Nanocomposite Membranes Enhance Bone Regeneration Through Restoring Physiological Electric Microenvironment

Stimuli-responsive microcarriers and their application in tissue repair: A review of magnetic and electroactive microcarrier

Microcarrier applications have made great advances in tissue engineering in recent years, which can load cells, drugs, and bioactive factors. These microcarriers can be minimally injected into the defect to help reconstruct a good microenvironment for tissue repair. In order to achieve more ideal performance and face more complex tissue damage, an increasing amount of effort has been focused on microcarriers that can actively respond to external stimuli. These microcarriers have the functions of directional movement, targeted enrichment, material release control, and providing signals conducive to tissue repair. Given the high controllability and designability of magnetic and electroactive microcarriers, the research progress of these microcarriers is highlighted in this review. Their structure, function and applications, potential tissue repair mechanisms, and challenges are discussed. In summary, through the design with clinical translation ability, meaningful and comprehensive experimental characterization, and in-depth study and application of tissue repair mechanisms, stimuli-responsive microcarriers have great potential in tissue repair.

Remote coupling of electrical and mechanical cues by diurnal photothermal irradiation synergistically promotes bone regeneration

Recapitulating the natural extracellular physical microenvironment has emerged as a promising method for tissue regeneration, as multiple physical interventions, including ultrasound, thermal and electrical therapy, have shown great potential. However, simultaneous coupling of multiple physical cues to highly bio-mimick natural characteristics for improved tissue regeneration still remains formidable. Coupling of intrinsic electrical and mechanical cues has been regarded as an effective way to modulate tissue repair. Nevertheless, precise and convenient manipulation on coupling of mechano-electrical signals within extracellular environment to facilitate tissue regeneration remains challengeable. Herein, a photothermal-sensitive piezoelectric membrane was designed for simultaneous integration of electrical and mechanical signals in response to NIR irradiation. The high-performance mechano-electrical coupling under NIR exposure synergistically triggered the promotion of osteogenic differentiation of stem cells and enhances bone defect regeneration by increasing cellular mechanical sensing, attachment, spreading and cytoskeleton remodeling. This study highlights the coupling of mechanical signals and electrical cues for modulation of osteogenesis, and sheds light on alternative bone tissue engineering therapies with multiple integrated physical cues for tissue repair.

Design of PDMS/PAN composite membranes with ultra-interfacial stability via layer integration

The interfacial interaction between the selective layer and porous substrate directly determines the separation performance and service lifetime of functional composite membranes. Till now, almost all reported polymeric selective layers are physically in contact with the substrate, which is unsatisfactory for long-term operation. Herein, we introduced a functional composite membrane with ultra-interfacial stability via layer integration between the polydimethylsiloxane selective layer and polyacrylonitrile substrate, where a facile light-triggered copolymerization achieved their covalent bonding. The critical load for the failure of the selective layer is 45.73 mN when testing the interfacial adhesion, i.e., 5.8 times higher than that before modification and significantly higher than previous reports. It also achieves superior pervaporation performance with a separation factor of 9.54 and membrane flux of 1245.6 g m-2 h-1 feeding a 1000 ppm phenol/water solution at 60 °C that is significantly higher than the same type of polymeric ones. Not limited to pervaporation, such a strategy sheds light on the design of highly stable composite membranes with different purposes, while the facile photo-trigged technique shows enormous scalability.

Advances in biomaterials for oral-maxillofacial bone regeneration: spotlight on periodontal and alveolar bone strategies

The intricate nature of oral-maxillofacial structure and function, coupled with the dynamic oral bacterial environment, presents formidable obstacles in addressing the repair and regeneration of oral-maxillofacial bone defects. Numerous characteristics should be noticed in oral-maxillofacial bone repair, such as irregular morphology of bone defects, homeostasis between hosts and microorganisms in the oral cavity and complex periodontal structures that facilitate epithelial ingrowth. Therefore, oral-maxillofacial bone repair necessitates restoration materials that adhere to stringent and specific demands. This review starts with exploring these particular requirements by introducing the particular characteristics of oral-maxillofacial bones and then summarizes the classifications of current bone repair materials in respect of composition and structure. Additionally, we discuss the modifications in current bone repair materials including improving mechanical properties, optimizing surface topography and pore structure and adding bioactive components such as elements, compounds, cells and their derivatives. Ultimately, we organize a range of potential optimization strategies and future perspectives for enhancing oral-maxillofacial bone repair materials, including physical environment manipulation, oral microbial homeostasis modulation, osteo-immune regulation, smart stimuli-responsive strategies and multifaceted approach for poly-pathic treatment, in the hope of providing some insights for researchers in this field. In summary, this review analyzes the complex demands of oral-maxillofacial bone repair, especially for periodontal and alveolar bone, concludes multifaceted strategies for corresponding biomaterials and aims to inspire future research in the pursuit of more effective treatment outcomes.

A Janus, robust, biodegradable bacterial cellulose/Ti3C2Tx MXene bilayer membranes for guided bone regeneration

Guided bone regeneration (GBR) stands as an essential modality for craniomaxillofacial bone defect repair, yet challenges like mechanical weakness, inappropriate degradability, limited bioactivity, and intricate manufacturing of GBR membranes hindered the clinical efficacy. Herein, we developed a Janus bacterial cellulose(BC)/MXene membrane through a facile vacuum filtration and etching strategy. This Janus membrane displayed an asymmetric bilayer structure with interfacial compatibility, where the dense layer impeded cell invasion and the porous layer maintained stable space for osteogenesis. Incorporating BC with Ti3C2Tx MXene significantly enhanced the mechanical robustness and flexibility of the material, enabling clinical operability and lasting GBR membrane supports. It also contributed to a suitable biodegradation rate, which aligned with the long-term bone repair period. After demonstrating the desirable biocompatibility, barrier role, and osteogenic capability in vitro, the membrane's regenerative potential was also confirmed in a rat cranial defect model. The excellent bone repair performance could be attributed to the osteogenic capability of MXene nanosheets, the morphological cues of the porous layer, as well as the long-lasting, stable regeneration space provided by the GBR membrane. Thus, our work presented a facile, robust, long-lasting, and biodegradable BC/MXene GBR membrane, offering a practical solution to craniomaxillofacial bone defect repair.

Advances in electroactive biomaterials: Through the lens of electrical stimulation promoting bone regeneration strategy

The regenerative capacity of bone is indispensable for growth, given that accidental injury is almost inevitable. Bone regenerative capacity is relevant for the aging population globally and for the repair of large bone defects after osteotomy (e.g., following removal of malignant bone tumours). Among the many therapeutic modalities proposed to bone regeneration, electrical stimulation has attracted significant attention owing to its economic convenience and exceptional curative effects, and various electroactive biomaterials have emerged. This review summarizes the current knowledge and progress regarding electrical stimulation strategies for improving bone repair. Such strategies range from traditional methods of delivering electrical stimulation via electroconductive materials using external power sources to self-powered biomaterials, such as piezoelectric materials and nanogenerators. Electrical stimulation and osteogenesis are related via bone piezoelectricity. This review examines cell behaviour and the potential mechanisms of electrostimulation via electroactive biomaterials in bone healing, aiming to provide new insights regarding the mechanisms of bone regeneration using electroactive biomaterials.

The translational potential of this article

This review examines the roles of electroactive biomaterials in rehabilitating the electrical microenvironment to facilitate bone regeneration, addressing current progress in electrical biomaterials and the mechanisms whereby electrical cues mediate bone regeneration. Interactions between osteogenesis-related cells and electroactive biomaterials are summarized, leading to proposals regarding the use of electrical stimulation-based therapies to accelerate bone healing.

