Manipulation of Mg2+-Ca2+ Switch on the Development of Bone Mimetic Hydroxyapatite

Mechanical properties of simulated dentin caries treated with metal cations and L-ascorbic acid 2-phosphate

This pH cycling study aimed to investigate the effects of L-Ascorbic acid 2-phosphate (AA2P) salts of Mg, Zn, Mn, Sr, and Ba on the surface microhardness, compressive strength, diametral tensile strength (DTS), and solubility of root canal dentin. 186 cylindrical dentin specimens from 93 teeth were fortified with optimal concentrations of AA2P salts of Mg (0.18 mM), Zn (5.3 µM), Mn (2.2 × 10-8 M), Sr (1.8 µM), and Ba (1.9 µM). Saline was used as the control group. These dentin specimens underwent a 3-day cycling process simulating dentin caries formation through repeated sequences of demineralization and remineralization. Surface microhardness at 100 and 500 µm depths (n = 10/subgroup), scanning electron microscopy (n = 3/group), compressive strength (n = 10/group), DTS (n = 6/group), and solubility (n = 5/group) tests were performed to analyze the dentin specimens. Data were analyzed using Kolmogorov-Smirnov, one-way ANOVA, and Post Hoc Tukey tests (p < 0.05). The control group had significantly lower microhardness at both depths (p < 0.001), reduced DTS (p = 0.001), decreased compressive strength (p < 0.001), and higher weight loss (p < 0.001) than all other groups. The Sr group had the highest compressive strength and microhardness among all the groups. The microhardness was significantly higher for the 500 µm depth than the 100 µm depth (p < 0.001), but the difference in microhardness between depths across groups was not significant (p = 0.211). All fortifying solutions provided some protection against artificial caries lesions. Therefore, these elements might have penetrated and reinforced the demineralized dentin against acid dissolution.

The Mutual Incorporation of Mg2+ and CO32- into Hydroxyapatite: A DFT Study

Hydroxyapatite (HA) with a stoichiometry composition of Ca₁₀(PO₄)₆(OH)₂ is widely applied for various biomedical issues, first of all for bone defect substitution, as a catalyst, and as an adsorbent for soil and water purification. The incorporation of foreign ions changes the acid-base relation, microstructure, porosity, and other properties of the HA materials. Here, we report the results of calculations of the density functional theory and analyze the possibility of two foreign ions, CO₃^2- and Mg²⁺, to be co-localized in the HA structure. The Na⁺ was taken into account for charge balance preservation. The analysis revealed the favorable incorporation of CO₃^2- and Mg²⁺ as a complex when they interact with each other. The energy gain over the sole ion incorporation was pronounced when CO₃^2- occupied the A position and Mg²⁺ was in the Ca(2) position and amounted to -0.31 eV. In the most energy-favorable complex, the distance between Mg²⁺ and the O atom of carbonate ion decreased compared to Mg…O distances to the surrounding phosphate or hydroxide ions, and amounted to 1.98 Å. The theoretical calculations agree well with the experimental data reported earlier. Understating the structure-properties relationship in HA materials varying in terms of composition, stoichiometry, and morphology paves the way to rational designs of efficient bio-based catalytic systems.

Role of nanostructured materials in hard tissue engineering

The rise in the use of biomaterials in bone regeneration in the last decade has exponentially multiplied the number of publications, methods, and approaches to improve and optimize their functionalities and applications. In particular, biomimetic strategies based on the self-assembly of molecules to design, create and characterize nanostructured materials have played a very relevant role. We address this idea on four different but related points: self-setting bone cements based on calcium phosphate, as stable tissue support and regeneration induction; metallic prosthesis coatings for cell adhesion optimization and prevention of inflammatory response exacerbation; bio-adhesive hybrid materials as multiple drug delivery localized platforms and finally bio-inks. The effect of the physical, chemical, and biological properties of the newest biomedical devices on their bone tissue regenerative capacity are summarized, described, and analyzed in detail. The roles of experimental conditions, characterization methods and synthesis routes are emphasized. Finally, the future opportunities and challenges of nanostructured biomaterials with their advantages and shortcomings are proposed in order to forecast the future directions of this field of research.

