Co-incorporation of graphene oxide/silver nanoparticle into poly-L-lactic acid fibrous: A route toward the development of cytocompatible and antibacterial coating layer on magnesium implants

Effect of the Synergistic Interaction of Micro- and Nanostructures with Silver Ions on the Biocompatibility and Antimicrobial Properties of Ti-15Mo-2.5Ag

Titanium and titanium alloys have the advantages of a low density and a close elastic modulus to natural bone, which can reduce the stress-shielding effect and become one of the first choices for human hard tissue replacement and repair. However, implant site infection is still one of the main reasons for implantation failure. In this paper, 2.5 wt % Ag element was added to Ti-15Mo to obtain a low modulus, and a surface anodization was applied to improve the surface biocompatibility. The elastic modulus, micromorphology, surface elemental valence, corrosion resistance, antimicrobial properties, and cytocompatibility were investigated by mechanical tests, scanning electron microscopy, X-ray photoelectron spectroscopy, electrochemical tests, inductively coupled plasma spectroscopy, plate counting method, and cellular tests. The experimental results showed that the anodized Ti-15Mo-2.5Ag sample exhibited an elastic modulus of 79 GPa, a strong corrosion resistance, a strong antimicrobial ability of ≥99.99%, and good biocompatibility. It was demonstrated that the formation of Ag2O on the surface and Ag ion release improved the antimicrobial properties and that the structural synergism of silver ions with micro- and nanostructures played an important role in promoting the early spreading of cells and improving the cytocompatibility.

Interface properties of nanostructured carbon-coated biological implants: an overview

The interfaces between medical implants and living tissues are of great complexity because of the simultaneous occurrence of a wide variety of phenomena. The engineering of implant surfaces represents a crucial challenge in material science, but the further improvement of implant properties remains a critical task. It can be achieved through several processes. Among them, the production of specialized coatings based on carbon-based materials stands very promising. The use of carbon coatings allows one to simultaneously fine-tune tribological, mechanical, and chemical properties. Here, we review applications of nanostructured carbon coatings (nanodiamonds, carbon nanotubes, and graphene-related materials) for the improvement of the overall properties of medical implants. We are focusing on biological interactions, improved corrosion resistance, and overall mechanical properties, trying to provide a complete overview within the field.

A Kinetic Approach to Synergize Bactericidal Efficacy and Biocompatibility in Silver-Based Sol-Gel Coatings

Silver ions are antimicrobial agents with powerful action against bacteria. Applications in surface treatments, as Ag+-functionalized sol-gel coatings, are expected in the biomedical field to prevent contaminations and infections. The potential cytotoxicity of Ag+ cations toward human cells is well known though. However, few studies consider both the bactericidal activity and the biocompatibility of the Ag+-functionalized sol-gels. Here, we demonstrate that the cytotoxicity of Ag+ cations is circumvented, thanks to the ability of Ag+ cations to kill Escherichia coli (E. coli) much faster than normal human dermal fibroblasts (NHDFs). This phenomenon was investigated in the case of two silver nitrate-loaded sol-gel coatings: one with 0.5 w/w% Ag+ cations and the second with 2.5 w/w%. The maximal amount of released Ag+ ions over time (0.25 mg/L) was ten times lower than the minimal inhibition (MIC) and minimal bactericidal (MBC) concentrations (respectively, 2.5 and 16 mg/L) for E. coli and twice lower to the minimal cytotoxic concentration (0.5 mg/L) observed in NHDFs. E. coli were killed 8-18 times, respectively, faster than NHDFs by silver-loaded sol-gel coatings. This original approach, based on the kinetic control of the biological activity of Ag+ cations instead of a concentration effect, ensures the bactericidal protection while maintaining the biocompatibility of the Ag+ cation-functionalized sol-gels. This opens promising applications of silver-loaded sol-gel coatings for biomedical tools in short-term or indirect contacts with the skin.

Mg alloys with antitumor and anticorrosion properties for orthopedic oncology: A review from mechanisms to application strategies

As a primary malignant bone cancer, osteosarcoma (OS) poses a great threat to human health and is still a huge challenge for clinicians. At present, surgical resection is the main treatment strategy for OS. However, surgical intervention will result in a large bone defect, and some tumor cells remaining around the excised bone tissue often lead to the recurrence and metastasis of OS. Biomedical Mg-based materials have been widely employed as orthopedic implants in bone defect reconstruction, and, especially, they can eradicate the residual OS cells due to the antitumor activities of their degradation products. Nevertheless, the fast corrosion rate of Mg alloys has greatly limited their application scope in the biomedical field, and the improvement of the corrosion resistance will impair the antitumor effects, which mainly arise from their rapid corrosion. Hence, it is vital to balance the corrosion resistance and the antitumor activities of Mg alloys. The presented review systematically discussed the potential antitumor mechanisms of three corrosion products of Mg alloys. Moreover, several strategies to simultaneously enhance the anticorrosion properties and antitumor effects of Mg alloys were also proposed.

Laser-assisted surface alloying of titanium with silver to enhance antibacterial and bone-cell mineralization properties of orthopedic implants

Orthopedic device-related infection (ODRI) poses a significant threat to patients with titanium-based implants. The challenge lies in developing antibacterial surfaces that preserve the bulk mechanical properties of titanium implants while exhibiting characteristics similar to bone tissue. In response, we present a two-step approach: silver nanoparticle (AgNP) coating followed by selective laser-assisted surface alloying on commonly used titanium alumina vanadium (TiAl6V4) implant surfaces. This process imparts antibacterial properties without compromising the bulk mechanical characteristics of the titanium alloy. Systematic optimization of laser beam power (8-40 W) resulted in an optimized surface (32 W) with uniform TiAg alloy formation. This surface displayed a distinctive hierarchical mesoporous textured surface, featuring cauliflower-like nanostructures measuring between 5-10 nm uniformly covering spatial line periods of 25 μm while demonstrating homogenous elemental distribution of silver throughout the laser processed surface. The optimized laser processed surface exhibited prolonged superhydrophilicity (40 days) and antibacterial efficacy (12 days) against Staphylococcus aureus and Escherichia coli. Additionally, there was a significant twofold increase in bone mineralization compared to the pristine Ti6Al4V surface (p < 0.05). Rockwell hardness tests confirmed minimal (<1%) change in bulk mechanical properties compared to the pristine surface. This innovative laser-assisted approach, with its precisely tailored surface morphology, holds promise for providing enduring antibacterial and osteointegration properties, rendering it an optimal choice for modifying load-bearing implant devices without altering material bulk characteristics.

