Calcium orthophosphate deposits: Preparation, properties and biomedical applications

Exploring the physicochemical traits, antifungal capabilities, and 3D spatial complexity of hydroxyapatite with Ag+Mg2+ substitution in the biocomposite thin films

The silver/magnesium doped hydroxyapatite (AgMgHAp, Ca10-x-yAgxMgy(PO4)6(OH)2, xAg=0.05 and yMg=0.02) nanocomposites coatings were deposited on Si substrate using the dip coating technique. The resulting coatings were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), Fourier transform infrared (FTIR-ATR) spectroscopy, atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). The EDS analysis highlighted the presence of the constitutive elements of the silver/magnesium doped hydroxyapatite (AgMgHAp) nanocomposites coatings. The surface microtexture of the AgMgHAp was assessed by atomic force microscopy (AFM) technique. The AFM data suggested the obtaining of a uniform deposited layer comprised of equally distributed nanoconglomerates. FT-IR studies highlighted the presence of vibrational modes associated with the phosphate and hydroxyl groups. No bands associated with silver or magnesium were observed. The XPS analysis highlighted the presence of the constituent elements of hydroxyapatite (Ca 2p, P 2 s, O 1 s), as well as dopants (Ag 3d, Mg 1 s and Mg 2p). The antifungal evaluation of AgMgHAp coatings was carried out using the Candida albicans ATCC 10231 fungal strain. The results of the antifungal assay revealed that the AgMgHAp coatings exhibited a strong inhibitory antifungal activity. Furthermore, the data highlighted that the AgMgHAp inhibited the development of biofilm on their surface. The results revealed that the antifungal activity of the coating varied based on the duration of incubation. On the other hand, the data also showed that AgMgHAp nanocomposites coatings inhibited the fungal cell adhesion and development from the early stages of the incubation. In addition to morphological analysis, we additionally take advantage of AFM images to investigate and explore the domain of fractal and multifractal analysis applied to the films under evaluation. Our studies indicates that nanocomposite coatings made from AgMgHAp demonstrate strong antifungal properties. Our studies indicates that nanocomposite coatings made from AgMgHAp demonstrate strong antifungal properties. These results suggest the potential of AgMgHAp nanocomposite coatings as a promising solution for developing innovative antifungal devices in biomedical applications.

Functionalization of the NiTi Shape Memory Alloy Surface through Innovative Hydroxyapatite/Ag-TiO2 Hybrid Coatings

The objective of this research was to develop a surface modification for the NiTi shape memory alloy, thereby enabling its long-term application in implant medicine. This was achieved through the creation of innovative multifunctional hybrid layers comprising a nanometric molecular system of silver-rutile (Ag-TiO2), known for its antibacterial properties, in conjunction with bioactive submicro- and nanosized hydroxyapatite (HAp). The multifunctional, continuous, crack-free coatings were produced using the electrophoretic deposition method (EPD) at 20 V/1 min. Structural and morphological analyses through Raman spectrometry and scanning electron microscopy (SEM) provided comprehensive insights into the obtained coating. The silver within the layer existed in the form of nanometric silver carbonates (Ag2CO3) and metallic nanosilver. Based on DTA/TG results, dilatometric measurements, and high-temperature microscopy, the heat treatment temperature for the deposited layers was set at 800 °C for 2 h. The procedures applied resulted in the creation of a new generation of materials with a distinct structure compared with the initial nanopowders. The resulting composite layer, measuring 2 μm in thickness, comprised hydroxyapatite (HAp), apatite carbonate (CHAp), metallic silver, silver oxides, Ag@C, and rutile exhibiting a defective structure. This structural characteristic contributes significantly to its heightened activity, influencing both bioactivity and biocompatibility properties.

Porous scaffold hydroxyapatite from sand lobster shells (Panulirus homarus) using polyethylene oxide/chitosan as polymeric porogen for bone tissue engineering

The hydroxyapatite (HAp; Ca10 (PO4 )6 (OH)2 )) has good biocompatibility, bioactivity, and osteoconductivity as a bone implant because the main inorganic mineral of human bone is HAp. The use of scaffold HAp from biogenic resources that contain high calcium and polymer as a pore forming agent to support bone growth is a longstanding area of interest. In this study, porous scaffolds based on HAp were synthesized from sand lobster (SL; Panulirus homarus) shells as a source of calcium using the porogen leaching method with polyethylene oxide (PEO) and chitosan (Chs) as polymeric porogen. The present study aims to synthesize HAp derived from SL shells and evaluate the effect variations of PEO on the physicochemical properties of the scaffold and cytotoxicity in cell viability assay. Briefly, the SL shell powder was calcinated with temperature variations of 600°C, 800°C, and 1000°C for 6 h. Based on the characterization, it was shown that 1000°C was the optimum calcination temperature for SL shells to synthesize HAp using the precipitation method. The characterization results of HAp using energy dispersive x-ray (EDX) revealed that the molar ratio of Ca/P was 1.67. The Fourier transform infrared (FTIR) and x-ray diffractometer (XRD) spectral patterns indicated that HAp had been successfully synthesized with minor β-tricalcium phosphate (β-TCP), a calcium phosphate with high biocompatibility. Porous scaffolds were synthesized by varying the concentration of PEO at 0, 5, 10, and 15 wt %. Physicochemical analysis revealed that a higher concentration of PEO affected decreased crystallinity and compressive strength, but on the other hand, the porosity and pore sizes increased. Based on the physicochemical analysis, the synthesized porous scaffold showed that HAp/PEO/Chs 15 wt % had the most potential as a scaffold for biomedical applications. MTT Assay, after 24 h incubation, revealed that the scaffold was safe for use at low concentrations on the MC3T3E1 osteoblast cells, with a percentage of cell viability of 83.23 ± 3.18% at 23.4375 μg/mL. Although the cell viability decreased at higher concentrations, the HAp/PEO/Chs 15 wt % scaffold was cytocompatible with the cells. Thus, in the present study, HAp/PEO/Chs 15 wt % was the best scaffold based on pore structure, chemical composition, mechanical and crystalographic properties and cell viability.

