A biomimetic hierarchical scaffold: natural growth of nanotitanates on three-dimensional microporous Ti-based metals

Diffusion-driven fabrication of calcium and phosphorous-doped zinc oxide heterostructures on titanium to achieve dual functions of osteogenesis and preventing bacterial infections

Conventional Ti-based implants are vulnerable to postsurgical infection and improving the antibacterial efficiency without compromising the osteogenic ability is one of the key issues in bone implant design. Although zinc oxide (ZnO) nanorods grown on Ti substrates hydrothermally can improve the antibacterial properties, but cannot meet the stringent requirements of bone implants, as rapid degradation of ZnO and uncontrolled leaching of Zn2+ are detrimental to peri-implant cells and tissues. To solve these problems, a lattice-damage-free method is adopted to modify the ZnO nanorods with thin calcium phosphate (CaP) shells. The Ca and P ions from the CaP shells diffuse thermally into the ZnO lattice to prevent the ZnO nanorods from rapid degradation and ensure the sustained release of Zn2+ ions as well. Furthermore, the designed heterostructural nanorods not only induce the osteogenic performances of MC3T3-E1 cells but also exhibit excellent antibacterial ability against S. aureus and E. coli bacteria via physical penetration. In vivo studies also reveal that hybrid Ti-ZnO@CaP5 can not only eradicates bacteria in contact, but also provides sufficient biocompatibility without causing excessive inflammation response. Our study provides insights into the design of multifunctional biomaterials for bone implants. STATEMENT OF SIGNIFICANCE: • A lattice-damage-free method is adopted to modify the ZnO nanorods with thin calcium phosphate (CaP) shells. • The dynamic process of Ca and P diffusion into the ZnO lattice is analyzed by experimental verification and theoretical calculation. • The degradation rate of ZnO nanorods is significantly decreased after CaP deposition. • The ZnO nanorods after CaP deposition can not only sterilize bacteria in contact via physical penetration, but also provide sufficient biocompatibility and osteogenic capability without causing excessive inflammation response..

Porous NiTi Dental Implant Fabricated by a Metal Injection Molding: An in Vivo Biocompatibility Evaluation in an Animal Model

This study assessed the corrosion resistance, intracutaneous reactivity, acute systemic toxicity, and in situ tissue effect of the implantation of porous NiTi fabricated by metal injection molding in animal models. For the intracutaneous reactivity study, five intracutaneous injections were administered per site with and without the tested extract in polar and nonpolar solutions. The extract was also delivered via intravenous and intraperitoneal routes for acute systemic toxicity. TiAl6 V4 (control) and porous NiTi were implanted in rabbit femora for a period of 13 weeks to evaluate the in situ tissue response. Corrosion was evaluated through open and cyclic polarization in PBS, while biocompatibility was investigated by assessing the general conditions, skin irritation score (edema and erythema), and histopathology. No active dissolution or hysteresis loop was observed in the corrosion study. None of the animals exhibited death, moribundity, impending death, severe pain, self-mutilation, or overgrooming. No edema was observed at injection sites. Only the positive control showed an erythematous reaction at 24, 48, and 72 h observations (p < 0.001). Porous NiTi showed a low in situ biological response for inflammation, neovascularization, and fibrosis in comparison to the control implant (p = 0.247, 0.005, and 0.011, respectively). Porous NiTi also demonstrated high pitting corrosion resistance while causing no acute hypersensitivity or acute systemic toxicity. The study concludes that porous NiTi implants were unlikely to cause local sensitization, acute systemic toxicity, or chronic inflammatory reactions in an animal model. Porous NiTi also exhibited osseointegration equivalent to Ti6AI4 V of known biocompatibility.

Wettability and biological responses of titanium surface's biomimetic hexagonal microstructure

In this research, an experiment was conducted on how the surface wettability and biocompatibility of staplers' titanium nails impact the healing of gastrointestinal tissue. Firstly, the bionic hexagonal structure was prepared on the surface of Ti metal by laser processing technology, and the laser textured titanium samples were observed by scanning electron microscope. Then, the liquid-solid contact angle-measuring instrument was used to characterize the wettability of titanium samples. Finally, cells were cultured on the surface of different titanium samples, CCK8 assay and qRT-PCR were carried out to investigate cell adhesion and collagen secretion on the surface of different samples. The results showed that the bionic hexagonal surface increased the surface roughness, reduced the liquid-solid contact angle, and promoted the adhesion and collagen secretion of fibroblasts. The increased wettability provided a better growth environment for cell growth. Microtexture is an important factor affecting the behavior of cells and its size parameters regulate cell gene expression, which is worthy of further study.

Monte Carlo calculations of radiotherapy dose distributions within and around orthopaedic implants

Background and purpose

Cancer patients often require a titanium orthopaedic implant to support or replace lost bone. In radiation treatment, the dose distribution is perturbed causing regions of high and low dose at material interfaces. Since the survival of integrating bone tissue is critical to implant success, the aim of this study was to determine the dose distribution in and around the scaffold, when constructed from titanium or Poly-ether-ether-ketone (PEEK).

Materials and methods

The dose distributions in the pores and along boundaries for three implant scaffold designs were calculated using Monte-Carlo methods in Geant4/GATE, with the material taken as titanium or PEEK. The 3D dose distributions were analysed in MATLAB and segmented using image masks, yielding the dose distributions in key regions of interest. To evaluate the effect of the predicted dose perturbations, the cell survival was calculated using the linear-quadratic model for SAOS-2 cells (bone) using experimentally determined radiation response data.