Experimental investigation of ultrasonic assisted coating on three-point bending behavior of 3D printed polymeric bone plates for biomedical applications

3D printed Poly Lactic Acid (PLA) bone plates exhibit limited three-point bending strength, restricting their viability in biomedical applications. The application of polydopamine (PDM) enhances the three-point bending strength by undergoing covalent interactions with PLA molecular structure. However, the heavy nature of PDM particles leads to settling at the container base at higher coating solution concentrations. This study investigates the impact of ultrasonic-assisted coating parameters on the three-point bending strength. Utilizing Response Surface Methodology (RSM) for statistical modeling, the study examines the influence of ultrasonic vibration power (UP), coating solution concentration (CC), and submersion time (TIME). RSM optimization recommended 100 % UP, 6 mg/ml CC, and 150 min TIME, resulting in maximum three-point bending strength of 83.295 MPa. Microscopic images from the comparative analysis revealed non-uniform coating deposition with mean thickness of 6.153 µm under normal coating. In contrast, ultrasonic-assisted coating promoted uniform deposition with mean thickness of 18.05 µm. The results demonstrate that ultrasonic-assisted coating induces PDM particle collision, preventing settling at the container base, and enhances three-point bending strength by 7.27 % to 23.24 % compared to the normal coating condition. This study emphasizes on the potential of ultrasonic-assisted coating to overcome the limitations of direct immersion coating technique.

Silver/Graphene Oxide Nanostructured Coatings for Modulating the Microbial Susceptibility of Fixation Devices Used in Knee Surgery

Exploring silver-based and carbon-based nanomaterials' excellent intrinsic antipathogenic effects represents an attractive alternative for fabricating anti-infective formulations. Using chemical synthesis protocols, stearate-conjugated silver (Ag@C18) nanoparticles and graphene oxide nanosheets (nGOs) were herein obtained and investigated in terms of composition and microstructure. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) characterizations revealed the formation of nanomaterials with desirable physical properties, while X-ray diffraction (XRD) analyses confirmed the high purity of synthesized nanomaterials. Further, laser-processed Ag@C18-nGO coatings were developed, optimized, and evaluated in terms of biological and microbiological outcomes. The highly biocompatible Ag@C18-nGO nanostructured coatings proved suitable candidates for the local modulation of biofilm-associated periprosthetic infections.

Cationic cellulose filter papers modified with ZnO/Ag/GO nanocomposite as point of use gravity-driven filters for bacterial removal from water

The surface modification of filters with large pore sizes for the development of low-cost gravity-driven point-of-use (POU) technologies for water disinfection can be an effective strategy to empower people to access safe water instantly, especially in low- and middle-income countries. In this study, the surface of commercial cellulose filter papers, as cheap and bio-based filters, was modified with polydopamine (PDA), polyethyleneimine (PEI) and ZnO/Ag/GO nanocomposite (ZnO/Ag/GO@PDA/PEI papers) for bacterial removal from water. PDA/PEI incorporation introduced a cationic functional layer, which can entrap negative bacteria and make a stable chemical bond with the nanocomposite. ZnO/Ag/GO exhibited promising synergistic antibacterial activities (30 times stronger than ZnO). As a result, 3 sheets of ZnO/Ag/GO@PDA/PEI papers showed a 99.98% bacterial reduction (E. coli), which met the WHO standards. Moreover, the leached zinc and silver in the filtrate were far below the WHO's limits (380 and 10 ppb, respectively). The results showed that the modified papers could be reused multiple times. After six times of reuse, the flow rate dropped slightly (below 20%) and the bacterial removal efficiency was more than 99.9%. This study is valuable for developing filters for treating bacterial-contaminated water on-site with no need for energy, which is a demand in many countries.

The cytocompatibility of graphene oxide as a platform to enhance the effectiveness and safety of silver nanoparticles through in vitro studies

The increasing emergence of antibiotic-resistant bacteria and the need to reduce the use of antibiotics call for the development of safe alternatives, such as silver nanoparticles. However, their potential cytotoxic effect needs to be addressed. Graphene oxide provides a large platform that can increase the effectiveness and safety of silver nanoparticles. Graphene oxide and silver nanoparticles complex applied as a part of an innovative material might have direct contact with human tissues, such as skin, or might be inhaled from aerosol or exfoliated pieces of the complex. Thereby, the safety of the prepared complex has to be evaluated carefully, employing a range of methods. We demonstrated the high cytocompatibility of graphene oxide and the graphene oxide-silver nanoparticles complex toward human cell lines, fetal foreskin fibroblasts (HFFF2), and lung epithelial cells (A549). The supporting platform of graphene oxide also neutralized the slight toxicity of bare silver nanoparticles. Finally, in studies on Staphylococcus aureus and Pseudomonas aeruginosa, the number of bacteria reduction was observed after incubation with silver nanoparticles and the graphene oxide-silver nanoparticles complex. Our findings confirm the possibility of employing a graphene oxide-silver nanoparticles complex as a safe agent with reduced silver nanoparticles' cytotoxicity and antibacterial properties.

Corrosion-tailoring, osteogenic, anti-inflammatory, and antibacterial aspirin-loaded organometallic hydrogel composite coating on biodegradable Zn for orthopedic applications

Zn and its alloys are receiving increasing interest for biodegradable orthopedic implant applications owing to their moderate corrosion rate and the potential functionality of Zn2+. However, their non-uniform corrosion behavior and insufficient osteogenic, anti-inflammatory, and antibacterial properties do not meet the comprehensive requirements of orthopedic implants in clinical use. Herein, an aspirin (an acetylsalicylic acid, ASA, 10, 50, 100, and 500 mg/L)-loaded carboxymethyl chitosan (CMC)/gelatin (Gel)-Zn2+ organometallic hydrogel composite coating (CMC/Gel&Zn2+/ASA) was fabricated on a Zn surface via an alternating dip-coating method, aiming to obtain a material with these comprehensive properties improved. The organometallic hydrogel composite coatings, ca. 12-16 μm in thickness, showed compact, homogeneous, and micro-bulge structured surface morphology. The coatings protected well the Zn substrate from pitting/localized corrosion and contained the release of the bioactive components, Zn2+ and ASA, in a sustained and stable manner in long-term in vitro immersions in Hank's solution. The coated Zn showed greater ability to promote proliferation and osteogenic differentiation for MC3T3-E1 osteoblasts, and better anti-inflammatory capacity when compared with uncoated Zn. Additionally, this coating displayed excellent antibacterial activity against both Escherichia coli (>99 % antibacterial rate) and Staphylococcus aureus (>98 % antibacterial rate). Such appealing properties can be attributed to the compositional nature of the coating, namely the sustained release of Zn2+ and ASA, as well as the surface physiochemical properties because of its unique microstructure. This organometallic hydrogel composite coating can be considered a promising option for the surface modification of biodegradable Zn-based orthopedic implants among others.