Bioactivity properties of hydroxyapatite/clay nanocomposites

The need for bioactive and non-toxic biomaterials is on a high demand in tissue engineering applications nowadays. Hydroxyapatite (HAp) is the chief constituent of teeth and bones in mammas. One of the major challenges with the use of HAp in engineering application is its brittleness and to overcome this, it's important to react it with a material that can enhanced it's fragility. To this end, HAp and HAp/clay nanocomposites were developed via wet chemical process to mimic natural HAp and to equally confer special properties such as mechanical properties, high surface area, crystallinity, high porosity, and biocompatibility on the biomaterial. The functional groups properties of the as-prepared nanocomposites analyzed by FT-IR showed that the HAp and clay posed reactive centers such as Al-Al-OH, Si-Si-OH, Si-O, PO43-, -OH, and Si-O-Al. The XRD results confirmed the formation of HAp/clay nanocomposite, while SEM and TEM images showed the morphologies of the prepared nanocomposites to be round shape particles. Besides, EDX result revealed the Ca/P ratio of HAp and HAp-C to be lower than that of stoichiometric ratio (1.67) which implies the presence of K, Na, Ca, Mg, Si and Al in the HAp/clay nanocomposite. The mechanical properties of the apatite were greatly enhanced by the addition of clay. The physiological behaviour of the fabricated apatite composites in saline solution showed steady increase in the values of the saline pH of the various biomolecules until day 5 and became fairly constant at day 7 with pH range of 7.30-7.38. Though the saline solution was acidic at the beginning due to dissolved carbon dioxide, the pH of the saline solution containing the nanocomposites gradually became neutral and fairly alkaline over time as a result of the presence of Lewis basis structures in the composites which helps in neutralizing the acidic solution. Furthermore, proliferation of apatites particles onto the surface of the nanocomposites was observed after treatment with simulated body fluids (SBF) media for 7 days. Thus, HAp/clay nanocomposites can be useful biomaterials in bone tissue engineering.

Effect of Magnesium Substitution on Structural Features and Properties of Hydroxyapatite

Hydroxyapatite (HAP) is the main mineral component of bones and teeth. It is widely used in medicine as a bone filler and coating for implants to promote new bone growth. Ion substitutions into the HAP structure highly affect its properties. One of the most important substituents is magnesium. This paper presents new results obtained using high-precision hybrid density functional theory calculations for Mg/Ca substitutions in HAP in a wide magnesium concentration range within a 2 × 2 × 2 supercell model. Experimental data on the mechanochemical synthesis of HAP-Mg samples with different Mg concentrations are also presented. A comparison between the experiment and the theory showed good agreement: the HAP-Mg unit cell parameters and volume decreased with increasing degree of Mg/Ca substitution. The changes in the distances between the Ca and O, Ca and H, and Mg and O ions upon Mg/Ca substitution in different calcium positions was analyzed. The resulting asymmetry and distortion of the cell parameters were evaluated. It was shown that bulk modulus, energy levels, and band gap depend on the degree of Mg substitutions in the Ca1 and Ca2 positions. The formation energies of Mg/Ca substitutions showed non-monotonic behavior that was different for Ca1 and Ca2 positions. The Ca2 position had a slightly higher probability (~5 meV/f.u.) of substitution than Ca1 position at a Mg concentration x = 0.5. At x = 1, substitution in both positions can coexist. The simulated IR spectra for different Mg/Ca substitutions showed that Mg in the Ca2 position changes the IR spectrum more significantly than Mg in the Ca1 position. Similar changes were recorded in the IR spectra of the synthesized samples. The electronic structure is shown to be sensitive to the number and position of substitutions, which may be used to tweak the optical properties of the HAP-Mg material.

An overview of translational research in bone graft biomaterials

Natural bone healing is often inadequate to treat fractures with critical size bone defects and massive bone loss. Immediate surgical interventions through bone grafts have been found to be essential on such occasions. Naturally harvested bone grafts, although are the preferred choice of the surgeons; they suffer from serious clinical limitations, including disease transmission, donor site morbidity, limited supply of graft etc. Synthetic bone grafts, on the other hand, offer a more clinically appealing approach to decode the pathways of bone repair through use of tissue engineered biomaterials. This article critically retrospects the translational research on various engineered biomaterials towards bringing transformative changes in orthopaedic healthcare. The first section of the article discusses about composition and ultrastructure of bone along with the global perspectives on statistical escalation of bone fracture surgeries requiring use of bone grafts. The next section reviews the types, benefits and challenges of various natural and synthetic bone grafts. An overview of clinically relevant biomaterials from traditionally used metallic, bioceramic, and biopolymeric biomaterials to new generation composites have been summarised. Finally, this narrative review concludes with the discussion on the emerging trends and future perspectives of the promising bone grafts.

Functionalization of the Implant Surface Made of NiTi Shape Memory Alloy

To functionalize and improve the biocompatibility of the surface of a medical implant made of NiTi shape memory alloy and used in practice, a clamp, multifunctional layers composed of amorphous TiO₂ interlayer, and a hydroxyapatite coating were produced. Electrophoresis, as an efficient method of surface modification, resulted in the formation of a uniform coating under a voltage of 60 V and deposition time of 30 s over the entire volume of the implant. The applied heat treatment (800 °C/2 h) let toa dense, crack-free, well-adhered HAp coating with a thickness of ca. 1.5 μm. and a high crack resistance to deformation associated with the induction of the shape memory effect in the in the deformation range similar to the real implant work after implantation. Moreover, the obtained coating featured a hydrophilic (CA = 59.4 ± 0.3°) and high biocompatibility.

Zinc- and Copper-Doped Mesoporous Borate Bioactive Glasses: Promising Additives for Potential Use in Skin Wound Healing Applications

In this study, zinc (Zn)- and copper (Cu)-doped 13-93B3 borate mesoporous bioactive glasses (MBGs) were successfully synthesized using nitrate precursors in the presence of Pluronic P123. We benefited from computational approaches for predicting and confirming the experimental findings. The changes in the dynamic surface tension (SFT) of simulated body fluid (SBF) were investigated using the Du Noüy ring method to shed light on the mineralization process of hydroxyapatite (HAp) on the glass surface. The obtained MBGs were in a glassy state before incubation in SBF. The formation of an apatite-like layer on the SBF-incubated borate glasses was investigated by X-ray diffraction (XRD) and scanning electron microscopy (SEM). The incorporation of Zn and Cu into the basic composition of 13-93B3 glass led to changes in the glass transition temperature (Tg) (773 to 556 °C), particle size (373 to 64 nm), zeta potential (−12 to −26 mV), and specific surface area (SBET) (54 to 123 m2/g). Based on the K-means algorithm and chi-square automatic interaction detection (CHAID) tree, we found that the SFT of SBF is an important factor for the prediction and confirmation of the HAp mineralization process on the glasses. Furthermore, we proposed a simple calculation, based on SFT variation, to quantify the bioactivity of MBGs. The doped and dopant-free borate MBGs could enhance the proliferation of mouse fibroblast L929 cells at a concentration of 0.5 mg/mL. These glasses also induced very low hemolysis (<5%), confirming good compatibility with red blood cells. The results of the antibacterial test revealed that all the samples could significantly decrease the viability of Pseudomonas aeruginosa. In summary, we showed that Cu-/Zn-doped borate MBGs can be fabricated using a cost-effective method and also show promise for wound healing/skin tissue engineering applications, as especially supported by the cell test with fibroblasts, good compatibility with blood, and antibacterial properties.