Biomimetic-inspired piezoelectric ovalbumin/BaTiO3 scaffolds synergizing with anisotropic topology for modulating Schwann cell and DRG behavior

The treatment of peripheral nerve injury is a clinical challenge that tremendously affected the patients' health and life. Anisotropic topographies and electric cues can simulate the regenerative microenvironment of nerve from physical and biological aspects, which show promising application in nerve regeneration. However, most studies just unilaterally emphasize the effect of sole topological- or electric- cue on nerve regeneration, while rarely considering the synergistic function of both cues simultaneously. In this study, a biomimetic-inspired piezoelectric topological ovalbumin/BaTiO3 scaffold that can provide non-invasive electrical stimulation in situ was constructed by combining piezoelectric BaTiO3 nanoparticles and surface microtopography. The results showed that the incorporation of piezoelectric nanoparticles could improve the mechanical properties of the scaffolds, and the piezoelectric output of the scaffolds after polarization was significantly increased. Biological evaluation revealed that the piezoelectric topological scaffolds could regulate the orientation growth of SCs, promote axon elongation of DRG, and upregulate the genes expression referring to myelination and axon growth, thus rapidly integrated chemical-mechanical signals and transmitted them for effectively promoting neuronal myelination, which was closely related to peripheral neurogenesis. The study suggests that the anisotropic surface topology combined with non-invasive electronic stimulation of the ovalbumin/BaTiO3 scaffolds possess a promising application prospect in the repair and regeneration of peripheral nerve injury.

Recent Advancements in Bone Tissue Engineering: Integrating Smart Scaffold Technologies and Bio-Responsive Systems for Enhanced Regeneration

In exploring the challenges of bone repair and regeneration, this review evaluates the potential of bone tissue engineering (BTE) as a viable alternative to traditional methods, such as autografts and allografts. Key developments in biomaterials and scaffold fabrication techniques, such as additive manufacturing and cell and bioactive molecule-laden scaffolds, are discussed, along with the integration of bio-responsive scaffolds, which can respond to physical and chemical stimuli. These advancements collectively aim to mimic the natural microenvironment of bone, thereby enhancing osteogenesis and facilitating the formation of new tissue. Through a comprehensive combination of in vitro and in vivo studies, we scrutinize the biocompatibility, osteoinductivity, and osteoconductivity of these engineered scaffolds, as well as their interactions with critical cellular players in bone healing processes. Findings from scaffold fabrication techniques and bio-responsive scaffolds indicate that incorporating nanostructured materials and bioactive compounds is particularly effective in promoting the recruitment and differentiation of osteoprogenitor cells. The therapeutic potential of these advanced biomaterials in clinical settings is widely recognized and the paper advocates continued research into multi-responsive scaffold systems.

Piezoelectric hydrogel for treatment of periodontitis through bioenergetic activation

The impaired differentiation ability of resident cells and disordered immune microenvironment in periodontitis pose a huge challenge for bone regeneration. Herein, we construct a piezoelectric hydrogel to rescue the impaired osteogenic capability and rebuild the regenerative immune microenvironment through bioenergetic activation. Under local mechanical stress, the piezoelectric hydrogel generated piezopotential that initiates osteogenic differentiation of inflammatory periodontal ligament stem cells (PDLSCs) via modulating energy metabolism and promoting adenosine triphosphate (ATP) synthesis. Moreover, it also reshapes an anti-inflammatory and pro-regenerative niche through switching M1 macrophages to the M2 phenotype. The synergy of tilapia gelatin and piezoelectric stimulation enhances in situ regeneration in periodontal inflammatory defects of rats. These findings pave a new pathway for treating periodontitis and other immune-related bone defects through piezoelectric stimulation-enabled energy metabolism modulation and immunomodulation.

Strontium-Containing Piezoelectric Biofilm Promotes Dentin Tissue Regeneration

It remains an obstacle to induce the regeneration of hard dentin tissue in clinical settings. To overcome this, a P(VDF-TrFE) piezoelectric film with 2 wt% SrCl2 addition is designed. The biofilm shows a high flexibility, a harmonious biocompatibility, and a large piezoelectric d33 coefficient of 14 pC N-1, all contributing to building an electric microenvironment that favor the recruitment of dental pulp stem cells (DPSCs) and their differentiation into odontoblasts during normal chewing, speaking, etc. On the other hand, the strontium ions can be gradually released from the film, thus promoting DPSC odonto-differentiation. In vivo experiments also demonstrate that the film induces the release of dentin minerals and regeneration of dentin tissue. In the large animal dentin defect models, this piezoelectric film induces in situ dentin tissue formation effectively over a period of three months. This study illustrates a therapeutic potential of the piezoelectric film to improve dentin tissue repair in clinical settings.

Cell membrane vesicles derived from hBMSCs and hUVECs enhance bone regeneration

Bone tissue renewal can be enhanced through co-transplantation of bone mesenchymal stem cells (BMSCs) and vascular endothelial cells (ECs). However, there are apparent limitations in stem cell-based therapy which hinder its clinic translation. Hence, we investigated the potential of alternative stem cell substitutes for facilitating bone regeneration. In this study, we successfully prepared cell membrane vesicles (CMVs) from BMSCs and ECs. The results showed that BMSC-derived cell membrane vesicles (BMSC-CMVs) possessed membrane receptors involved in juxtacrine signaling and growth factors derived from their parental cells. EC-derived cell membrane vesicles (EC-CMVs) also contained BMP2 and VEGF derived from their parental cells. BMSC-CMVs enhanced tube formation and migration ability of hUVECs, while EC-CMVs promoted the osteogenic differentiation of hBMSCs in vitro. Using a rat skull defect model, we found that co-transplantation of BMSC-CMVs and EC-CMVs could stimulate angiogenesis and bone formation in vivo. Therefore, our research might provide an innovative and feasible approach for cell-free therapy in bone tissue regeneration.

Wireless Electric Cues Mediate Autologous DPSC-Loaded Conductive Hydrogel Microspheres to Engineer the Immuno-Angiogenic Niche for Homologous Maxillofacial Bone Regeneration

Stem cell therapy serves as an effective treatment for bone regeneration. Nevertheless, stem cells from bone marrow and peripheral blood are still lacking homologous properties. Dental pulp stem cells (DPSCs) are derived from neural crest, in coincidence with maxillofacial tissues, thus attracting great interest in in situ maxillofacial regenerative medicine. However, insufficient number and heterogenous alteration of seed cells retard further exploration of DPSC-based tissue engineering. Electric stimulation has recently attracted great interest in tissue regeneration. In this study, a novel DPSC-loaded conductive hydrogel microspheres integrated with wireless electric generator is fabricated. Application of exogenous electric cues can promote stemness maintaining and heterogeneity suppression for unpredictable differentiation of encapsulated DPSCs. Further investigations observe that electric signal fine-tunes regenerative niche by improvement on DPSC-mediated paracrine pattern, evidenced by enhanced angiogenic behavior and upregulated anti-inflammatory macrophage polarization. By wireless electric stimulation on implanted conductive hydrogel microspheres, loaded DPSCs facilitates the construction of immuno-angiogenic niche at early stage of tissue repair, and further contributes to advanced autologous mandibular bone defect regeneration. This novel strategy of DPSC-based tissue engineering exhibits promising translational and therapeutic potential for autologous maxillofacial tissue regeneration.

Wearable Magnetoelectric Stimulation for Chronic Wound Healing by Electrospun CoFe2O4@CTAB/PVDF Dressings

Magnetoelectric stimulation is a promising therapy for various disorders due to its high efficacy and safety. To explore its potential in chronic skin wound treatment, we developed a magnetoelectric dressing, CFO@CTAB/PVDF (CCP), by electrospinning cetyltrimethylammonium bromide-modified CoFe2O4 (CFO) particles with polyvinylidene fluoride. Cetyltrimethylammonium bromide (CTAB) serves as a dispersion surfactant for CFO, with its quaternary ammonium cations imparting antibacterial and hydrophilic properties to the dressing. Electrospinning polarizes polyvinylidene fluoride (PVDF) molecules and forms a fibrous membrane with flexibility and breathability. With a wearable electromagnetic induction device, a dynamic magnetic field is established to induce magnetostrictive deformation of CFO nanoparticles. Consequently, a piezoelectric potential is generated on the surface of PVDF nanofibers to enhance the endogenous electrical field in the wound, achieving a cascade coupling of electric-magnetic-mechanical-electric effects. Bacteria and cell cultures show that 2% CTAB effectively balances antibacterial property and fibroblast activity. Under dynamic magnetoelectric stimulation, the CCP dressing demonstrates significant upregulation of TGF-β, FGF, and VEGF, promoting L929 cell adhesion and proliferation. Moreover, it facilitates the healing of diabetic rat skin wounds infected with Staphylococcus aureus within 2 weeks. Histological and molecular biology evaluations confirm the anti-inflammatory effect of CTAB and the accelerated formation of collagen and vessel by electrical stimulation. This work provides insights into the application of magnetoelectric stimulation in the healing of chronic wounds.