Silver-Containing Biomaterials for Biomedical Hard Tissue Implants

Bacterial infection caused by biomaterials is a very serious problem in the clinical treatment of implants. The emergence of antibiotic resistance has prompted other antibacterial agents to replace traditional antibiotics. Silver is rapidly developing as an antibacterial candidate material to inhibit bone infections due to its significant advantages such as high antibacterial timeliness, high antibacterial efficiency, and less susceptibility to bacterial resistance. However, silver has strong cytotoxicity, which can cause inflammatory reactions and oxidative stress, thereby destroying tissue regeneration, making the application of silver-containing biomaterials extremely challenging. In this paper, the application of silver in biomaterials is reviewed, focusing on the following three issues: 1) how to ensure the excellent antibacterial properties of silver, and not easy to cause bacterial resistance; 2) how to choose the appropriate method to combine silver with biomaterials; 3) how to make silver-containing biomaterials in hard tissue implants have further research. Following a brief introduction, the discussion focuses on the application of silver-containing biomaterials, with an emphasis on the effects of silver on the physicochemical properties, structural properties, and biological properties of biomaterials. Finally, the review concludes with the authors' perspectives on the challenges and future directions of silver in commercialization and in-depth research.

Li-Mg-Si bioceramics provide a dynamic immuno-modulatory and repair-supportive microenvironment for peripheral nerve regeneration

Biomaterials can modulate the local immune and repair-supportive microenvironments to promote peripheral nerve regeneration. Inorganic bioceramics have been widely used for regulating tissue regeneration and local immune response. However, little is known on whether inorganic bioceramics can have potential for enhancing peripheral nerve regeneration and what are the mechanisms underlying their actions. Here, the inorganic lithium-magnesium-silicon (Li-Mg-Si, LMS) bioceramics containing scaffolds are fabricated and characterized. The LMS-containing scaffolds had no cytotoxicity against rat Schwann cells (SCs), but promoted their migration and differentiation towards a remyelination state by up-regulating the expression of neurotrophic factors in a β-catenin-dependent manner. Furthermore, using single cell-sequencing, we showed that LMS-containing scaffolds promoted macrophage polarization towards the pro-regenerative M2-like cells, which subsequently facilitated the migration and differentiation of SCs. Moreover, implantation with the LMS-containing nerve guidance conduits (NGCs) increased the frequency of M2-like macrophage infiltration and enhanced nerve regeneration and motor functional recovery in a rat model of sciatic nerve injury. Collectively, these findings indicated that the inorganic LMS bioceramics offered a potential strategy for enhancing peripheral nerve regeneration by modulating the immune microenvironment and promoting SCs remyelination.

Antibacterial PLA/Mg composite with enhanced mechanical and biological performance for biodegradable orthopedic implants

Biodegradability, bone-healing rate, and prevention of bacterial infection are critical factors for orthopedic implants. Polylactic acid (PLA) is a good candidate biodegradable material; however, it has insufficient mechanical strength and bioactivity for orthopedic implants. Magnesium (Mg), has good bioactivity, biodegradability, and sufficient mechanical properties, similar to that of bone. Moreover, Mg has an inherent antibacterial property via a photothermal effect, which generates localized heat, thus preventing bacterial infection. Therefore, Mg is a good candidate material for PLA composites, to improve their mechanical and biological performance and add an antibacterial property. Herein, we fabricated an antibacterial PLA/Mg composite for enhanced mechanical and biological performance with an antibacterial property for application as biodegradable orthopedic implants. The composite was fabricated with 15 and 30 vol% of Mg homogeneously dispersed in PLA without the generation of a defect using a high-shear mixer. The composites exhibited an enhanced compressive strength of 107.3 and 93.2 MPa, and stiffness of 2.3 and 2.5 GPa, respectively, compared with those of pure PLA which were 68.8 MPa and 1.6 GPa, respectively. Moreover, the PLA/Mg composite at 15 vol% Mg exhibited significant improvement of biological performance in terms of enhanced initial cell attachment and cell proliferation, whereas the composite at 30 vol% Mg showed deteriorated cell proliferation and differentiation because of the rapid degradation of the Mg particles. In turn, the PLA/Mg composites exerted an antibacterial effect based on the inherent antibacterial property of Mg as well as the photothermal effect induced by near-infrared (NIR) treatment, which can minimize infection after implantation surgery. Therefore, antibacterial PLA/Mg composites with enhanced mechanical and biological performance may be a candidate material with great potential for biodegradable orthopedic implants.

Elastin-like recombinamer-mediated hierarchical mineralization coatings on Zr-16Nb-xTi (x = 4,16 wt%) alloy surfaces improve biocompatibility

The biocompatibility of biomedical materials is vital to their applicability and functionality. However, modifying surfaces for enhanced biocompatibility using traditional surface treatment techniques is challenging. We employed a mineralizing elastin-like recombinamer (ELR) self-assembling platform to mediate mineralization on Zr-16Nb-xTi (x = 4,16 wt%) alloy surfaces, resulting in the modification of surface morphology and bioactivity while improving the biocompatibility of the material. We modulated the level of nanocrystal organization by adjusting the cross-linker ratio. Nanoindentation tests revealed that the mineralized configuration had nonuniformity with respect to Young's modulus and hardness, with the center areas having higher values (5.626 ± 0.109 GPa and 0.264 ± 0.022 GPa) compared to the edges (4.282 ± 0.327 GPa and 0.143 ± 0.023 GPa). The Scratch test results indicated high bonding strength (2.668 ± 0.117 N) between the mineralized coating and the substrate. Mineralized Zr-16Nb-xTi (x = 4,16 wt%) alloys had higher viability compared to untreated alloys, which exhibited high cell viability (>100 %) after 5 days and high alkaline phosphatase activity after 7 days. Cell proliferation assays indicated that MG 63 cells grew faster on mineralized surfaces than on untreated surfaces. Scanning electron microscopy imaging confirmed that the cells adhered and spread well on mineralized surfaces. Furthermore, hemocompatibility test results revealed that all mineralized samples were non-hemolytic. Our results demonstrate the viability of employing the ELR mineralizing platform to improve alloy biocompatibility.

Enhancement of antibacterial properties and biocompatibility of Ti6Al4V by graphene oxide/strontium nanocomposite electrodepositing

Ti₆Al₄V is a widely used orthopedic implant material in clinics. Due to its poor antibacterial properties, surface modification is required to prevent peri-implantation infection. However, chemical linkers used for surface modification have generally been reported to have detrimental effects on cell growth. In this work, by optimizing parameters related to electrodeposition, a composite structural coating with graphene oxide (GO) compact films in the inner layer and 35 nm diameter strontium (Sr) nanoparticles in the outer layer was constructed on the surface of Ti₆Al₄V without using substance harmful to bone marrow mesenchymal stem cells (BMSCs) growth. The antibacterial properties of Ti₆Al₄V are enhanced by the controlled release of Sr ions and incomplete masking of the GO surface, showing excellent antibacterial activity against Staphylococcus aureus in bacterial culture assays. The biomimetic GO/Sr coating has a reduced roughness of the implant surface and a water contact angle of 44.1°, improving the adhesion, proliferation and differentiation of BMSCs. Observations of synovial tissue and fluid in the joint in an implantation model of rabbit knee also point to the superior anti-infective properties of the novel GO/Sr coating. In summary, the novel GO/Sr nanocomposite coating on the surface of Ti₆Al₄V effectively prevents surface colonization of Staphylococcus aureus and eliminates local infections in vitro and in vivo.