Titanium Membranes with Hydroxyapatite/Titania Bioactive Ceramic Coatings: Characterization and In Vivo Biocompatibility Testing

Titanium membranes and meshes are used for the repair of trauma, tumors, and hernia in dentistry and maxillofacial and abdominal surgery. But such membranes demonstrate the limited effectiveness of integration in recipients due to their bioinertness. In this study, we prepared titania oxide (by microarc oxidation) and/or HAp (by electrophoresis deposition) coatings with alginate soaking. We used annealing at 700 °C for 2.5 h for HAp crystallinity increasing with achievement of an acceptable Ca²⁺ release rate. The feedstock HAp and prepared coatings were characterized by X-ray diffraction, IR spectroscopy, electron and optical confocal microscopy, and thermal analysis, as well as the in vitro study of solubility in saline and in vivo tests with the animal model of subcutaneous implantation (with Wistar rats). Biocompatible compounds were found for all deposited coatings. We noted that the best biological response was detected for the annealed Ca-P/TiO₂ bilayer with alginate binding. In this case, the coating crystallinity was ≈40.5-50.0%. The Ca²⁺ release rate was 2.042 ± 0.058%/mm² at 168 h after immersion in saline. Thin and mature tissue capsules with minimal inflammation and vascularization were found in histological sections. We did not detect any unwanted responses around the implants, including inflammation infiltration, suppuration, bacterial infections, tissue lyses, and, finally, implant rejection. This information is expected to be useful for understanding the properties of bioactive ceramic coatings and improving the quality of medical care in dentistry and maxillofacial surgery and other applications of titanium membranes in medicine.

Advanced Biomaterials and Coatings

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Electrodeposition of Calcium Phosphate Coatings on Metallic Substrates for Bone Implant Applications: A Review

This review summaries more than three decades of scientific knowledge on electrodeposition of calcium phosphate coatings. This low-temperature process aims to make the surface of metallic bone implants bioactive within a physiological environment. The first part of the review describes the reaction mechanisms that lead to the synthesis of a bioactive coating. Electrodeposition occurs in three consecutive steps that involve electrochemical reactions, pH modification, and precipitation of the calcium phosphate coating. However, the process also produces undesired dihydrogen bubbles during the deposition because of the reduction of water, the solvent of the electrolyte solution. To prevent the production of large amounts of dihydrogen bubbles, the current density value is limited during deposition. To circumvent this issue, the use of pulsed current has been proposed in recent years to replace the traditional direct current. Thanks to breaking times, dihydrogen bubbles can regularly escape from the surface of the implant, and the deposition of the calcium phosphate coating is less disturbed by the accumulation of bubbles. In addition, the pulsed current has a positive impact on the chemical composition, morphology, roughness, and mechanical properties of the electrodeposited calcium phosphate coating. Finally, the review describes one of the most interesting properties of electrodeposition, i.e., the possibility of adding ionic substituents to the calcium phosphate crystal lattice to improve the biological performance of the bone implant. Several cations and anions are reviewed from the scientific literature with a description of their biological impact on the physiological environment.

In vivo evaluation of bone regeneration behavior of novel β-tricalcium phosphate/layered double hydroxide nanocomposite granule as bone graft substitutes

This study was based on in vivo assessment of bone regeneration capacity of synthesized porous β-tricalcium phosphate (β-TCP) nanocomposite granules and aimed to explore the effects of fabricated β-TCP granules reinforced with layered double hydroxides (LDH) nanoclay compared to β-TCP granules, in terms of osteoconductivity and biodegradability. Granules with diameters of 2-3 mm were implanted into cavities drilled in rabbit distal femur and were left in situ for up to 3 months. The mechanical study demonstrated that the presence of LDH nanoparticles in β-TCP granules resulted in a significant increase in compressive modulus from 174.4 to 231.4 MPa, while the porosity was constant at 76%-80%. The results revealed that the obtained granules showed no cytotoxicity. In this study, x-ray radiographic, micro-computed tomography, and histological staining analysis were taken to evaluate the percentage of bone ingrowth and biodegradability of the porous granules. The results exhibited that both granules support bone regeneration and also the amount of new bone formation in the bone defect filled with both granules was almost six times higher than the empty defects. Although no significant difference in bone formation for two different granules was observed, a higher biodegradability was detected in β-TCP granules in comparison to β-TCP/LDH granules. Overall, the addition of LDH nanoclay (10%) enhanced the physicochemical and mechanical properties of β-TCP granules while it is biological and osteoconductity properties have been maintained and its biodegradation rate has been decreased.

A Study of Thermal Stability of Hydroxyapatite

High-temperature powder sintering is an integral part of the dense ceramic manufacturing process. In order to find the optimal conditions for producing a ceramic product, the information about its behavior at high temperatures is required. However, the data available in the literature are very contradictory. In this work, the thermal stability of hydroxyapatite prepared by a solid-state mechanochemical method and structural changes occurring during sintering were studied. Stoichiometric hydroxyapatite was found to remain as a single-phase apatite structure with the space group P63/m up to 1300 °C inclusively. A further increase in the sintering temperature leads to its partial decomposition, a decrease in the crystallite size of the apatite phase, and the appearance of significant structural strains. It was shown that small deviations from stoichiometry in the Ca/P ratio upward or downward during the hydroxyapatite synthesis lead to a significant decrease in the thermal stability of hydroxyapatite. An apatite containing almost no hydroxyl groups, which is close to the composition of oxyapatite, was prepared. It was shown that the congruent melting of stoichiometric hydroxyapatite upon slow heating in a high-temperature furnace does not occur. At the same time, the fast heating of hydroxyapatite by laser radiation allows, under certain conditions, its congruent melting with the formation of a recrystallized monolayer of oxyhydroxyapatite. The data obtained in this study can be used when choosing sintering conditions to produce hydroxyapatite-based ceramics.

