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Li J, Kim C, Pan CC, Babian A, Lui E, Young JL, Moeinzadeh S, Kim S, Yang YP. Hybprinting for musculoskeletal tissue engineering. iScience 2022; 25:104229. [PMID: 35494239 PMCID: PMC9051619 DOI: 10.1016/j.isci.2022.104229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This review presents bioprinting methods, biomaterials, and printing strategies that may be used for composite tissue constructs for musculoskeletal applications. The printing methods discussed include those that are suitable for acellular and cellular components, and the biomaterials include soft and rigid components that are suitable for soft and/or hard tissues. We also present strategies that focus on the integration of cell-laden soft and acellular rigid components under a single printing platform. Given the structural and functional complexity of native musculoskeletal tissue, we envision that hybrid bioprinting, referred to as hybprinting, could provide unprecedented potential by combining different materials and bioprinting techniques to engineer and assemble modular tissues.
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Affiliation(s)
- Jiannan Li
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA
| | - Carolyn Kim
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA.,Department of Mechanical Engineering, 416 Escondido Mall, Stanford University, Stanford, CA 94305, USA
| | - Chi-Chun Pan
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA.,Department of Mechanical Engineering, 416 Escondido Mall, Stanford University, Stanford, CA 94305, USA
| | - Aaron Babian
- Department of Biological Sciences, University of California, Davis CA 95616, USA
| | - Elaine Lui
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA.,Department of Mechanical Engineering, 416 Escondido Mall, Stanford University, Stanford, CA 94305, USA
| | - Jeffrey L Young
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA
| | - Seyedsina Moeinzadeh
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA
| | - Sungwoo Kim
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA
| | - Yunzhi Peter Yang
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 300 Pasteur Drive BMI 258, Stanford, CA 94305, USA.,Department of Materials Science and Engineering, Stanford University, 496 Lomita Mall, Stanford, CA 94305, USA.,Department of Bioengineering, Stanford University, 443 Via Ortega, Stanford, CA 94305, USA
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2
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Belaid H, Barou C, Collart-Dutilleul PY, Desoutter A, Kajdan M, Bernex F, Tétreau R, Cuisinier F, Barés J, Huon V, Teyssier C, Cornu D, Cavaillès V, Bechelany M. Fabrication of Radio-Opaque and Macroporous Injectable Calcium Phosphate Cement. ACS APPLIED BIO MATERIALS 2022; 5:3075-3085. [PMID: 35584545 DOI: 10.1021/acsabm.2c00345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this work was the development of injectable radio-opaque and macroporous calcium phosphate cement (CPC) to be used as a bone substitute for the treatment of pathologic vertebral fractures. A CPC was first rendered radio-opaque by the incorporation of zirconium dioxide (ZrO2). In order to create macroporosity, poly lactic-co-glycolic acid (PLGA) microspheres around 100 μm were homogeneously incorporated into the CPC as observed by scanning electron microscopy. Physicochemical analyses by X-ray diffraction and Fourier transform infrared spectroscopy confirmed the brushite phase of the cement. The mechanical properties of the CPC/PLGA cement containing 30% PLGA (wt/wt) were characterized by a compressive strength of 2 MPa and a Young's modulus of 1 GPa. The CPC/PLGA exhibited initial and final setting times of 7 and 12 min, respectively. Although the incorporation of PLGA microspheres increased the force necessary to inject the cement and decreased the percentage of injected mass as a function of time, the CPC/PLGA appeared fully injectable at 4 min. Moreover, in comparison with CPC, CPC/PLGA showed a full degradation in 6 weeks (with 100% mass loss), and this was associated with an acidification of the medium containing the CPC/PLGA sample (pH of 3.5 after 6 weeks). A cell viability test validated CPC/PLGA biocompatibility, and in vivo analyses using a bone defect assay in the caudal vertebrae of Wistar rats showed the good opacity of the CPC through the tail and a significant increased degradation of the CPC/PLGA cement a month after implantation. In conclusion, this injectable CPC scaffold appears to be an interesting material for bone substitution.
