Action of FGMgCO3Ap-collagen composite in promoting bone formation

Sintering densification mechanism and mechanical properties of the 3D-printed high-melting-point-difference magnesium oxide/calcium phosphate composite bio-ceramic scaffold

Over the past few years, biodegradable ceramic scaffolds have gained significant attention in the field of bone repair. Calcium phosphate (Ca3(PO4)2)- and magnesium oxide (MgO)-based ceramics are biocompatible, osteogenic, and biodegradable, making them attractive for potential applications. However, the mechanical properties of Ca3(PO4)2 are limited. We developed a magnesium oxide/calcium phosphate composite bio-ceramic scaffold characterized by a high melting point difference, using vat photopolymerization (VP) technology to address this issue. The primary goal was to fabricate high-strength ceramic scaffolds using biodegradable materials. In this study, we investigated ceramic scaffolds with varying MgO contents and sintering temperatures. We also discussed the co-sintering densification mechanism of high and low melting-point materials associated with composite ceramic scaffolds. During sintering, a liquid phase was generated, which filled up the pores generated during the vaporization of additives (such as resin) under the influence of capillary force. This led to an increase in the extent of ceramic densification realized. Moreover, we found ceramic scaffolds with 80 wt% MgO exhibited the best mechanical performance. This kind of composite scaffold performed better than pure MgO scaffold. The results reported herein highlight that high-density composite ceramic scaffolds can be potentially used in the field of bone repair.

High Boron Content Enhances Bioactive Glass Biodegradation

Derived Hench bioactive glass (BaG) containing boron (B) is explored in this work as it plays an important role in bone development and regeneration. B was also found to enhance BaG dissociation. However, it is only possible to incorporate a limited amount of B. To increase the amount of B in BaG, bioactive borosilicate glasses (BaG-B_x) were fabricated based on the use of the solution-gelation process (sol-gel). In this work, a high B content (20 wt.%) in BaG, respecting the conditions of bioactivity and biodegradability required by Hench, was achieved for the first time. The capability of BaG-B_x to form an apatite phase was assessed in vitro by immersion in simulated body fluid (SBF). Then, the chemical structure and the morphological changes in the fabricated BaG-B_x (x = 0, 5, 10 and 20) were studied. The formation of hydroxyapatite (HAp) layer was observed with X-ray diffraction (XRD) and infrared (IR) spectroscopy. The presence of HAp layer was confirmed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Enhanced bioactivity and chemical stability of BaG-B_x were evaluated with an ion exchange study based on Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES) and energy dispersive spectroscopy (EDS). Results indicate that by increasing the concentration of B in BaG-Bx, the crystallization rate and the quality of the newly formed HAp layer on BaG-B_x surfaces can be improved. The presence of B also leads to enhanced degradation of BaGs in SBF. Accordingly, BAG-B_x can be used for bone regeneration, especially in children, because of its faster degradation as compared to B-free glass.

Optimizing the ECAP Parameters of Biodegradable Mg-Zn-Zr Alloy Based on Experimental, Mathematical Empirical, and Response Surface Methodology

Experimental investigations were conducted on Mg-3Zn-0.6Zr alloy under different ECAP conditions of number of passes, die angles, and processing route types, aimed at investigating the impact of the ECAP parameters on the microstructure evolution, corrosion behavior, and mechanical properties to reach optimum performance characteristics. To that end, the response surface methodology (RSM), analysis of variance, second-order regression models, genetic algorithm (GA), and a hybrid RSM-GA were utilized in the experimental study to determine the optimum ECAP processing parameters. All of the anticipated outcomes were within a very small margin of the actual experimental findings, indicating that the regression model was adequate and could be used to predict the optimization of ECAP parameters. According to the results of the experiments, route Bc is the most efficient method for refining grains. The electrochemical impedance spectroscopy results showed that the 4-passes of route Bc via the 120°-die exhibited higher corrosion resistance. Still, the potentiodynamic polarization results showed that the 4-passes of route Bc via the 90°-die demonstrated a better corrosion rate. Furthermore, the highest Vicker's microhardness, yield strength, and tensile strength were also disclosed by four passes of route Bc, whereas the best ductility at fracture was demonstrated by two passes of route C.

Antibacterial amorphous magnesium phosphate/graphene oxide for accelerating bone regeneration

Magnesium phosphates (MgP)s have attracted interest as an alternative biomaterial compared to the calcium phosphate (CaP)s compounds in the bone regeneration application in terms of their prominent biodegradability, lack of cytotoxicity, and ability of bone repair stimulation. Among them, amorphous magnesium phosphates (AMP)s indicated a higher rate of resorption, while preserving high osteoblasts viability and proliferation, which is comparable to their CaP peers. However, fast degradation of AMP leads to the initial fast release of Mg²⁺ ions and adverse effects on its excellent biological features. It seems that the addition of graphene oxide (GO) to magnesium phosphate can moderate its degradation rate. Hence, a novel in situ synthesized AMP powders containing 0.05, 0.25, 0.5, and 1 wt% of graphene oxide (AMP/GO) were developed to achieve a favorable degradation rate, desirable antibacterial properties against both Escherichia coli (E. coli), Staphylococcus aureus (S. aureus) accompanying with proper cell viability and proliferation. The incorporation of 0.5 wt% of graphene oxide into the AMP ceramic led to reduce the release of Mg²⁺ ions from 571.2 ± 12.9 mg/L to 372.8 ± 14.7 mg/L and P ions from 354.8 ± 11.9 mg/L to 245.3 ± 9.9 mg/L, at day 10 of immersion in PBS. Besides, AMP/0.5 GO bioceramics were capable of eradicating all bacterial colonies of both strains. On the other hand, MG63 cells viability went up from 143.46% ± 7.54 to 184.46% ± 11.54 on the 7th day of culture in the presence of 0.5 wt% of GO compared to pure AMP ceramic. Furthermore, alizarin red staining and alkaline phosphatase (ALP) activity demonstrated the ability of AMP/GO to maintain the osteogenic phenotype of MG63 cells during 7 days culture. Therefore, it can be concluded that well distributed and in situ synthesized AMP/0.5GO powders can be a promising biomaterial for bone tissue regeneration.