Functional role of inorganic trace elements in dentin apatite tissue-Part 1: Mg, Sr, Zn, and Fe

Many essential elements exist in nature with significant influence on dentin and bone apatite tissue. Hydroxyapatite (HAp) is the major inorganic crystalline structure of dentin that provides a site for various physiological functions such as surface layer ion exchange. Decades of apatite research have shown that enamel is a high-substituted crystalline apatite, but recent findings suggest that dentin apatite may play a more important role in regulating ion exchange as well as mineral crystallinity. This article is the first part of a review series on the functional role of inorganic trace elements including magnesium, strontium, zinc, and iron in dentin hydroxyapatite. The morphology, physiology, crystallinity, and solubility of these elements as they get substituted into the HAp lattice are extensively discussed. An electronic search was performed on the role of these elements in dentin apatite from January 2007 to September 2021. The relationship between different elements and their role in the mineral upkeep of dentin apatite was evaluated. Several studies recognized the role of these elements in dentinal apatite composition and its subsequent effects on morphology, crystallinity, and solubility. These elements are of great importance in physiological processes and an essential part of living organisms. Magnesium and strontium stimulate osteoblast activity, while zinc can improve overall bone quality with its antibacterial properties. Iron nanoparticles are also vital in promoting bone tissue growth as they donate or accept electrons in redox reactions. Thus, understanding how these elements impact dentin apatite structure is of great clinical significance.

A Comparative EPR Study of Non-Substituted and Mg-Substituted Hydroxyapatite Behaviour in Model Media and during Accelerated Ageing

To assess the application potential of novel biomaterials, their behaviour in model media and upon sterilization should be investigated, as well as the stability related to their storage conditions. Such data are lacking for Mg-substituted HAP (Mg-HAP). Therefore, the changes in the local structure of non-substituted and Mg-HAP after irradiation and immersion in corrected simulated fluid and saline solution for 28 days were followed by electron paramagnetic resonance (EPR) spectroscopy for the first time. To better understand the stability of radical species induced by sterilization, EPR spectra of samples kept for 2 h at temperatures up to 373 K were recorded to provide an insight into the stability of the sample storage conditions by the accelerated aging method. Samples were characterized by PXRD, FTIR, SEM, EDS, AAS and TGA. Results confirmed that irradiation does not induce changes in the composition or the structure of any of the investigated materials. Fading or the complete disappearance of radical signals in the EPR spectra after immersion in both media was accompanied by the disappearance of other phases formed as a minor byproduct in the synthesis of substituted HAP, as confirmed by PXRD and FTIR analysis. Obtained results confirm the great potential of Mg-HAPs for biomedical applications, although closer attention should be given to the processes related to sample storage stability at different temperatures.

Zn/Sr dual ions-collagen co-assembly hydroxyapatite enhances bone regeneration through procedural osteo-immunomodulation and osteogenesis

The immune microenvironment induced by biomaterials played vital roles in bone regeneration. Hydroxyapatite (HA) and its ion-substituted derivates represent a large class of core inorganic materials for bone tissue engineering. Although ion substitution was proved to be a potent way to grant HA more biological functions, few studies focused on the immunomodulatory properties of ion-doped HA. Herein, to explore the potential osteoimmunomodulatory effects of ion-doped HA, zinc and strontium co-assembled into HA through a collagen template biomimetic way (ZnSr-Col-HA) was successfully achieved. It was found that ZnSr-Col-HA could induce a favorable osteo-immune microenvironment by stimulating macrophages. Furthermore, ZnSr-Col-HA demonstrated a procedural promoting effect on osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. Specifically, the osteo-immune microenvironment acted as a dominant factor in promoting osteogenic gene expressions at the early stage through OSM signal pathway. Whereas the direct stimulating effects on BMSCs by Zn²⁺/Sr²⁺ were more effectively at the later stage with Nfatc1/Maf and Wnt signals activated. In vivo study confirmed strong promoting effects of ZnSr-Col-HA on critical-sized cranial defect repair. The current study indicated that such a combined biomaterial design philosophy of dual ion-doping and biomimetic molecular co-assembly to endow HA applicable osteoimmunomodulatory characteristics might bring up a new cutting-edge concept for bone regeneration study.

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Zn/Sr dual ions-collagen co-assembly hydroxyapatite (ZnSr-Col-HA) was achieved via a molecular template biomimetic way.