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Affiliation(s)
- Habib Belaid
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France.,IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - Carole Barou
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France.,IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France.,Biologics 4 Life, 84120 Pertuis, France
| | | | - Alban Desoutter
- Laboratoire de Bioingénierie et Nanosciences, EA4203, Université de Montpellier, 34193 Montpellier, France
| | - Marilyn Kajdan
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - Florence Bernex
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France.,BioCampus, RHEM, Université de Montpellier, CNRS UAR3426, INSERM, F-34298 Montpellier, France
| | - Raphaël Tétreau
- Service d'Imagerie, Institut Régional du Cancer Montpellier, Montpellier F-34298, France
| | - Frédéric Cuisinier
- Laboratoire de Bioingénierie et Nanosciences, EA4203, Université de Montpellier, 34193 Montpellier, France
| | - Jonathan Barés
- Laboratoire de Mécanique et Génie Civil, Univ Montpellier, CNRS, Montpellier 34090, France
| | - Vincent Huon
- Laboratoire de Mécanique et Génie Civil, Univ Montpellier, CNRS, Montpellier 34090, France
| | - Catherine Teyssier
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - David Cornu
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France
| | - Vincent Cavaillès
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - Mikhael Bechelany
- Institut Européen des Membranes, IEM, UMR 5635, Univ Montpellier, CNRS, ENSCM, 34095 Montpellier, France
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3
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Lu T, He F, Ye J. Physicochemical Properties, In Vitro Degradation, and Biocompatibility of Calcium Phosphate Cement Incorporating Poly(lactic- co-glycolic acid) Particles with Different Morphologies: A Comparative Study. ACS OMEGA 2021; 6:8322-8331. [PMID: 33817492 PMCID: PMC8015133 DOI: 10.1021/acsomega.1c00031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/01/2021] [Indexed: 05/13/2023]
Abstract
Calcium phosphate cement (CPC) is one of the most promising synthetic biomaterials for bone defect repair, but its low degradation rate and the lack of macropores restrict its repair effect. Poly(lactic-co-glycolic acid) (PLGA) is commonly used as an in situ pore forming agent in CPC, and the morphology of PLGA would affect the properties of CPC. In this study, three kinds of PLGA particles with different morphologies, including dense PLGA microspheres, dense milled PLGA particles with an irregular shape, and porous PLGA microspheres, were respectively incorporated into CPC matrix. The influences of the morphology of PLGA particles on the setting time, porosity, mechanical properties, in vitro degradation, and cytocompatibility of CPC were comparatively investigated. The results showed that the CPC composites containing dense spherical and irregularly shaped PLGA particles showed proper setting time and better compressive strength, but the CPC composite incorporating porous PLGA microspheres significantly prolonged the final setting time and dramatically decreased the compressive strength of CPC. The CPC composite containing irregularly shaped PLGA particles has shown a slightly faster in vitro degradation rate than that containing dense PLGA microspheres. In addition, the CPC composites containing dense PLGA particles were beneficial for cell proliferation. Taken together, the dense PLGA particles are suitable for use as in situ pore forming agents in the CPC matrix, and meanwhile, the dense irregularly shaped PLGA particles are more easily prepared with low cost.