Synthetic amorphous calcium phosphates (ACPs): preparation, structure, properties, and biomedical applications

Amorphous calcium phosphates (ACPs) represent a metastable amorphous state of other calcium orthophosphates (abbreviated as CaPO₄) possessing variable compositional but rather identical glass-like physical properties, in which there are neither translational nor orientational long-range orders of the atomic positions. In nature, ACPs of a biological origin are found in the calcified tissues of mammals, some parts of primitive organisms, as well as in the mammalian milk. Manmade ACPs can be synthesized in a laboratory by various methods including wet-chemical precipitation, in which they are the first solid phases, precipitated after a rapid mixing of aqueous solutions containing dissolved ions of Ca²⁺ and PO₄^3- in sufficient amounts. Due to the amorphous nature, all types of synthetic ACPs appear to be thermodynamically unstable and, unless stored in dry conditions or doped by stabilizers, they tend to transform spontaneously to crystalline CaPO₄, mainly to ones with an apatitic structure. This intrinsic metastability of the ACPs is of a great biological relevance. In particular, the initiating role that metastable ACPs play in matrix vesicle biomineralization raises their importance from a mere laboratory curiosity to that of a reasonable key intermediate in skeletal calcifications. In addition, synthetic ACPs appear to be very promising biomaterials both for manufacturing artificial bone grafts and for dental applications. In this review, the current knowledge on the occurrence, structural design, chemical composition, preparation, properties, and biomedical applications of the synthetic ACPs have been summarized.

Detonation Spraying of Hydroxyapatite on a Titanium Alloy Implant

Hydroxyapatite (HA), the major mineral component of tooth enamel and natural bones, is a good candidate for bone tissue engineering. Synthetic HA is used for making coatings on metallic implants intended for medical applications. A HA coating renders the implant biocompatible and osteoinductive. In addition, it improves fixation and the overall performance of the implanted object. In the present work, HA coatings were deposited on a medical titanium alloy implant with mesh geometry and a developed surface by detonation spraying. The feedstock powder was HA obtained by the dry mechanochemical method. Single-phase HA coatings were obtained. The coatings were formed not only on the surfaces normal to the particle flow direction, but also on the sides of the mesh elements. Despite partial melting of the powder, no decomposition of HA occurred. This work demonstrates the prospects of detonation spraying for the production of HA coatings on metallic implants with complex geometries.

Comparison of Biocompatible Coatings Produced by Plasma Electrolytic Oxidation on cp-Ti and Ti-Zr-Nb Superelastic Alloy

The paper compares the coatings produced by plasma electrolytic oxidation (PEO) on commercially pure titanium and a novel superelastic alloy Ti-18Zr-15Nb (at. %) for implant applications. The PEO coatings were produced on both alloys in the identical pulsed bipolar regime. The properties of the coatings were examined using scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDX), potentiodynamic polarization (PDP), and electrochemical impedance spectroscopy (EIS). The PEO process kinetics was modeled based on the Avrami theorem and Cottrell equation using a relaxation method. The resultant coatings contain TiO2, for both alloys, and NbO2, Nb2O5, ZrO2 for Ti-18Zr-15Nb alloy. The coating on the Ti-18Zr-15Nb alloy has a higher thickness, porosity, and roughness compared to that on cp-Ti. The values of the kinetic coefficients of the PEO process—higher diffusion coefficient and lower time constant for the processing of Ti-18Zr-15Nb—explain this effect. According to the electrochemical studies, PEO coatings on Ti-18Zr-15Nb alloy provide better corrosion protection. Higher corrosion resistance, porosity, and roughness contribute to better biocompatibility of the PEO coating on Ti-18Zr-15Nb alloy compared to cp-Ti.

Fabrication and Evaluation of Layered Double Hydroxide-Enriched ß-Tricalcium Phosphate Nanocomposite Granules for Bone Regeneration: In Vitro Study

One of the most important challenges facing tissue engineering researches is the scaffold design with optimum physical and mechanical properties for growth and proliferation of cells, and tissue formation. The aim of this study was to produce a novel nanocomposite containing β-tricalcium phosphate and layered double hydroxide (β-TCP-LDH) and analyzing the capacity of its osteogenic activity in vitro. In this paper, β-tricalcium phosphate and layered double hydroxide powders were synthesized by co-precipitation processes. Then, the porous nanocomposite granules were prepared by the polyurethane sponge replication method. In this study, four kinds of β-TCP granules containing LDHs nanoparticles (ranging from 0.1 to 10 wt%) have been prepared. X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDX) analyses were selected to study the phase structure, morphology, and phase distribution, respectively. Physicochemical characterizations demonstrated that the granules were synthesized successfully. Interconnected macro pores ranging over 200-500 μm were observed for all kinds of granules. SEM micrographs showed that human mesenchymal stem cells (hMSCs) were attached to the surfaces of the granules and proliferated in good shape. The results warranted that the synthesized granules exhibited good biocompatibility and mineralization. Based on the results of compressive strength and porosity tests, the most suitable type of granule is β-TCP/LDH 10 wt% with 77% porosity and compressive modulus of 231.4 MPa, which can be utilized in bone tissue engineering. To our knowledge, layered double hydroxides have not previously been incorporated into tricalcium phosphate granules for bone grafting. Also, this study is the first report on the effects of LDH on the mechanical properties and porosity of β-TCP granules. Our results demonstrated that β-TCP/LDH nanocomposite granule has a great potential for bone defects regeneration and tissue engineering applications.

Customized additive manufacturing of porous Ti6Al4V scaffold with micro-topological structures to regulate cell behavior in bone tissue engineering

Scaffold micro-topological structure plays an important role in the regulation of cell behavior in bone tissue engineering. This paper investigated the effect of 3D printing parameters on the scaffold micro-topological structure and its subsequent cell behaviors. By setting of different 3D printing parameters, i.e., the 3D printing laser power, the scanning interval and the thickness of sliced layers, the highest resolution up to 20 μm can be precisely fabricated. Scaffolds' characterization results indicated that the laser power affected the forming quality of melt tracks, the scanning interval distance determined the size of regularly arranged pores, and the thickness of sliced layers affected the morphological and structural characteristics. By regulating of these printing parameters, customized porous Ti6Al4V scaffold with varied hierarchical micro-topological structure can be obtained. In vitro cell culturing results showed that the regular porous micro-topological structure of scaffolds with the aperture close to cell size was more suitable for cell proliferation and adhesion. The overall distribution of cells on regular porous scaffolds was similar to the orderly arrangement of cultivated crops in the field. The findings suggested that customization of the scaffold provided an effective way to regulate cellular behavior and biological properties.

