Development, characterisation and biocompatibility testing of a cobalt-containing titanium phosphate-based glass for engineering of vascularized hard tissues

Advancements in incorporating metal ions onto the surface of biomedical titanium and its alloys via micro-arc oxidation: a research review

The incorporation of biologically active metallic elements into nano/micron-scale coatings through micro-arc oxidation (MAO) shows significant potential in enhancing the biological characteristics and functionality of titanium-based materials. By introducing diverse metal ions onto titanium implant surfaces, not only can their antibacterial, anti-inflammatory and corrosion resistance properties be heightened, but it also promotes vascular growth and facilitates the formation of new bone tissue. This review provides a thorough examination of recent advancements in this field, covering the characteristics of commonly used metal ions and their associated preparation parameters. It also highlights the diverse applications of specific metal ions in enhancing osteogenesis, angiogenesis, antibacterial efficacy, anti-inflammatory and corrosion resistance properties of titanium implants. Furthermore, the review discusses challenges faced and future prospects in this promising area of research. In conclusion, the synergistic approach of micro-arc oxidation and metal ion doping demonstrates substantial promise in advancing the effectiveness of biomedical titanium and its alloys, promising improved outcomes in medical implant applications.

The structural role and coordination environment of cobalt in 45P2O5-CaO-Na2O phosphate glasses: thermal properties and Raman, UV-vis-NIR, and EPR spectroscopy

Cobalt-containing materials are of interest for a wide range of applications, from biomaterials to solid-state lasers in optics. For instance, Co²⁺ is known to trigger the formation of new blood vessels, i.e. angiogenesis. Here, the use of phosphate glasses as a vehicle for local release of Co²⁺ ions is an attractive strategy to overcome the vascularisation limitation in tissue engineering. This study aimed to establish structure-property correlations as a function of the coordination environment of cobalt in 45P₂O₅-(30 - x)CaO-25Na₂O-xCoO (x: 0.01 to 10 mol%) glasses. Constant polymerization and O/P ratio, resulting ultimately in constant basicity, were shown by ICP-OES and Raman spectroscopy. The latter, combined with EPR analysis, indicated that Co²⁺ was the predominant oxidation state and the presence of Co³⁺ can be excluded. UV-vis-NIR absorption spectra showed that the ratio between Co²⁺ in four- and six-fold coordination remained constant throughout the glass series. Their thermal properties measured by DSC and heating microscopy did not change much in the substitution range studied here. The steady trend in T_g values suggests a compensation between two opposite effects caused by the presence of four and six-fold coordinated Co²⁺, both being present at a constant ratio throughout the glasses. Accordingly, the higher field strength of Co²⁺ compared to that of Ca²⁺ is expected to strengthen the glass network. In contrast, four-fold coordinated cobalt is expected to weaken the network by connecting fewer fragments of the phosphate glass network than six-fold coordinated cobalt. These results indicate that the structural properties of the glasses with constant basicity are influenced by the coordination number of Co²⁺.

Biological Evaluation of Zinc Phosphate Cement for Potential Bone Contact Applications

Zinc phosphate cement is used in dentistry to lute crowns and bridges. So far, its biocompatibility for other applications has not been studied. This paper reports the biocompatibility of zinc phosphate towards MG63 cells, testing both the material (discs; 3 mm diameter × 1 mm thick) and leachate from the cement. Cell viability was determined using an MTT assay, and cytotoxicity from the effects of leachate, studied in triplicate. Microscopy (optical and scanning electron) determined the morphology and proliferation of cells attached to zinc phosphate. ICP-OES measured element release into leachate, and anti-microbial behaviour was determined against Streptococcus pyrogenes cultured on a Brain Heart Infusion agar using cement discs (3 mm diameter × 1 mm thick). Zones of inhibition were measured after 72 h. MG63 cells proliferated on zinc phosphate surfaces and retained their morphology. The cells were healthy and viable as shown by an MTT assay, both on cement and in leachate. High levels of phosphorus but low levels of zinc were released into leachate. The cement showed minimal antimicrobial activity against S. pyogenes, probably due to the long maturation times used. Zinc phosphate cement was found to be biocompatible towards MG63 cells, which indicates that it may be capable of use in bone contact applications.