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Affiliation(s)
- Teliang Lu
- School
of Materials Science and Engineering and Key Laboratory of Biomedical
Materials of Ministry of Education, South
China University of Technology, Guangzhou 510641, China
- National
Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China
- Key
Laboratory of Biomedical Engineering of Guangdong Province and Innovation
Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510641, China
| | - Fupo He
- School
of Electromechanical Engineering, Guangdong
University of Technology, Guangzhou 510006, China
| | - Jiandong Ye
- School
of Materials Science and Engineering and Key Laboratory of Biomedical
Materials of Ministry of Education, South
China University of Technology, Guangzhou 510641, China
- National
Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China
- Key
Laboratory of Biomedical Engineering of Guangdong Province and Innovation
Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510641, China
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4
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Ning L, Gil CJ, Hwang B, Theus AS, Perez L, Tomov ML, Bauser-Heaton H, Serpooshan V. Biomechanical factors in three-dimensional tissue bioprinting. APPLIED PHYSICS REVIEWS 2020; 7:041319. [PMID: 33425087 PMCID: PMC7780402 DOI: 10.1063/5.0023206] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/23/2020] [Indexed: 05/07/2023]
Abstract
3D bioprinting techniques have shown great promise in various fields of tissue engineering and regenerative medicine. Yet, creating a tissue construct that faithfully represents the tightly regulated composition, microenvironment, and function of native tissues is still challenging. Among various factors, biomechanics of bioprinting processes play fundamental roles in determining the ultimate outcome of manufactured constructs. This review provides a comprehensive and detailed overview on various biomechanical factors involved in tissue bioprinting, including those involved in pre, during, and post printing procedures. In preprinting processes, factors including viscosity, osmotic pressure, and injectability are reviewed and their influence on cell behavior during the bioink preparation is discussed, providing a basic guidance for the selection and optimization of bioinks. In during bioprinting processes, we review the key characteristics that determine the success of tissue manufacturing, including the rheological properties and surface tension of the bioink, printing flow rate control, process-induced mechanical forces, and the in situ cross-linking mechanisms. Advanced bioprinting techniques, including embedded and multi-material printing, are explored. For post printing steps, general techniques and equipment that are used for characterizing the biomechanical properties of printed tissue constructs are reviewed. Furthermore, the biomechanical interactions between printed constructs and various tissue/cell types are elaborated for both in vitro and in vivo applications. The review is concluded with an outlook regarding the significance of biomechanical processes in tissue bioprinting, presenting future directions to address some of the key challenges faced by the bioprinting community.
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Affiliation(s)
- Liqun Ning
- Department of Biomedical Engineering, Emory University School of Medicine and Georgia Institute of Technology, Atlanta, Georgia 30322, USA
| | - Carmen J. Gil
- Department of Biomedical Engineering, Emory University School of Medicine and Georgia Institute of Technology, Atlanta, Georgia 30322, USA
| | - Boeun Hwang
- Department of Biomedical Engineering, Emory University School of Medicine and Georgia Institute of Technology, Atlanta, Georgia 30322, USA
| | - Andrea S. Theus
- Department of Biomedical Engineering, Emory University School of Medicine and Georgia Institute of Technology, Atlanta, Georgia 30322, USA
| | - Lilanni Perez
- Department of Biomedical Engineering, Emory University School of Medicine and Georgia Institute of Technology, Atlanta, Georgia 30322, USA
| | - Martin L. Tomov
- Department of Biomedical Engineering, Emory University School of Medicine and Georgia Institute of Technology, Atlanta, Georgia 30322, USA
| | - Holly Bauser-Heaton
- Authors to whom correspondence should be addressed:. Telephone: 404-712-9717. Fax: 404-727-9873
| | - Vahid Serpooshan
- Authors to whom correspondence should be addressed:. Telephone: 404-712-9717. Fax: 404-727-9873
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5
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Yousefi AM. A review of calcium phosphate cements and acrylic bone cements as injectable materials for bone repair and implant fixation. J Appl Biomater Funct Mater 2020; 17:2280800019872594. [PMID: 31718388 DOI: 10.1177/2280800019872594] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Treatment of bone defects caused by trauma or disease is a major burden on human healthcare systems. Although autologous bone grafts are considered as the gold standard, they are limited in availability and are associated with post-operative complications. Minimally invasive alternatives using injectable bone cements are currently used in certain clinical procedures, such as vertebroplasty and balloon kyphoplasty. Nevertheless, given the high incidence of fractures and pathologies that result in bone voids, there is an unmet need for injectable materials with desired properties for minimally invasive procedures. This paper provides an overview of the most common injectable bone cement materials for clinical use. The emphasis has been placed on calcium phosphate cements and acrylic bone cements, while enabling the readers to compare the opportunities and challenges for these two classes of bone cements. This paper also briefly reviews antibiotic-loaded bone cements used in bone repair and implant fixation, including their efficacy and cost for healthcare systems. A summary of the current challenges and recommendations for future directions has been brought in the concluding section of this paper.