Key Properties of a Bioactive Ag-SiO2/TiO2 Coating on NiTi Shape Memory Alloy as Necessary at the Development of a New Class of Biomedical Materials

Recent years have seen the dynamic development of methods for functionalizing the surface of implants using biomaterials that can mimic the physical and mechanical nature of native tissue, prevent the formation of bacterial biofilm, promote osteoconduction, and have the ability to sustain cell proliferation. One of the concepts for achieving this goal, which is presented in this work, is to functionalize the surface of NiTi shape memory alloy by an atypical glass-like nanocomposite that consists of SiO2-TiO2 with silver nanoparticles. However, determining the potential medical uses of bio(nano)coating prepared in this way requires an analysis of its surface roughness, tribology, or wettability, especially in the context of the commonly used reference coat-forming hydroxyapatite (HAp). According to our results, the surface roughness ranged between (112 ± 3) nm (Ag-SiO2)-(141 ± 5) nm (HAp), the water contact angle was in the range (74.8 ± 1.6)° (Ag-SiO2)-(70.6 ± 1.2)° (HAp), while the surface free energy was in the range of 45.4 mJ/m2 (Ag-SiO2)-46.8 mJ/m2 (HAp). The adhesive force and friction coefficient were determined to be 1.04 (Ag-SiO2)-1.14 (HAp) and 0.247 ± 0.012 (Ag-SiO2) and 0.397 ± 0.034 (HAp), respectively. The chemical data showed that the release of the metal, mainly Ni from the covered NiTi substrate or Ag from Ag-SiO2 coating had a negligible effect. It was revealed that the NiTi alloy that was coated with Ag-SiO2 did not favor the formation of E. coli or S. aureus biofilm compared to the HAp-coated alloy. Moreover, both approaches to surface functionalization indicated good viability of the normal human dermal fibroblast and osteoblast cells and confirmed the high osteoconductive features of the biomaterial. The similarities of both types of coat-forming materials indicate an excellent potential of the silver-silica composite as a new material for the functionalization of the surface of a biomaterial and the development of a new type of functionalized implants.

Self-Assembled Type I Collagen-Apatite Fibers with Varying Mineralization Extent and Luminescent Terbium Promote Osteogenic Differentiation of Mesenchymal Stem Cells

This work explores in depth the simultaneous self-assembly and mineralization of type I collagen by a base-acid neutralization technique to prepare biomimetic collagen-apatite fibrils with varying mineralization extent and doped with luminescent bactericidal Tb³⁺ ions. Two variants of the method are tested: base-acid titration, a solution of Ca(OH)₂ is added dropwise to a stirred solution containing type I collagen dispersed in H₃ PO₄ ; and direct mixing, the Ca(OH)₂ solution is added by fast dripping onto the acidic solution. Only the direct mixing variant yielded an effective control of calcium phosphate polymorphism. Luminescence spectroscopy reveals the long luminescence lifetime and high relative luminescence intensity of the Tb³⁺ -doped materials, while two-photon confocal fluorescence microscopy shows the characteristic green fluorescence light when using excitation wavelength of 458 nm, which is not harmful to bone tissue. Cytotoxicity/viability tests reveal that direct mixing samples show higher cell proliferation than titration samples. Additionally, osteogenic differentiation essays show that all mineralized fibrils promote the osteogenic differentiation, but the effect is more pronounced when using samples prepared by direct mixing, and more notably when using the Tb³⁺ -doped mineralized fibrils. Based on these findings it is concluded that the new nanocomposite is an ideal candidate for bone regenerative therapy.

Current Challenges and Innovative Developments in Hydroxyapatite-Based Coatings on Metallic Materials for Bone Implantation: A Review

Biomaterials are in use for the replacement and reconstruction of several tissues and organs as treatment and enhancement. Metallic, organic, and composites are some of the common materials currently in practice. Metallic materials contribute a big share of their mechanical strength and resistance to corrosion properties, while organic polymeric materials stand high due to their biocompatibility, biodegradability, and natural availability. To enhance the biocompatibility of these metals and alloys, coatings are frequently applied. Organic polymeric materials and ceramics are extensively utilized for this purpose due to their outstanding characteristics of biocompatibility and biodegradability. Hydroxyapatite (HAp) is the material from the ceramic class which is an ultimate candidate for coating on these metals for biomedical applications. HAp possesses similar chemical and structural characteristics to normal human bone. Due to the bioactivity and biocompatibility of HAp, it is used for bone implants for regenerating bone tissues. This review covers an extensive study of the development of HAp coatings specifically for the orthopaedic applications that include different coating techniques and the process parameters of these coating techniques. Additionally, the future direction and challenges have been also discussed briefly in this review, including the coating of HAp in combination with other calcium magnesium phosphates that occur naturally in human bone.

Facile preparation of nanostructured octacalcium phosphate coatings on micro-arc oxidized magnesium with different functionalities for bone repair application

Magnesium (Mg) has been considered as the next-generation orthopedic implant material due to its biodegradability, but high degradation rate and severe cytotoxicity hinder its clinical application. Preparing micro-arc oxidation (MAO)/octacalcium phosphate (OCP) composite coating is considered as an ideal approach to solve the problems. In this work, nanostructured OCP coatings with variable structures were prepared facilely on MAO coated Mg by chemical deposition (CD) in a simple trace PO₄^3- ion contained Ca(NO₃)₂ solution. The results show that nanostructured OCP grows and covers the MAO coating completely after CD. The morphology and thickness of OCP coating can be regulated by varying deposition time. The thinnest OCP coating with a fine structure is observed after 0.5 h of deposition, which shows the best cytocompatibility. Extending deposition time roughens the surface structure and thickens the coatings. The thickest OCP coating with a coarse structure can be obtained after 2 h of deposition, which shows the best corrosion resistance and mineralization. These results clearly indicate the functionality of the OCP coating can be easily tailored only by varying deposition time to meet different clinical requirements.

Exploring Macroporosity of Additively Manufactured Titanium Metamaterials for Bone Regeneration with Quality by Design: A Systematic Literature Review

Additive manufacturing facilitates the design of porous metal implants with detailed internal architecture. A rationally designed porous structure can provide to biocompatible titanium alloys biomimetic mechanical and biological properties for bone regeneration. However, increased porosity results in decreased material strength. The porosity and pore sizes that are ideal for porous implants are still controversial in the literature, complicating the justification of a design decision. Recently, metallic porous biomaterials have been proposed for load-bearing applications beyond surface coatings. This recent science lacks standards, but the Quality by Design (QbD) system can assist the design process in a systematic way. This study used the QbD system to explore the Quality Target Product Profile and Ideal Quality Attributes of additively manufactured titanium porous scaffolds for bone regeneration with a biomimetic approach. For this purpose, a total of 807 experimental results extracted from 50 different studies were benchmarked against proposed target values based on bone properties, governmental regulations, and scientific research relevant to bone implants. The scaffold properties such as unit cell geometry, pore size, porosity, compressive strength, and fatigue strength were studied. The results of this study may help future research to effectively direct the design process under the QbD system.