Results

High dose gradients were found along the boundaries of the titanium implants, but not for the corresponding PEEK implants. The dose to the internal cavities of the titanium implants was enhanced by 10–15% near the proximal interface whereas for PEEK, there was no significant dose perturbation. The predicted perturbation caused by the titanium implant was shown to decrease the survival for SAOS-2 cells by 7% which was not found for the PEEK implants.

Conclusion

PEEK was shown to be a more favourable orthopaedic implant material over titanium for cancer patients considering radiation therapy.

Emerging zero-dimensional to four-dimensional biomaterials for bone regeneration

Bone is one of the most sophisticated and dynamic tissues in the human body, and is characterized by its remarkable potential for regeneration. In most cases, bone has the capacity to be restored to its original form with homeostatic functionality after injury without any remaining scarring. Throughout the fascinating processes of bone regeneration, a plethora of cell lineages and signaling molecules, together with the extracellular matrix, are precisely regulated at multiple length and time scales. However, conditions, such as delayed unions (or nonunion) and critical-sized bone defects, represent thorny challenges for orthopedic surgeons. During recent decades, a variety of novel biomaterials have been designed to mimic the organic and inorganic structure of the bone microenvironment, which have tremendously promoted and accelerated bone healing throughout different stages of bone regeneration. Advances in tissue engineering endowed bone scaffolds with phenomenal osteoconductivity, osteoinductivity, vascularization and neurotization effects as well as alluring properties, such as antibacterial effects. According to the dimensional structure and functional mechanism, these biomaterials are categorized as zero-dimensional, one-dimensional, two-dimensional, three-dimensional, and four-dimensional biomaterials. In this review, we comprehensively summarized the astounding advances in emerging biomaterials for bone regeneration by categorizing them as zero-dimensional to four-dimensional biomaterials, which were further elucidated by typical examples. Hopefully, this review will provide some inspiration for the future design of biomaterials for bone tissue engineering.

Biomechanics of Additively Manufactured Metallic Scaffolds-A Review

This review paper is related to the biomechanics of additively manufactured (AM) metallic scaffolds, in particular titanium alloy Ti6Al4V scaffolds. This is because Ti6Al4V has been identified as an ideal candidate for AM metallic scaffolds. The factors that affect the scaffold technology are the design, the material used to build the scaffold, and the fabrication process. This review paper includes thus a discussion on the design of Ti6A4V scaffolds in relation to how their behavior is affected by their cell shapes and porosities. This is followed by a discussion on the post treatment and mechanical characterization including in-vitro and in-vivo biomechanical studies. A review and discussion are also presented on the ongoing efforts to develop predictive tools to derive the relationships between structure, processing, properties and performance of powder-bed additive manufacturing of metals. This is a challenge when developing process computational models because the problem involves multi-physics and is of multi-scale in nature. Advantages, limitations, and future trends in AM scaffolds are finally discussed. AM is considered at the forefront of Industry 4.0, the fourth industrial revolution. The market of scaffold technology will continue to boom because of the high demand for human tissue repair.

Chitosan-sodium alginate-based coatings for self-strengthening anticorrosion and antibacterial protection of titanium substrate in artificial saliva

A self-strengthening coating with silver nanoparticles (Ag NPs) doped chitosan (CHI) and sodium alginate (SA) polyelectrolytes was constructed on the surface of polydopamine (PDA) coated Ti substrate by a layer-by-layer assembly method. The PDA coating exhibited an excellent bond with Ti substrate, and also can uniformly deposit Ag NPs via a mild method without introducing any exogenous reductant. The CHI coating was assembled through a spin-coating method for controlling Ag⁺ release. The SA was introduced to enhance the anticorrosion performance by forming calcium alginate (CA) in a corrosive medium. The corrosion protection was investigated with electrochemical impedance spectroscopy and polarization curves tests in fluorine-containing artificial saliva. During immersion, the charge-transfer resistance and the protection efficiency (ŋ) presented a continuous increase with the immersion time, demonstrating that this coating possessed a remarkable self-strengthening capability, and the compositions of the outermost film changed from SA to CA with the Ca²⁺ cations of the corrosive medium as a crosslinker by SEM and EDS analysis. Furthermore, the ŋ remained up to 96.8% after immersion of 30 days, and then the coating also displayed a distinct inhibition zone on S. mutans. These results prove this coating possesses an excellent anticorrosion performance and antibacterial property.

Bioinspired Fabrication of Calcium-Doped TiP Coating with Nanofibrous Microstructure to Accelerate Osseointegration

Bioinspired by the morphology of osteoclast-resorbed bone surfaces, we prepared a calcium-doped titanium phosphate (Ca-TiP) coating, which consists of a nanofibrous network, on titanium (Ti) substrate via a simple two-step hydrothermal method, trying to mimic natural bone compositionally and microstructurally. The in vitro studies show that the Ca-TiP coating with synergistic features of nanofibrous biomimetic topography and surface chemistry could elicit intensively osteogenic behavior and responses including enhanced cell adhesion, spreading, and proliferation as well as alkaline phosphatase (ALP) activity and up-regulated expression of bone-related genes, which inevitably benefit the formation of new bone and the quality of osseointegration. When the two control groups are compared in vivo, the significantly improved new bone formation in the early stage and the much stronger interfacial bonding with the surrounding bone for Ca-TiP coating suggest that Ca-TiP coating modified Ti implants hold great potential for orthopedic and dental applications.