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Affiliation(s)
- Azizeh-Mitra Yousefi
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, OH, USA
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6
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Lodoso-Torrecilla I, van Gestel NAP, Diaz-Gomez L, Grosfeld EC, Laperre K, Wolke JGC, Smith BT, Arts JJ, Mikos AG, Jansen JA, Hofmann S, van den Beucken JJJP. Multimodal pore formation in calcium phosphate cements. J Biomed Mater Res A 2017; 106:500-509. [PMID: 28940662 DOI: 10.1002/jbm.a.36245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/08/2017] [Accepted: 09/21/2017] [Indexed: 01/05/2023]
Abstract
Calcium phosphate cements (CPCs) are commonly used as bone substitute materials. However, their slow degradation rate and lack of macroporosity hinders new bone formation. Poly(dl-lactic-co-glycolic acid) (PLGA) incorporation is of great interest as, upon degradation, produces acidic by-products that enhance CPC degradation. Yet, new bone formation is delayed until PLGA degradation occurs a few weeks after implantation. Therefore, the aim of this study was to accelerate the early stage pore formation within CPCs in vitro. With that purpose, we incorporated the water-soluble porogen sucrose at different weight percentages (10 or 20 wt %) to CPC and CPC/PLGA composites. The results revealed that incorporation of sucrose porogens increased mass loss within the first week of in vitro degradation in groups containing sucrose compared to control groups. After week 1, a further mass loss was observed related to PLGA and CPC degradation. Macroporosity analysis confirmed that macroporosity formation is influenced by the dissolution of sucrose at an early stage and by the degradation of PLGA and CPC at a later stage. We concluded that the combination of sucrose and PLGA porogens in CPC is a promising approach to promote early stage bone tissue ingrowth and complete replacement of CPC through multimodal pore formation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 500-509, 2018.
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Affiliation(s)
| | - Nicole A P van Gestel
- Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Luis Diaz-Gomez
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Department of Bioengineering, Rice University, Houston, Texas, 77030
| | | | | | - Joop G C Wolke
- Department of Biomaterials, Radboudumc, Nijmegen, The Netherlands
| | - Brandon T Smith
- Department of Bioengineering, Rice University, Houston, Texas, 77030
| | - Jacobus J Arts
- Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, Houston, Texas, 77030.,Department of Chemical and Biomolecular Engineering, Rice University, Houston, Texas, 77005
| | - John A Jansen
- Department of Biomaterials, Radboudumc, Nijmegen, The Netherlands
| | - Sandra Hofmann
- Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Biomechanics, Swiss Federal Institute of Technology Zürich (ETHZ), Zürich, Switzerland
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Ryabenkova Y, Pinnock A, Quadros P, Goodchild R, Möbus G, Crawford A, Hatton P, Miller C. The relationship between particle morphology and rheological properties in injectable nano-hydroxyapatite bone graft substitutes. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 75:1083-1090. [DOI: 10.1016/j.msec.2017.02.170] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/25/2017] [Accepted: 02/28/2017] [Indexed: 12/01/2022]
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8
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Castro AGB, Polini A, Azami Z, Leeuwenburgh SCG, Jansen JA, Yang F, van den Beucken JJJP. Incorporation of PLLA micro-fillers for mechanical reinforcement of calcium-phosphate cement. J Mech Behav Biomed Mater 2017; 71:286-294. [PMID: 28376362 DOI: 10.1016/j.jmbbm.2017.03.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 03/18/2017] [Accepted: 03/26/2017] [Indexed: 01/09/2023]
Abstract
Calcium phosphate cements (CPCs) are biocompatible, resorbable, injectable and osteoconductive. Those properties render such materials suitable for applications where bone repair and regeneration is required However, their brittle nature limits their application only to non-load-bearing applications. The incorporation of long polymeric fibers can improve the mechanical properties of CPCs, but aggregation is a major problem. Instead, short polymeric fillers can be easily dispersed in the cement matrix, but their reinforcing effect has not been studied yet. In this study, continuous poly-L-lactic acid fibers (PLLA) with a smooth or porous surface morphology were prepared by electrospinning. PLLA micro-fillers were developed, by means of an aminolysis process, and added to α-TCP or α-TCP/PLGA-based cements. Micro-filler distribution as well as the morphology, cohesiveness, setting times and mechanical properties were evaluated. PLLA micro-fillers were homogeneously dispersed throughout the cement while the handling properties were not significantly affected. A decrease in the initial setting times was observed when PLLA was added, while the mechanical properties were comparable to those of the α-TPC or α-TCP/PLGA compositions.