Green synthetic sodium alginate-glycerol-MXene nanocomposite membrane with excellent flexibility and mineralization ability for guided bone regeneration

Developing a novel bioactive material as a barrier membrane for guided bone regeneration (GBR) surgery remains challenging. As a new member of two-dimensional (2D) material family, MXene is a promising candidate component for barrier membranes due to its high specific surface area and osteogenic differentiation ability. In this work, a green and simple SA/glycerol/MXene (SgM) composite membrane was prepared via solvent casting method by using sodium alginate (SA) and MXene (M) as raw materials while employing glycerol (g) as a plasticizer. The addition of glycerol significantly increased the elongation at the break of SA from 10%-20% to 240%-360%, while the introduction of MXene promoted the deposition of calcium and phosphorus to form hydroxyapatite. At the same time, the roughness of the SgM composite membrane is apparently improved, which is conducive to cell adhesion and proliferation. This work provides a basis for further research on SgM composite membrane as GBR membrane for the treatment of bone defects.

Signalling pathways underlying pulsed electromagnetic fields in bone repair

Pulsed electromagnetic field (PEMF) stimulation is a prospective non-invasive and safe physical therapy strategy for accelerating bone repair. PEMFs can activate signalling pathways, modulate ion channels, and regulate the expression of bone-related genes to enhance osteoblast activity and promote the regeneration of neural and vascular tissues, thereby accelerating bone formation during bone repair. Although their mechanisms of action remain unclear, recent studies provide ample evidence of the effects of PEMF on bone repair. In this review, we present the progress of research exploring the effects of PEMF on bone repair and systematically elucidate the mechanisms involved in PEMF-induced bone repair. Additionally, the potential clinical significance of PEMF therapy in fracture healing is underscored. Thus, this review seeks to provide a sufficient theoretical basis for the application of PEMFs in bone repair.

Piezoelectrically and Topographically Engineered Scaffolds for Accelerating Bone Regeneration

Bone regeneration remains a critical concern across diverse medical disciplines, because it is a complex process that requires a combinatorial approach involving the integration of mechanical, electrical, and biological stimuli to emulate the native cellular microenvironment. In this context, piezoelectric scaffolds have attracted considerable interest owing to their remarkable ability to generate electric fields in response to dynamic forces. Nonetheless, the application of such scaffolds in bone tissue engineering has been limited by the lack of a scaffold that can simultaneously provide both the intricate electromechanical environment and the biocompatibility of the native bone tissue. Here, we present a pioneering biomimetic scaffold that combines the unique properties of piezoelectric and topographical enhancement with the inherent osteogenic abilities of hydroxyapatite (HAp). Notably, the novelty of this work lies in the incorporation of HAp into polyvinylidene fluoride-co-trifluoro ethylene in a freestanding form, leveraging its natural osteogenic potential within a piezoelectric framework. Through comprehensive in vitro and in vivo investigations, we demonstrate the remarkable potential of these scaffolds to accelerate bone regeneration. Moreover, we demonstrate and propose three pivotal mechanisms─(i) electrical, (ii) topographical, and (iii) paracrine─that collectively contribute to the facilitated bone healing process. Our findings present a synergistically derived biomimetic scaffold design with wide-ranging prospects for bone regeneration as well as various regenerative medicine applications.

Computational design and evaluation of the mechanical and electrical behavior of a piezoelectric scaffold: a preclinical study

Piezoelectric scaffolds have been recently developed to explore their potential to enhance the bone regeneration process using the concept of piezoelectricity, which also inherently occurs in bone. In addition to providing mechanical support during bone healing, with a suitable design, they are supposed to produce electrical signals that ought to favor the cell responses. In this study, using finite element analysis (FEA), a piezoelectric scaffold was designed with the aim of providing favorable ranges of mechanical and electrical signals when implanted in a large bone defect in a large animal model, so that it could inform future pre-clinical studies. A parametric analysis was then performed to evaluate the effect of the scaffold design parameters with regard to the piezoelectric behavior of the scaffold. The designed scaffold consisted of a porous strut-like structure with piezoelectric patches covering its free surfaces within the scaffold pores. The results showed that titanium or PCL for the scaffold and barium titanate (BT) for the piezoelectric patches are a promising material combination to generate favorable ranges of voltage, as reported in experimental studies. Furthermore, the analysis of variance showed the thickness of the piezoelectric patches to be the most influential geometrical parameter on the generation of electrical signals in the scaffold. This study shows the potential of computer tools for the optimization of scaffold designs and suggests that patches of piezoelectric material, attached to the scaffold surfaces, can deliver favorable ranges of electrical stimuli to the cells that might promote bone regeneration.

Novel Polyetherimide Dielectrics: Molecular Design, Energy Storage Property, and Self-Healing Performance

The development of high-temperature resistant dielectrics with excellent dielectric properties and self-healing behavior is crucial for the application of metallized film capacitors. In this work, a series of polyetherimide (PEI) dielectric films are designed and fabricated. The introduction of polar groups is in favor to the increase of permittivity, and the flexible connection such as the ether group will facilitate the reduction of dielectric loss. Moreover, the oxygen elements are beneficial to the "self-healing" of metallized film capacitors. Consequently, the permittivity of 3.53-4.00, dissipation factor of 0.281-0.517%, and Weibull breakdown strength of 347-674 MV m-1 are obtained for the PEI dielectrics. In addition, PEI-4 (BPADA-BAPP) and PEI-8 (BPADA-MDA) are selected to further investigate dielectric breakdown (150 °C), electrical displacement-electric filed (D-E) loop (at room temperature and 150 °C) as well as self-healing performance, which will evaluate their potential in practical applications. The results show that PEI-8 has stable breakdown field strength and high charge-discharge efficiency at elevated temperatures. Metallized film capacitor based on PEI-8 exhibits excellent self-healing performance, with pleasing self-clear morphology, high breakdown voltage, and reduced self-healing energy. Therefore, PEI-8 is considered as a potential candidate for metallized film capacitors applied under harsh conditions.

Accelerated Bone Regeneration on the Metal Surface through Controllable Surface Potential

Surface potential is rarely investigated as an independent factor in influencing tissue regeneration on the metal surface. In this work, the surface potential on the titanium (Ti) surface was designed to be tailored and adjusted independently, which arises from the ferroelectricity and piezoelectricity of poled poly(vinylidene fluoride-trifluoroethylene) (PVTF). Notably, it is found that such controllable surface potential on the metal surface significantly promotes osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro as well as bone regeneration in vivo. In addition, the intracellular calcium ion (Ca2+) concentration measurement further proves that such controllable surface potential on the metal surface could activate the transmembrane calcium channels and allow the influx of extracellular Ca2+ into the cytoplasm. That might be the reason for improved osteogenic differentiation of BMSCs and bone regeneration. These findings reveal the potential of the metal surface with improved bioactivity for stimulation of osteogenesis and show great prospects for fabricable implantable medical devices with adjustable surface potential.

Metallurgical manipulation of surface Volta potential in bimetals and cell response of human mesenchymal stem cells

Bioelectricity plays an overriding role in directing cell migration, proliferation, differentiation etc. Tailoring the electro-extracellular environment through metallurgical manipulation could modulate the surrounding cell behaviors. In this study, different electric potential patterns, in terms of Volta potential distribution and gradient, were created on the metallic surface as an electric microenvironment, and their effects on adherent human mesenchymal stem cells were investigated. Periodically and randomly distributed Volta potential pattern, respectively, were generated on the surface through spark plasma sintering of two alternatively stacked dissimilar metals films and of a mixture of metallic powders. Actin cytoskeleton staining demonstrated that the Volta potential pattern strongly affected cell attachment and deformation. The cytoskeletons of cells were observed to elongate along the Volta potential gradient and across the border of adjacent regions with higher and lower potentials. Moreover, the steepest potential gradient resulting from the drastic compositional changes on the periodic borders gave rise to the strongest osteogenic tendency among all the samples. This study suggests that tailoring the Volta potential distribution and gradient of metallic biomaterials via metallurgical manipulation is a promising approach to activate surrounding cells, providing an extra degree of freedom for designing desirable bone-repairing metallic implants.