Pharmaceutical electrospinning and 3D printing scaffold design for bone regeneration

Bone regenerative engineering provides a great platform for bone tissue regeneration covering cells, growth factors and other dynamic forces for fabricating scaffolds. Diversified biomaterials and their fabrication methods have emerged for fabricating patient specific bioactive scaffolds with controlled microstructures for bridging complex bone defects. The goal of this review is to summarize the points of scaffold design as well as applications for bone regeneration based on both electrospinning and 3D bioprinting. It first briefly introduces biological characteristics of bone regeneration and summarizes the applications of different types of material and the considerations for bone regeneration including polymers, ceramics, metals and composites. We then discuss electrospinning nanofibrous scaffold applied for the bone regenerative engineering with various properties, components and structures. Meanwhile, diverse design in the 3D bioprinting scaffolds for osteogenesis especially in the role of drug and bioactive factors delivery are assembled. Finally, we discuss challenges and future prospects in the development of electrospinning and 3D bioprinting for osteogenesis and prominent strategies and directions in future.

Excellency of Hydroxyapatite Composite Scaffolds for Bone Tissue Engineering

The hydroxyapatite [HAp, Ca10(PO4)6(OH)2] has a variety of applications in bone fillers and replacements due to its excellent bioactivity and osteoconductivity. It comprises the main inorganic component of hard tissues. Among the various approaches, a composite approach using several components like biopolymer, gelatin, collagen, and chitosan in the functionalization of scaffolds with HAp has the prospective to be an engineered biomaterial for bone tissue engineering. HAp composite scaffolds have been developed to obtain a material with different functionalities such as surface reactivity, bioactivity, mechanical strength, and capability of drug or growth factor delivery. Several techniques and processes for the synthesis and fabrication of biocompatible HAp composite scaffolds suitable for bone regeneration are addressed here. Further, this chapter described the excellences of various HAp composite scaffolds used in in vitro and in vivo experiments in bone tissue engineering.

Effect of Laser Parameters on Processing of Biodegradable Magnesium Alloy WE43 via Selective Laser Melting Method

The global aim of the theme of magnesium alloy processing by the selective laser melting technology is to enable printing of replacements into the human body. By combining the advantages of WE43 magnesium alloy and additive manufacturing, it is possible to print support structures that have very similar properties to human bones. However, printing magnesium alloy parts is very difficult, and the printing strategies are still under development. Knowledge of weld deposit behaviour is needed to design a complex printing strategy and still missing. The main aim of the manuscript is the find a stable process window and identify the dependence of the weld deposit shape and properties on the laser power and scanning speed. The range of the tested parameters was 100–400 W and 100–800 mm/s for laser power and scanning speed. The profilometry and light microscopy were used to verify the continuity and shape evaluation. The microhardness and EDX analysis were used for the detailed view of the weld deposit. The manuscript specifies the weld deposit dimensions, their changes depending on laser power and scanning speed, and the continuity of the weld tracks. The stable weld deposits are made by the energy density of 5.5–12 J/mm². Thin walls were also created by layering welds to determine the surface roughness scattering (Ra 35–60) for various settings of laser power and scanning speed.

Obtaining and Characterizing Thin Layers of Magnesium Doped Hydroxyapatite by Dip Coating Procedure

A simple dip coating procedure was used to prepare the magnesium doped hydroxyapatite coatings. An adapted co-precipitation method was used in order to obtain a Ca25−xMgx(PO4)6(OH)2, 25MgHAp (xMg = 0.25) suspension for preparing the coatings. The stabilities of 25MgHAp suspensions were evaluated using ultrasound measurements, zeta potential (ZP), and dynamic light scattering (DLS). Using transmission electron microscopy (TEM) and scanning electron microscopy (SEM) information at nanometric resolution regarding the shape and distribution of the 25MgHAp particles in suspension was obtained. The surfaces of obtained layers were evaluated using SEM and atomic force microscopy (AFM) analysis. The antimicrobial evaluation of 25MgHAp suspensions and coatings on various bacterial strains and fungus were realized. The present study presents important results regarding the physico-chemical and antimicrobial studies of the magnesium doped hydroxyapatite suspensions, as well as the coatings. The studies have shown that magnesium doped hydroxyapatite suspensions prepared with xMg = 0.25 presented a good stability and relevant antimicrobial properties. The coatings made using 25MgHAp suspension were homogeneous and showed remarkable antimicrobial properties. Also, it was observed that the layer realized has antimicrobial properties very close to those of the suspension. Both samples of the 25MgHAp suspensions and coatings have very good biocompatible properties.

Enhanced Mechanical Properties of Surface Treated AZ31 Reinforced Polymer Composites

To enhance the potential application of naturally biodegradable polylactic acid (PLA)-based composites reinforced with magnesium alloy, anodized coatings between Mg and PLA were fabricated on AZ31 magnesium alloy rods. After anodizing (AO) at four different treatment times, the surface demonstrated a typical porous MgO ceramics morphology, which greatly improved the mechanical properties of composite rods compared to untreated pure Mg. This was attributed to the micro-anchoring effect, which increases interfacial binding forces significantly between the Mg rod and PLA. Additionally, the AO layer can also substantially improve the degradability of composite rods in Hank’s solution, due to good corrosion resistance and stronger bonding between PLA and Mg. With a prolonged immersion time of up to 30 days, the porous MgO coating was eventually found to be degraded, evolving to a comparatively smooth surface resulting in a decline in mechanical properties due to a decrease in interfacial bonding strength. According to the current findings, the PLA-clad surface treated Mg composite rod may hold promise for use as a bioresorbable implant material for orthopedic inner fixation.