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Affiliation(s)
- Antonio G B Castro
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Alessandro Polini
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Zohal Azami
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Sander C G Leeuwenburgh
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - John A Jansen
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
| | - Fang Yang
- Department of Biomaterials, Radboudumc, Philips van Leydenlaan 25, Nijmegen 6525 EX, The Netherlands
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Smith BT, Santoro M, Grosfeld EC, Shah SR, van den Beucken JJ, Jansen JA, Mikos. AG. Incorporation of fast dissolving glucose porogens into an injectable calcium phosphate cement for bone tissue engineering. Acta Biomater 2017; 50:68-77. [PMID: 27956363 DOI: 10.1016/j.actbio.2016.12.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/06/2016] [Accepted: 12/08/2016] [Indexed: 12/25/2022]
Abstract
Calcium phosphate cements (CPCs) have been extensively investigated as scaffolds in bone tissue engineering in light of their chemical composition closely resembling the mineral component of bone extracellular matrix. Yet, the degradation kinetics of many CPCs is slow compared to de novo bone formation. In order to overcome this shortcoming, the use of porogens within CPCs has been suggested as a potential strategy to increase scaffold porosity and promote surface degradation. This study explored the usage of glucose microparticles (GMPs) as porogens for the introduction of macroporosity within CPCs, and characterized the handling properties and physicochemical characteristics of CPCs containing GMPs. Samples were fabricated with four different weight fractions of GMPs (10, 20, 30, and 40%) and two different size ranges (100-150μm and 150-300μm), and were assayed for porosity, pore size distribution, morphology, and compressive mechanical properties. Samples were further tested for their handling properties - specifically, setting time and cohesiveness. Additionally, these same analyses were conducted on samples exposed to a physiological solution in order to estimate the dissolution kinetics of GMPs and its effect on the properties of the composite. GMPs were efficiently encapsulated and homogeneously dispersed in the resulting composite. Although setting times increased for GMP/CPC formulations compared to control CPC material, increasing the Na2HPO4 concentration in the liquid phase decreased the initial setting time to clinically acceptable values (i.e. <15min). Incorporation of GMPs led to the formation of instant macroporosity upon cement setting, and encapsulated GMPs completely dissolved in three days, resulting in a further increase in scaffold porosity. However, the dissolution of GMPs decreased scaffold compressive strength. Overall, the introduction of GMPs into CPC resulted in macroporous scaffolds with good handling properties, as well as designer porosity and pore size distribution via selection of the appropriate size/weight fraction of GMPs. The data demonstrate that GMPs are promising porogens for the production of highly tunable porous CPC scaffolds. STATEMENT OF SIGNIFICANCE Calcium phosphate cements have shown great promise for the regeneration of bone. However, macropores (>100μm) are required for promoting bone ingrowth. Several studies have investigated methods to generate macroporosity within calcium phosphate cements but many of these methods either affect the cement setting or take weeks or months to generate the maximum porosity. This work offers a new method for generating macroporosity within calcium phosphate cements by utilizing glucose microparticles. The microparticles dissolve in less then 72h, thereby generating scaffolds with maximum porosity in short period of time. The results will offer a new method for generating macroporosity within calcium phosphate cements.