Microenvironment-targeted strategy steers advanced bone regeneration

Treatment of large bone defects represents a great challenge in orthopedic and craniomaxillofacial surgery. Traditional strategies in bone tissue engineering have focused primarily on mimicking the extracellular matrix (ECM) of bone in terms of structure and composition. However, the synergistic effects of other cues from the microenvironment during bone regeneration are often neglected. The bone microenvironment is a sophisticated system that includes physiological (e.g., neighboring cells such as macrophages), chemical (e.g., oxygen, pH), and physical factors (e.g., mechanics, acoustics) that dynamically interact with each other. Microenvironment-targeted strategies are increasingly recognized as crucial for successful bone regeneration and offer promising solutions for advancing bone tissue engineering. This review provides a comprehensive overview of current microenvironment-targeted strategies and challenges for bone regeneration and further outlines prospective directions of the approaches in construction of bone organoids.

Physical stimuli-emitting scaffolds: The role of piezoelectricity in tissue regeneration

The imbalance between life expectancy and quality of life is increasing due to the raising prevalence of chronic diseases. Musculoskeletal disorders and chronic wounds affect a growing percentage of people and demand more efficient tools for regenerative medicine. Scaffolds that can better mimic the natural physical stimuli that tissues receive under healthy conditions and during healing may significantly aid the regeneration process. Shape, mechanical properties, pore size and interconnectivity have already been demonstrated to be relevant scaffold features that can determine cell adhesion and differentiation. Much less attention has been paid to scaffolds that can deliver more dynamic physical stimuli, such as electrical signals. Recent developments in the precise measurement of electrical fields in vivo have revealed their key role in cell movement (galvanotaxis), growth, activation of secondary cascades, and differentiation to different lineages in a variety of tissues, not just neural. Piezoelectric scaffolds can mimic the natural bioelectric potentials and gradients in an autonomous way by generating the electric stimuli themselves when subjected to mechanical loads or, if the patient or the tissue lacks mobility, ultrasound irradiation. This review provides an analysis on endogenous bioelectrical signals, recent developments on piezoelectric scaffolds for bone, cartilage, tendon and nerve regeneration, and their main outcomes in vivo. Wound healing with piezoelectric dressings is addressed in the last section with relevant examples of performance in animal models. Results evidence that a fine adjustment of material composition and processing (electrospinning, corona poling, 3D printing, annealing) provides scaffolds that act as true emitters of electrical stimuli that activate endogenous signaling pathways for more efficient and long-term tissue repair.

Effective Orthodontic Tooth Movement via an Occlusion-Activated Electromechanical Synergistic Dental Aligner

Malocclusion is a prevalent dental health problem plaguing over 56% worldwide. Mechanical orthodontic aligners render directional teeth movement extensively used for malocclusion treatment in the clinic, while mechanical regulation inefficiency prolongs the treatment course and induces adverse complications. As a noninvasive physiotherapy, an appropriate electric field plays a vital role in tissue metabolism engineering. Here, we propose an occlusion-activated electromechanical synergistic dental aligner that converts occlusal energy into a piezo-excited alternating electric field for accelerating orthodontic tooth movement. Within an 18-day intervention, significantly facilitated orthodontic results were obtained from young and aged Sprague-Dawley rats, increasing by 34% and 164% in orthodontic efficiency, respectively. The different efficiencies were attributed to age-distributed periodontal tissue status. Mechanistically, the electromechanical synergistic intervention modulated the microenvironment, enhanced osteoblast and osteoclast activity, promoted alveolar bone metabolism, and ultimately accelerated tooth movement. This work holds excellent potential for personalized and effective treatment for malocclusions, which would vastly reduce the suffering of the long orthodontic course.

Biodegradable Piezoelectric Polymers: Recent Advancements in Materials and Applications

Recent materials, microfabrication, and biotechnology improvements have introduced numerous exciting bioelectronic devices based on piezoelectric materials. There is an intriguing evolution from conventional unrecyclable materials to biodegradable, green, and biocompatible functional materials. As a fundamental electromechanical coupling material in numerous applications, novel piezoelectric materials with a feature of degradability and desired electrical and mechanical properties are being developed for future wearable and implantable bioelectronics. These bioelectronics can be easily integrated with biological systems for applications, including sensing physiological signals, diagnosing medical problems, opening the blood-brain barrier, and stimulating healing or tissue growth. Therefore, the generation of piezoelectricity from natural and synthetic bioresorbable polymers has drawn great attention in the research field. Herein, the significant and recent advancements in biodegradable piezoelectric materials, including natural and synthetic polymers, their principles, advanced applications, and challenges for medical uses, are reviewed thoroughly. The degradation methods of these piezoelectric materials through in vitro and in vivo studies are also investigated. These improvements in biodegradable piezoelectric materials and microsystems could enable new applications in the biomedical field. In the end, potential research opportunities regarding the practical applications are pointed out that might be significant for new materials research.

In situ activation of flexible magnetoelectric membrane enhances bone defect repair

For bone defect repair under co-morbidity conditions, the use of biomaterials that can be non-invasively regulated is highly desirable to avoid further complications and to promote osteogenesis. However, it remains a formidable challenge in clinical applications to achieve efficient osteogenesis with stimuli-responsive materials. Here, we develop polarized CoFe₂O₄@BaTiO₃/poly(vinylidene fluoridetrifluoroethylene) [P(VDF-TrFE)] core-shell particle-incorporated composite membranes with high magnetoelectric conversion efficiency for activating bone regeneration. An external magnetic field force conduct on the CoFe₂O₄ core can increase charge density on the BaTiO₃ shell and strengthens the β-phase transition in the P(VDF-TrFE) matrix. This energy conversion increases the membrane surface potential, which hence activates osteogenesis. Skull defect experiments on male rats showed that repeated magnetic field applications on the membranes enhanced bone defect repair, even when osteogenesis repression is elicited by dexamethasone or lipopolysaccharide-induced inflammation. This study provides a strategy of utilizing stimuli-responsive magnetoelectric membranes to efficiently activate osteogenesis in situ.

Manipulation of Heterogeneous Surface Electric Potential Promotes Osteogenesis by Strengthening RGD Peptide Binding and Cellular Mechanosensing

The heterogeneity of extracellular matrix (ECM) topology, stiffness, and architecture is a key factor modulating cellular behavior and osteogenesis. However, the effects of heterogeneous ECM electric potential at the micro- and nanoscale on osteogenesis remain to be elucidated. Here, the heterogeneous distribution of surface potential is established by incorporating ferroelectric BaTiO₃ nanofibers (BTNF) into poly(vinylidene fluoridetrifluoroethylene) (P(VDF-TrFE)) matrix based on phase-field and first-principles simulation. By optimizing the aspect ratios of BTNF fillers, the anisotropic distribution of surface potential on BTNF/P(VDF-TrFE) nanocomposite membranes can be achieved by strong spontaneous electric polarization of BTNF fillers. These results indicate that heterogeneous surface potential distribution leads to a meshwork pattern of fibronectin (FN) aggregation, which increased FN-III7-10 (FN fragment) focal flexibility and anchor points as predicted by molecular dynamics simulation. Furthermore, integrin clustering, focal adhesion formation, cell spreading, and adhesion are enhanced sequentially. Increased traction of actin fibers amplifies mechanotransduction by promoting nuclear translocation of YAP/Runx2, which enhances osteogenesis in vitro and bone regeneration in vivo. The work thus provides fundamental insights into the biological effects of surface potential heterogeneity at the micro- and nanoscale on osteogenesis, and also develops a new strategy to optimize the performance of electroactive biomaterials for tissue regenerative therapies.