MWCNTs-TiO2 Incorporated-Mg Composites to Improve the Mechanical, Corrosion and Biological Characteristics for Use in Biomedical Fields

This study attempts to synthesize MgZn/TiO₂-MWCNTs composites with varying TiO₂-MWCNT concentrations using mechanical alloying and a semi-powder metallurgy process coupled with spark plasma sintering. It also aims to investigate the mechanical, corrosion, and antibacterial properties of these composites. When compared to the MgZn composite, the microhardness and compressive strength of the MgZn/TiO₂-MWCNTs composites were enhanced to 79 HV and 269 MPa, respectively. The results of cell culture and viability experiments revealed that incorporating TiO₂-MWCNTs increased osteoblast proliferation and attachment and enhanced the biocompatibility of the TiO₂-MWCNTs nanocomposite. It was observed that the corrosion resistance of the Mg-based composite was improved and the corrosion rate was reduced to about 2.1 mm/y with the addition of 10 wt% TiO₂-1 wt% MWCNTs. In vitro testing for up to 14 days revealed a reduced degradation rate following the incorporation of TiO₂-MWCNTs reinforcement into a MgZn matrix alloy. Antibacterial evaluations revealed that the composite had antibacterial activity, with an inhibition zone of 3.7 mm against Staphylococcus aureus. The MgZn/TiO₂-MWCNTs composite structure has great potential for use in orthopedic fracture fixation devices.

In-vivo bone remodeling potential of Sr-d-Ca-P /PLLA-HAp coated biodegradable ZK60 alloy bone plate

Magnesium and its alloys are widely applied biomaterials due to their biodegradability and biocompatibility. However, rapid degradation and hydrogen gas evolution hinder its applicability on a commercial scale. In this study, we developed an Mg alloy bone plate for bone remodeling and support after a fracture. We further coated the Mg alloy plate with Sr-D-Ca-P (Sr dopped Ca-P coating) and Sr-D-Ca-P/PLLA-HAp to evaluate and compare their biodegradability and biocompatibility in both in vitro and in vivo experiments. Chemical immersion and dip coating were employed for the formation of Sr-D-Ca-P and PLLA-HAp layers, respectively. In vitro evaluation depicted that both coatings delayed the degradation process and exhibited excellent biocompatibility. MC3T3-E1cells proliferation and osteogenic markers expression were also promoted. In vivo results showed that both Sr-D-Ca-P and Sr-D-Ca-P/PLLA-HAp coated bone plates had slower degradation rate as compared to Mg alloy. Remarkable bone remodeling was observed around the Sr-D-Ca-P/PLLA-HAp coated bone plate than bare Mg alloy and Sr-D-Ca-P coated bone plate. These results suggest that Sr-D-Ca-P/PLLA-HAp coated Mg alloy bone plate with lower degradation and enhanced biocompatibility can be applied as an orthopedic implant.

The effect of Co-encapsulated GNPs-CNTs nanofillers on mechanical properties, degradation and antibacterial behavior of Mg-based composite

Magnesium (Mg)-based composites, as one group of the biodegradable materials, enjoy high biodegradability, biocompatibility, and non-toxicity making them a great option for implant applications. In this paper, by the semi powder metallurgy (SPM) technique, the graphene nano-platelets (GNPs) and carbon nanotubes (CNTs) nanosystems, as reinforcements, are dispersed homogenously in the Mg-Zn (MZ) alloy matrix. Subsequently, the composite is successfully produced employing the spark plasma sintering (SPS) process. Compared to the unreinforced MZ sample, GNPs + CNTs mixture reinforced composite exhibits higher compressive strength (∼75%). Notably, adding only 1 wt % of GNPs + CNTs to the MZ matrix reduces the rate of the degradation in the Mg-based composite by almost 2- fold. Examining the antibacterial activity demonstrate that the incorporation of GNPs + CNTs into the Mg-based matrix is likely to prevent the infiltration and development of Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) significantly. While the MTT with 0.5 and 1 wt % GNPs + CNTs does not demonstrate cytotoxicity to the MG63 cells, the excessive GNPs + CNTs results in a certain degree of poisonousness. In general, the findings of the present research attest to the viable application of MZ/GNPs + CNTs composites for implants as well as bone infection treatment.

A comprehensive review of properties of the biocompatible thin films on biodegradable Mg alloys

Magnesium (Mg) and its alloys have attracted attention as biodegradable materials for biomedical applications owing to their mechanical properties being comparable to that of bone. Mg is a vital trace element in many enzymes and thus forms one of the essential factors for human metabolism. However, before being used in biomedical applications, the early stage or fast degradation of Mg and its alloys in the physiological environment should be controlled. The degradation of Mg alloys is a critical criterion that can be controlled by a surface modification which is an effective process for conserving their desired properties. Different coating methods have been employed to modify Mg surfaces to provide good corrosion resistance and biocompatibility. This review aims to provide information on different coatings and discuss their physical and biological properties. Finally, the current withstanding challenges have been highlighted and discussed, followed by shedding some light on future perspectives.

When 2D nanomaterials meet biomolecules: design strategies and hybrid nanostructures for bone tissue engineering

2D nanomaterials show great potential in biomedical applications due to their unique physical and chemical surface properties. This review includes typical 2D nanomaterials used in bone tissue engineering (BTE), such as graphene oxide, hexagonal boron nitride, molybdenum disulfide, black phosphorus, and MXenes. Moreover, the construction methods of BTE materials with 2D nanosheets are analyzed. Before designing a BTE material, it is essential to understand the relationship between the material structure and properties. Notably, 2D nanomaterials can be hybridized with biomaterials, such as polypeptides, proteins, and polysaccharides, to improve biocompatibility and host responses. The effects of the surface properties and size of 2D nanomaterials on cellular behavior, gene expression, antibacterial properties, and cytotoxicity in BTE applications are also discussed. This work provides new design ideas and directions for constructing 2D nanomaterial-based BTE scaffolds.

Green-synthesized silver nanoparticle coating on paper for antibacterial and antiviral applications

The use of active packaging has attracted considerable attention over recent years to prevent and decrease the risk of bacterial and viral infection. Thus, this work aims to develop active packaging using a paper coated with green-synthesized silver nanoparticles (AgNPs). Effects of different silver nitrate (AgNO3) concentrations, viz. 50, 100, 150, and 200 mM (AgNPs-50, AgNPs-100, AgNPs-150, and AgNPs-200, respectively), on green synthesis of AgNPs and coated paper properties were investigated. A bio-reducing agent from mangosteen peel extract (ex-Garcinia mangostana (GM)) and citric acid as a crosslinking agent for a starch/polyvinyl alcohol matrix were also used in the synthetic process. The presence of AgNPs, ex-GM, and citric acid indicated the required synergistic antibacterial activities for gram-positive and gram-negative bacteria. The paper coated with AgNPs-150 showed complete inactivation of virus within 1 min. Water resistance and tensile strength of paper improved when being coated with AgNPs-150. The tensile strength of the coated paper was found to be in the same range as that of a common packaging paper. Result revealed that the obtained paper coated with AgNPs was proven to be effective in antibacterial and antiviral activities; hence, it could be used as an active packaging material for items that require manual handling by a number of people.