Biodegradable magnesium alloy (WE43) in bone-fixation plate and screw

The purpose of the present study was to evaluate the mechanical strength and the absorption rate of WE43 material and to develop an absorbable metallic plate and screw for craniofacial application. The extruded WE43 plate and screw were evaluated using a LeFort I osteotomy canine model of 10 beagle dogs. Animals were divided into two groups: five dogs in the experimental group and five dogs in the control group. μCT was acquired at 4, 12, and 24 weeks. At 24 weeks after the operation, all animals were sacrificed, and histologic evaluation was performed. Swelling and gas formation were observed in three dogs in the experimental groups at 8 weeks. From 12 weeks, infraorbital fistula and inflammation were observed in three dogs in the experimental group, which gradually decreased and disappeared at 24 weeks. Other two dogs showed less gas formation at 12 weeks. The plates were completely absorbed, and gas formation was not observed at 24 weeks in these two dogs. New bone was well formed around the plates and screws in both groups. Histologic examination showed no specific differences between two groups. The mechanical strength of extruded WE43 was sufficient for mid‐facial application. Plates and screws made with appropriately treated WE43 have the potential to be useful clinically.

Degradation and Biocompatibility of AZ31 Magnesium Alloy Implants In Vitro and In Vivo: A Micro-Computed Tomography Study in Rats

In current orthodontic practice, miniscrew implants (MSIs) for anchorage and bone fixation plates (BFPs) for surgical orthodontic treatment are commonly used. MSIs and BFPs that are made of bioabsorbable material would avoid the need for removal surgery. We investigated the mechanical, degradation and osseointegration properties and the bone-implant interface strength of the AZ31 bioabsorbable magnesium alloy to assess its suitability for MSIs and BFPs. The mechanical properties of a Ti alloy (TiA), AZ31 Mg alloy (MgA), pure Mg and poly-L-lactic acid (PLA) were investigated using a nanoindentation test. Also, pH changes in the solution and degradation rates were determined using immersion tests. Three-dimensional, high-resolution, micro-computed tomography (CT) of implants in the rat femur was performed. Biomechanical push-out testing was conducted to calculate the maximum shear strength of the bone-implant interface. Scanning electron microscopy (SEM), histological analysis and an evaluation of systemic inflammation were performed. MgA has mechanical properties similar to those of bone, and is suitable for implants. The degradation rate of MgA was significantly lower than that of Mg. MgA achieved a significantly higher bone-implant bond strength than TiA. Micro-CT revealed no significant differences in bone density or bone-implant contact between TiA and MgA. In conclusion, the AZ31 Mg alloy is suitable for both MSIs and BFPs.

Prospective Clinical and Histologic Evaluation of Alveolar Socket Healing Following Ridge Preservation Using a Combination of Hydroxyapatite and Collagen Biomimetic Xenograft Versus Demineralized Bovine Bone

PURPOSE

This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation.

MATERIALS

Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons.

RESULTS

Twenty patients (12 males, 8 females, mean age 42.8 ± 5.1 years, range 33-50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07 ± 10.3%) and DBBM (22.77 ± 6.95%), and a significantly higher residual material% for DBBM (15.77 ± 1.95%) than MgHA (5.01 ± 1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group.

CONCLUSION

The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.

Biocompatibility and osteogenic activity of guided bone regeneration membrane based on chitosan-coated magnesium alloy

Ideally, a guided bone regeneration membrane (GBRM) should possess high strength, as for titanium membranes, along with excellent biocompatibility and osteoconductivity, as for natural absorbable collagen membranes. Besides titanium, magnesium (Mg) is another metal widely used in the biomedical field, which also exhibits biodegradability. In this study, a composite chitosan‑magnesium (CS-Mg) membrane was fabricated by dip-coating Mg alloy into chitosan solution. In vitro and in vivo tests were performed to investigate whether this membrane could be used as biodegradable GBRM, and the test results were compared with those obtained for a commercial GBRM (Heal-All). The microstructure was analyzed by scanning electron microscopy-electron dispersive spectroscopy. The degradation behavior was investigated by immersing the membranes into Dulbecco's modified Eagle medium (DMEM). The in vitro biocompatibility was evaluated by cell adhesion, cytotoxicity and alkaline phosphatase (ALP) assays using MG63 cells. The cytotoxicity and ALP assays were performed with diluted extracts of Mg, CS-Mg and Heal-All. The results show that CS-Mg has a suitable degradation rate, as well as similar cell adhesion and cytocompatibility to Heal-All. However, the 10% CS-Mg extracts exhibited higher ALP activity at 3 and 5 days (p < 0.05) compared with the medium control and the Heal-All extracts, but no differences with 10% Mg extracts (p > 0.05). Rabbit calvarial defects were used for testing the osteogenic activity in vivo. Three groups of samples were examined: CS-Mg, Heal-All, and a blank control. Higher amounts of new bone were formed for the CS-Mg and Heal-All groups (p < 0.05) compared with the blank control, whereas no significant differences between the CS-Mg and Heal-All groups were observed (p > 0.1). In conclusion, the CS-Mg membrane shows great potential for application as a biodegradable metallic GBRM with excellent osteogenic activity.