Assessing Biomaterial-Induced Stem Cell Lineage Fate by Machine Learning-Based Artificial Intelligence

Current functional assessment of biomaterial-induced stem cell lineage fate in vitro mainly relies on biomarker-dependent methods with limited accuracy and efficiency. Here a "Mesenchymal stem cell Differentiation Prediction (MeD-P)" framework for biomaterial-induced cell lineage fate prediction is reported. MeD-P contains a cell-type-specific gene expression profile as a reference by integrating public RNA-seq data related to tri-lineage differentiation (osteogenesis, chondrogenesis, and adipogenesis) of human mesenchymal stem cells (hMSCs) and a predictive model for classifying hMSCs differentiation lineages using the k-nearest neighbors (kNN) strategy. It is shown that MeD-P exhibits an overall accuracy of 90.63% on testing datasets, which is significantly higher than the model constructed based on canonical marker genes (80.21%). Moreover, evaluations of multiple biomaterials show that MeD-P provides accurate prediction of lineage fate on different types of biomaterials as early as the first week of hMSCs culture. In summary, it is demonstrated that MeD-P is an efficient and accurate strategy for stem cell lineage fate prediction and preliminary biomaterial functional evaluation.

Mimicking natural electrical environment with cellulose acetate scaffolds enhances collagen formation of osteoblasts

The medical field is continuously seeking new solutions and materials, where cellulose materials due to their high biocompatibility have great potential. Here we investigate the applicability of cellulose acetate (CA) electrospun fibers for bone tissue regeneration. For the first time we show the piezoelectric properties of electrospun CA fibers via high voltage switching spectroscopy piezoresponse force microscopy (HVSS-PFM) tests, which are followed by surface potential studies using Kelvin probe force microscopy (KPFM) and zeta potential measurements. Piezoelectric coefficient for CA fibers of 6.68 ± 1.70 pmV^-1 along with high surface (718 mV) and zeta (-12.2 mV) potentials allowed us to mimic natural electrical environment favoring bone cell attachment and growth. Importantly, the synergy between increased surface potential and highly developed structure of the fibrous scaffold led to the formation of a vast 3D network of collagen produced by osteoblasts only after 7 days of in vitro culture. We clearly show the advantages of CA scaffolds as a bone replacement material, when long-lasting structural support is needed.

Bioinspired Piezoelectric Periosteum to Augment Bone Regeneration via Synergistic Immunomodulation and Osteogenesis

Ideal periosteum materials are required to participate in a sequence of bone repair-related physiological events, including the initial immune response, endogenous stem cell recruitment, angiogenesis, and osteogenesis. However, conventional tissue-engineered periosteal materials have difficulty achieving these functions by simply mimicking the periosteum via structural design or by loading exogenous stem cells, cytokines, or growth factors. Herein, we present a novel biomimetic periosteum preparation strategy to comprehensively enhance the bone regeneration effect using functionalized piezoelectric materials. The resulting biomimetic periosteum possessing an excellent piezoelectric effect and improved physicochemical properties was prepared using a biocompatible and biodegradable poly(3-hydroxybutyric acid-co-3-hydrovaleric acid) (PHBV) polymer matrix, antioxidized polydopamine-modified hydroxyapatite (PHA), and barium titanate (PBT), which were further incorporated into the polymer matrix to fabricate a multifunctional piezoelectric periosteum by a simple one-step spin-coating method. The addition of PHA and PBT dramatically enhanced the physicochemical properties and biological functions of the piezoelectric periosteum, resulting in improved surface hydrophilicity and roughness, enhanced mechanical performance, tunable degradation behavior, and stable and desired endogenous electrical stimulations, which is conducive to accelerating bone regeneration. Benefiting from endogenous piezoelectric stimulation and bioactive components, the as-fabricated biomimetic periosteum demonstrated favorable biocompatibility, osteogenic activity, and immunomodulatory functions in vitro, which not only promoted adhesion, proliferation, and spreading as well as osteogenesis of mesenchymal stem cells (MSCs) but also effectively induced M2 macrophage polarization, thereby suppressing reactive oxygen species (ROS)-induced inflammatory reactions. Through in vivo experiments, the biomimetic periosteum with endogenous piezoelectric stimulation synergistically accelerated the formation of new bone in a rat critical-sized cranial defect model. The whole defect was almost completely covered by new bone at 8 weeks post treatment, with a thickness close to that of the host bone. Collectively, with its favorable immunomodulatory and osteogenic properties, the biomimetic periosteum developed here represents a novel method to rapidly regenerate bone tissue using piezoelectric stimulation.

The bioelectrical properties of bone tissue

Understanding the bioelectrical properties of bone tissue is key to developing new treatment strategies for bone diseases and injuries, as well as improving the design and fabrication of scaffold implants for bone tissue engineering. The bioelectrical properties of bone tissue can be attributed to the interaction of its various cell lineages (osteocyte, osteoblast and osteoclast) with the surrounding extracellular matrix, in the presence of various biomechanical stimuli arising from routine physical activities; and is best described as a combination and overlap of dielectric, piezoelectric, pyroelectric and ferroelectric properties, together with streaming potential and electro-osmosis. There is close interdependence and interaction of the various electroactive and electrosensitive components of bone tissue, including cell membrane potential, voltage-gated ion channels, intracellular signaling pathways, and cell surface receptors, together with various matrix components such as collagen, hydroxyapatite, proteoglycans and glycosaminoglycans. It is the remarkably complex web of interactive cross-talk between the organic and non-organic components of bone that define its electrophysiological properties, which in turn exerts a profound influence on its metabolism, homeostasis and regeneration in health and disease. This has spurred increasing interest in application of electroactive scaffolds in bone tissue engineering, to recapitulate the natural electrophysiological microenvironment of healthy bone tissue to facilitate bone defect repair.

Cell Behavior Changes and Enzymatic Biodegradation of Hybrid Electrospun Poly(3-hydroxybutyrate)-Based Scaffolds with an Enhanced Piezoresponse after the Addition of Reduced Graphene Oxide

This is the first comprehensive study of the impact of biodegradation on the structure, surface potential, mechanical and piezoelectric properties of poly(3-hydroxybutyrate) (PHB) scaffolds supplemented with reduced graphene oxide (rGO) as well as cell behavior under static and dynamic mechanical conditions. There is no effect of the rGO addition up to 1.0 wt% on the rate of enzymatic biodegradation of PHB scaffolds for 30 d. The biodegradation of scaffolds leads to the depolymerization of the amorphous phase, resulting in an increase in the degree of crystallinity. Because of more regular dipole order in the crystalline phase, surface potential of all fibers increases after the biodegradation, with a maximum (361 ± 5 mV) after the addition of 1 wt% rGO into PHB as compared to pristine PHB fibers. By contrast, PHB-0.7rGO fibers manifest the strongest effective vertical (0.59 ± 0.03 pm V^-1 ) and lateral (1.06 ± 0.02 pm V^-1 ) piezoresponse owing to a greater presence of electroactive β-phase. In vitro assays involving primary human fibroblasts reveal equal biocompatibility and faster cell proliferation on PHB-0.7rGO scaffolds compared to pure PHB and nonpiezoelectric polycaprolactone scaffolds. Thus, the developed biodegradable PHB-rGO scaffolds with enhanced piezoresponse are promising for tissue-engineering applications.