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A procedural promoting effect of ZnSr-Col-HA on osteogenic differentiation of BMSCs was firstly found.

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A novel material design philosophy was proposed for dual ions-doped biomimetic HA with osteoimmunomodulatory properties.

Ba/Mg co-doped hydroxyapatite/PLGA composites enhance X-ray imaging and bone defect regeneration

Hydroxyapatite (HA) is the most commonly used orthopedic implant material. In recent years, the emergence of cationic doped hydroxyapatite has revealed more possibilities for the biological application of HA. Conventional HA does not promote new bone formation because of its poor osteoinductive activity, and has a similar density to that of bone, leading to difficulty in distinguishing both via imaging. Magnesium ions are useful for regulating the cellular behavior and promoting bone regeneration. Ba ion related compounds, such as BaSO₄, have a strong X-ray shielding effect. In this study, Ba/Mg@HA was synthesized to prepare Ba/Mg@HA/PLGA composites, and we aimed to investigate if Ba/Mg@HA/PLGA composites enhanced bone repair on osteoblasts and tibial defects, as well as the X-ray and CT imaging ability of bone implants in rats. The in vitro experimental results showed that the Ba/Mg@HA/PLGA composites significantly improved the attachment and osteogenic differentiation of MC3T3-E1 cells. These include the promotion of mineral deposition, enhancement of alkaline phosphatase activity, upregulation of OCN and COL-1 gene expression, and increase in COL-1 and OCN protein expression in a time- and concentration-dependent manner. The in vivo experimental results showed that the Ba/Mg@HA/PLGA composites significantly increased the rate of bone defect healing and the expression of BMP-2 and COL-1 in the bones of rats. X-ray and CT imaging results showed that the Ba/Mg@HA/PLGA composites enhanced the X-ray imaging ability. These findings indicate that the Ba/Mg@HA/PLGA composites can effectively promote bone formation and improve the X-ray and CT imaging abilities to a certain extent.

The Physico-Chemical Properties and Exploratory Real-Time Cell Analysis of Hydroxyapatite Nanopowders Substituted with Ce, Mg, Sr, and Zn (0.5-5 at.%)

Cation-substituted hydroxyapatite (HA), standalone or as a composite (blended with polymers or metals), is currently regarded as a noteworthy candidate material for bone repair/regeneration either in the form of powders, porous scaffolds or coatings for endo-osseous dental and orthopaedic implants. As a response to the numerous contradictions reported in literature, this work presents, in one study, the physico-chemical properties and the cytocompatibility response of single cation-doped (Ce, Mg, Sr or Zn) HA nanopowders in a wide concentration range (0.5–5 at.%). The modification of composition, morphology, and structure was multiparametrically monitored via energy dispersive X-ray, X-ray photoelectron, Fourier-transform infrared and micro-Raman spectroscopy methods, as well as by transmission electron microscopy and X-ray diffraction. From a compositional point of view, Ce and Sr were well-incorporated in HA, while slight and pronounced deviations were observed for Mg and Zn, respectively. The change of the lattice parameters, crystallite size, and substituting cation occupation factors either in the Ca(I) or Ca(II) sites were further determined. Sr produced the most important HA structural changes. The in vitro biological performance was evaluated by the (i) determination of leached therapeutic cations (by inductively coupled plasma mass spectrometry) and (ii) assessment of cell behaviour by both conventional assays (e.g., proliferation—3-(4,5-dimethyl thiazol-2-yl) 5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium assay; cytotoxicity—lactate dehydrogenase release assay) and, for the first time, real-time cell analysis (RTCA). Three cell lines were employed: fibroblast, osteoblast, and endothelial. When monophasic, the substituted HA supported the cells’ viability and proliferation without signs of toxicity. The RTCA results indicate the excellent adherence of cells. The study strived to offer a perspective on the behaviour of Ce-, Mg-, Sr-, or Zn-substituted HAs and to deliver a well-encompassing viewpoint on their effects. This can be highly important for the future development of such bioceramics, paving the road toward the identification of candidates with highly promising therapeutic effects.