Biodegradable interbody cages for lumbar spine fusion: Current concepts and future directions

Lumbar fusion often remains the last treatment option for various acute and chronic spinal conditions, including infectious and degenerative diseases. Placement of a cage in the intervertebral space has become a routine clinical treatment for spinal fusion surgery to provide sufficient biomechanical stability, which is required to achieve bony ingrowth of the implant. Routinely used cages for clinical application are made of titanium (Ti) or polyetheretherketone (PEEK). Ti has been used since the 1980s; however, its shortcomings, such as impaired radiographical opacity and higher elastic modulus compared to bone, have led to the development of PEEK cages, which are associated with reduced stress shielding as well as no radiographical artefacts. Since PEEK is bioinert, its osteointegration capacity is limited, which in turn enhances fibrotic tissue formation and peri-implant infections. To address shortcomings of both of these biomaterials, interdisciplinary teams have developed biodegradable cages. Rooted in promising preclinical large animal studies, a hollow cylindrical cage (Hydrosorb™) made of 70:30 poly-l-lactide-co-d, l-lactide acid (PLDLLA) was clinically studied. However, reduced bony integration and unfavourable long-term clinical outcomes prohibited its routine clinical application. More recently, scaffold-guided bone regeneration (SGBR) with application of highly porous biodegradable constructs is emerging. Advancements in additive manufacturing technology now allow the cage designs that match requirements, such as stiffness of surrounding tissues, while providing long-term biomechanical stability. A favourable clinical outcome has been observed in the treatment of various bone defects, particularly for 3D-printed composite scaffolds made of medical-grade polycaprolactone (mPCL) in combination with a ceramic filler material. Therefore, advanced cage design made of mPCL and ceramic may also carry initial high spinal forces up to the time of bony fusion and subsequently resorb without clinical side effects. Furthermore, surface modification of implants is an effective approach to simultaneously reduce microbial infection and improve tissue integration. We present a design concept for a scaffold surface which result in osteoconductive and antimicrobial properties that have the potential to achieve higher rates of fusion and less clinical complications. In this review, we explore the preclinical and clinical studies which used bioresorbable cages. Furthermore, we critically discuss the need for a cutting-edge research program that includes comprehensive preclinical in vitro and in vivo studies to enable successful translation from bench to bedside. We develop such a conceptual framework by examining the state-of-the-art literature and posing the questions that will guide this field in the coming years.

Advances in Biologically Applicable Graphene-Based 2D Nanomaterials

Climate change and increasing contamination of the environment, due to anthropogenic activities, are accompanied with a growing negative impact on human life. Nowadays, humanity is threatened by the increasing incidence of difficult-to-treat cancer and various infectious diseases caused by resistant pathogens, but, on the other hand, ensuring sufficient safe food for balanced human nutrition is threatened by a growing infestation of agriculturally important plants, by various pathogens or by the deteriorating condition of agricultural land. One way to deal with all these undesirable facts is to try to develop technologies and sophisticated materials that could help overcome these negative effects/gloomy prospects. One possibility is to try to use nanotechnology and, within this broad field, to focus also on the study of two-dimensional carbon-based nanomaterials, which have excellent prospects to be used in various economic sectors. In this brief up-to-date overview, attention is paid to recent applications of graphene-based nanomaterials, i.e., graphene, graphene quantum dots, graphene oxide, graphene oxide quantum dots, and reduced graphene oxide. These materials and their various modifications and combinations with other compounds are discussed, regarding their biomedical and agro-ecological applications, i.e., as materials investigated for their antineoplastic and anti-invasive effects, for their effects against various plant pathogens, and as carriers of bioactive agents (drugs, pesticides, fertilizers) as well as materials suitable to be used in theranostics. The negative effects of graphene-based nanomaterials on living organisms, including their mode of action, are analyzed as well.

A Review on Antibacterial Biomaterials in Biomedical Applications: From Materials Perspective to Bioinks Design

In tissue engineering, three-dimensional (3D) printing is an emerging approach to producing functioning tissue constructs to repair wounds and repair or replace sick tissue/organs. It allows for precise control of materials and other components in the tissue constructs in an automated way, potentially permitting great throughput production. An ink made using one or multiple biomaterials can be 3D printed into tissue constructs by the printing process; though promising in tissue engineering, the printed constructs have also been reported to have the ability to lead to the emergence of unforeseen illnesses and failure due to biomaterial-related infections. Numerous approaches and/or strategies have been developed to combat biomaterial-related infections, and among them, natural biomaterials, surface treatment of biomaterials, and incorporating inorganic agents have been widely employed for the construct fabrication by 3D printing. Despite various attempts to synthesize and/or optimize the inks for 3D printing, the incidence of infection in the implanted tissue constructs remains one of the most significant issues. For the first time, here we present an overview of inks with antibacterial properties for 3D printing, focusing on the principles and strategies to accomplish biomaterials with anti-infective properties, and the synthesis of metallic ion-containing ink, chitosan-containing inks, and other antibacterial inks. Related discussions regarding the mechanics of biofilm formation and antibacterial performance are also presented, along with future perspectives of the importance of developing printable inks.

Inorganic Nanoparticles in Bone Healing Applications

Modern biomedicine aims to develop integrated solutions that use medical, biotechnological, materials science, and engineering concepts to create functional alternatives for the specific, selective, and accurate management of medical conditions. In the particular case of tissue engineering, designing a model that simulates all tissue qualities and fulfills all tissue requirements is a continuous challenge in the field of bone regeneration. The therapeutic protocols used for bone healing applications are limited by the hierarchical nature and extensive vascularization of osseous tissue, especially in large bone lesions. In this regard, nanotechnology paves the way for a new era in bone treatment, repair and regeneration, by enabling the fabrication of complex nanostructures that are similar to those found in the natural bone and which exhibit multifunctional bioactivity. This review aims to lay out the tremendous outcomes of using inorganic nanoparticles in bone healing applications, including bone repair and regeneration, and modern therapeutic strategies for bone-related pathologies.

The Effect of Co-Encapsulated GO-Cu Nanofillers on Mechanical Properties, Cell Response, and Antibacterial Activities of Mg-Zn Composite

Magnesium-based composites have recently been studied as biodegradable materials for preparing orthopedic implants. In this article, the graphene oxide (GO) and GO-Cu nanosystem has been homogenously dispersed as a reinforcement in the matrix of Mg-Zn (MZ) alloy using the semi powder metallurgy (SPM) method, and subsequently, the composite has been successfully manufactured using the spark plasma sintering (SPS) process. GO and GO-Cu reinforced composite displayed a higher compressive strength (~55%) than the unreinforced Mg-Zn sample. GO and GO-Cu dual nanofillers presented a synergistic effect on enhancing the effectiveness of load transfer and crack deflection in the Mg-based matrix. Besides, the GO-Cu dual nanofillers displayed a synergistic influence on antibacterial activity through combining the capturing influences of GO nanosheets with the killing influences of Cu. However, electrochemical and in-vitro immersion evaluation showed that Cu-GO reinforcement had a slightly negative effect on the corrosion behavior of the Mg-Zn sample, but the incorporation of GO enhanced corrosion resistance of the composite. Moreover, MZ/GO and MZ/GO-Cu nanocomposites showed acceptable cytotoxicity to MG-63 cells and revealed a high potential for use as an orthopedic implant material. Based on the research results, MZ/GO-Cu nanocomposite could be used in bone tissue engineering applications.