Microstructure and Defect-Based Fatigue Mechanism Evaluation of Brazed Coaxial Ti/Al2O3 Joints for Enhanced Endoprosthesis Design

Alumina-based ceramic hip endoprosthesis heads have excellent tribological properties, such as low wear rates. However, stress peaks can occur at the point of contact with the prosthesis stem, increasing the probability of fracture. This risk should be minimized, especially for younger and active patients. Metal elevations at the stem taper after revision surgery without removal of a well-fixed stem are also known to increase the risk of fracture. A solution that also eliminates the need for an adapter sleeve could be a fixed titanium insert in the ceramic ball head, which would be suitable as a damping element to reduce the occurrence of stress peaks. A viable method for producing such a permanent titanium–ceramic joint is brazing. Therefore, a brazing method was developed for coaxial samples, and two modifications were made to the ceramic surface to braze a joint that could withstand high cyclic loading. This cyclic loading was applied in multiple amplitude tests in a self-developed test setup, followed by fractographic studies. Computed tomography and microstructural analyses—such as energy dispersive X-ray spectroscopy—were also used to characterize the process–structure–property relationships. It was found that the cyclic loading capacity can be significantly increased by modification of the surface structure of the ceramic.

Multifarious applications of bioactive glasses in soft tissue engineering

Tissue engineering (TE), a new paradigm in regenerative medicine, repairs and restores the diseased or damaged tissues and eliminates drawbacks associated with autografts and allografts. In this context, many biomaterials have been developed for regenerating tissues and are considered revolutionary in TE due to their flexibility, biocompatibility, and biodegradability. One such well-documented biomaterial is bioactive glasses (BGs), known for their osteoconductive and osteogenic potential and their abundant orthopedic and dental clinical applications. However, in the last few decades, the soft tissue regenerative potential of BGs has demonstrated great promise. Therefore, this review comprehensively covers the biological application of BGs in the repair and regeneration of tissues outside the skeleton system. BGs promote neovascularization, which is crucial to encourage host tissue integration with the implanted construct, making them suitable biomaterial scaffolds for TE. Moreover, they heal acute and chronic wounds and also have been reported to restore the injured superficial intestinal mucosa, aiding in gastroduodenal regeneration. In addition, BGs promote regeneration of the tissues with minimal renewal capacity like the heart and lungs. Besides, the peripheral nerve and musculoskeletal reparative properties of BGs are also reported. These results show promising soft tissue regenerative potential of BGs under preclinical settings without posing significant adverse effects. Albeit, there is limited bench-to-bedside clinical translation of elucidative research on BGs as they require rigorous pharmacological evaluations using standardized animal models for assessing biomolecular downstream pathways.

Bioactive glass: A multifunctional delivery system

Bioactive glasses (BAGs) were invented five decades ago and have been widely used clinically in orthopedic and stomatology. However, in the past two decades, BAGs have been explored immensely by several researchers worldwide as a multifunctional delivery system for a multitude of therapeutics ranging from metal ions to small molecules (e.g., drugs) and macromolecules (e.g., DNA). The impetus for devising a BAG-based delivery system in the 21st century is based upon the facilitative properties it offers for entrapment of a wide range of therapeutic molecules and the tailorable controlled release kinetics to the target tissue site along with the biological activity of the ionic dissolution products in several pathological conditions such as osteoporosis, cancer, infection, and inflammation. This review comprises two parts: the first part discusses the need for a new delivery system and how the journey from melt quench progressed towards template-based sol-gel mesoporous. In the second part, we have comprehended the scientific advancements made so far, emphasizing BAGs as a delivery system ranging from therapeutic ions to phytopharmaceuticals. We have also highlighted a few loopholes that have prevented bench-to-bedside clinical translation of a plethora of elucidative researches done so far.