Micro- and Nanohemispherical 3D Imprints Modulate the Osteogenic Differentiation and Mineralization Tendency of Bone Cells

Surface topography has been reported to play a key role in modulating cell behaviors, yet the mechanism through which it modulates these behaviors is not fully understood, especially in the case of three-dimensional (3D) topographies. In this study, a series of novel hemispherical 3D imprints ranging from the nanoscale to the microscale were prepared on titanium (Ti) surfaces using a customized interfacial lithography method. Mouse embryo osteoblast precursor cells (MC3T3-E1) were selected to investigate the solitary effect of specific hemispherical 3D imprints on cellular behaviors. The results indicated that varied hemispherical 3D imprints can affect the formation of filopodia and the arrangement of the cytoskeleton in different ways. Specifically, they can alter the spreading morphologies of cells and lead to deformation of the nucleus, which eventually affects cell proliferation and osteogenic differentiation. Cells cultured on different hemispherical 3D imprints exhibited promoted proliferation and osteogenic differentiation to different degrees; for example, cells cultured on 90 and 500 nm hemispherical imprints formed abundant filopodia and exhibited the highest alkaline phosphatase activity and osteogenic gene expression, respectively. Four-week tibia implantation also confirmed that 90 nm hemispherical imprints improved the osteogenic ability in vivo compared with an unpatterned Ti substrate. In addition to promoted proliferation, colonization of more cells on the surface of implants and induction of rapid osteogenic differentiation can occur. Our work provides a rational way to balance cell proliferation and differentiation, which can accelerate bone integration of an implant and host tissue.

Exploring the mechanism behind improved osteointegration of phosphorylated titanium implants with hierarchically structured topography

Titanium (Ti) and its alloys have been frequently used in dental and orthopedic implants, but the undesired oxide layer easily formed on the surface tends to be the cause of implant failure for Ti-based implants. To address this problem, we herein prepared a phosphorylated Ti coating (TiP-Ti) with a micro/nano hierarchically structured topography on commercially pure Ti implants by a hydrothermal method to improve its osteointegration capacity. The surface morphology, chemical composition, and biological activity were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), contact-angle measurement, and protein adsorption assay. Osteointegration of TiP-Ti implants in rat tibia was investigated by biomechanical testing, micro-CT and histological analyses. We further explored the proposed mechanism which improves osteointegration of TiP-Ti implants by proliferation, adhesion, and differentiation assays of rat bone marrow mesenchymal stem cells (BMSCs). Our results demonstrated that the improved osteointegration mainly benefited from the better spread and adhesion of BMSCs on the micro/nano hierarchically structured TiP-Ti surfaces compared to hydroxyapatite coated Ti (HA-Ti), the positive control, and untreated Ti (untreated-Ti), the negative control. In conclusion, TiP-Ti surface is a promising candidate implant surface design to accelerate the osteointegration of Ti-based implants in biomedical applications.

Long-lasting bactericidal activity through selective physical puncture and controlled ions release of polydopamine and silver nanoparticles-loaded TiO2 nanorods in vitro and in vivo

Background: Titanium (Ti) implant-associated infection, which is mostly caused by bacterial adhesion and biofilm formation, may result in implant failure and secondary surgery. Thus it is an urgent issue to prevent bacterial infections at the earliest step.

Purpose: To develop a novel surface strategy of polydopamine (PDA) and silver (Ag) nanoparticle-loaded TiO₂ nanorods (NRDs) coatings on Ti alloy.

Materials and methods: Ag-TiO₂@PDA NRDs was fabricated on Ti alloy by hydrothermal synthesis. The antibacterial activity of Ag-TiO₂@PDA NRDs against Escherichia coli and methicillin-resistant Staphylococcus aureus were tested by FE-SEM, Live/Dead staining, zone of inhibition, bacteria counting method and protein leakage analysis in vitro. In addition, an implant infection model was conducted and the samples were tested by X-ray, Micro-CT and histological analysis in vivo. Besides, cell morphology and cytotoxicity of Mouse calvarial cells (MC3T3-E1) were characterized by FE-SEM, immunofluorescence and CCK-8 test in vitro.

Results: Our study successfully developed a new surface coating of Ag-TiO₂@PDA NRDs. The selective physical puncture of bacteria and controlled release of Ag+ ions of Ag-TiO₂@PDA NRDs achieved a long-lasting bactericidal ability and anti-biofilm activity with satisfied biocompatibility.

Conclusion: This strategy may be promising for clinical applications to reduce the occurrence of infection in the implant surgeries

Fast, Cost-effective and Energy Efficient Mercury Removal-Recycling Technology

We herein present a novel and sustainable technology for mercury recycling, with the maximum observed uptake capacity. Facile synthesis of the most efficient (~1.9 gg-1) nano-trap, made of montmorillonite-Fe-iron oxides, was performed to instantaneously remove mercury(II) ions from water. Elemental Hg was recovered from the adduct, by employing Fe granules, at ambient conditions. Varied pHs and elevated temperatures further enhanced this already highly efficient recycling process. The reduction of Hg(II) to Hg(I) by the nano trap and Hg(I) to Hg(0) by Fe granules are the main driving forces behind the recycling process. Facile sustainable recycling of the nano-trap and Fe granules require no additional energy. We have further developed a recyclable model for Hg nano-trap, which is inexpensive (<$5 CAD), and can remove mercury in a few seconds. This technology has multiple applications, including in the communities exposed to mercury contamination.