Polymer-Based Nanofiber-Nanoparticle Hybrids and Their Medical Applications

The search for higher-quality nanomaterials for medicinal applications continues. There are similarities between electrospun fibers and natural tissues. This property has enabled electrospun fibers to make significant progress in medical applications. However, electrospun fibers are limited to tissue scaffolding applications. When nanoparticles and nanofibers are combined, the composite material can perform more functions, such as photothermal, magnetic response, biosensing, antibacterial, drug delivery and biosensing. To prepare nanofiber and nanoparticle hybrids (NNHs), there are two primary ways. The electrospinning technology was used to produce NNHs in a single step. An alternate way is to use a self-assembly technique to create nanoparticles in fibers. This paper describes the creation of NNHs from routinely used biocompatible polymer composites. Single-step procedures and self-assembly methodologies are used to discuss the preparation of NNHs. It combines recent research discoveries to focus on the application of NNHs in drug release, antibacterial, and tissue engineering in the last two years.

Dual Synergistic Effects of MgO-GO Fillers on Degradation Behavior, Biocompatibility and Antibacterial Activities of Chitosan Coated Mg Alloy

The aim of this work was to establish and characterize chitosan/graphene oxide- magnesium oxide (CS/GO-MgO) nanocomposite coatings on biodegradable magnesium-zinc-cerium (Mg-Zn-Ce) alloy. In comparison to that of pure CS coatings, all composite coatings encapsulating GO-MgO had better adhesion strength to the Mg-Zn-Ce alloy substrate. The result depicted that the co-encapsulation of GO-MgO into the CS layer leads to diminish of contact angle value and hence escalates the hydrophilic characteristic of coated Mg alloy. The electrochemical test demonstrated that the CS/GO-MgO coatings significantly increased the corrosion resistance because of the synergistic effect of the GO and MgO inside the CS coating. The composite coating escalated cell viability and cell differentiation, according to cytocompatibility tests due to the presence of GO and MgO within the CS. The inclusion of GO-MgO in CS film, on the other hand, accelerates the formation of hydroxyapatite (HA) during 14 days immersion in SBF. Immersion results, including weight loss and hydrogen evolution tests, presented that CS/GO-MgO coating enables a considerably reduced degradation rate of Mg-Zn-Ce alloy when compared to the bare alloy. In terms of antibacterial-inhibition properties, the GO-MgO/CS coatings on Mg substrates showed antibacterial activity against Escherichia coli (E. coli), with a large inhibition area around the specimens, particularly for the coating containing a higher concentration of GO-MgO. Bacterial growth was not inhibited by the bare Mg alloy samples. The CS/GO-MgO composite coating is regarded as a great film to enhance the corrosion resistance, bioactivity, and antibacterial performance of Mg alloy implants.

Role of Surface Preparation in Corrosion Resistance Due to Silane Coatings on a Magnesium Alloy

Coating of an organo-silane (Bis-1,2-(TriethoxySilyl)Ethane (BTSE)) has been observed to improve the corrosion resistance of magnesium alloy AZ91D. Three different types of surface preparations have been employed before condensing the silane coating on to the substrate. Corrosion resistance was investigated using electrochemical impedance spectroscopy (EIS). A specific alkali treatment of the substrate prior to the coating has been found to improve the corrosion resistance of the coated alloy, which has been attributed to the ability of the treatment in facilitating the condensation of a relatively compact siloxane film.

GO-based antibacterial composites: Application and design strategies

Graphene oxide (GO), for its unique structure with high biocompatibility and designability, is widely used in the antibacterial field. Various strategies have been designed to fabricate GO-based composites with antibacterial properties. This review summarized these strategies, divided them into three types and interpreted their antibacterial mechanisms: (i) "GO*/non-GO" type in which GO acts as the single antibacterial core, (ii) "GO*/non-GO*" type in which GO and non-GO components function synergistically as dual antibacterial cores, (iii) "GO/non-GO*" type in which non-GO acts as the single antibacterial core, while GO component plays a supportive, not a dominant role in antibiosis. Besides, the fields suiting their applications and factors influencing their antibacterial properties were analyzed. Finally, the limitations and prospects in the current researches were discussed. In summary, GO-based composites have revolutionized antibacterial strategies. This review may serve as a reference to inspire further research on GO-based antibacterial composites.

Use of biomaterials in scaphoid fracture fixation, a systematic review

BACKGROUND

Scaphoid fractures account for 60-70% carpal injury. Due to limited vascular supply achieving adequate reduction and healing is important to avoid complications including avascular necrosis. Recent technological advances have led to renewed vigour in bioabsorbable material research to develop devices which could be used without the need for removal and complications including stress shielding and suboptimal imaging.

METHODS

A systematic search of databases including PubMed, Ovid Medline, and Google Scholar databases was made to identify studies related to the use of bioabsorbable materials in scaphoid fixation and postoperative patient outcomes. PRISMA guidelines were utilised for this review.

FINDINGS

Initial search results yielded 852 studies. 124 studies were screened, with 79 patients across 7 studies included in this review. Poly-L-Lactic acid derivatives were the most common biomaterial for scaphoid fixation, with magnesium and polyglycolide also used. Levels of evidence for studies ranged between III-IV. Analysis demonstrated mixed findings with generally comparable outcomes to conventional alloy-based screws.

INTERPRETATION

Development in bioabsorbable materials is ongoing, however there remains a dearth in data regarding their use in the scaphoid. Further research is needed to establish the efficacy and applicability of bioabsorbable devices in the scaphoid bone.

Application of Electrospinning in Antibacterial Field

In recent years, electrospun nanofibers have attracted extensive attention due to their large specific surface area, high porosity, and controllable shape. Among the many applications of electrospinning, electrospun nanofibers used in fields such as tissue engineering, food packaging, and air purification often require some antibacterial properties. This paper expounds the development potential of electrospinning in the antibacterial field from four aspects: fiber morphology, antibacterial materials, antibacterial mechanism, and application fields. The effects of fiber morphology and antibacterial materials on the antibacterial activity and characteristics are first presented, then followed by a discussion of the antibacterial mechanisms and influencing factors of these materials. Typical application examples of antibacterial nanofibers are presented, which show the good prospects of electrospinning in the antibacterial field.