Antibacterial tooth surface created by laser-assisted pseudo-biomineralization in a supersaturated solution

A technique for implementing biocompatible and antibacterial functions to a targeted region on tooth surfaces has potential in dental treatments. We have recently demonstrated pseudo-biomineralization, i.e., the growth of an apatite layer on a human dentin substrate by a laser-assisted biomimetic (LAB) process, based on pulsed laser irradiation in a supersaturated CaP solution. In this study, pseudo-biomineralization was induced in the presence of fluoride ions using the LAB process in order to fabricate an antibacterial fluoride-incorporated apatite (FAp) layer on the dentin surface. After processing for 30 min, a micron-thick FAp layer was formed heterogeneously at the laser-irradiated solid-liquid interface via pseudo-biomineralization. A time-course study revealed that the LAB process first eliminated the pre-existing organic layer, while allowing fluoride incorporation into the dentin surface within 1 min. Within 5 min, FAp nanocrystals precipitated on the dentin surface. Within 30 min, these nanocrystals acquired a pillar-like structure that was weakly oriented in the direction normal to the substrate surface to form a dense micron-thick layer. This layer was integrated seamlessly with the underlying dentin without any apparent gaps. The FAp layer exhibited antibacterial activity against a major oral bacterium, Streptococcus mutans. The proposed LAB process is expected to be a useful new tool for tooth surface functionalization via facile and area-specific pseudo-biomineralization.

Magnesium Doped Hydroxyapatite-Based Coatings Obtained by Pulsed Galvanostatic Electrochemical Deposition with Adjustable Electrochemical Behavior

The aim of this study was to adapt the electrochemical behavior in synthetic body fluid (SBF) of hydroxyapatite-based coatings obtained by pulsed galvanostatic electrochemical deposition through addition of Mg in different concentrations. The coatings were obtained by electrochemical deposition in a typical three electrodes electrochemical cell in galvanic pulsed mode. The electrolyte was obtained by subsequently dissolving Ca(NO3)2·4H2O, NH4H2PO4, and Mg(NO3)2·6H2O in ultra-pure water and the pH value was set to 5. The morphology consists of elongated and thin ribbon-like crystals for hydroxyapatite (HAp), which after the addition of Mg became a little wider. The elemental and phase composition evidenced that HAp was successfully doped with Mg through pulsed galvanostatic electrochemical deposition. The characteristics and properties of hydroxyapatite obtained electrochemically can be controlled by adding Mg in different concentrations, thus being able to obtain materials with different properties and characteristics. In addition, the addition of Mg can lead to the control of hydroxyapatite bioactive ceramics in terms of dissolution rate.

Hydroxyapatite Surfaces Functionalized with a Self-Assembling Peptide: XPS, RAIRS and NEXAFS Study

Hydroxyapatite (HAP) coatings can improve the biocompatibility and bioactivity of titanium alloys, such as Ti6Al4V, commonly used as material for orthopedic prostheses. In this framework, we have studied the surface of HAP coatings enriched with Mg and either Si or Ti deposited by RF magnetron sputtering on Ti6Al4V. HAP coatings have been furtherly functionalized by adsorption of a self-assembling peptide (SAP) on the HAP surface, with the aim of increasing the material bioactivity. The selected SAP (peptide sequence AbuEAbuEAbuKAbuKAbuEAbuEAbuKAbuK) is a self-complementary oligopeptide able to generate extended ordered structures by self-assembling in watery solutions. Samples were prepared by incubation of the HAP coatings in SAP solutions and subsequently analyzed by X-Ray Photoelectron Spectroscopy (XPS), Fourier Transform Infrared (FTIR) and Near Edge X-Ray Absorption Fine Structure (NEXAFS) spectroscopies, in order to determine the amount of adsorbed peptide, the peptide stability and the structure of the peptide overlayer on the HAP coatings as a function of the HAP substrate and of the pH of the mother SAP solution. Experimental data yielded evidence of SAP adsorption on the HAP surface, and peptide overlayers showed ordered structure and molecular orientation. The thickness of the SAP overlayer depends on the composition of the HAP coating.

Functionalization of the NiTi Shape Memory Alloy Surface by HAp/SiO2/Ag Hybrid Coatings Formed on SiO2-TiO2 Glass Interlayer

The surface modification of NiTi shape memory alloys is a method for increasing their multi-functionalities. In our solution, hydroxyapatite powder was mixed with a chemically synthesized silicon dioxide/silver (nSiO2/Ag) nanocomposite in a different weight ratio between components (1:1, 5:1, and 10:1) and then electrophoretically deposited on the surface of the NiTi alloy, under various time and voltage conditions. Subsequently, uniform layers were subjected to heat treatment at 700 °C for 2 h in an argon atmosphere to improve the strength of their adhesion to the NiTi substrate. A change in linear dimensions of the co-deposited materials during the sintering process was also analyzed. After the heat treatment, XRD, Raman, and Scanning Electron Microscopy (SEM) + Energy Dispersive Spectrometer (EDS) studies revealed the formation of completely new composite coatings, which consisted of rutile and TiO2-SiO2 glass with silver oxide and HAp particles that were embedded into such coatings. It was found that spalling characterized the 1:1 ratio coating, while the others were crack-free, well-adhered, and capable of deformation to 3.5%. Coatings with a higher concentration of nanocomposite were rougher. Electrochemical impedance spectroscopy (EIS) tests in Ringer's solution revealed the capacitive behavior of the material with high corrosion resistance. The kinetics and susceptibility to pitting corrosion was the highest for the NiTi electrode that was coated with a 5:1 ratio HAp/nSiO2/Ag hybrid coating.

Extraction of Hydroxyapatite Nanostructures from Marine Wastes for the Fabrication of Biopolymer-Based Porous Scaffolds

Three-dimensional porous nanocomposites consisting of gelatin-carboxymethylcellulose (CMC) cross-linked by carboxylic acids biopolymers and monophasic hydroxyapatite (HA) nanostructures were fabricated by lyophilization, for soft-bone-tissue engineering. The bioactive ceramic nanostructures were prepared by a novel wet-chemical and low-temperature procedure from marine wastes containing calcium carbonates. The effect of surface-active molecules, including sodium dodecyl sulfate (SDS) and hexadecyltrimethylammonium bromide (CTAB), on the morphology of HA nanostructures is shown. It is demonstrated that highly bioactive and monophasic HA nanorods with an aspect ratio > 10 can be synthesized in the presence of SDS. In vitro studies on the bioactive biopolymer composite scaffolds with varying pore sizes, from 100 to 300 μm, determine the capacity of the developed procedure to convert marine wastes to profitable composites for tissue engineering.

