcined/unsintered hydroxyapatite (HA) and poly-l-lactide-co-glycolide (u-HA/PLLA/PGA) are novel bioresorbable bioactive materials with bone regeneration characteristics and have been used to treat mandibular defects in a rat model. However, the bone regenerative interaction with the periosteum, the inflammatory response, and the degradation of this material have not been examined. In this study, we used a rat mandible model to compare the above features in u-HA/PLLA/PGA and uncalcined/unsintered HA and poly-l-lactic acid (u-HA/PLLA). We divided 11 male Sprague–Dawley rats into 3- and 16-week groups. In each group, we assessed the characteristics of a u-HA/PLLA/PGA sheet covering the right mandibular angle and a u-HA/PLLA sheet covering the left mandibular angle in three rats each, and one rat was used as a sham control. The remaining three rats in the 16-week group were used for a degradation assessment and received both sheets of material as in the material assessment subgroup. At 3 and 16 weeks after surgery, the rats were sacrificed, and mandible specimens were subjected to micro-computed tomography, histological analysis, and immunohistochemical staining. The results indicated that the interaction between the periosteum and u-HA/PLLA/PGA material produced significantly more new bone regeneration with a lower inflammatory response and a faster resorption rate compared to u-HA/PLLA alone. These findings may indicate that this new biomaterial has ideal potential in treating maxillofacial defects of the midface and orbital regions.

Nanosilver-loaded PMMA bone cement doped with different bioactive glasses - evaluation of cytocompatibility, antibacterial activity, and mechanical properties

Nanosilver-loaded PMMA bone cement (BC-AgNp) is a novel cement developed as a replacement for conventional cements. Despite its favorable properties and antibacterial activity, BC-AgNp still lacks biodegradability and bioactivity. Hence, we investigated doping with bioactive glasses (BGs) to create a new bioactive BC characterized by time-varying porosity and gradual release of AgNp. The BC Cemex was used as the base material and modified simultaneously with the AgNp and BGs: melted 45S5 and 13-93B3 glasses with various particle sizes and sol-gel derived SiO₂/CaO microparticles. The effect of BG addition was examined by microscopic analysis, an assessment of setting parameters, wettability, FTIR and UV-VIS spectroscopy, mechanical testing, and hemo- and cytocompatibility and antibacterial efficiency studies. The results show that it is possible to incorporate various BGs into BC-AgNp, which leads to different properties depending on the type and size of BGs. The smaller particles of melted BGs showed higher porosity and better antibacterial properties with the moderate deterioration of mechanical properties. The sol-gel derived BGs, however, displayed a tendency for agglomeration and random distribution in BC-AgNp. The BGs with greater solubility more efficiently improve the antibacterial properties of BC-AgNp. Besides, the unreacted MMA monomer release could negatively influence the cellular response. Despite that, cements doped with different BGs are suitable for medical applications.

Investigation into morphological and electromechanical surface properties of reduced-graphene-oxide-loaded composite fibers for bone tissue engineering applications: A comprehensive nanoscale study using atomic force microscopy approach

We decided to implement an extensive atomic force microscopy study in order to get deeper understanding of surface-related nanoscale properties of 3D printed pristine polycaprolactone and its reduced-graphene-oxide-loaded composites. The study included surface visualization and roughness quantification, elastic modulus and adhesion force assessment with force spectroscopy, along with kelvin probe force microscopy evaluation of local changes of surface potential. Atomic force microscopy examination was followed by scanning electron microscopy visualization and wettability assessment. Moreover, systematic examination of reduced graphene oxide flakes fabricated exclusively for this study was performed, including: scanning electron microscopy, Raman spectroscopy, X-ray photoelectron spectroscopy and combustion elemental analysis. The addition of reduced graphene oxide resulted in thickening of the composite fibers and surface roughness enhancement. In addition, elastic modulus of composite fibers was higher and at the same time adhesion forces between scanning probe and tested surface was lower than for pristine polymeric ones. Lastly, we recorded local (nanoscale) alterations of surface potential of fibers with addition of graphene-derivative. The results clearly suggest graphene derivative's dose-dependent alteration of elastic modulus and adhesion force recorded with atomic force microscope. Moreover, changes of the material's surface properties were followed by changes of its electrical properties.

3D PCL/Gelatin/Genipin Nanofiber Sponge as Scaffold for Regenerative Medicine

Recent advancements in tissue engineering and material science have radically improved in vitro culturing platforms to more accurately replicate human tissue. However, the transition to clinical relevance has been slow in part due to the lack of biologically compatible/relevant materials. In the present study, we marry the commonly used two-dimensional (2D) technique of electrospinning and a self-assembly process to construct easily reproducible, highly porous, three-dimensional (3D) nanofiber scaffolds for various tissue engineering applications. Specimens from biologically relevant polymers polycaprolactone (PCL) and gelatin were chemically cross-linked using the naturally occurring cross-linker genipin. Potential cytotoxic effects of the scaffolds were analyzed by culturing human dermal fibroblasts (HDF) up to 23 days. The 3D PCL/gelatin/genipin scaffolds produced here resemble the complex nanofibrous architecture found in naturally occurring extracellular matrix (ECM) and exhibit physiologically relevant mechanical properties as well as excellent cell cytocompatibility. Samples cross-linked with 0.5% genipin demonstrated the highest metabolic activity and proliferation rates for HDF. Scanning electron microscopy (SEM) images indicated excellent cell adhesion and the characteristic morphological features of fibroblasts in all tested samples. The three-dimensional (3D) PCL/gelatin/genipin scaffolds produced here show great potential for various 3D tissue-engineering applications such as ex vivo cell culturing platforms, wound healing, or tissue replacement.