A Comprehensive Review on Surface Modifications of Biodegradable Magnesium-Based Implant Alloy: Polymer Coatings Opportunities and Challenges

The development of biodegradable implants is certainly intriguing, and magnesium and its alloys are considered significant among the various biodegradable materials. Nevertheless, the fast degradation, the generation of a significant amount of hydrogen gas, and the escalation in the pH value of the body solution are significant barriers to their use as an implant material. The appropriate approach is able to solve this issue, resulting in a decrease the rate of Mg degradation, which can be accomplished by alloying, surface adjustment, and mechanical treatment. Surface modification is a practical option because it not only improves corrosion resistance but also prepares a treated surface to improve bone regeneration and cell attachment. Metal coatings, ceramic coatings, and permanent polymers were shown to minimize degradation rates, but inflammation and foreign body responses were also suggested. In contrast to permanent materials, the bioabsorbable polymers normally show the desired biocompatibility. In order to improve the performance of drugs, they are generally encapsulated in biodegradable polymers. This study summarized the most recent advancements in manufacturing polymeric coatings on Mg alloys. The related corrosion resistance enhancement strategies and future potentials are discussed. Ultimately, the major challenges and difficulties are presented with aim of the development of polymer-coated Mg-based implant materials.

Improved Bacteriostatic and Anticorrosion Effects of Polycaprolactone/Chitosan Coated Magnesium via Incorporation of Zinc Oxide

Magnesium has been recognized as a groundbreaking biodegradable biomaterial for implant applications, but its use is limited because it degrades too quickly in physiological solutions. This paper describes the research on the influence of polycaprolactone (PCL)/chitosan (CS)/zinc oxide (ZnO) composite coating (PCL/CS/ZnO) on the corrosion resistance and antibacterial activity of magnesium. The PCL/CS film presented a porous structure with thickness of about 40-50 μm, while after incorporation of ZnO into the PCL/CS, a homogenous film without pores and defects was attained. The ZnO embedded in PCL/CS enhanced corrosion resistance by preventing corrosive ions diffusion in the magnesium substrate. The corrosion, antibacterial, and cell interaction mechanism of the PCL/CS/ZnO composite coating is discussed in this study. In vitro cell culture revealed that the PCL/CS coating with low loaded ZnO significantly improved cytocompatibility, but coatings with high loaded ZnO were able to induce some cytotoxicity osteoblastic cells. It was also found that enhanced antibacterial activity of the PCL/CS/ZnO coating against both Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria, while less significant antibacterial activity was detected for uncoated Mg and PCL/CS coating. Based on the results, the PCL/CS coatings loaded with low ZnO content may be recommended as a candidate material for biodegradable Mg-based orthopedic implant applications.

Fabrication and Characterization of Polyvinylpyrrolidone-Eggshell Membrane-Reduced Graphene Oxide Nanofibers for Tissue Engineering Applications

One of the best methods to prevent wound infection and speed up wound healing is wound dressing based on nanofiber-polymer scaffolds, which have acceptable antimicrobial performance and appropriate skin regeneration capabilities. In this paper, the electrospinning method was applied to synthesize the polyvinylpyrrolidone-acrylic acid hydrogel (PVPA)-eggshell membrane (ESM)-reduced graphene oxide (rGO) nanosheets nanocomposite dressings with different reduced graphene oxide contents (0, 0.5, 1, and 2 wt.%). Thus, smooth nanofibers were fabricated, including a high amount of rGO, which reduced the fiber diameter. Based on the results, rGO played an important role in water impermeability. The results showed that by increasing the rGO concentration from 0.5 to 2 wt%, the contact angle value increased persistently. Results showed that compared to PVPA-ESM, the mechanical strength and strain of PVPA-ESM/1 wt% rGO significantly enhanced 28% and 23%, respectively. Incorporation of 1 wt% rGO enhanced swelling ratio from 875% for PVPA-ESM to 1235% after 420 min, while increasing the rGO to 2 wt% increased the degradation rate of the composites. According to the in vitro cell culture studies, PVPA-ESM wound dressings with 0.5-1 wt% rGO content enhanced PC12 cell viability compared to the wound dressings without rGO nanosheets. Generally, rGO-loaded PVPA-ESM nanofiber wound dressing can be considered as a potential candidate to be used in skin regeneration applications.

Silver Nanoparticles Attenuate the Antimicrobial Activity of the Innate Immune System by Inhibiting Neutrophil-Mediated Phagocytosis and Reactive Oxygen Species Production

PURPOSE

Despite the extensive development of antibacterial biomaterials, there are few reports on the effects of materials on the antibacterial ability of the immune system, and in particular of neutrophils. In this study, we observe differences between the in vivo and in vitro anti-infective efficacies of silver nanoparticles (AgNPs). The present study was designed to further explore the mechanism for this inconsistency using ex vivo models and in vitro experiments.

METHODS

AgNPs were synthesized using the polyol process and characterized by transmission electron microscopy and X-ray photoelectron spectroscopy. The antibacterial ability of AgNPs and neutrophils was tested by the spread-plate method. The infected air pouch model was prepared to detect the antimicrobial ability of AgNPs in vivo. Furthermore, blood-AgNPs-bacteria co-culture model and reactive oxygen species (ROS) measurement were used to evaluate the effect of AgNPs to neutrophil-mediated phagocytosis and ROS production.

RESULTS

The antibacterial experiments in vitro showed that AgNPs had superior antibacterial properties in cell compatible concentration. While, AgNPs had no significant antibacterial effect in vivo, and pathological section in AgNPs group indicated less neutrophil infiltration in inflammatory site than S. aureus group. Furthermore, AgNPs were found to reduce the phagocytosis of neutrophils and inhibit their ability to produce ROS and superoxide during ex vivo and in vitro experiments.

CONCLUSION

This study selects AgNPs as the representative of inorganic nano-biomaterials and reveals the phenomenon and the mechanism underlying the significant AgNPs-induced inhibition of the antibacterial ability of neutrophils, and may have a certain enlightening effect on the development of biomaterials in the future. In the fabrication of antibacterial biomaterials, however, attention should be paid to both cell and immune system safety to make the antibacterial properties of the biomaterials and innate immune system complement each other and jointly promote the host's ability to resist the invasion of pathogenic microorganisms.

CNT and rGO reinforced PMMA based bone cement for fixation of load bearing implants: Mechanical property and biological response

Polymethyl methacrylate (PMMA) bone cements (BCs) have some drawbacks, including limited bioactivity and bone formation, as well as inferior mechanical properties, which may result in failure of the BC. To deal with the mentioned issues, novel bioactive polymethyl methacrylate-hardystonite (PMMA-HT) bone cement (BC) reinforced with 0.25 and 0.5 wt% of carbon nanotube (CNT) and reduced graphene oxide (rGO) was synthesized. In this context, the obtained bone cements were evaluated in terms of their mechanical and biological characteristics. The rGO reinforced bone cement exhibited better mechanical properties to the extent that the addition of 0.5 wt% of rGO where its compressive and tensile strength of bioactive PMMA-HT/rGO cement escalated from 92.07 ± 0.72 MPa, and 40.02 ± 0.71 MPa to 187.48 ± 5.79 MPa and 64.92 ± 0.75 MPa, respectively. Besides, the mechanisms of toughening, apatite formation, and cell interaction in CNT and rGO encapsulated PMMA have been studied. Results showed that the existence of CNT and rGO in BCs led to increase of MG63 osteoblast viability, and proliferation. However, rGO reinforced bone cement was more successful in supporting MG63 cell attachment compared to the CNT counterpart due to its wrinkled surface, which made a suitable substrate for cell adhesion. Based on the results, PMMA-HT/rGO can be a proper bone cement for the fixation of load-bearing implants.