Advanced Materials Based on Nanosized Hydroxyapatite

The development of new materials based on hydroxyapatite has undergone a great evolution in recent decades due to technological advances and development of computational techniques. The focus of this review is the various attempts to improve new hydroxyapatite-based materials. First, we comment on the most used processing routes, highlighting their advantages and disadvantages. We will now focus on other routes, less common due to their specificity and/or recent development. We also include a block dedicated to the impact of computational techniques in the development of these new systems, including: QSAR, DFT, Finite Elements of Machine Learning. In the following part we focus on the most innovative applications of these materials, ranging from medicine to new disciplines such as catalysis, environment, filtration, or energy. The review concludes with an outlook for possible new research directions.

Hydroxyapatite Based Materials for Bone Tissue Engineering: A Brief and Comprehensive Introduction

Hydroxyapatite (HA) is widely used in bone tissue engineering for its bioactivity and biocompatibility, and a growing number of researchers are exploring ways to improve the physical properties and biological functions of hydroxyapatite. Up to now, HA has been used as inorganic building blocks for tissue engineering or as nanofillers to blend with polymers, furthermore, various methods such as ion doping or surface modification have been also reported to prepare functionalized HA. In this review, we try to give a brief and comprehensive introduction about HA-based materials, including ion-doped HA, HA/polymer composites and surface modified HA and their applications in bone tissue engineering. In addition, the prospective of HA is also discussed. This review may be helpful for researchers to get a general understanding about the development of hydroxyapatite based materials.

Ion release from hydroxyapatite and substituted hydroxyapatites in different immersion liquids: in vitro experiments and theoretical modelling study

Multi-substituted hydroxyapatites (ms-HAPs) are currently gaining more consideration owing to their multifunctional properties and biomimetic structure, owning thus an enhanced biological potential in orthopaedic and dental applications. In this study, nano-hydroxyapatite (HAP) substituted with multiple cations (Sr2+, Mg2+ and Zn2+) for Ca2+ and anion ( Si O 4 4 - ) for P O 4 3 - and OH-, specifically HAPc-5%Sr and HAPc-10%Sr (where HAPc is HAP-1.5%Mg-0.2%Zn-0.2%Si), both lyophilized non-calcined and lyophilized calcined, were evaluated for their in vitro ions release. These nanomaterials were characterized by scanning electron microscopy, field emission-scanning electron microscopy and energy-dispersive X-ray, as well as by atomic force microscope images and by surface specific areas and porosity. Further, the release of cations and of phosphate anions were assessed from nano-HAP and ms-HAPs, both in water and in simulated body fluid, in static and simulated dynamic conditions, using inductively coupled plasma optical emission spectrometry. The release profiles were analysed and the influence of experimental conditions was determined for each of the six nanomaterials and for various periods of time. The pH of the samples soaked in the immersion liquids was also measured. The ion release mechanism was theoretically investigated using the Korsmeyer-Peppas model. The results indicated a mechanism principally based on diffusion and dissolution, with possible contribution of ion exchange. The surface of ms-HAP nanoparticles is more susceptible to dissolution into immersion liquids owing to the lattice strain provoked by simultaneous multi-substitution in HAP structure. According to the findings, it is rational to suggest that both materials HAPc-5%Sr and HAPc-10%Sr are bioactive and can be potential candidates in bone tissue regeneration.

Advanced Mg, Zn, Sr, Si Multi-Substituted Hydroxyapatites for Bone Regeneration

Purpose

Compositional tailoring is gaining more attention in the development of advanced biomimetic nanomaterials. In this study, we aimed to prepare advanced multi-substituted hydroxyapatites (ms-HAPs), which show similarity with the inorganic phase of bones and might have therapeutic potential for bone regeneration.

Materials

Novel nano hydroxyapatites substituted simultaneously with divalent cations: Mg²⁺ (1.5%), Zn²⁺ (0.2%), Sr²⁺ (5% and 10%), and Si (0.2%) as orthosilicate (SiO₄^4-) were designed and successfully synthesized for the first time.

Methods

The ms-HAPs were obtained via a wet-chemistry precipitation route without the use of surfactants, which is a safe and ecologically friendly method. The composition of synthesized materials was determined by inductively coupled plasma optical emission spectrometry (ICP-OES). The materials were characterized by X-ray powder diffraction (XRD), FT-IR and FT-Raman spectroscopy, BET measurements and by imaging techniques using high-resolution TEM (HR-TEM), FE-SEM coupled with EDX, and atomic force microscopy (AFM). The ion release was measured in water and in simulated body fluid (SBF).