Characterisation of osteogenic and vascular responses of hMSCs to Ti-Co doped phosphate glass microspheres using a microfluidic perfusion platform

Using microspherical scaffolds as building blocks to repair bone defects of specific size and shape has been proposed as a tissue engineering strategy. Here, phosphate glass (PG) microcarriers doped with 5 mol % TiO₂ and either 0 mol % CoO (CoO 0%) or 2 mol % CoO (CoO 2%) were investigated for their ability to support osteogenic and vascular responses of human mesenchymal stem cells (hMSCs). Together with standard culture techniques, cell-material interactions were studied using a novel perfusion microfluidic bioreactor that enabled cell culture on microspheres, along with automated processing and screening of culture variables. While titanium doping was found to support hMSCs expansion and differentiation, as well as endothelial cell-derived vessel formation, additional doping with cobalt did not improve the functionality of the microspheres. Furthermore, the microfluidic bioreactor enabled screening of culture parameters for cell culture on microspheres that could be potentially translated to a scaled-up system for tissue-engineered bone manufacturing.

Nanotechnology for angiogenesis: opportunities and challenges

Angiogenesis plays a critical role within the human body, from the early stages of life (i.e., embryonic development) to life-threatening diseases (e.g., cancer, heart attack, stroke, wound healing). Many pharmaceutical companies have expended huge efforts on both stimulation and inhibition of angiogenesis. During the last decade, the nanotechnology revolution has made a great impact in medicine, and regulatory approvals are starting to be achieved for nanomedicines to treat a wide range of diseases. Angiogenesis therapies involve the inhibition of angiogenesis in oncology and ophthalmology, and stimulation of angiogenesis in wound healing and tissue engineering. This review aims to summarize nanotechnology-based strategies that have been explored in the broad area of angiogenesis. Lipid-based, carbon-based and polymeric nanoparticles, and a wide range of inorganic and metallic nanoparticles are covered in detail. Theranostic and imaging approaches can be facilitated by nanoparticles. Many preparations have been reported to have a bimodal effect where they stimulate angiogenesis at low dose and inhibit it at higher doses.

Transition metal-doped cryogels as bioactive materials for wound healing applications

Transition metals (TM) are essential microelements with various biological functions demanded in tissue regeneration applications. Little is known about therapeutic potential of TM within soft hydrogel biomaterials. The soluble divalent TM, such as Zn, Cu, Mn and Co, were stably incorporated into gelatin network during cryogelation. TM content in the resultant cryogels varied from 0.1 × 10³ to 11.8 × 10³ ppm, depending on the TM type and concentration in the reaction solution. Zn component was uniformly complexed with the gelatin scaffold according to elemental imaging, increasing the swelling of polymer walls and the G'/G″ values and also decreasing the size of cryogel macro-pores. Zn-doped cryogels supported migration of human skin fibroblasts (HSF); only upper Zn content of 11.8 × 10³ ppm in the scaffold caused c.a. 50% inhibition of cell growth. Zn ions solubilized in culture medium were more active towards HSF (IC₅₀ ≈ 0.3 mM). Treatment of splinted full-skin excisional wounds in rats with the Zn-doped and non-doped cryogels showed that Zn considerably promoted passing inflammatory/proliferation phases of healing process, inducing more intense dermis formation and structuration. The results show the feasibility of development of cryogel based formulations with different TM and support high phase-specific ability of the Zn-gelatin cryogels to repair acute wounds.