Native Osseous CaP Biomineral Coating on a Biomimetic Multi-Spiked Connecting Scaffold Prototype for Cementless Resurfacing Arthroplasty Achieved by Combined Electrochemical Deposition

The multi-spiked connecting scaffold (MSC-Scaffold) prototype with spikes mimicking the interdigitations of articular subchondral bone is an essential innovation in surgically initiated fixation of resurfacing arthroplasty (RA) endoprosthesis components. This paper aimed to present a determination of the suitable range of conditions for the calcium phosphate (CaP) potentiostatic electrochemical deposition (ECD_V=const) on the MSC-Scaffold prototype spikes to achieve a biomineral coating with a native Ca/P ratio. The CaP ECD_V=const process on the MSC-Scaffold Ti4Al6V pre-prototypes was investigated for potential V_ECDfrom −9 to −3 V, and followed by 48 h immersion in a simulated body fluid. An acid–alkaline pretreatment (AAT) was applied for a portion of the pre-prototypes. Scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD) studies of deposited coatings together with coatings weight measurements were performed. Themost suitable V_ECD range, from −5.25 to −4.75 V, was determined as the native biomineral Ca/P ratio of coatings was achieved. AAT increases the weight of deposited coatings (44% for V_ECD = −5.25 V, 9% for V_ECD = −5.00 V and 15% for V_ECD = −4.75 V) and the coverage degree of the lateral spike surfaces (40% for V_ECD = −5.25 V, 14% for V_ECD = −5.00 V and 100% for V_ECD = −4.75 V). XRD confirmed that the multiphasic CaP coating containing crystalline octacalcium phosphate is produced on the lateral surface of the spikes of the MSC-Scaffold. ECD_V=const preceded by AAT prevents micro-cracks on the bone-contacting surfaces of the MSC-Scaffold prototype, increases its spikes’ lateral surface coverage, and results in the best modification effect at V_ECD = −5.00 V. To conclude, the biomimetic MSC-Scaffold prototype with desired biomineral coating of native Ca/P ratio was obtained for cementless RA endoprostheses.

Modification of titanium surface via Ag-, Sr- and Si-containing micro-arc calcium phosphate coating

The current research is devoted to the study of the modification of the titanium implants by the micro-arc oxidation with bioactive calcium phosphate coatings containing Ag or Sr and Si elements. The coatings' microstructure, phase composition, morphology, physicochemical and biological properties were examined by scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD). Ag-containing and Sr-Si-incorporated coatings were formed in alkaline and acid electrolytes, respectively. The formation of the coatings occurred at different ranges of the applied voltages, which led to the significant difference in the coatings properties. The trace elements Ag, Sr and Si participated intensively in the plasma-chemical reactions of the micro-arc coatings formation. Ag-containing coatings demonstrated strong antibacterial effect against Staphylococcus aureus AТСС 6538-P. MTT in vitro test with 3T3-L1 fibroblasts showed no cytotoxicity appearance on Sr-Si-incorporated coatings.

Functionalized calcium orthophosphates (CaPO4) and their biomedical applications

Due to the chemical similarity to natural calcified tissues (bones and teeth) of mammals, calcium orthophosphates (abbreviated as CaPO₄) appear to be good biomaterials for creation of artificial bone grafts. However, CaPO₄ alone have some restrictions, which limit their biomedical applications. Various ways have been developed to improve the properties of CaPO₄ and their functionalization is one of them. Namely, since surfaces always form the interfaces between implanted grafts and surrounding tissues, the state of CaPO₄ surfaces plays a crucial role in the survival of bone grafts. Although the biomedically relevant CaPO₄ possess the required biocompatible properties, some of their properties could be better. For example, functionalization of CaPO₄ to enhance cell attachment and cell material interactions has been developed. In addition, to prepare stable formulations from nanodimensional CaPO₄ particles and prevent them from agglomerating, the surfaces of CaPO₄ particles are often functionalized by sorption of special chemicals. Furthermore, there are functionalizations in which CaPO₄ are exposed to various types of physical treatments. This review summarizes the available knowledge on CaPO₄ functionalizations and their biomedical applications.

Laser-assisted biomineralization on human dentin for tooth surface functionalization

A technique for tooth surface modification with biocompatible calcium phosphate (CaP) has huge potential in dental applications. Recently, we achieved a facile and area-specific CaP coating on artificial materials by a laser-assisted biomimetic process (LAB process), which consists of pulsed laser irradiation in a supersaturated CaP solution. In this study, we induced the rapid biomineralization on the surface of human dentin by using the LAB process. A human dentin substrate was immersed in a supersaturated CaP solution, then its surface was irradiated with weak pulsed laser light for 30 min (LAB process). Ultrastructural analyses revealed that the pristine substrate had a demineralized collagenous layer on its surface due to the previous EDTA surface cleaning. After the LAB process, this collagenous layer disappeared and was replaced with a submicron-thick hydroxyapatite layer. We believe that the laser irradiation induced pseudo-biomineralization through the laser ablation of the collagenous layer, followed by CaP nucleation and growth at the dentin-liquid interface. The mineralized layer on the dentin substrate consisted of needle-like hydroxyapatite nanocrystals, whose c-axes were weakly oriented along the direction perpendicular to the substrate surface. This LAB process would offer a new tool enabling tooth surface modification and functionalization through the in situ pseudo-biomineralization.

Synthetic hydroxyapatite and its use in bioactive coatings

An approach to solve the limitations of autologous bone grafting procedures in bone injury treatment is to develop bioactive coatings in the implantation system. The objective of this work is to compare the temperature effect on the stability of hydroxyapatite, graphene, and collagen colloidal suspensions to be used as biocompatible and bioactive coatings on a carbon fiber composite surface. Synthesized hydroxyapatite was assessed by X-ray diffraction. Zeta potential at different temperatures was evaluated. Specimens were characterized using scanning electron microscopy and Raman analysis. The results showed that the best hydroxyapatite/graphene ratio was 85/15, while those of the hydroxyapatite/collagen mixtures were 85/15. A hydroxyapatite/graphene/collagen mixture was synthesized based on these results.