Results

Characterization methods confirmed the presence of the unique phase of pure stoichiometric HAP structure and high compositional purity of all synthesized nanomaterials. The doping elements influenced the crystallite size, the crystallinity, lattice parameters, morphology, particle size and shape, specific surface area, and porosity. Results showed a decrease in both nanoparticle size and crystallinity degree, coupled with an increase in specific surface area of these advanced ms-HAP materials, in comparison with pure stoichiometric HAP. The release of biologically important ions was confirmed in different liquid media, both in static and simulated dynamic conditions.

Conclusion

The incorporation of the four substituting elements into the HAP structure is demonstrated. Synthesized nanostructured ms-HAP materials might inherit the in vivo effects of substituting functional elements and properties of hydroxyapatite for bone healing and regeneration. Results revealed a rational tailoring approach for the design of a next generation of bioactive ms-HAPs as promising candidates for bone regeneration.

Self-fluorescent antibiotic MoOx-hydroxyapatite: a nano-theranostic platform for bone infection therapies

Nowadays, the repair of large-size bone defects represents a huge medical challenge. A line of attack is the construction of advanced biomaterials having multifunctional properties. In this work, we show the creation of biocompatible MoOx-hydroxyapatite nanoparticles (nano-HA/MoOx) that simultaneously exhibit self-activated fluorescence and antibiotic skills. Along this text, we demonstrate that the insertion of molybdenum, an essential trace element, into the non-stoichiometric calcium deficient hydroxyapatite lattice generates intrinsic electronic point defects that exacerbate its epifluorescence blue emission and provokes new red emissions, preserving, always, its bioactivity. Furthermore, these point defects, acting as electron acceptors, stimulate the materials' biological redox status and promote the death of pathogen microorganisms after their direct contact. A putative mechanism, by which bacteria lose electrons from their metabolic circuit that alter the function of their cytoplasmic membrane and potentially die, agrees with our results. Our findings highlight the importance of tuning the electronic communications between biomaterial interfaces and biological units, and support the use of self-fluorescent MoOx-hydroxyapatite nanoparticles as fundamental building blocks for new real-time imaging platforms against bone infection.

Biocompatible chitosan-collagen-hydroxyapatite nanofibers coated with platelet-rich plasma for regenerative engineering of the rotator cuff of the shoulder

Over the last few decades, extraordinary progress has been accomplished in the field of bone tissue engineering. Containing an incredible number of growth factors required for the process of osteogenesis, platelet-rich plasma (PRP) has gained much interest. However, because of the conflicting results obtained in various investigations, its adequacy remains a riddle. Accordingly, in this paper, we explore the in vitro application of biocompatible chitosan–collagen–hydroxyapatite (CS–COLL–HAP) nanofibers coated with platelet-rich plasma (PRP) (CS–COLL–HAP/PRP) scaffolds for the regenerative engineering of the rotator cuff (RCF) of the shoulder. FTIR spectroscopy, XRD, SEM-EDX and HRTEM were performed to evaluate the characteristics of nanofibers. After confirmation of the physicochemical properties of nanofibers, the osteogenic capability of the scaffold was assessed by measuring the relative calcium content, ALP activity, and gene expression. The results of viability and live/dead assay and cell adhesion test indicated the adequacy of the PRP when coupled with nanofibers in contrast to the other tested groups. In vivo staining affirmed increased collagen association in the PRP with nanofiber scaffolds at 30 days and 60 days. In conclusion, the addition of the PRP into CS–COLL–HAP nanofibers in this examination affected the osteogenic differentiation of osteoblast cells, and therefore, it may have an incredible perspective for bone tissue applications.

Over the last few decades, extraordinary progress has been accomplished in the field of bone tissue engineering.

Noble microfluidic system for bioceramic nanoparticles engineering

Bioceramic nanoparticles have many potential applications within the biomedical device industry. However, these applications demand a precise control of their sizes, shapes and morphology which play a main role in most properties. In this work, we report a new route for the synthesis of hydroxyapatite nanoparticles using a microfluidic device. The process is carried out by continuous laminar flow through the device. The obtained nanoparticles have showed same properties (composition, length, orientation, roughness) than those produced by conventional methods, however, our device can afford to fine tune the structure via simple engineering, i.e., produce nanoparticles of different size only by varying the flow velocity. In addition to the efficiency and novelty of this system, the optimization of personnel costs makes it very profitable economically.