Microstructure, mechanical, corrosion properties and cytotoxicity of beta‑calcium polyphosphate reinforced ZK61 magnesium alloy composite by spark plasma sintering

Magnesium alloy (ZK61) and beta-tricalcium phosphate (β-TCP) composite ZK61/xβ-TCP (x = 0, 5, 10, 15 wt%) are fabricated using spark plasma sintering (SPS). In this study, the microstructure, mechanical properties, degradation behavior in simulated body fluid and cytotoxicity tests of composite were investigated. The results show that when the content of β-TCP was 5 wt%, which could be evenly distributed on the boundary of ZK61 particles. But agglomeration phenomenon appeared when the content of β-TCP reached 15 wt%. The hardness and the compressive strength increase with increasing of β-TCP content, and ZK61/15β-TCP achieves a maximum Vickers hardness of 94.81 HV_0.1 and compressive strength of 402 ± 9 MPa. The immersion tests indicate that corrosion resistance of the composites are better than that of ZK61 matrix, especially ZK61/5β-TCP. Corrosion products of the composite surface are mainly Mg(OH)₂, HA and Ca₃(PO₄)₂. The cytotoxicity tests indicate that composite extracts have no toxicity to L-929 cells. These results suggest that ZK61/xβ-TCP composites are promising candidate for degradable implant materials.

The Influence of Mg2+ Ions on the In Vitro Efficacy of Chitosan-Titanium Dioxide Nanotubes (CTNTs) Scaffolds

Low mechanical strength and lack of osteoconductive cues are problems associated with chitosan-based scaffolds. This research aimed to fabricate reinforced chitosan-titanium dioxide (TiO2) nanotubes (CTNTs) scaffolds attributed to the enhanced biocompatibility and physical properties of TiO2 nanotubes (TNTs). The incorporation of hydrothermally synthesized TNTs at weight percent of 16 into chitosan was achieved via direct blending and lyophilization. CTNTs scaffolds were further subjected to 24-h adsorption in MgCl2 solutions of 0.5 mM, 1 mM, 2.5 mM, and 5 mM at physiological pH. The adsorption affinity of CTNTs towards Mg2+ ions was high and mainly attributed to the macroporosity of scaffolds and nanocavities of TNTs. The maximum monolayer adsorption capacity of CTNTs for Mg2+ ions was 8.8 mg/g scaffolds. Its adsorption isotherm fitted well with Langmuir isotherm by showing R2 of 0.9995. Fluorescence-based staining, cell viability, and alkaline phosphatase assays indicated that the adsorbed Mg2+ ions onto CTNTs scaffolds aided in promoting higher proliferation and early differentiation of MG63 cells than scaffolds without Mg2+ ions in a concentration-dependent manner. Based on current results, CTNTs scaffolds with Mg2+ ions may be a potential biomaterial for bone regeneration.

Unraveling the osteogenesis of magnesium by the activity of osteoblasts in vitro

Magnesium (Mg) alloys, having a unique combination of strength and degradation, are being explored for various craniofacial and orthopedic applications. Nevertheless, the underlying mechanism of Mg²⁺ to stimulate bone formation needs further investigation. In this in vitro study, the degradation behavior of pure Mg and the effect of Mg²⁺ on the activity of osteoblasts were elucidated. From the corrosion test, it was determined that the degradation of pure Mg was able to create an alkaline microenvironment. It was further determined that Mg²⁺ promoted the proliferation and differentiation of osteoblasts. By western blotting analysis, it was noted that Mg²⁺ increased the phosphorylation of ERK (enhanced the c-fos level) and induced GSK3β phosphorylation (enhanced the β-catenin levels). These results demonstrated that the degradation of Mg was able to promote the proliferation and differentiation of osteoblasts, which may be related to the newly created alkaline microenvironment and the osteogenesis potential of released Mg²⁺ through the MAPK/ERK signaling pathway.

The Bioresorption and Guided Bone Regeneration of Absorbable Hydroxyapatite-Coated Magnesium Mesh

INTRODUCTION

Nonabsorbable metallic membrane for guided bone regeneration is remained permanently even though after complete healing. There would be metallic exposure followed by the risk of infection; the membrane should be removed for the additional procedure such as implant installation. Since absorbable nonmetallic mesh is absorbed within 3 to 6 months, it is unnecessary to be removed. However, the absorbable membrane shows lower retention, lower mechanical strength, and difficulty of manipulation than the nonabsorbable ones.The purpose of this study is to evaluate the ability of absorbable metallic mesh (hydroxyapatite-coated magnesium mesh) with acceptable mechanical properties and satisfying biocompatibility.

METHODS

The bioresorption and fate of magnesium were evaluated in Sprague Dawley rat (SD rat) with critical defect of calvarium. The critical defect with a diameter of 8 mm was made on calvarium using trephine bur in 18 SD rats. The defected models were divided into 2 groups: the control group (9 SD rat) without mesh and the experimental group (9 SD rat) with the insertion of prototype HA-coated magnesium mesh. The 3 SD rats were sacrificed at 6, 12, and 18 weeks. The histopathological and radiographic examinations were performed afterward.

RESULTS

In the control group, there was no specific symptom. The experimental group also showed no specific symptom including swelling and dehiscence related to hydrogen gas formation. From 6 to 18 weeks, the experimental group showed the progressive absorption and fracture of magnesium mesh. However, there was no specific effectiveness of guided bone regeneration in both groups. There was no significant difference in bone volume, bone surface, and bone volume fraction between the negative control group and the group with magnesium mesh (P >0.05).

CONCLUSION

Hydroxyapatite-coated magnesium mesh showed reasonable process of bioresorption and bony reaction; however, the effectiveness of guided bone regeneration and management of the bioresorption rate should be reconsidered.