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10
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O'Neill R, McCarthy HO, Montufar EB, Ginebra MP, Wilson DI, Lennon A, Dunne N. Critical review: Injectability of calcium phosphate pastes and cements. Acta Biomater 2017; 50:1-19. [PMID: 27838464 DOI: 10.1016/j.actbio.2016.11.019] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 11/03/2016] [Accepted: 11/08/2016] [Indexed: 12/26/2022]
Abstract
Calcium phosphate cements (CPC) have seen clinical success in many dental and orthopaedic applications in recent years. The properties of CPC essential for clinical success are reviewed in this article, which includes properties of the set cement (e.g. bioresorbability, biocompatibility, porosity and mechanical properties) and unset cement (e.g. setting time, cohesion, flow properties and ease of delivery to the surgical site). Emphasis is on the delivery of calcium phosphate (CaP) pastes and CPC, in particular the occurrence of separation of the liquid and solid components of the pastes and cements during injection; and established methods to reduce this phase separation. In addition a review of phase separation mechanisms observed during the extrusion of other biphasic paste systems and the theoretical models used to describe these mechanisms are discussed. STATEMENT OF SIGNIFICANCE Occurrence of phase separation of calcium phosphate pastes and cements during injection limits their full exploitation as a bone substitute in minimally invasive surgical applications. Due to lack of theoretical understanding of the phase separation mechanism(s), optimisation of an injectable CPC that satisfies clinical requirements has proven difficult. However, phase separation of pastes during delivery has been the focus across several research fields. Therefore in addition to a review of methods to reduce phase separation of CPC and the associated constraints, a review of phase separation mechanisms observed during extrusion of other pastes and the theoretical models used to describe these mechanisms is presented. It is anticipated this review will benefit future attempts to develop injectable calcium phosphate based systems.
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Affiliation(s)
- R O'Neill
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Rd, Belfast BT9 5AH, United Kingdom
| | - H O McCarthy
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom
| | - E B Montufar
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Universitat Politècnica de Catalunya. BarcelonaTech (UPC), Av. Diagonal 647, 08028 Barcelona, Spain; Institute for Bioengineering of Catalonia, C. Baldiri Reixach 10, 08028 Barcelona, Spain
| | - M-P Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Universitat Politècnica de Catalunya. BarcelonaTech (UPC), Av. Diagonal 647, 08028 Barcelona, Spain; Institute for Bioengineering of Catalonia, C. Baldiri Reixach 10, 08028 Barcelona, Spain
| | - D I Wilson
- Department of Chemical Engineering and Biotechnology, New Museums Site, Pembroke Street, University of Cambridge, CB2 3RA, United Kingdom
| | - A Lennon
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Rd, Belfast BT9 5AH, United Kingdom
| | - N Dunne
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom; Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Stokes Building, Collins Avenue, Dublin 9, Ireland; Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.
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11
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Gohil SV, Kumar N. An injectable and biomimetic multi-phase nanocomposite for non-invasive bone tissue engineering: fabrication and mechanistic evaluation. POLYM ADVAN TECHNOL 2017. [DOI: 10.1002/pat.4022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Shalini V. Gohil
- Department of Pharmaceutics; National Institute of Pharmaceutical Education and Research (NIPER); Sector 67, S.A.S. Nagar Punjab India 160062
- Department of Orthopaedic Surgery; UConn Health Center; Farmington Connecticut USA 06030
| | - Neeraj Kumar
- Department of Pharmaceutics; National Institute of Pharmaceutical Education and Research (NIPER); Sector 67, S.A.S. Nagar Punjab India 160062
- Department of Applied Sciences; Chandigarh Engineering College (CEC); Landran Mohali Punjab India 140307
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Wu T, Shi H, Ye J. Effect of PLGA/lecithin hybrid microspheres and β-tricalcium phosphate granules on the physicochemical properties, in vitro degradation and biocompatibility of calcium phosphate cement. RSC Adv 2015. [DOI: 10.1039/c5ra06861d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
CPC with beta-TCP granules and PLGA/Lec microspheres reveals better degradability and cell affinity along with proper physicochemical properties.