Biomedical Porous Shape Memory Alloys for Hard-Tissue Replacement Materials

Porous shape memory alloys (SMAs), including NiTi and Ni-free Ti-based alloys, are unusual materials for hard-tissue replacements because of their unique superelasticity (SE), good biocompatibility, and low elastic modulus. However, the Ni ion releasing for porous NiTi SMAs in physiological conditions and relatively low SE for porous Ni-free SMAs have delayed their clinic applications as implantable materials. The present article reviews recent research progresses on porous NiTi and Ni-free SMAs for hard-tissue replacements, focusing on two specific topics: (i) synthesis of porous SMAs with optimal porous structure, microstructure, mechanical, and biological properties; and, (ii) surface modifications that are designed to create bio-inert or bio-active surfaces with low Ni releasing and high biocompatibility for porous NiTi SMAs. With the advances of preparation technique, the porous SMAs can be tailored to satisfied porous structure with porosity ranging from 30% to 85% and different pore sizes. In addition, they can exhibit an elastic modulus of 0.4⁻15 GPa and SE of more than 2.5%, as well as good cell and tissue biocompatibility. As a result, porous SMAs had already been used in maxillofacial repairing, teeth root replacement, and cervical and lumbar vertebral implantation. Based on current research progresses, possible future directions are discussed for "property-pore structure" relationship and surface modification investigations, which could lead to optimized porous biomedical SMAs. We believe that porous SMAs with optimal porous structure and a bioactive surface layer are the most competitive candidate for short-term and long-term hard-tissue replacement materials.

3D bioactive composite scaffolds for bone tissue engineering

Bone is the second most commonly transplanted tissue worldwide, with over four million operations using bone grafts or bone substitute materials annually to treat bone defects. However, significant limitations affect current treatment options and clinical demand for bone grafts continues to rise due to conditions such as trauma, cancer, infection and arthritis. Developing bioactive three-dimensional (3D) scaffolds to support bone regeneration has therefore become a key area of focus within bone tissue engineering (BTE). A variety of materials and manufacturing methods including 3D printing have been used to create novel alternatives to traditional bone grafts. However, individual groups of materials including polymers, ceramics and hydrogels have been unable to fully replicate the properties of bone when used alone. Favourable material properties can be combined and bioactivity improved when groups of materials are used together in composite 3D scaffolds. This review will therefore consider the ideal properties of bioactive composite 3D scaffolds and examine recent use of polymers, hydrogels, metals, ceramics and bio-glasses in BTE. Scaffold fabrication methodology, mechanical performance, biocompatibility, bioactivity, and potential clinical translations will be discussed.

Promoting Osseointegration of Ti Implants through Micro/Nanoscaled Hierarchical Ti Phosphate/Ti Oxide Hybrid Coating

In this study, micro/nanoscaled hierarchical hybrid coatings containing titanium (Ti) phosphate and Ti oxide have been fabricated with the aim of promoting osseointegration of Ti-based implants. Three representative surface coatings, namely, micro/nanograss Ti (P-G-Ti), micro/nanoclump Ti, (P-C-Ti), and micro/nanorod Ti (P-R-Ti), have been produced. In-depth investigations into the coating surface morphology, topography, chemical composition, and the surface/cell interaction have been carried out using scanning electron microscopy, transmission electron microscope, X-ray photoelectron spectroscopy, X-ray diffraction, contact-angle measurement, and protein adsorption assay. In addition, in vitro performance of the coating (cell proliferation, adhesion, and differentiation) has been evaluated using rat bone marrow stromal cells (BMSCs), and in vivo assessments have been carried out based on a rat tibia implantation model. All the hybrid coating modified implants demonstrated enhanced protein adsorption and BMSC viability, adhesion and differentiation, with P-G-Ti showing the best bioactivity among all samples. Subsequent i n vivo osseointegration tests confirmed that P-G-Ti has induced a much stronger interfacial bonding with the host tissue, indicated by the 2-fold increase in the ultimate shear strength and over 6-fold increase in the maximum push-out force compared to unmodified Ti implants. The state-of-the-art coating technology proposed for Ti-based implants in this study holds great potential in advancing medical devices for next-generation healthcare technology.

Replication and bioactivation of Ti-based alloy scaffold macroscopically identical to cancellous bone from polymeric template with TiNbZr powders

In the present work, a new type of porous Ti-based alloy scaffold with high porosity (about 75%) and interconnected pores in the range of 300-1000 µm was fabricated by polymeric foam replication method with TiNbZr powders. This porous scaffold, which is consisted with major β phase Ti and minor α Ti phase, exhibits a compressive strength of 14.9 MPa and an elastic modulus of 0.21 GPa, resembling the mechanical properties of nature human cancellous bone (σ = 10-50 MPa, E = 0.01-3.0 GPa). To improve its osteogenic potential, a bioactive nanostructural titanate network coating was applied to the scaffold surface using hydrothermal treatment. The bone-like apatite inducing ability of the treated scaffold was systemically assessed using SBF immersion during 3-28 days. The nanostructural titanate network coated on porous TiNbZr scaffold is favorable for apatite nucleation and subsequent growth due to the hydrolysis of titanate. The results suggest that highly porous TiNbZr scaffolds with an appropriate bioactive coating, which was fabricated in this study, could be potentially used for bone tissue engineering application.