Mechanical, Structural, and Biological Properties of Chitosan/Hydroxyapatite/Silica Composites for Bone Tissue Engineering

The aim of this work was to fabricate novel bioactive composites based on chitosan and non-organic silica, reinforced with calcium β-glycerophosphate (Ca-GP), sodium β-glycerophosphate pentahydrate (Na-GP), and hydroxyapatite powder (HAp) in a range of concentrations using the sol–gel method. The effect of HAp, Na-GP, and Ca-GP contents on the mechanical properties, i.e., Young’s modulus, compressive strength, and yield strain, of hybrid composites was analyzed. The microstructure of the materials obtained was visualized by SEM. Moreover, the molecular interactions according to FTIR analysis and biocompatibility of composites obtained were examined. The CS/Si/HAp/Ca-GP developed from all composites analyzed was characterized by the well-developed surface of pores of two sizes: large ones of 100 μm and many smaller pores below 10 µm, the behavior of which positively influenced cell proliferation and growth, as well as compressive strength in a range of 0.3 to 10 MPa, Young’s modulus from 5.2 to 100 MPa, and volumetric shrinkage below 60%. This proved to be a promising composite for applications in tissue engineering, e.g., filling small bone defects.

Measurement of Dynamic Elastic Modulus and Poisson's Ratio of Chemically Strengthened Glass

Glass with strong durability and transparency has been in the spotlight in various fields, including displays. Elastic and shear moduli and Poisson’s ratio are important properties of glasses. The purpose of this study is to evaluate the change in mechanical properties, such as the dynamic elastic modulus and Poisson’s ratio, with respect to the chemical strengthening time of glass for display applications, as measured by static and dynamic methods. The basic measurement principle of the dynamic method is to measure acoustic speed or resonant frequency using an ultrasonic generator. The mechanical properties of both non-strengthened and chemically strengthened glasses were investigated. It was found that the strength of the chemically strengthened glass decreased when chemical strengthening time increased. Chemical strengthening increased the bending strength and decreased the elastic modulus due to the introduction of compressive residual stress at the surface.

Dielectric Spectroscopy and Thermal Properties of Poly(lactic) Acid Reinforced with Carbon-Based Particles: Experimental Study and Design Theory

In the present study, polylactic acid (PLA) enriched with carbonaceous particles like multi-walled carbon nanotubes (MWCNTs), graphene nanoplates (GNPs) or a combination of both up 12 wt % of loading are used for producing 3D-printed specimens with fused deposition modeling (FDM) technology which are then experimentally and theoretically investigated. The goal is to propose a non-conventional filaments indicated for additive manufacturing process with improved dielectric and thermal properties, compared to the performances exhibited by the unfilled polymer. In the light of the above, a wide dielectric spectroscopy and a thermal analysis, supported by a morphological investigation, are performed. The results highlight that the introduction of 1-dimensional filler (MWCNTs) are more suitable for improving the dielectric properties of the resulting materials, due to the enhancement of the interfacial polarization and the presence of functionalized groups, whereas 2-dimensional nanoparticles (GNPs) better favor the thermal conduction mechanisms thanks to the lower thermal boundary resistance between the two phases, polymer/filler. In particular, with a loading of 12 wt % of MWCNTs the relative permittivity reaches the value of 5.35 × 10³ much greater than that of 3.7 measured for unfilled PLA while for the thermal conductivity the enhancement with 12 wt % of GNPs is about 261% respect the thermal behavior of the neat polymer. The experimental results are correlated to theoretical findings, whereas a design of experiment (DoE) approach is adopted for investigating how the different fillers influence the dielectric and thermal performances of the 3D-printed parts, thus assisting the design of such innovative materials that appear promising for development and applications in the electromagnetic (EM) field and heat transfer.

Initial experiences with a novel biodegradable device for percutaneous closure of atrial septal defects: From preclinical study to first-in-human experience

Objective

To evaluate the feasibility, safety, and effectiveness of a novel, absorbable atrial septal defect (ASD) closure device made of poly‐l‐lactic acid (PLLA) in a swine model of ASD and for the first time in humans.

Methods

A preclinical safety study was conducted using a swine model of ASD. In a clinical setting, five pediatric patients underwent ASD closure with the PLLA device with fluoroscopic and transthoracic echocardiography guidance. The procedural results and clinical outcomes at 1 day, 30 days, 3 months, and 6 months after closure were analyzed.

Results

The 24‐ and 36‐month follow‐up results of the preclinical study demonstrated that the PLLA device exhibited good endothelialization and degradability in the swine model. In the clinical study, successful device implantation was achieved in all five patients (median age, 3.6 years; range, 3.1–6.5 years). The mean defect size was (13.6 ± 2.7) mm. Follow‐up at 30 days, 3 months, and 6 months was completed in all five cases. The complete defect closure rates with no residual shunt at 30 days, 3 months, and 6 months follow‐up were 60% (3/5), 80% (4/5), and 80% (4/5), respectively. No device dislodgement, significant aortic valve or mitral valve regurgitation, new onset cardiac arrhythmia, or other adverse events were reported.

Conclusion

The study results demonstrated that it is feasible to implant the PLLA device for closure of small to medium sized ASDs without significant residual shunts or severe adverse events in humans. The PLLA device exhibited good endothelialization and degradability in the swine model at 24 and 36 months. Further studies to evaluate long‐term safety and effectiveness with the device in a large cohort of patients are warranted.