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Affiliation(s)
- Tingting Wu
- School of Materials Science and Engineering
- South China University of Technology
- Guangzhou 510640
- China
- National Engineering Research Center for Tissue Restoration and Reconstruction
| | - Haishan Shi
- School of Materials Science and Engineering
- South China University of Technology
- Guangzhou 510640
- China
- National Engineering Research Center for Tissue Restoration and Reconstruction
| | - Jiandong Ye
- School of Materials Science and Engineering
- South China University of Technology
- Guangzhou 510640
- China
- National Engineering Research Center for Tissue Restoration and Reconstruction
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Maenz S, Kunisch E, Mühlstädt M, Böhm A, Kopsch V, Bossert J, Kinne RW, Jandt KD. Enhanced mechanical properties of a novel, injectable, fiber-reinforced brushite cement. J Mech Behav Biomed Mater 2014; 39:328-38. [DOI: 10.1016/j.jmbbm.2014.07.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 07/22/2014] [Accepted: 07/28/2014] [Indexed: 02/05/2023]
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Calcium phosphate cements for bone substitution: chemistry, handling and mechanical properties. Acta Biomater 2014; 10:1035-49. [PMID: 24231047 DOI: 10.1016/j.actbio.2013.11.001] [Citation(s) in RCA: 352] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 10/29/2013] [Accepted: 11/01/2013] [Indexed: 01/02/2023]
Abstract
Since their initial formulation in the 1980s, calcium phosphate cements (CPCs) have been increasingly used as bone substitutes. This article provides an overview on the chemistry, kinetics of setting and handling properties (setting time, cohesion and injectability) of CPCs for bone substitution, with a focus on their mechanical properties. Many processing parameters, such as particle size, composition of cement reactants and additives, can be adjusted to control the setting process of CPCs, concomitantly influencing their handling and mechanical performance. Moreover, this review shows that, although the mechanical strength of CPCs is generally low, it is not a critical issue for their application for bone repair--an observation not often realized by researchers and clinicians. CPCs with compressive strengths comparable to those of cortical bones can be produced through densification and/or homogenization of the cement matrix. The real limitation for CPCs appears to be their low fracture toughness and poor mechanical reliability (Weibull modulus), which have so far been only rarely studied.
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Bodakhe S, Verma S, Garkhal K, Samal SK, Sharma SS, Kumar N. Injectable photocrosslinkable nanocomposite based on poly(glycerol sebacate) fumarate and hydroxyapatite: development, biocompatibility and bone regeneration in a rat calvarial bone defect model. Nanomedicine (Lond) 2013; 8:1777-95. [PMID: 23384697 DOI: 10.2217/nnm.12.192] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM An injectable, photocrosslinkable nanocomposite was prepared using a fumarate derivative of poly(glycerol sebacate) and nanohydroxyapatite. MATERIALS & METHODS Polymers with varying physical and mechanical properties were synthesized. Furthermore, nanocomposites were developed using a homogenization process by combining nanohydroxyapatite within poly(glycerol sebacate) matrix via photocrosslinking and evaluated both in vitro and in vivo. RESULTS & DISCUSSION The nanocomposites were injectable, highly bioactive and biocompatible. Addition of nanohydroxyapatite led to enhanced mechanical properties with an ultimate strength of 8 MPa. The optimized nanocomposite showed good in vitro cell attachment, proliferation and differentiation of rat bone marrow-derived mesenchymal stem cells. The in vivo evaluation in a rat calvarial bone defect model showed significantly high alkaline phosphatase activity and bone regeneration. CONCLUSION This injectable, biocompatible and bioactive in situ hardening composite graft was found to be suitable for load-bearing bone regeneration applications using minimally invasive surgery.