Effect of the Nano Crystal Size on the X-ray Diffraction Patterns of Biogenic Hydroxyapatite from Human, Bovine, and Porcine Bones

This paper focuses on the study of the effect of the change of the crystal size on the shape and width of the X-ray diffraction patterns for defatted and deproteinized bones as well as incinerated biogenic hydroxyapatite obtained from bovine, porcine, and human bones. Inductively Couple Plasma showed the presence of some ions such as Mg, K, Al, Fe, Zn, and Na for all samples. The nanometric size of the crystals was determined through High Resolution Transmission Electron Microscopy in which ordered crystals were found. The calcination of raw clean bones at 720 °C produced a transition of crystal size from nano to micro due to a coalescence phenomenon, this was accompanied by a decrease of the peak width of the X-ray diffraction patterns due to the decrease of the inelastic scattering contribution from the microcrystals. A simulation of the effect of the crystallite size on the shape and width of the X-ray patterns was done using PDF-4 software which confirmed that raw ordered bone crystals produce broad peaks which so far have been erroneously assigned to polycrystalline hydroxyapatite with low crystalline quality.

Adsorption/desorption study of antibiotic and anti-inflammatory drugs onto bioactive hydroxyapatite nano-rods

The use of high doses of antibacterial and anti-inflammatory drugs for patients with bone diseases, associated to implants or bone filling, can develop adverse effects; and consequently, it promotes to think new strategies to avoid this problem. In this work, it has been described the adsorption/release (or desorption) behavior of two drugs, ciprofloxacin (CIP) and ibuprofen (IBU), onto hydroxyapatite (nano-HA) at 37 °C. Through Ultraviolet-Visible (UV-Vis) spectroscopy, the concentrations of both drugs in adsorption, kinetic and desorption processes were obtained. The Fourier Transformed-Infrared (FT-IR) spectroscopy, Zeta-potential (ζ-potential), High-Resolution Transmission Electron Microscopy (H-TEM) and x-Ray Diffraction (xRD) were also used to characterize bared nanoparticles and those with adsorbed drugs. Five adsorption models (Langmuir, Freundlich, Sips, Temkin and Dubinin-Radushkevich) were used for describing the behavior of both active compounds. The adsorption processes (CIP/nano-HA and IBU/nano-HA) were better predicted by the Sips model than by the others. The kinetic adsorption data were processed, for both active agents, by application of Avrami's model. Desorption/release process (of both drugs) was evaluated though Korsmeyer-Peppas (K-P) model. Owing to the predictability of these systems, we propose the use of these active ceramics as potential bone filler for improving the treatment against bacterial bone infections and to avoid its associated inflammatory process.

La-Doped biomimetic scaffolds facilitate bone remodelling by synchronizing osteointegration and phagocytic activity of macrophages

The capacity of osteoconduction held by HA/CS, osteoinduction by La³⁺, and biodegradability by a La-HA/CS composite, contributes to an ideal scaffold for osteointegration and remodelling.

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

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

Electroactive Mg2+-Hydroxyapatite Nanostructured Networks against Drug-Resistant Bone Infection Strains

Surface colonization competition between bacteria and host cells is one of the critical factors involved in tissue/implant integration. Current biomaterials are evaluated for their ability both of withstanding favorable responses of host tissue cells and of resisting bacterial contamination. In this work, the antibacterial ability of biocompatible Mg²⁺-substituted nanostructured hydroxyapatite (HA) was investigated. The densities of Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli strains were significantly decreased after culture in the presence of Mg-substituted HA materials in direct correlation with Mg²⁺-Ca²⁺ switch in the HA lattice. It was noticed that this decrease was accompanied by a minimal alteration of bacterial environments; therefore, the Mg²⁺-HA antibacterial effect was associated with the material surface topography and it electroactive behavior. It was observed that 2.23 wt % Mg²⁺-HA samples exhibited the best antibacterial performance; it decreased 2-fold the initial population of E. coli, P. aeruginosa, and S. aureus at the intermediate concentration (50 mg mL^-1 of broth). Our results reinforce the potential of Mg-HA nanostructured materials to be used in antibacterial coatings for implantable devices and/or medicinal materials to prevent bone infection and to promote wound healing.