Nanostructure Mediated Piezoelectric Effect of Tetragonal BaTiO3 Coatings on Bone Mesenchymal Stem Cell Shape and Osteogenic Differentiation

In recent years, porous titanium (Ti) scaffolds with BaTiO₃ coatings have been designed to promote bone regeneration. However, the phase transitions of BaTiO₃ have been understudied, and their coatings have yielded low effective piezoelectric coefficients (EPCs < 1 pm/V). In addition, piezoelectric nanomaterials bring many advantages in eliciting cell-specific responses. However, no study has attempted to design a nanostructured BaTiO₃ coating with high EPCs. Herein, nanoparticulate tetragonal phase BaTiO₃ coatings with cube-like nanoparticles but different effective piezoelectric coefficients were fabricated via anodization combining two hydrothermal processes. The effects of nanostructure-mediated piezoelectricity on the spreading, proliferation, and osteogenic differentiation of human jaw bone marrow mesenchymal stem cells (hJBMSCs) were explored. We found that the nanostructured tetragonal BaTiO₃ coatings exhibited good biocompatibility and an EPC-dependent inhibitory effect on hJBMSC proliferation. The nanostructured tetragonal BaTiO₃ coatings of relatively smaller EPCs (<10 pm/V) exhibited hJBMSC elongation and reorientation, broad lamellipodia extension, strong intercellular connection and osteogenic differentiation enhancement. Overall, the improved hJBMSC characteristics make the nanostructured tetragonal BaTiO₃ coatings promising for application on implant surfaces to promote osseointegration.

MXene-Functionalized Ferroelectric Nanocomposite Membranes with Modulating Surface Potential Enhance Bone Regeneration

Rapid and effective bone defect repair remains a challenging issue for clinical treatment. Applying biomaterials with endogenous surface potential has been widely studied to enhance bone regeneration, but how to regulate the electric potential and surface morphology of the implanted materials precisely to achieve an optimal bioelectric microenvironment is still a major challenge. The aim of this study is to develop electroactive biomaterials that better mimic the extracellular microenvironment for bone regeneration. Hence, MXene/polyvinylidene fluoride (MXene/PVDF) ferroelectric nanocomposite membranes were prepared by electrospinning. Physicochemical characterization demonstrated that Ti₃C₂T_x MXene nanosheets were wrapped in PVDF shell layer and the surface morphology and potential were modulated by altering the content of MXene, where uniform distribution of fibers and enhanced electric potential can be obtained and precisely assembled into a natural extracellular matrix (ECM) in bone tissue. Consequently, the MXene/PVDF membranes facilitated cell adhesion, stretching, and growth, showing good biocompatibility; meanwhile, their intrinsic electric potential promoted the recruitment of osteogenic cells and accelerated the differentiation of osteoblast. Furthermore, 1 wt % MXene/PVDF membrane with a suitable surface potential and better topographical structure for bone regeneration qualitatively and quantitatively promoted bone tissue formation in a rat calvarial bone defect after 4 and 8 weeks of healing. The fabricated MXene/PVDF ferroelectric nanocomposite membranes show a biomimetic microenvironment with a sustainable electric potential and optimal 3D topographical structure, providing an innovative and well-suited strategy for application in bone regeneration.

Restoring the electrical microenvironment using ferroelectric nanocomposite membranes to enhance alveolar ridge regeneration in a mini-pig preclinical model

The maintenance and incremental growth of the alveolar bone at the tooth extraction site, to achieve the required height and width for implant restoration, remains a major clinical challenge. Here, the concept of restoring the electrical microenvironment to improve the effects of alveolar ridge preservation (ARP) was investigated in a mini-pig preclinical model. The endogeneous electrical microenvironment of the dental alveolar socket was recapitulated by fabricating a biomimetic ferroelectric BaTiO₃/poly(vinylidene fluoridetrifluoroethylene) (BTO/P(VDF-TrFE)) non-resorbable nanocomposite membrane polarized by corona poling. The polarized nanocomposite membrane exhibited excellent electrical stability. After implantation with bone grafts and covering with the charged membrane in tooth extraction sites for three months, both the vertical and horizontal dimension resorption of the alveolar ridge were significantly prevented, as assessed by cone beam computed tomography (CBCT) analyses. Micro-CT analysis showed that the charged membrane induced significant enhancement of newly regenerated bone at the tooth extraction sites. Histological analysis further confirmed that the restoration of the electrical microenvironment significantly promoted buccal alveolar bone regeneration and maturation. In addition, the charged membranes can maintain their structural integrity during the entire implantation period and exhibit positive long-term systemic safety, as assessed by preclinical sub-chronic systemic toxicity. These findings thus provide an innovative strategy for restoring the electrical microenvironment to enhance ARP following dentition defect and edentulism, which could further advance prosthodontics implant technology.

Electrical charge on ferroelectric nanocomposite membranes enhances SHED neural differentiation

Stem cells from human exfoliated deciduous teeth (SHED) uniquely exhibit high proliferative and neurogenic potential. Charged biomaterials have been demonstrated to promote neural differentiation of stem cells, but the dose-response effect of electrical stimuli from these materials on neural differentiation of SHED remains to be elucidated. Here, by utilizing different annealing temperatures prior to corona poling treatment, BaTiO₃/P(VDF-TrFE) ferroelectric nanocomposite membranes with varying charge polarization intensity (d₃₃ ≈ 0, 4, 12 and 19 pC N⁻¹) were fabricated. Enhanced expression of neural markers, increased cell elongation and more prominent neurite outgrowths were observed with increasing surface charge of the nanocomposite membrane indicating a dose-response effect of surface electrical charge on SHED neural differentiation. Further investigations of the underlying molecular mechanisms revealed that intracellular calcium influx, focal adhesion formation, FAK-ERK mechanosensing pathway and neurogenic-related ErbB signaling pathway were implicated in the enhancement of SHED neural differentiation by surface electrical charge. Hence, this study confirms the dose-response effect of biomaterial surface charge on SHED neural differentiation and provides preliminary insights into the molecular mechanisms and signaling pathways involved.

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Membrane surface charge can be precisely controlled by adjusting annealing temperature and corona poling parameters.

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Both earlier and later neurogenic differentiation of SHED appear to be dose-dependently enhanced by surface charge.

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Underlying molecular mechanisms may involve intracellular Ca2+ influx, focal adhesion formation, FAK-ERK and ErbB signaling.

Improved osteointegration response using high strength perovskite BaTiO3 coatings prepared by chemical bath deposition

A wide range of bioactive materials have been investigated for tissue engineering and regeneration. Barium titanate is a promising smart material to be used as scaffold for bone tissue engineering. Barium titanate coatings are prepared in the present study using chemical bath deposition technique. Coatings are prepared at room temperature with the variation in solution molarity from 0.1 to 1.2 M. Perovskite tetragonal phase is observed after annealing the samples at 300 °C using 1.0-1.2 M solutions. Normal-anomalous dielectric response is observed for annealed coatings. Maximum transmission of ∼55% and ∼82% is observed under as-prepared and annealed coatings, respectivly. Variation in direct band gap, i.e. 3.45-3.64 eV, is observed with varying molarity. High hardness of the coatings (∼1180 HV) is observed at 1.2M with fracture toughness of ∼22 MPam^-1/2. Biodegradation studies show smaller values of weight loss even after immersion in simulated body fluid (SBF) after 26 weeks. Barium titanate coatings also show high antioxidant activity. BaTiO₃'s antibacterial reaction is evaluated against microorganisms such as Escherichia coli (E. coli) and Staphylococcus aureus. Antibacterial activity shows highest zone of inhibition (∼31 mm) against Staphylococcus aureus bacteria. Quantitative real-time PCR is used to assess the gene expression profile in cultivated cells. Thus, coatings produced without the use of hazardous solvents/reagents utilizing CBD technique are a potential material for biomedical applications.

Interface modified BTO@PS-co-mah/PS composite dielectrics with enhanced breakdown strength and ultralow dielectric loss

Dielectrics of the polymer-matrix composite are considered to present combined advantages from both the polymer matrix and inorganic fillers. However, the breakdown strength, as well as energy density, is not effectively enhanced due to the poor compatibility between the organic and inorganic components. Herein, polymer composites derived from polystyrene (PS) and barium titanate (BTO) are proposed and beneficial interface modification by poly(styrene-co-maleic anhydride) (PS-co-mah) is conducted to improve compatibility between the inorganic filler and polymer matrix. The results show that the BTO@PS-co-mah/PS composites, in which the interfacial layer of PS-co-mah would undergo chemical reactions with the aminated BTO and blend PS matrix with excellent physical compatibility, exhibit enhanced breakdown strength and declined dielectric loss compared with both pure PS and BTO/PS without interfacial modulation. Particularly, the BTO@PS-co-mah/PS composite with 5 wt% filler content indicates optimized performance with an E _b of 507 MV m^-1 and tan δ of 0.085%. It is deduced that the deep energy traps introduced by the PS-co-mah layer would weaken the local electric field and suppress the space charge transporting so as to optimize the performance of composites. Consequently, the interfacial-modified BTO@PS-co-mah/PS would present great potential for applications, such as film capacitors.