Rapid Biofilm Eradication on Bone Implants Using Red Phosphorus and Near-Infrared Light

Bone-implant-associated infections are common after orthopedic surgery due to impaired host immune response around the implants. In particular, when a biofilm develops, the immune system and antibiotic treatment find it difficult to eradicate, which sometimes requires a second operation to replace the infected implants. Most strategies have been designed to prevent biofilms from forming on the surface of bone implants, but these strategies cannot eliminate the biofilm when it has been established in vivo. To address this issue, a nonsurgical, noninvasive treatment for biofilm infection must be developed. Herein, a red-phosphorus-IR780-arginine-glycine-aspartic-acid-cysteine coating on titanium bone implants is prepared. The red phosphorus has great biocompatibility and exhibits efficient photothermal ability. The temperature sensitivity of Staphylococcus aureus biofilm is enhanced in the presence of singlet oxygen (¹ O₂ ) produced by IR780. Without damaging the normal tissue, the biofilm can be eradicated through a safe near-infrared (808 nm) photothermal therapy at 50 °C in vitro and in vivo. This approach reaches an antibacterial efficiency of 96.2% in vivo with 10 min of irradiation at 50 °C. Meanwhile, arginine-glycine-aspartic-acid-cysteine decorated on the surface of the implant can improve the cell adhesion, proliferation, and osteogenic differentiation.

Enhanced in vitro biocompatibility and osteogenesis of titanium substrates immobilized with dopamine-assisted superparamagnetic Fe3O4 nanoparticles for hBMSCs

Titanium (Ti) is an ideal bone substitute due to its superior bio-compatibility and remarkable corrosion resistance. However, in order to improve the osteoconduction and osteoinduction capacities in clinical applications, different kinds of surface modifications are typically applied to Ti alloys. In this study, we fabricated a tightly attached polydopamine-assisted Fe3O4 nanoparticle coating on Ti with magnetic properties, aiming to improve the osteogenesis of the Ti substrates. The PDA-assisted Fe3O4 nanoparticle coatings were characterized by scanning electron microscopy, energy dispersive spectroscopy, atomic force microscopy and water contact angle measurements. The cell attachment and proliferation rate of the human bone mesenchymal stem cells (hBMSCs) on the Ti surface significantly improved with the Fe3O4/PDA coating when compared with the pure Ti without a coating. Furthermore, the results of in vitro alkaline phosphatase (ALP) activity at 7 and 14 days and alizarin red S staining at 14 days showed that the Fe3O4/PDA coating on Ti promoted the osteogenic differentiation of hBMSCs. Moreover, hBMSCs co-cultured with the Fe3O4/PDA-coated Ti for approximately 14 days also exhibited a significantly higher mRNA expression level of ALP, osteocalcin and runt-related transcription factor-2 (RUNX2). Our in vitro results revealed that the present PDA-assisted Fe3O4 nanoparticle surface coating is an innovative method for Ti surface modification and shows great potential for clinical applications.

The Role of Nanomechanics in Healthcare

Nanomechanics has played a vital role in pushing our capability to detect, probe, and manipulate the biological species, such as proteins, cells, and tissues, paving way to a deeper knowledge and superior strategies for healthcare. Nanomechanical characterization techniques, such as atomic force microscopy, nanoindentation, nanotribology, optical tweezers, and other hybrid techniques have been utilized to understand the mechanics and kinetics of biospecies. Investigation of the mechanics of cells and tissues has provided critical information about mechanical characteristics of host body environments. This information has been utilized for developing biomimetic materials and structures for tissue engineering and artificial implants. This review summarizes nanomechanical characterization techniques and their potential applications in healthcare research. The principles and examples of label-free detection of cancers and myocardial infarction by nanomechanical cantilevers are discussed. The vital importance of nanomechanics in regenerative medicine is highlighted from the perspective of material selection and design for developing biocompatible scaffolds. This review interconnects the advancements made in fundamental materials science research and biomedical technology, and therefore provides scientific insight that is of common interest to the researchers working in different disciplines of healthcare science and technology.

Simultaneous hydrothermal bioactivation with nano-topographic modulation of porous titanium alloys towards enhanced osteogenic and antimicrobial responses

Post-implantation failure associated with insufficient host tissue integration at the bone–implant interface and aseptic loosening is a major concern in orthopaedics as well as in dentistry.

Balancing Bacteria-Osteoblast Competition through Selective Physical Puncture and Biofunctionalization of ZnO/Polydopamine/Arginine-Glycine-Aspartic Acid-Cysteine Nanorods

Bacterial infection and lack of bone tissue integration are two major concerns of orthopedic implants. In addition, osteoinductivity often decreases and toxicity may arise when antibacterial agents are introduced to increase the antibacterial ability. Here hybrid ZnO/polydopamine (PDA)/arginine-glycine-aspartic acid-cysteine (RGDC) nanorod (NR) arrays are designed and prepared on titanium (Ti) implants to not only enhance the osteoinductivity but also effectively kill bacteria simultaneously, which are ascribed to the selective physical puncture and the biofunctionalization of ZnO/PDA/RGDC nanorods during the competition between bacteria and osteoblasts. That is, owing to the much larger size of osteoblasts than bacteria, the hybrid NRs can puncture bacteria but not damage osteoblasts. Meanwhile, the cytocompatibility can be enhanced through the suppression of both reactive oxygen species and higher Zn²⁺ concentration by the covering of PDA and RGDC. The in vitro results confirm the selective puncture of the bacterial membrane and the better osteoinductivity. In vivo tests also show much higher antibacterial efficacy of the hybrid NRs with far less amounts of lobulated neutrophils and adherent bacteria in the surrounding tissues. In addition, the hybrid NRs also accelerate formation of new bone tissues (20.1% higher than pure Ti) and osteointegration between implants and newly formed tissues (32.0% higher than pure Ti) even in the presence of injected bacteria. This work provides a surface strategy for designing implants with desirable ability of osseointegration and infection prevention simultaneously, which will exhibit tremendous clinical potential in orthopedic and dental applications.