Comparative study of porous hydroxyapatite/chitosan and whitlockite/chitosan scaffolds for bone regeneration in calvarial defects

Hydroxyapatite (HAP; Ca10(PO4)6(OH)2) and whitlockite (WH; Ca18Mg2(HPO4)2(PO4)12) are widely utilized in bone repair because they are the main components of hard tissues such as bones and teeth. In this paper, we synthesized HAP and WH hollow microspheres by using creatine phosphate disodium salt as an organic phosphorus source in aqueous solution through microwave-assisted hydrothermal method. Then, we prepared HAP/chitosan and WH/chitosan composite membranes to evaluate their biocompatibility in vitro and prepared porous HAP/chitosan and WH/chitosan scaffolds by freeze drying to compare their effects on bone regeneration in calvarial defects in a rat model. The experimental results indicated that the WH/chitosan composite membrane had a better biocompatibility, enhancing proliferation and osteogenic differentiation ability of human mesenchymal stem cells than HAP/chitosan. Moreover, the porous WH/chitosan scaffold can significantly promote bone regeneration in calvarial defects, and thus it is more promising for applications in tissue engineering such as calvarial repair compared to porous HAP/chitosan scaffold.

Micromorphological effect of calcium phosphate coating on compatibility of magnesium alloy with osteoblast

Octacalcium phosphate (OCP) and hydroxyapatite (HAp) coatings were developed to control the degradation speed and to improve the biocompatibility of biodegradable magnesium alloys. Osteoblast MG-63 was cultured directly on OCP- and HAp-coated Mg-3Al-1Zn (wt%, AZ31) alloy (OCP- and HAp-AZ31) to evaluate cell compatibility. Cell proliferation was remarkably improved with OCP and HAp coatings which reduced the corrosion and prevented the H2O2 generation on Mg alloy substrate. OCP-AZ31 showed sparse distribution of living cell colonies and dead cells. HAp-AZ31 showed dense and homogeneous distribution of living cells, with dead cells localized over and around corrosion pits, some of which were formed underneath the coating. These results demonstrated that cells were dead due to changes in the local environment, and it is necessary to evaluate the local biocompatibility of magnesium alloys. Cell density on HAp-AZ31 was higher than that on OCP-AZ31 although there was not a significant difference in the amount of Mg ions released in medium between OCP- and HAp-AZ31. The outer layer of OCP and HAp coatings consisted of plate-like crystal with a thickness of around 0.1 μm and rod-like crystals with a diameter of around 0.1 μm, respectively, which grew from a continuous inner layer. Osteoblasts formed focal contacts on the tips of plate-like OCP and rod-like HAp crystals, with heights of 2-5 μm. The spacing between OCP tips of 0.8-1.1 μm was wider than that between HAp tips of 0.2-0.3 μm. These results demonstrated that cell proliferation depended on the micromorphology of the coatings which governed spacing of focal contacts. Consequently, HAp coating is suitable for improving cell compatibility and bone-forming ability of the Mg alloy.

Bioactive calcium phosphate-based glasses and ceramics and their biomedical applications: A review

An overview of the formation of calcium phosphate under in vitro environment on the surface of a range of bioactive materials (e.g. from silicate, borate, and phosphate glasses, glass-ceramics, bioceramics to metals) based on recent literature is presented in this review. The mechanism of bone-like calcium phosphate (i.e. hydroxyapatite) formation and the test protocols that are either already in use or currently being investigated for the evaluation of the bioactivity of biomaterials are discussed. This review also highlights the effect of chemical composition and surface charge of materials, types of medium (e.g. simulated body fluid, phosphate-buffered saline and cell culture medium) and test parameters on their bioactivity performance. Finally, a brief summary of the biomedical applications of these newly formed calcium phosphate (either in the form of amorphous or apatite) is presented.

Mineral-substituted hydroxyapatite reinforced poly(raffinose-citric acid)–polyethylene glycol nanocomposite enhances osteogenic differentiation and induces ectopic bone formation

Progress of biomimetic mineral-substituted hydroxyapatite reinforced poly(raffinose-citric acid)–polyethylene glycol–poly(raffinose-citric acid) for prospective ectopic bone formation.

Biomimetic, Osteoconductive Non-mulberry Silk Fiber Reinforced Tricomposite Scaffolds for Bone Tissue Engineering

Composite biomaterials as artificial bone graft materials are pushing the present frontiers of bioengineering. In this study, a biomimetic, osteoconductive tricomposite scaffold made of hydroxyapatite (HA) embedded in non-mulberry Antheraea assama (A. assama) silk fibroin fibers and its fibroin solution is explored for its osteogenic potential. Scaffolds were physico-chemically characterized for morphology, porosity, secondary structure conformation, water retention ability, biodegradability, and mechanical property. The results revealed a ∼5-fold increase in scaffold compressive modulus on addition of HA and silk fibers to liquid silk as compared to pure silk scaffolds while maintaining high scaffold porosity (∼90%) with slower degradation rates. X-ray diffraction (XRD) results confirmed deposition of HA crystals on composite scaffolds. Furthermore, the crystallite size of HA within scaffolds was strongly regulated by the intrinsic physical cues of silk fibroin. Fourier transform infrared (FTIR) spectroscopy studies indicated strong interactions between HA and silk fibroin. The fabricated tricomposite scaffolds supported enhanced cellular viability and function (ALP activity) for both MG63 osteosarcoma and human bone marrow stem cells (hBMSCs) as compared to pure silk scaffolds without fiber or HA addition. In addition, higher expression of osteogenic gene markers such as collagen I (Col-I), osteocalcin (OCN), osteopontin (OPN), and bone sialoprotein (BSP) further substantiated the applicability of HA composite silk scaffolds for bone related applications. Immunostaining studies confirmed localization of Col-I and BSP and were in agreement with real-time gene expression results. These findings demonstrate the osteogenic potential of developed biodegradable tricomposite scaffolds with the added advantage of the affordability of its components as bone graft substitute materials.