Biosynthesized Bandages Carrying Magnesium Oxide Nanoparticles Induce Cortical Bone Formation by Modulating Endogenous Periosteal Cells

Bone grafting is frequently conducted to treat bone defects caused by trauma and tumor removal, yet with significant medical and socioeconomic burdens. Space-occupying bone substitutes remain challenging in the control of osteointegration, and meanwhile activation of endogenous periosteal cells by using non-space-occupying implants to promote new bone formation becomes another therapeutic strategy. Here, we fabricated a magnesium-based artificial bandage with optimal micropatterns for activating periosteum-associated biomineralization. Collagen was self-assembled on the surface of magnesium oxide nanoparticles embedded electrospun fibrous membranes as a hierarchical bandage structure to facilitate the integration with periosteum in situ. After the implantation on the surface of cortical bone in vivo, magnesium ions were released to generate a pro-osteogenic immune microenvironment by activating the endogenous periosteal macrophages into M2 phenotype and, meanwhile, promote blood vessel formation and neurite outgrowth. In a cortical bone defect model, magnesium-based artificial bandage guided the surrounding newly formed bone tissue to cover the defected area. Taken together, our study suggests that the strategy of stimulating bone formation can be achieved with magnesium delivery to periosteum in situ and the proposed periosteal bandages act as a bioactive media for accelerating bone healing.

Effect of Piezoelectric BaTiO3 Filler on Mechanical and Magnetoelectric Properties of Zn0.25Co0.75Fe2O4/PVDF-TrFE Composites

Polymer-based multiferroics, combining magnetic and piezoelectric properties, are studied experimentally-from synthesis to multi-parameter characterization-in view of their prospects for fabricating biocompatible scaffolds. The main advantage of these systems is facile generation of mechanical deformations and electric signals in response to external magnetic fields. Herein, we address the composites based on PVDF-TrFE polymer matrices filled with a combination of piezoelectric (BaTiO_3, BTO) and/or ferrimagnetic (Zn_0.25Co_0.75Fe₂O₄, ZCFO) particles. It is shown that the presence of BTO micron-size particles favors stripe-type structuring of the ZCFO filler and enhances the magnetoelectric response of the sample up to 18.6 mV/(cm∙Oe). Besides that, the admixing of BTO particles is crucial because the mechanical properties of the composite filled with only ZCFO is much less efficient in transforming magnetic excitations into the mechanical and electric responses. Attention is focused on the local surfacial mechanical properties since those, to a great extent, determine the fate of stem cells cultivated on these surfaces. The nano-indentation tests are accomplished with the aid of scanning probe microscopy technique. With their proven suitable mechanical properties, a high level of magnetoelectric conversion and also biocompatibility, the composites of the considered type are enticing as the materials for multiferroic-based polymer scaffolds.

A biomimetic piezoelectric scaffold with sustained Mg2+ release promotes neurogenic and angiogenic differentiation for enhanced bone regeneration

Natural bone is a composite tissue made of organic and inorganic components, showing piezoelectricity. Whitlockite (WH), which is a natural magnesium-containing calcium phosphate, has attracted great attention in bone formation recently due to its unique piezoelectric property after sintering treatment and sustained release of magnesium ion (Mg²⁺). Herein, a composite scaffold (denoted as PWH scaffold) composed of piezoelectric WH (PWH) and poly(ε-caprolactone) (PCL) was 3D printed to meet the physiological demands for the regeneration of neuro-vascularized bone tissue, namely, providing endogenous electric field at the defect site. The sustained release of Mg²⁺ from the PWH scaffold, displaying multiple biological activities, and thus exhibits a strong synergistic effect with the piezoelectricity on inhibiting osteoclast activation, promoting the neurogenic, angiogenic, and osteogenic differentiation of bone marrow mesenchymal stromal cells (BMSCs) in vitro. In a rat calvarial defect model, this PWH scaffold is remarkably conducive to efficient neo-bone formation with rich neurogenic and angiogenic expressions. Overall, this study presents the first example of biomimetic piezoelectric scaffold with sustained Mg²⁺ release for promoting the regeneration of neuro-vascularized bone tissue in vivo, which offers new insights for regenerative medicine.

Janus electro-microenvironment membrane with surface-selective osteogenesis/gingival healing ability for guided bone regeneration

Guided bone regeneration is widely applied in clinical practice to treat alveolar bone defects. However, the rate of healing of severe alveolar bone defects is slow, and there is a high incidence of soft tissue wound dehiscence. In this study, we propose a barrier membrane with a Janus electro-microenvironment (JEM) to achieve side-selective bone regeneration and soft tissue healing. The JEM membrane was constructed using a polarized polyvinylidene fluoride ferroelectric membrane with different surface potentials on either side. It promoted osteogenic differentiation and bone regeneration on the negatively polarized side (JEM-) and soft tissue regeneration on the positively polarized side (JEM+). Further investigation revealed that the JEM-mediated promotion of bone formation was related to mitochondrial autophagy, as indicated by depolarization of the mitochondrial membrane potential and the expression of LC3, Pink I, and Parkin. Moreover, the gingival healing promoted by JEM+ was related to oxidative phosphorylation in mitochondria, as indicated by the upregulation of mitochondrial complexes I–V and an increase in ATP generation. The design concept of the JEM provides a new avenue for regulating tissue regeneration between different tissue interfaces.

Enhanced Cell Osteogenesis and Osteoimmunology Regulated by Piezoelectric Biomaterials with Controllable Surface Potential and Charges

Bone regeneration is a well-orchestrated process involving electrical, biochemical, and mechanical multiple physiological cues. Electrical signals play a vital role in the process of bone repair. The endogenous potential will spontaneously form on defect sites, guide the cell behaviors, and mediate bone healing when the bone fracture occurs. However, the mechanism on how the surface charges of implant potentially guides osteogenesis and osteoimmunology has not been clearly revealed yet. In this study, piezoelectric BaTiO₃/β-TCP (BTCP) ceramics are prepared by two-step sintering, and different surface charges are established by polarization. In addition, the cell osteogenesis and osteoimmunology of BMSCs and RAW264.7 on different surface charges were explored. The results showed that the piezoelectric constant d₃₃ of BTCP was controllable by adjusting the sintering temperature and rate. The polarized BTCP with a negative surface charge (BTCP-) promoted protein adsorption and BMSC extracellular Ca²⁺ influx. The attachment, spreading, migration, and osteogenic differentiation of BMSCs were enhanced on BTCP-. Additionally, the polarized BTCP ceramics with a positive surface charge (BTCP+) significantly inhibited M1 polarization of macrophages, affecting the expression of the M1 marker in macrophages and changing secretion of proinflammatory cytokines. It in turn enhanced osteogenic differentiation of BMSCs, suggesting that positive surface charges could modulate the bone immunoregulatory properties and shift the immune microenvironment to one that favored osteogenesis. The result provides an alternative method of synergistically modulating cellular immunity and the osteogenesis function and enhancing the bone regeneration by fabricating piezoelectric biomaterials with electrical signals.

The Osteogenic Role of Barium Titanate/Polylactic Acid Piezoelectric Composite Membranes as Guiding Membranes for Bone Tissue Regeneration

Purpose

Biopiezoelectric materials have good biocompatibility and excellent piezoelectric properties, and they can generate local currents in vivo to restore the physiological electrical microenvironment of the defect and promote bone regeneration. Previous studies of guided bone regeneration membranes have rarely addressed the point of restoring it, so this study prepared a Barium titanate/Polylactic acid (BT/PLA) piezoelectric composite membrane and investigated its bone-formation, with a view to providing an experimental basis for clinical studies of guided bone tissue regeneration membranes.