Novel vaterite-containing tricalcium silicate bone cement by surface functionalization using 3-aminopropyltriethoxysilane: setting behavior, in vitro bioactivity and cytocompatibility

A novel vaterite-containing tricalcium silicate (V-C₃S) was grafted by 3-aminopropyltriethoxysilane (APTES), and the amino groups have been successfully fixed on the vaterite-containing tricalcium silicate powder's surface (after grafting the amino group, V-C₃S was named A-V-C₃S). The setting behavior, mechanical properties, porosity, weight loss and anti-washout properties of the tricalcium silicate (C₃S), V-C₃S and A-V-C₃S bone cement were systematically investigated. The in vitro induction of hydroxyapatite (HAp) formation of C₃S, V-C₃S and A-V-C₃S bone cement was confirmed by x-ray diffraction, Fourier-transform infrared spectroscopy and scanning electron microscopy. The cell viability, cell proliferation and cell attachment were investigated to assess the effects of bone cement on MC3T3-E1 cells. Results showed that the setting time of A-V-C₃S bone cement can meet the requirements of a clinical test, with improved anti-washout properties and an appropriate degradation rate. The pH value of the soaking solution was obviously decreased by surface modification. Besides, the morphology and fluorescence photograph results revealed that the A-V-C₃S bone cement showed an enhanced biocompatibility effect on the proliferation and attachment of MC3T3-E1 cells. The A-V-C₃S bone cement was expected to be a potential bone-substitute material.

The role played by modified bioinspired surfaces in interfacial properties of biomaterials

The success of a biomaterial relies on an appropriate interaction between the surface of that biomaterial and the surrounding environment; more specifically, the success of a biomaterial depends on how fluids, proteins, and cells interact with the foreign material. For this reason, the surface properties of biomaterial, such as composition, charge, wettability, and roughness, must be optimized for a desired application to be achieved. In this review we highlight different bioinspired approaches that are used to manipulate and fine-tune the interfacial properties of biomaterials. Inspired by noteworthy natural processes, researchers have developed materials with a functional anatomy that range from hierarchical hybrid structures to self-cleaning interfaces. In this review we focus on (1) the creation of particles and modified surfaces inspired by the structure and composition of biogenic mineralized tissues, (2) the development of biofunctional coatings, (3) materials inspired by biomembranes and proteins, and (4) the design of superwettable materials. Our intention is to point out different bioinspired methodologies that have been used to design materials for biomedical applications and to discuss how interfacial properties modified by manipulation of these materials determine their final biological response. Our objective is to present future research directions and to highlight the potential of bioinspired materials. We hope this review will provide an understanding of the interplay between interfacial properties and biological response so that successful biomaterials can be achieved.

Surface bioactivation through the nanostructured layer on titanium modified by facile HPT treatment

Facile fabrication of nanostructured surface is of great importance for the use of titanium (Ti) implants in biomedical field. In this study, a low-cost and easy-to-operate method called HPT (hydrothermal & pressure) here has been developed and used to fabricate the expected nanostructured surface on Ti substrates. The effects of experimental parameters on the morphology of Ti surface were investigated and characterized. The results indicated that by altering the hydrothermal pressure, NaOH concentration and treating time, surface nanostructure like nanopetals or nanoflakes could be formed on the surface of Ti substrates. The orthogonal experiments were conducted to demonstrate the optimized operation conditions. A formation mechanism of the nanostructured titanate layer was proposed, revealing that the nanostructured layer could be formed via a special upward and downward co-growth manner. In vitro cell culture showed that the HPT treated Ti substrates, especially the T-10 sample, could greatly enhance the cell-material interactions, i.e. the cell proliferation and differentiation, focal protein adhesion, and osteogenic factor expression. The HPT method paves a new way to modify the surface of Ti implants with better bioactivity and promising prospect for future biomedical applications.

Stem Cells in Cardiovascular Medicine: the Road to Regenerative Therapies

PURPOSE OF REVIEW

The purpose of this review is to provide a broad overview of current trends in stem cell research and its applications in cardiovascular medicine. Researches on different stem cell sources, their inherent characteristics, and the limitations they have in medical applications are discussed. Additionally, uses of stem cells for both modeling and treating cardiovascular disease are discussed, taking note of the obstacles these engineered interventions must overcome to be clinically viable.

RECENT FINDINGS

Tissue engineering aims to replace dysfunctional tissues with engineered constructs. Stem cell technologies have been a great enabling factor in working toward this goal. Many tissue-engineered products are in development that utilize stem cell technology. Although promising, some refinement must be made to these constructs with respect to safety and functionality. A deeper understanding of basic differentiation and tissue developmental mechanisms is required to allow these engineered tissues to be translated into the clinic.