Coating Techniques for Functional Enhancement of Metal Implants for Bone Replacement: A Review

To facilitate patient healing in injuries and bone fractures, metallic implants have been in use for a long time. As metallic biomaterials have offered desirable mechanical strength higher than the stiffness of human bone, they have maintained their place. However, in many case studies, it has been observed that these metallic biomaterials undergo a series of corrosion reactions in human body fluid. The products of these reactions are released metallic ions, which are toxic in high dosages. On the other hand, as these metallic implants have different material structures and compositions than that of human bone, the process of healing takes a longer time and bone/implant interface forms slower. To resolve this issue, researchers have proposed depositing coatings, such as hydroxyapatite (HA), polycaprolactone (PCL), metallic oxides (e.g., TiO2, Al2O3), etc., on implant substrates in order to enhance bone/implant interaction while covering the substrate from corrosion. Due to many useful HA characteristics, the outcome of various studies has proved that after coating with HA, the implants enjoy enhanced corrosion resistance and less metallic ion release while the bone ingrowth has been increased. As a result, a significant reduction in patient healing time with less loss of mechanical strength of implants has been achieved. Some of the most reliable coating processes for biomaterials, to date, capable of depositing HA on implant substrate are known as sol-gel, high-velocity oxy-fuel-based deposition, plasma spraying, and electrochemical coatings. In this article, all these coating methods are categorized and investigated, and a comparative study of these techniques is presented.

Manipulation of the degradation behavior of calcium sulfate by the addition of bioglass

A bioactive calcium sulfate/glass composite was prepared using a sintering technique, and Ca–P–Si glass particles were prepared by spray pyrolysis. The glass exhibited bioactivity in terms of its ability to form apatite in a simulated body fluid. The glass was transformed into two crystallized phases, i.e., calcium phosphate and calcium silicate, respectively, during the heating stage. The presence of the crystallized phases retarded the densification of calcium sulfate. A high sintering temperature of 1200 °C was needed to prepare the composite. The increased addition of glass enhanced the strength and decreases the degradation rate of calcium sulfate. The new composite is not only degradable but also bioactive.

Current Status on Pulsed Laser Deposition of Coatings from Animal-Origin Calcium Phosphate Sources

The aim of this paper is to present the current status on animal-origin hydroxyapatite (HA) coatings synthesized by Pulsed Laser Deposition (PLD) technique for medical implant applications. PLD as a thin film synthesis method, although limited in terms of surface covered area, still gathers interest among researchers due to its advantages such as stoichiometric transfer, thickness control, film adherence, and relatively simple experimental set-up. While animal-origin HA synthesized by bacteria or extracted from animal bones, eggshells, and clams was tested in the form of thin films or scaffolds as a bioactive agent before, the reported results on PLD coatings from HA materials extracted from natural sources were not gathered and compared until the present study. Since natural apatite contains trace elements and new functional groups, such as CO32− and HPO42− in its complex molecules, physical-chemical results on the transfer of animal-origin HA by PLD are extremely interesting due to the stoichiometric transfer possibilities of this technique. The points of interest of this paper are the origin of HA from various sustainable resources, the extraction methods employed, the supplemental functional groups, and ions present in animal-origin HA targets and coatings as compared to synthetic HA, the coatings’ morphology function of the type of HA, and the structure and crystalline status after deposition (where properties were superior to synthetic HA), and the influence of various dopants on these properties. The most interesting studies published in the last decade in scientific literature were compared and morphological, elemental, structural, and mechanical data were compiled and interpreted. The biological response of different types of animal-origin apatites on a variety of cell types was qualitatively assessed by comparing MTS assay data of various studies, where the testing conditions were possible. Antibacterial and antifungal activity of some doped animal-origin HA coatings was also discussed.

Antimicrobial and anti-inflammatory drug-delivery systems at endodontic reparative material: Synthesis and characterization

OBJECTIVE

The aim of this study was to synthesize and characterize an experimental endodontic paste.

METHODS

An experimental endodontic paste (EX) was characterized by its particle size, zeta potential, drug content and morphology. The powder of EX is composed of amoxicillin microspheres, calcium tungstate and α-tricalcium phosphate, mixed with an indomethacin nanocapsules suspension. Ultracal^® (Ultradent), an iodoform-based paste (GP) and the EX were evaluated by its physical properties (flow, film thickness and radiopacity). The cytocompatibility was performed by MTT and SRB-colorimetric assays; the cell-migration was tested with scratch assay and cell-ability to remineralization with ALP and Alizarin Red S, with fibroblastic cell line. The antibacterial activity was assessed by the formation of inhibition zones and against planktonic bacteria.

RESULTS

The EX and UL flow achieved ISO6876 standard, and GP was lower than 17mm. All pastes achieved the film thickness required. Radiopacity was equivalent to 1.81±0.25mmAl for EX, which did not differ from GP group 1.39±0.33mmAl (p>0.05). The UL presented 3.04±0.33mmAl. The values for SRB showed better citocompatibility in comparison with MTT for all materials. The ALP activity and formation of mineralized nodules demonstrated the remineralization potential for UL and EX. Cell migration showed continuous wound closure until complete cell healing, however, the EX accelerated the process (p<0.05). The EX showed the greatest inhibition zone (p<0.05) and was the only group with antibacterial activity against planktonic bacteria.

SIGNIFICANCE

The synthesized endodontic paste demonstrated reliable physical and biological properties and could be a promising material for periapical tissue repair.

Cationic Substitutions in Hydroxyapatite: Current Status of the Derived Biofunctional Effects and Their In Vitro Interrogation Methods

High-performance bioceramics are required for preventing failure and prolonging the life-time of bone grafting scaffolds and osseous implants. The proper identification and development of materials with extended functionalities addressing socio-economic needs and health problems constitute important and critical steps at the heart of clinical research. Recent findings in the realm of ion-substituted hydroxyapatite (HA) could pave the road towards significant developments in biomedicine, with an emphasis on a new generation of orthopaedic and dentistry applications, since such bioceramics are able to mimic the structural, compositional and mechanical properties of the bone mineral phase. In fact, the fascinating ability of the HA crystalline lattice to allow for the substitution of calcium ions with a plethora of cationic species has been widely explored in the recent period, with consequent modifications of its physical and chemical features, as well as its functional mechanical and in vitro and in vivo biological performance. A comprehensive inventory of the progresses achieved so far is both opportune and of paramount importance, in order to not only gather and summarize information, but to also allow fellow researchers to compare with ease and filter the best solutions for the cation substitution of HA-based materials and enable the development of multi-functional biomedical designs. The review surveys preparation and synthesis methods, pinpoints all the explored cation dopants, and discloses the full application range of substituted HA. Special attention is dedicated to the antimicrobial efficiency spectrum and cytotoxic trade-off concentration values for various cell lines, highlighting new prophylactic routes for the prevention of implant failure. Importantly, the current in vitro biological tests (widely employed to unveil the biological performance of HA-based materials), and their ability to mimic the in vivo biological interactions, are also critically assessed. Future perspectives are discussed, and a series of recommendations are underlined.