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Affiliation(s)
- Santosh Bodakhe
- Department of Pharmaceutics, National Institute of Pharmaceutical Education & Research (NIPER), Sector 67, S.A.S. Nagar, Punjab, 160062, India
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Fatimi A, Tassin JF, Bosco J, Deterre R, Axelos MAV, Weiss P. Injection of calcium phosphate pastes: prediction of injection force and comparison with experiments. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2012; 23:1593-603. [PMID: 22528073 DOI: 10.1007/s10856-012-4640-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 03/29/2012] [Indexed: 05/06/2023]
Abstract
Calcium phosphate ceramics suspensions (ICPCS) are used in bone and dental surgery as injectable bone substitutes. This ICPCS biomaterial associates biphasic calcium phosphate (BCP) granules with hydroxypropylmethylcellulose (HPMC) polymer. Different ICPCS were prepared and their rheological properties were evaluated in parallel disks geometry as a function of the BCP weight ratio (35, 40, 45 and 50 %). The suspensions show a strongly increased viscosity as compared to the suspending fluid and the high shear rate part of the flow curve can be fitted with a power law model (Ostwald-de Waele model). The fitting parameters depend on the composition of the suspension. A simple device has been used to characterize extrusion of the paste using a disposable syringe fitted with a needle. The injection pressure of four ICPCS formulations was studied under various conditions (needle length and radius and volumetric flow rate), yielding an important set of data. A theoretical approach based on the capillary flow of non-Newtonian fluids was used to predict the necessary pressure for injection, on the basis of flow curves and extrusion conditions. The extrusion pressure calculated from rheological data shows a quantitative agreement with the experimental one for model fluids (Newtonian and HPMC solution) but also for the suspension, when needles with sufficiently large diameters as compared to the size of particles, are used. Depletion and possibly wall slip is encountered in the suspensions when narrower diameters are used, so that the injection pressure is less than that anticipated. However a constant proportionality factor exists between theory and injection experiments. The approach developed in this study can be used to correlate the rheological parameters to the necessary pressure for injection and defines the pertinent experimental conditions to obtain a quantitative agreement between theory and experiments.
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Affiliation(s)
- Ahmed Fatimi
- INSERM, U791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire, 1 place Alexis Ricordeau, BP 84215, 44042, Nantes Cedex 1, France.
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Zhong ML, Chen XQ, Fan HS, Zhang XD. Incorporation of salmon calcitonin-loaded poly(lactide-co-glycolide) (PLGA) microspheres into calcium phosphate bone cement and the biocompatibility evaluation in vitro. J BIOACT COMPAT POL 2012. [DOI: 10.1177/0883911512438027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Slow tissue ingrowth is the major drawback for the use of calcium phosphate cements; to address the issue, salmon calcitonin–loaded biodegradable poly(lactide- co-glycolide) microspheres were incorporated into calcium phosphate cement in this study. The effects of poly(lactide- co-glycolide) weight ratio on the mechanical strength, self-setting properties, and salmon calcitonin release ability of calcium phosphate cement were systematically investigated. The in vitro degradation behavior and the cumulative mass loss (%) of the composite during incubation in phosphate-buffered saline were studied. The release of salmon calcitonin was sustained for at least 35 days, and the release rate can be tailored by adjusting the ratio of PLGA. The scanning electron microscopic images of the composites after incubation for 48 days indicated that the poly(lactide- co-glycolide) degraded completely and formed a porous structure in the calcium phosphate cement. An in vitro cell culture of the calcium phosphate cement/salmon calcitonin–poly(lactide- co-glycolide) cement provided more biocompatible than calcium phosphate cement. This composite possesses the basic performance for clinical needs, and it has potential use for treating osteoporosis and accelerating bone repair.
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Affiliation(s)
- Mei-Ling Zhong
- National Engineering Research Center for Biomaterials, Sichuan University, Sichuan, Chengdu, China
| | - Xiao-Qin Chen
- National Engineering Research Center for Biomaterials, Sichuan University, Sichuan, Chengdu, China
| | - Hong-Song Fan
- National Engineering Research Center for Biomaterials, Sichuan University, Sichuan, Chengdu, China
| | - Xing-Dong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Sichuan, Chengdu, China
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Schnieders J, Gbureck U, Vorndran E, Schossig M, Kissel T. The effect of porosity on drug release kinetics from vancomycin microsphere/calcium phosphate cement composites. J Biomed Mater Res B Appl Biomater 2011; 99:391-8. [DOI: 10.1002/jbm.b.31910] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 04/21/2011] [Accepted: 05/16/2011] [Indexed: 11/05/2022]
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