The Antimicrobial Efficacy of Hypoxia Mimicking Cobalt Oxide Doped Phosphate-Based Glasses against Clinically Relevant Gram Positive, Gram Negative Bacteria and a Fungal Strain

Bioactive phosphate glasses are of considerable interest for a range of soft and hard tissue engineering applications. The glasses are degradable and can release biologically important ions in a controlled manner. The glasses can also potentially be used as an antimicrobial delivery system. In the given study, novel cobalt-doped phosphate-based glasses, (P₂O₅)₅₀(Na₂O)₂₀(CaO)_30-x(CoO)_x where 0 ≤ x (mol %) ≤ 10, were manufactured and characterized. As the cobalt oxide concentration increased, the rate of dissolution was observed to decrease. The antimicrobial potential of the glasses was studied using direct and indirect contact methods against both Escherichia coli (NCTC 10538) Staphylococcus aureus (ATCC 6538) and Candida albicans (ATCC 76615). The results showed strong, time dependent, and strain specific antimicrobial activity of the glasses against microorganisms when in direct contact. Antimicrobial activity (R) ≥ 2 was observed within 2 h against Escherichia coli, whereas a similar effect was achieved in 6 h against Staphylococcus aureus and Candida albicans. However, when in indirect contact, the dissolution products from the bioactive glasses failed to show an antimicrobial effect. Following direct exposure to the glasses for 7 days, osteoblast-like SAOS-2 cells showed a 5-fold increase in VEGF mRNA while THP-1 monocytic cells showed a 4-fold increase in VEGF mRNA expression when exposed to 10% CoO-doped glass compared with the cobalt free control glass. Endothelial cells stimulated with conditioned medium taken from cell cultures of THP-1 monocytes exposed to 10% CoO doped glass showed clear tubelike structure (blood vessel) formation after 4 h.

Towards modular bone tissue engineering using Ti–Co-doped phosphate glass microspheres: cytocompatibility and dynamic culture studies

The production of large quantities of functional vascularized bone tissue ex vivo still represent an unmet clinical challenge. Microcarriers offer a potential solution to scalable manufacture of bone tissue due to their high surface area-to-volume ratio and the capacity to be assembled using a modular approach. Microcarriers made of phosphate bioactive glass doped with titanium dioxide have been previously shown to enhance proliferation of osteoblast progenitors and maturation towards functional osteoblasts. Furthemore, doping with cobalt appears to mimic hypoxic conditions that have a key role in promoting angiogenesis. This characteristic could be exploited to meet the clinical requirement of producing vascularized units of bone tissue. In the current study, the human osteosarcoma cell line MG-63 was cultured on phosphate glass microspheres doped with 5% mol titanium dioxide and different concentrations of cobalt oxide (0%, 2% and 5% mol), under static and dynamic conditions (150 and 300 rpm on an orbital shaker). Cell proliferation and the formation of aggregates of cells and microspheres were observed over a period of two weeks in all glass compositions, thus confirming the biocompatibility of the substrate and the suitability of this system for the formation of compact micro-units of tissue. At the concentrations tested, cobalt was not found to be cytotoxic and did not alter cell metabolism. On the other hand, the dynamic environment played a key role, with moderate agitation having a positive effect on cell proliferation while higher agitation resulting in impaired cell growth. Finally, in static culture assays, the capacity of cobalt doping to induce vascular endothelial growth factor (VEGF) upregulation by osteoblastic cells was observed, but was not found to increase linearly with cobalt oxide content. In conclusion, Ti–Co phosphate glasses were found to support osteoblastic cell growth and aggregate formation that is a necessary precursor to tissue formation and the upregaulation of VEGF production can potentially support vascularization.