A Cytocompatible Robust Hybrid Conducting Polymer Hydrogel for Use in a Magnesium Battery

A cytocompatible robust hybrid conducting-polymer hydrogel, polypyrrole/poly(3,4-ethylenedioxythiophene) is developed. This hydrogel is suitable for electrode-cellular applications. It demonstrates a high battery performance when coupled with a bioresorbable Mg alloy in phosphate-buffered saline. A combination of suitable mechanical and electrochemical properties makes this hydrogel a promising material for bionic applications.

Long-term in vivo degradation behavior and near-implant distribution of resorbed elements for magnesium alloys WZ21 and ZX50

We report on the long-term effects of degrading magnesium implants on bone tissue in a growing rat skeleton using continuous in vivo micro-Computed Tomography, histological staining and Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS). Two different magnesium alloys-one rapidly degrading (ZX50) and one slowly degrading (WZ21)-were used to evaluate the bone response and distribution of released Mg and Y ions in the femur of male Sprague-Dawley rats. Regardless of whether the alloy degrades rapidly or slowly, we found that bone recovers restitutio ad integrum after complete degradation of the magnesium implant. The degradation of the Mg alloys generates a significant increase in Mg concentration in the cortical bone near the remaining implant parts, but the Mg accumulation disappears after the implant degrades completely. The degradation of the Y-containing alloy WZ21 leads to Y enrichment in adjacent bone tissues and in newly formed bone inside the medullary space. Locally high Y concentrations suggest migration not only of Y ions but also of Y-containing intermetallic particles. However, after the full degradation of the implant the Y-enrichment disappears almost completely. Hydrogen gas formation and ion release during implant degradation did not harm bone regeneration in our samples.

STATEMENT OF SIGNIFICANCE

Magnesium is generally considered to be one of the most attractive base materials for biodegradable implants, and many magnesium alloys have been optimized to adjust implant degradation. Delayed degradation, however, generates prolonged presence in the organism with the risk of foreign body reactions. While most studies so far have only ranged from several weeks up to 12months, the present study provides data for complete implant degradation and bone regeneration until 24months, for two magnesium alloys (ZX50, WZ21) with different degradation characteristics. μCT monitoring, histological staining and LA-ICP-MS illustrate the distribution of the elements in the neighboring bony tissues during implant degradation, and reveal in particular high concentrations of the rare-earth element Yttrium.

Cytotoxicity assessment of adipose-derived mesenchymal stem cells on synthesized biodegradable Mg-Zn-Ca alloys

Magnesium (Mg)-based alloys have been extensively considered as biodegradable implant materials for orthopedic surgery. Mg and its alloys are metallic biomaterials that can degrade in the body and promote new bone formation. In this study, the corrosion behavior and cytotoxicity of Mg-Zn-Ca alloys are evaluated with adipose-derived mesenchymal stem cells (ASCs). Mg-2Zn and Mg-2Zn-xCa (x=1, 2 and 3wt.%) alloys were designated. Mg alloys were analyzed with scanning electron microscopy and potentiodynamic polarization. To understand the in-vitro biocompatibility and cytotoxicity of Mg-2Zn and Mg-2Zn-xCa alloys, ASCs were cultured for 24 and 72h in contact with 10%, 50% and 100% extraction of all alloys prepared in DMEM. Cell cytotoxicity and viability of ASCs were examined by MTT assay. Alloying elements including Zn and Ca improved the corrosion resistance of alloys were compared with pure Mg. The cytotoxicity results showed that all alloys had no significant adverse effects on cell viability in 24h. After 72h, cell viability and proliferation increased in the cells exposed to pure Mg and Mg-2Zn-1Ca extracts. The release of Mg, Zn and Ca ions in culture media had no toxic impacts on ASCs viability and proliferation. Mg-2Zn-1Ca alloy can be suggested as a good candidate to be used in biomedical applications.

In Vitro Corrosion Study of Friction Stir Processed WE43 Magnesium Alloy in a Simulated Body Fluid

Corrosion behavior of friction stir processing (FSP) WE43 alloy in a simulated body fluid (SBF) was investigated. Micro-galvanic corrosion was the dominated corrosion behavior, and the corrosion resistance of FSP WE43 alloy was improved compared to the cast counterpart. Furthermore, due to the fine-grained and homogeneous microstructure, uniform corrosion morphology was observed on FSP WE43 alloy. According to the tensile properties of specimens with different immersion time intervals, FSP WE43 alloy shows better performance to maintain the mechanical integrity in SBF as compared to the as-cast alloy.

In vivo monitoring the biodegradation of magnesium alloys with an electrochemical H2 sensor

Monitoring the biodegradation process of magnesium and its alloys in vivo is challenging. Currently, this process is monitored by micro-CT and X-ray imaging in vivo, which require large and costly instrumentation. Here we report a simple and effective methodology to monitor the biodegradation process in vivo by sensing H2 transdermally above a magnesium sample implanted subcutaneously in a mouse. An electrochemical H2 microsensor was used to measure the biodegradation product H2 at the surface of the skin for two magnesium alloys (ZK40 and AZ31) and one high purity magnesium single crystal (Mg8H). The sensor was able to easily detect low levels of H2 (30-400μM) permeating through the skin with a response time of about 30s. H2 levels were correlated with the biodegradation rate as determined from weight loss measurements of the implants. This new method is noninvasive, fast and requires no major equipment.

STATEMENT OF SIGNIFICANCE

Biomedical devices such as plates and screws used for broken bone repair are being developed out of biodegradable magnesium alloys that gradually dissolve when no longer needed. This avoids subsequent removal by surgery, which may be necessary if complications arise. A rapid, non-invasive means for monitoring the biodegradation process in vivo is needed for animal testing and point of care (POC) evaluation of patients. Here we report a novel, simple, fast, and noninvasive method to monitor the biodegradation of magnesium in vivo by measuring the biodegradation product H2 with an electrochemical H2 sensor. Since H2 rapidly permeates through biological tissue, measurements are made by simply pressing the sensor tip against the skin above the implant; the response is within 30s.