An Updated Review on Silver Nanoparticles in Biomedicine

Silver nanoparticles (AgNPs) represent one of the most explored categories of nanomaterials for new and improved biomaterials and biotechnologies, with impressive use in the pharmaceutical and cosmetic industry, anti-infective therapy and wound care, food and the textile industry. Their extensive and versatile applicability relies on the genuine and easy-tunable properties of nanosilver, including remarkable physicochemical behavior, exceptional antimicrobial efficiency, anti-inflammatory action and antitumor activity. Besides commercially available and clinically safe AgNPs-based products, a substantial number of recent studies assessed the applicability of nanosilver as therapeutic agents in augmented and alternative strategies for cancer therapy, sensing and diagnosis platforms, restorative and regenerative biomaterials. Given the beneficial interactions of AgNPs with living structures and their nontoxic effects on healthy human cells, they represent an accurate candidate for various biomedical products. In the present review, the most important and recent applications of AgNPs in biomedical products and biomedicine are considered.

Advances in Antibacterial Functionalized Coatings on Mg and Its Alloys for Medical Use—A Review

As a revolutionary implant material, magnesium and its alloys have many exciting performances, such as biodegradability, mechanical compatibility, and excellent biosecurity. However, the rapid and uncontrollable degradation rate of magnesium greatly hampers its clinical use. Many efforts have been taken to enhance the corrosion resistance of magnesium. However, it must be noted that improving the corrosion resistance of magnesium will lead to the compromise of its antibacterial abilities, which are attribute and proportional to the alkaline pH during its degradation. Providing antibacterial functionalized coating is one of the best methods for balancing the degradation rate and the antibacterial ability of magnesium. Antibacterial functionalized magnesium is especially well-suited for patients with diabetes and infected wounds. Considering the extremely complex biological environment in the human body and the demands of enhancing corrosion resistance, biocompatibility, osteogenesis, and antibacterial ability, composite coatings with combined properties of different materials may be promising. The aim of this review isto collect and compare recent studies on antibacterial functionalized coatings on magnesium and its alloys. The clinical applications of antibacterial functionalized coatings and their material characteristics, antibacterial abilities, in vitro cytocompatibility, and corrosion resistance are also discussed in detail.

Polymethyl Methacrylate-Based Bone Cements Containing Carbon Nanotubes and Graphene Oxide: An Overview of Physical, Mechanical, and Biological Properties

Every year, millions of people in the world get bone diseases and need orthopedic surgery as one of the most important treatments. Owing to their superior properties, such as acceptable biocompatibility and providing great primary bone fixation with the implant, polymethyl methacrylate (PMMA)-based bone cements (BCs) are among the essential materials as fixation implants in different orthopedic and trauma surgeries. On the other hand, these BCs have some disadvantages, including Lack of bone formation and bioactivity, and low mechanical properties, which can lead to bone cement (BC) failure. Hence, plenty of studies have been concentrating on eliminating BC failures by using different kinds of ceramics and polymers for reinforcement and also by producing composite materials. This review article aims to evaluate mechanical properties, self-setting characteristics, biocompatibility, and bioactivity of the PMMA-based BCs composites containing carbon nanotubes (CNTs), graphene oxide (GO), and carbon-based compounds. In the present study, we compared the effects of CNTs and GO as reinforcement agents in the PMMA-based BCs. Upcoming study on the PMMA-based BCs should concentrate on trialing combinations of these carbon-based reinforcing agents as this might improve beneficial characteristics.

Three-Dimensional Printing Constructs Based on the Chitosan for Tissue Regeneration: State of the Art, Developing Directions and Prospect Trends

Chitosan (CS) has gained particular attention in biomedical applications due to its biocompatibility, antibacterial feature, and biodegradability. Hence, many studies have focused on the manufacturing of CS films, scaffolds, particulate, and inks via different production methods. Nowadays, with the possibility of the precise adjustment of porosity size and shape, fiber size, suitable interconnectivity of pores, and creation of patient-specific constructs, 3D printing has overcome the limitations of many traditional manufacturing methods. Therefore, the fabrication of 3D printed CS scaffolds can lead to promising advances in tissue engineering and regenerative medicine. A review of additive manufacturing types, CS-based printed constructs, their usages as biomaterials, advantages, and drawbacks can open doors to optimize CS-based constructions for biomedical applications. The latest technological issues and upcoming capabilities of 3D printing with CS-based biopolymers for different applications are also discussed. This review article will act as a roadmap aiming to investigate chitosan as a new feedstock concerning various 3D printing approaches which may be employed in biomedical fields. In fact, the combination of 3D printing and CS-based biopolymers is extremely appealing particularly with regard to certain clinical purposes. Complications of 3D printing coupled with the challenges associated with materials should be recognized to help make this method feasible for wider clinical requirements. This strategy is currently gaining substantial attention in terms of several industrial biomedical products. In this review, the key 3D printing approaches along with revealing historical background are initially presented, and ultimately, the applications of different 3D printing techniques for fabricating chitosan constructs will be discussed. The recognition of essential complications and technical problems related to numerous 3D printing techniques and CS-based biopolymer choices according to clinical requirements is crucial. A comprehensive investigation will be required to encounter those challenges and to completely understand the possibilities of 3D printing in the foreseeable future.

Clinoenstatite/Tantalum Coating for Enhancement of Biocompatibility and Corrosion Protection of Mg Alloy

Biodegradable Mg alloys have appeared as the most appealing metals for biomedical applications, particularly as temporary bone implants. However, issues regarding high corrosion rate and biocompatibility restrict their application. Hence, in the present work, nanostructured clinoenstatite (CLT, MgSiO3)/tantalum nitride (TaN) was deposited on the Mg-Ca-Zn alloy via electrophoretic deposition (EPD) along with physical vapor deposition (PVD) to improve the corrosion and biological characteristics of the Mg-Ca-Zn alloy. The TaN intermediate layer with bubble like morphology possessed a compact and homogenous structure with a thickness of about 950 nm while the thick CLT over-layer (~15 μm) displayed a less compact structure containing nano-porosities as well as nanoparticles with spherical morphology. The electrochemical tests demonstrated that the as prepared CLT/TaN film is able to substantially increase the anticorrosion property of Mg-Ca-Zn bare alloy. Cytocompatibility outcomes indicated that formation of CLT and TaN on the Mg bare alloy surface enhanced cell viability, proliferation and growth, implying excellent biocompatibility. Taken together, the CLT/TaN coating exhibits appropriate characteristic including anticorrosion property and biocompatibility in order to employ in biomedical files.