Nanojoint Formation between Ceramic Titanate Nanowires and Spot Melting of Metal Nanowires with Electron Beam

Construction of nanoarchitectures requires techniques like joint formation and trimming. For ceramic materials, however, it is extremely difficult to form nanojoints by conventional methods like merging. In this work, we demonstrate that ceramic titanate nanowires (NWs) can be joined by spot melting under electron beam (e-beam) irradiation (EBI). The irradiation fuses the contacted spot of titanate NWs yielding an intact nanojoint. Nanojoints with different morphologies can be produced. The joint structures consist of titanium dioxide (TiO₂) rutile, anatase, and titanate phases in the direction away from the e-beam melting spot. The titanate binds to anatase via a crystallographic matching coherent interface (the oxygen atoms at the interface are shared by the two phases) and the anatase solidly binds to the rutile joint. The resulting rutile joint is stable at high temperatures. Additionally, it is demonstrated that the heat production from EBI treated rutile can be utilized to break metal NWs (Ag, Cu, and Ni) apart by spot melting. The required e-beam intensity is considerably mild (75 pA/cm²) which allows visual access and control over the NW melting. Direct melting of Ag and Cu is not applicable under EBI due to their high thermal conductivity even with high current density (500 pA/cm²). Our findings reveal that ceramic nanojoint formation and spot melting at nanoscale are applicable if the properties of nanomaterials are understood and properly utilized.

Dopamine Modified Organic-Inorganic Hybrid Coating for Antimicrobial and Osteogenesis

A hybrid coating composed of hydroxyapatite (HA), Ag nanoparticles (NPs), and chitosan (CS) was successfully prepared on a Ti substrate by a layer-by-layer assembly process. A polydopamine-assisted (PDA-assisted) coating showed a good bond with HA. Ag NPs were uniformly distributed into the hybrid coating through a solution method and ultraviolet light reduction. A CS nanofilm was deposited via spin-coating to control the release of Ag⁺ from the hybrid coating. The results disclosed that the 3-layer CS coating could efficiently control the release of Ag⁺ from the hybrid coating via the Fickian diffusion mechanism and that the PDA/HA/Ag/CS-1 coating exhibited antibacterial ratios of 63.0% and 51.8% against E. coli and S. aureus, respectively. Furthermore, the normal structure of E. coli was obviously destroyed by two types of Ag doped coatings. The cell viability assay showed that CS effectively reduced the cytotoxicity of the hybrid coating after a 7 day incubation. The hybrid coating presented high ALP activities at days 3 and 14. The results reveal that hybrid coatings can endow Ti implants with good antibacterial capability as well as cell viability and osteogenic activity.

Antibacterial Activity of Silver Doped Titanate Nanowires on Ti Implants

A nanostructured film composed of one-dimensional titanate nanowires (TNWs) was employed as a carrier of Ag nanoparticles and chitosan (CS) to improve the surface antibacterial activity and biocompatibility of titanium implants. A TNWs film was produced on a Ti substrate by an alkali hydrothermal reaction and subsequently doped by Ag nanoparticles through an ultraviolet light chemical reduction. The CS nanofilm was deposited on the Ag nanoparticles through a spin-assisted layer by layer assembly method. The results disclosed that Ag nanoparticles were successfully carried by TNWs and homogeneously distributed on the entire surface. Moreover, a CS nanofilm was also successfully deposited on the Ag nanoparticles. Antibacterial tests showed that the samples modified with a higher initial concentration of AgNO3 solution exhibited better antibacterial activity, and that a CS nanofilm could further improve the antibacterial activity of the TNWs. Cell viability and ALP tests revealed that the release of Ag(+) was detrimental for the growth, proliferation, and differentiation of MC3T3, and that CS could lower the negative effects of Ag gradually as the incubation time increased.

The Manufacturing of High Porosity Iron with an Ultra-Fine Microstructure via Free Pressureless Spark Plasma Sintering

High porosity (>40 vol %) iron specimens with micro- and nanoscale isotropic pores were fabricated by carrying out free pressureless spark plasma sintering (FPSPS) of submicron hollow Fe-N powders at 750 °C. Ultra-fine porous microstructures are obtained by imposing high heating rates during the preparation process. This specially designed approach not only avoids the extra procedures of adding and removing space holders during the formation of porous structures, but also triggers the continued phase transitions of the Fe-N system at relatively lower processing temperatures. The compressive strength and energy absorption characteristics of the FPSPS processed specimens are examined here to be correspondingly improved as a result of the refined microstructure.

3D-Printed Scaffolds and Biomaterials: Review of Alveolar Bone Augmentation and Periodontal Regeneration Applications

To ensure a successful dental implant therapy, the presence of adequate vertical and horizontal alveolar bone is fundamental. However, an insufficient amount of alveolar ridge in both dimensions is often encountered in dental practice due to the consequences of oral diseases and tooth loss. Although postextraction socket preservation has been adopted to lessen the need for such invasive approaches, it utilizes bone grafting materials, which have limitations that could negatively affect the quality of bone formation. To overcome the drawbacks of routinely employed grafting materials, bone graft substitutes such as 3D scaffolds have been recently investigated in the dental field. In this review, we highlight different biomaterials suitable for 3D scaffold fabrication, with a focus on “3D-printed” ones as bone graft substitutes that might be convenient for various applications related to implant therapy. We also briefly discuss their possible adoption for periodontal regeneration.

Graded porous inorganic materials derived from self-assembled block copolymer templates

Graded porous inorganic materials directed by macromolecular self-assembly are expected to offer unique structural platforms relative to conventional porous inorganic materials. Their preparation to date remains a challenge, however, based on the sparsity of viable synthetic self-assembly pathways to control structural asymmetry. Here we demonstrate the fabrication of graded porous carbon, metal, and metal oxide film structures from self-assembled block copolymer templates by using various backfilling techniques in combination with thermal treatments for template removal and chemical transformations. The asymmetric inorganic structures display mesopores in the film top layers and a gradual pore size increase along the film normal in the macroporous sponge-like support structure. Substructure walls between macropores are themselves mesoporous, constituting a structural hierarchy in addition to the pore gradation. Final graded structures can be tailored by tuning casting conditions of self-assembled templates as well as the backfilling processes. We expect that these graded porous inorganic materials may find use in applications including separation, catalysis, biomedical implants, and energy conversion and storage.