Functions of the Mg–HA coating on carbon/carbon composite surface to promote the proliferation and osteogenic differentiation of mBMSCs

This study aims to evaluate the functions of the Mg–hydroxyapatite (Mg–HA) bio-coating on carbon/carbon composite (C/C) surface to promote the proliferation and osteogenic differentiation of bone mesenchymal stem cell (BMSCs).

Calcium Orthophosphate-Containing Biocomposites and Hybrid Biomaterials for Biomedical Applications

The state-of-the-art on calcium orthophosphate (CaPO4)-containing biocomposites and hybrid biomaterials suitable for biomedical applications is presented. Since these types of biomaterials offer many significant and exciting possibilities for hard tissue regeneration, this subject belongs to a rapidly expanding area of biomedical research. Through the successful combinations of the desired properties of matrix materials with those of fillers (in such systems, CaPO4 might play either role), innovative bone graft biomaterials can be designed. Various types of CaPO4-based biocomposites and hybrid biomaterials those are either already in use or being investigated for biomedical applications are extensively discussed. Many different formulations in terms of the material constituents, fabrication technologies, structural and bioactive properties, as well as both in vitro and in vivo characteristics have been already proposed. Among the others, the nano-structurally controlled biocomposites, those containing nanodimensional compounds, biomimetically fabricated formulations with collagen, chitin and/or gelatin, as well as various functionally graded structures seem to be the most promising candidates for clinical applications. The specific advantages of using CaPO4-based biocomposites and hybrid biomaterials in the selected applications are highlighted. As the way from a laboratory to a hospital is a long one and the prospective biomedical candidates have to meet many different necessities, the critical issues and scientific challenges that require further research and development are also examined.

Development of thermosensitive hydrogels of chitosan, sodium and magnesium glycerophosphate for bone regeneration applications

Thermosensitive injectable hydrogels based on chitosan neutralized with sodium beta-glycerophosphate (Na-β-GP) have been studied as biomaterials for drug delivery and tissue regeneration. Magnesium (Mg) has been reported to stimulate adhesion and proliferation of bone forming cells. With the aim of improving the suitability of the aforementioned chitosan hydrogels as materials for bone regeneration, Mg was incorporated by partial substitution of Na-β-GP with magnesium glycerophosphate (Mg-GP). Chitosan/Na-β-GP and chitosan/Na-β-GP/Mg-GP hydrogels were also loaded with the enzyme alkaline phosphatase (ALP) which induces hydrogel mineralization. Hydrogels were characterized physicochemically with respect to mineralizability and gelation kinetics, and biologically with respect to cytocompatibility and cell adhesion. Substitution of Na-β-GP with Mg-GP did not negatively influence mineralizability. Cell biological testing showed that both chitosan/Na-β-GP and chitosan/Na-β-GP/Mg-GP hydrogels were cytocompatible towards MG63 osteoblast-like cells. Hence, chitosan/Na-β-GP/Mg-GP hydrogels can be used as an alternative to chitosan/Na-β-GP hydrogels for bone regeneration applications. However the incorporation of Mg in the hydrogels during hydrogel formation did not bring any appreciable physicochemical or biological benefit.

A novel multilayer model with controllable mechanical properties for magnesium-based bone plates

Proper mechanical properties are essential for the clinical application of magnesium-based implants. In the present work, a novel multilayer model composed of three layers with desirable features was developed. The modulus of the multilayer model can be adjusted by changing the thickness of each layer. To combine three layers and improve the corrosion resistance of the whole multilayer model, the polycaprolactone coating was employed. In the immersion test, pH values, the concentration of released magnesium ions, and weight loss indicate that the corrosion rate of multilayer models is considerable lower than that of the one-layer bare substrate. The three-point bending test, which is used to examine models' mechanical properties, shows that the flexural modulus of multilayer models is reduced effectively. In addition, the mechanical degradation of multilayer models is more stable, compared to the one-layer substrate.

Single walled carbon nanotubes reinforced mineralized hydroxyapatite composite coatings on titanium for improved biocompatible implant applications

Carbon nanotubes reinforced mineralized hydroxyapatite (CNT/M-HAP) composite coating on titanium by pulsed electrodeposition is a promising approach to produce bioimplants with better osseointegration capacity and improved mechanical property.

Long-term in vivo experimental investigations on magnesium doped hydroxyapatite bone substitutes

Despite several efforts to find suitable alternatives to autologous bone, no bone substitute currently available provides the same characteristics and properties. Nevertheless, among the wide range of materials proposed as bone substitutes, calcium phosphate materials represent the most promising category and the present study is aimed at improving the knowledge on non-stoichiometric magnesium-doped hydroxyapatite substitutes (Mg-HA), tested in two different formulations: Mg-HA Putty and Mg-HA Granules. These bone substitutes were implanted bilaterally into iliac crest bone defects in healthy sheep and comparative histological, histomorphometric, microhardness and ultrastructural assessments were performed 9, 12, 18 and 24 months after surgery to elucidate bone tissue apposition, mineralization and material degradation in vivo. The results confirmed that the biomimetic bone substitutes provide a histocompatible and osteoconductive structural support, during the bone formation process, and give essential information about the in vivo resorption process and biological behavior of biomimetic bone substitutes.

Hydroxyapatite-Based Biomaterials Versus Autologous Bone Graft in Spinal Fusion: An In Vivo Animal Study

STUDY DESIGN

An in vivo study was designed to compare the efficacy of biomimetic magnesium-hydroxyapatite (MgHA) and of human demineralized bone matrix (HDBM), both dispersed in a mixture of biomimetic MgHA nanoparticles, with that of an autologous bone graft.