Characterisation of CorGlaes(®) Pure 107 fibres for biomedical applications

A degradable ultraphosphate (55 mol % P2O5) quinternary phosphate glass composition has been characterised in terms of its chemical, mechanical and degradation properties both as a bulk material and after drawing into fibres. This glass formulation displayed a large processing window simplifying fibre drawing. The fibres displayed stiffness and strength of 65.5 ± 20.8 GPa and 426±143 MPa. While amorphous discs of the glass displayed a linear dissolution rate of 0.004 mg cm(-2) h(-1) at 37 °C, in a static solution with a reduction in media pH. Once drawn into fibres, the dissolution process dropped the pH to <2 in distilled water, phosphate buffer saline and corrected-simulated body fluid, displaying an autocatalytic effect with >90 % mass loss in 4 days, about seven times faster than anticipated for this solution rate. Only cell culture media was able to buffer the pH taking over a week for full fibre dissolution, however, still four times faster dissolution rate than as a bulk material. However, at early times the development of a HCA layer was seen indicating potential bioactivity. Thus, although initial analysis indicated potential orthopaedic implant applications, autocatalysis leads to accelerating degradation in vitro.

Bioactive and biocompatible copper containing glass-ceramics with remarkable antibacterial properties and high cell viability designed for future in vivo trials

The efficiency of 60SiO₂·(32 − x) CaO·8P₂O₅·xCuO (mol%) glass-ceramics were proved, and was determined the most appropriate composition for further in vivo trials.

Strontium- and calcium-containing, titanium-stabilised phosphate-based glasses with prolonged degradation for orthopaedic tissue engineering

Strontium- and calcium-releasing, titanium-stabilised phosphate-based glasses with a controlled degradation rate are currently under development for orthopaedic tissue engineering applications. Ca and/or Sr were incorporated at varying concentrations in quaternary phosphate-based glasses, in order to promote osteoinduction. Ti was incorporated at a fixed concentration in order to prolong degradation. Glasses of the general formula (P₂O₅)–(Na₂O)–(TiO₂)–(CaO)–(SrO) were prepared via the melt-quench technique. The materials were characterised by energy-dispersive X-ray spectroscopy, X-ray diffraction, ³¹P magic angle spinning nuclear magnetic resonance, Fourier transform infrared spectroscopy, differential thermal analysis and density determination. The dissolution rate in distilled water was determined by measuring mass loss, ion release and pH change over a two-week period. In addition, the cytocompatibility and alkaline phosphatase activity of an osteoblast-like cell line cultured on the surface of glass discs was assessed. The glasses were shown to be amorphous and contained Q¹, Q² and Q³ species. Fourier transform infrared spectroscopy revealed small changes in the glass structure as Ca was substituted with Sr and differential thermal analysis confirmed a decrease in crystallisation temperature with increasing Sr content. Degradation and ion release studies also showed that mass loss was positively correlated with Sr content. These results were attributed to the lower electronegativity of Sr in comparison to Ca favouring the formation of phosphate-based mineral phases. All compositions supported cell proliferation and survival and induced at least 2.3-fold alkaline phosphatase activity relative to the control. Glass containing 17.5 mol% Sr had 3.6-fold greater alkaline phosphatase activity than the control. The gradual release of Ca and Sr supported osteoinduction, indicating their potential suitability in orthopaedic tissue engineering applications.

Novel Co-akermanite (Ca2CoSi2O7) bioceramics with the activity to stimulate osteogenesis and angiogenesis

Both osteogenesis and angiogenesis of bioactive materials play the vital role in the regeneration of large skeletal defects.

Engineering muscle constructs for the creation of functional engineered musculoskeletal tissue

Volumetric muscle loss (VML) is a disabling condition in which current clinical procedures are suboptimal. The field of tissue engineering has many promising strategies for the creation of functional skeletal muscle in vitro. However, there are still two key limitations that prevent it from becoming a solution for treating VML. First, engineered muscle tissue must be biocompatible to facilitate muscle tissue regrowth without generating an immune response. Second, engineered muscle constructs must be scaled up to facilitate replacement of clinically relevant volumes of tissue (centimeters in diameter). There are currently no tissue engineering strategies to produce tissue constructs that are both biocompatible and large enough to facilitate clinical repair. However, recent advances in tissue engineering using synthetic scaffolds, native scaffolds, or scaffold-free approaches may lead to a solution for repair of VML injuries.