Methods

BT/PLA composite membranes with different BT ratio were prepared by solution casting method, and piezoelectric properties were performed after corona polarization treatment. The optimal BT ratio was selected and then subjected to in vitro cytological experiments and in vivo osteogenic studies in rats. The effects on adhesion, proliferation and osteogenic differentiation of the pre-osteoblastic cell line (MC3T3-E1) were investigated. The effect of composite membranes on bone repair of cranial defects in rats was investigated after 4 and 12 weeks.

Results

The highest piezoelectric coefficient d33 were obtained when the BT content was 20%, reaching (7.03 ± 0.26) pC/N. The value could still be maintained at (4.47±0.17) pC/N after 12 weeks, meeting the piezoelectric constant range of bone. In vitro, the MC3T3-E1 cells showed better adhesion and proliferative activity in the group of polarized 20%BT. The highest alkaline phosphatase (ALP) content was observed in cells of this group. In vivo, it promoted rapid bone regeneration. At 4 weeks postoperatively, new bone formation was evident at the edges of the defect, with extensive marrow cavity formation; after 12 weeks, the defect was essentially completely closed, with density approximating normal bone tissue and significant mineralization.

Conclusion

The BT/PLA piezoelectric composite membrane has good osteogenic properties and provides a new idea for guiding the research of membrane materials for bone tissue regeneration.

Smart biomaterials and their potential applications in tissue engineering

Smart biomaterials have been rapidly advancing ever since the concept of tissue engineering was proposed. Interacting with human cells, smart biomaterials can play a key role in novel tissue morphogenesis. Various aspects of biomaterials utilized in or being sought for the goal of encouraging bone regeneration, skin graft engineering, and nerve conduits are discussed in this review. Beginning with bone, this study summarizes all the available bioceramics and materials along with their properties used singly or in conjunction with each other to create scaffolds for bone tissue engineering. A quick overview of the skin-based nanocomposite biomaterials possessing antibacterial properties for wound healing is outlined along with skin regeneration therapies using infrared radiation, electrospinning, and piezoelectricity, which aid in wound healing. Furthermore, a brief overview of bioengineered artificial skin grafts made of various natural and synthetic polymers has been presented. Finally, by examining the interactions between natural and synthetic-based biomaterials and the biological environment, their strengths and drawbacks for constructing peripheral nerve conduits are highlighted. The description of the preclinical outcome of nerve regeneration in injury healed with various natural-based conduits receives special attention. The organic and synthetic worlds collide at the interface of nanomaterials and biological systems, producing a new scientific field including nanomaterial design for tissue engineering.

Periosteum-Inspired Membranes Integrated with Bioactive Magnesium Oxychloride Ceramic Nanoneedles for Guided Bone Regeneration

Guided bone regeneration (GBR) technique using a barrier membrane holds great potential to allow the single-stage reconstruction of critical-sized bone defects. Here, bioactive nanoneedle-like magnesium oxychloride ceramics (MOCs) are synthesized and recruited as an osteoinductive factor within a polycaprolactone-gelatin A (PCL-GelA) membranous matrix to generate a periosteum-mimicking biphasic GBR membrane (PCL-GelA/MOC) to accelerate calvarial defect repair. The PCL-GelA/MOC membrane acts as a shield for defect areas and a reservoir of osteoinductive molecules, which provides a favorable microenvironment for supporting cell proliferation, infiltration, and differentiation. This membrane leads to accelerated osteogenesis and angiogenesis, effectual defect bridging, and significantly enhanced bone regeneration when applied to a 5 mm sized rat calvarial defect. This makes this innovative and multifunctional GBR membrane a suitable candidate for clinical applications with promising curative efficacy.

Modulating the surface potential of microspheres by phase transition in strontium doped barium titanate to restore the electric microenvironment for bone regeneration

The endogenous electrical potential generated by native bone and periosteum plays a key role in maintaining bone mass and quality. Inspired by the electrical properties of bone, different negative surface potentials are built on microspheres to restore electric microenvironment for powerful bone regeneration, which was prepared by the combination of strontium-doped barium titanate (Sr-BTO) nanoparticles and poly (lactic-co-glycolic acid) (PLGA) with high electrostatic voltage field (HEV). The surface potential was modulated through regulating the phase composition of nanoparticles in microspheres by the doping amount of strontium ion (Sr2+). As a result, the 0.1Sr-BTO/PLGA group shows the lowest surface potential and its relative permittivity is closer to natural bone. As expected, the 0.1Sr-BTO/PLGA microspheres performed cytocompatibility, osteogenic activity in vitro and enhance bone regeneration in vivo. Furthermore, the potential mechanism of Sr-BTO/PLGA microspheres to promote osteogenic differentiation was further explored. The lower surface potential generated on Sr-BTO/PLGA microspheres regulates cell membrane potential and leads to an increase in the intracellular calcium ion (Ca2+) concentration, which could activate the Calcineurin (CaN)/Nuclear factor of activated T-cells (NFAT) signaling pathway to promote osteogenic differentiation. This study established an effective method to modulate the surface potential, which provides a prospective exploration for electrical stimulation therapy. The 0.1Sr-BTO/PLGA microsphere with lower surface potential and bone-matched dielectric constant is expected to have great potential in the field of bone regeneration.

Ternary MXene-loaded PLCL/collagen nanofibrous scaffolds that promote spontaneous osteogenic differentiation

Conventional bioinert bone grafts often have led to failure in osseointegration due to low bioactivity, thus much effort has been made up to date to find alternatives. Recently, MXene nanoparticles (NPs) have shown prominent results as a rising material by possessing an osteogenic potential to facilitate the bioactivity of bone grafts or scaffolds, which can be attributed to the unique repeating atomic structure of two carbon layers existing between three titanium layers. In this study, we produced MXene NPs-integrated the ternary nanofibrous matrices of poly(L-lactide-co-ε-caprolactone, PLCL) and collagen (Col) decorated with MXene NPs (i.e., PLCL/Col/MXene), as novel scaffolds for bone tissue engineering, via electrospinning to explore the potential benefits for the spontaneous osteogenic differentiation of MC3T3-E1 preosteoblasts. The cultured cells on the physicochemical properties of the nanofibrous PLCL/Col/MXene-based materials revealed favorable interactions with the supportive matrices, highly suitable for the growth and survival of preosteoblasts. Furthermore, the combinatorial ternary material system of the PLCL/Col/MXene nanofibers obviously promoted spontaneous osteodifferentiation with positive cellular responses by providing effective microenvironments for osteogenesis. Therefore, our results suggest that the unprecedented biofunctional advantages of the MXene-integrated PLCL/Col nanofibrous matrices can be expanded to a wide range of strategies for the development of effective scaffolds in bone tissue regeneration.

Electreted Sandwich Membranes with Persistent Electrical Stimulation for Enhanced Bone Regeneration

Physiologically relevant electrical microenvironments play an indispensable role in manipulating bone metabolism. Although implanted biomaterials that simulate the electrical properties of natural tissues using conductive or piezoelectric materials have been introduced in the field of bone regeneration, the application of electret materials to provide stable and persistent electrical stimulation has rarely been studied in biomaterial design. In this study, a silicon dioxide electret-incorporated poly(dimethylsiloxane) (SiO₂/PDMS) composite electroactive membrane was designed and fabricated to explore its bone regeneration efficacy. SiO₂ electrets were homogeneously dispersed in the PDMS matrix, and sandwich-like composite membranes were fabricated using a facile layer-by-layer blade-coating method. Following the encapsulation, electret polarization was conducted to obtain the electreted composite membranes. The surface potential of the composite membrane could be adjusted to a bone-promotive biopotential by tuning the electret concentration, and the prepared membranes exhibited favorable electrical stability during an observation period of up to 42 days. In vitro biological experiments indicated that the electreted SiO₂/PDMS membrane promoted cellular activity and osteogenic differentiation of mesenchymal stem cells. In vivo, the electreted composite membrane remarkably facilitated bone regeneration through persistent endogenous electrical stimulation. These findings suggest that the electreted sandwich-like membranes, which maintain a stable and physiological electrical microenvironment, are promising candidates for enhancing bone regeneration.