OBJECTIVE

The objective of this study was to evaluate 2 new bone substitutes as alternatives to a bone autograft for spinal fusion, determining their osteoinductive and osteoconductive properties, and their capacity of remodeling, using a large animal model.

SUMMARY OF BACKGROUND DATA

Spinal fusion is a common surgical procedure and it is performed for different conditions. A successful fusion requires potentially osteogenic, osteoinductive, and osteoconductive biomaterials.

METHODS

A posterolateral spinal fusion model involved 18 sheep, bilaterally implanting test materials between the vertebral transverse processes. The animals were divided into 2 groups: 1 fusion level was treated with MgHA (group 1) or with HDBM-MgHA (group 2). The other fusion level received bone autografts in both groups.

RESULTS

Radiographical, histological, and microtomographic results indicated good osteointegration between the spinous process and the vertebral foramen for both materials. Histomorphometry revealed no significant differences between MgHA and autologous bone for all the parameters examined, whereas significantly lower values of bone volume were observed between HDBM-MgHA and autologous bone. Moreover, the normalization of the histomorphometric data with autologous bone revealed that MgHA showed a significantly higher value of bone volume and a lower value of trabecular number, more similar to autologous bone than HDBM-MgHA.

CONCLUSION

The study showed that the use of MgHA in an ovine model of spinal fusion led to the deposition of new bone tissue without qualitative and quantitative differences with respect to new bone formed with autologous bone, whereas the HDBM-MgHA led to a reduced deposition of newly formed bone tissue.

LEVEL OF EVIDENCE

N/A.

Generation of composites for bone tissue-engineering applications consisting of gellan gum hydrogels mineralized with calcium and magnesium phosphate phases by enzymatic means

Mineralization of hydrogels, desirable for bone regeneration applications, may be achieved enzymatically by incorporation of alkaline phosphatase (ALP). ALP-loaded gellan gum (GG) hydrogels were mineralized by incubation in mineralization media containing calcium and/or magnesium glycerophosphate (CaGP, MgGP). Mineralization media with CaGP:MgGP concentrations 0.1:0, 0.075:0.025, 0.05:0.05, 0.025:0.075 and 0:0.1 (all values mol/dm³ , denoted A, B, C, D and E, respectively) were compared. Mineral formation was confirmed by IR and Raman, SEM, ICP-OES, XRD, TEM, SAED, TGA and increases in the the mass fraction of the hydrogel not consisting of water. Ca was incorporated into mineral to a greater extent than Mg in samples mineralized in media A-D. Mg content and amorphicity of mineral formed increased in the order A < B < C < D. Mineral formed in media A and B was calcium-deficient hydroxyapatite (CDHA). Mineral formed in medium C was a combination of CDHA and an amorphous phase. Mineral formed in medium D was an amorphous phase. Mineral formed in medium E was a combination of crystalline and amorphous MgP. Young's moduli and storage moduli decreased in dependence of mineralization medium in the order A > B > C > D, but were significantly higher for samples mineralized in medium E. The attachment and vitality of osteoblastic MC3T3-E1 cells were higher on samples mineralized in media B-E (containing Mg) than in those mineralized in medium A (not containing Mg). All samples underwent degradation and supported the adhesion of RAW 264.7 monocytic cells, and samples mineralized in media A and B supported osteoclast-like cell formation. Copyright © 2014 John Wiley & Sons, Ltd.

Biodegradability engineering of biodegradable Mg alloys: tailoring the electrochemical properties and microstructure of constituent phases

Crystalline Mg-based alloys with a distinct reduction in hydrogen evolution were prepared through both electrochemical and microstructural engineering of the constituent phases. The addition of Zn to Mg-Ca alloy modified the corrosion potentials of two constituent phases (Mg + Mg2Ca), which prevented the formation of a galvanic circuit and achieved a comparable corrosion rate to high purity Mg. Furthermore, effective grain refinement induced by the extrusion allowed the achievement of much lower corrosion rate than high purity Mg. Animal studies confirmed the large reduction in hydrogen evolution and revealed good tissue compatibility with increased bone deposition around the newly developed Mg alloy implants. Thus, high strength Mg-Ca-Zn alloys with medically acceptable corrosion rate were developed and showed great potential for use in a new generation of biodegradable implants.

Nanostructured hydroxyapatite/poly(lactic-co-glycolic acid) composite coating for controlling magnesium degradation in simulated body fluid

Biodegradable magnesium (Mg) and its alloys have many attractive properties (e.g. comparable mechanical properties to cortical bone) for orthopedic implant applications, but they degrade too rapidly in the human body to meet clinical requirements. Nanostructured hydroxyapatite (nHA)/poly(lactic-co-glycolic acid) (PLGA) composite coatings provide synergistic properties for controlling degradation of Mg-based substrates and improving bone-implant integration. In this study, nHA/PLGA composites were spin coated onto Mg-based substrates and the results showed that the nHA/PLGA coatings retained nano-scale features with nHA dispersed in PLGA matrix. In comparison with non-coated Mg, the nHA/PLGA composite coated Mg increased the corrosion potential and decreased the corrosion current in revised simulated body fluid (rSBF). After 24 h of immersion in rSBF, increased calcium phosphate (CaP) deposition and formation of Mg-substituted CaP rosettes were observed on the surface of the nHA/PLGA coated Mg, indicating greater bioactivity. In contrast, no significant CaP was deposited on the PLGA coated Mg. Since both PLGA coating and nHA/PLGA coating showed some degree of delamination from Mg-based substrates during extended immersion in rSBF, the coating processing and properties should be further optimized in order to take full advantage of biodegradable Mg and nHA/PLGA nanocomposites for orthopedic applications.