Nanotechnology in the Regeneration of Complex Tissues

Modern medicine faces a growing crisis as demand for organ transplantations continues to far outstrip supply. By stimulating the body’s own repair mechanisms, regenerative medicine aims to reduce demand for organs, while the closely related field of tissue engineering promises to deliver “off-the-self” organs grown from patients’ own stem cells to improve supply. To deliver on these promises, we must have reliable means of generating complex tissues. Thus far, the majority of successful tissue engineering approaches have relied on macroporous scaffolds to provide cells with both mechanical support and differentiative cues. In order to engineer complex tissues, greater attention must be paid to nanoscale cues present in a cell’s microenvironment. As the extracellular matrix is capable of driving complexity during development, it must be understood and reproduced in order to recapitulate complexity in engineered tissues. This review will summarize current progress in engineering complex tissue through the integration of nanocomposites and biomimetic scaffolds.

Alkali-treated titanium selectively regulating biological behaviors of bacteria, cancer cells and mesenchymal stem cells

Many attentions have been paid to the beneficial effect of alkali-treated titanium to bioactivity and osteogenic activity, but few to the other biological effect. In this work, hierarchical micro/nanopore films were prepared on titanium surface by acid etching and alkali treatment and their biological effects on bacteria, cancer cells and mesenchymal stem cells were investigated. Gram-positive Staphylococcus aureus, Gram-negative Escherichia coli, and human cholangiocarcinoma cell line RBE were used to investigate whether alkali-treated titanium can influence behaviors of bacteria and cancer cells. Responses of bone marrow mesenchymal stem cells (BMMSCs) to alkali-treated titanium were also subsequently investigated. The alkali-treated titanium can potently reduce bacterial adhesion, inhibit RBE and BMMSCs proliferation, while can better promote BMMSCs osteogenesis and angiogenesis than acid-etched titanium. The bacteriostatic ability of the alkali-treated titanium is proposed to result from the joint effect of micro/nanotopography and local pH increase at bacterium/material interface due to the hydrolysis of alkali (earth) metal titanate salts. The inhibitory action of cell proliferation is thought to be the effect of local pH increase at cell/material interface which causes the alkalosis of cells. This alkalosis model reported in this work will help to understand the biologic behaviors of various cells on alkali-treated titanium surface and design the intended biomedical applications.

Rolled-up functionalized nanomembranes as three-dimensional cavities for single cell studies

We use micropatterning and strain engineering to encapsulate single living mammalian cells into transparent tubular architectures consisting of three-dimensional (3D) rolled-up nanomembranes. By using optical microscopy, we demonstrate that these structures are suitable for the scrutiny of cellular dynamics within confined 3D-microenvironments. We show that spatial confinement of mitotic mammalian cells inside tubular architectures can perturb metaphase plate formation, delay mitotic progression, and cause chromosomal instability in both a transformed and nontransformed human cell line. These findings could provide important clues into how spatial constraints dictate cellular behavior and function.

Self-assembly of collagen on flat surfaces: the interplay of collagen-collagen and collagen-substrate interactions

Fibrillar collagens, common tissue scaffolds in live organisms, can also self-assemble in vitro from solution. While previous in vitro studies showed that the pH and the electrolyte concentration in solution largely control the collagen assembly, the physical reasons why such control could be exerted are still elusive. To address this issue and to be able to simulate self-assembly over large spatial and temporal scales, we have developed a microscopic model of collagen with explicit interactions between the units that make up the collagen molecules, as well as between these units and the substrate. We have used this model to investigate assemblies obtained via molecular dynamics deposition of collagen on a substrate at room temperature using an implicit solvent. By comparing the morphologies from our molecular dynamics simulations with those from our atomic-force microscopy experiments, we have found that the assembly is governed by the competition between the collagen-collagen interactions and those between collagen and the substrate. The microscopic model developed here can serve for guiding future experiments that would explore new regions of the parameter space.

25th anniversary article: scalable multiscale patterned structures inspired by nature: the role of hierarchy

Multiscale, hierarchically patterned surfaces, such as lotus leaves, butterfly wings, adhesion pads of gecko lizards are abundantly found in nature, where microstructures are usually used to strengthen the mechanical stability while nanostructures offer the main functionality, i.e., wettability, structural color, or dry adhesion. To emulate such hierarchical structures in nature, multiscale, multilevel patterning has been extensively utilized for the last few decades towards various applications ranging from wetting control, structural colors, to tissue scaffolds. In this review, we highlight recent advances in scalable multiscale patterning to bring about improved functions that can even surpass those found in nature, with particular focus on the analogy between natural and synthetic architectures in terms of the role of different length scales. This review is organized into four sections. First, the role and importance of multiscale, hierarchical structures is described with four representative examples. Second, recent achievements in multiscale patterning are introduced with their strengths and weaknesses. Third, four application areas of wetting control, dry adhesives, selectively filtrating membranes, and multiscale tissue scaffolds are overviewed by stressing out how and why multiscale structures need to be incorporated to carry out their performances. Finally, we present future directions and challenges for scalable, multiscale patterned surfaces.

Wear mechanism and tribological characteristics of porous NiTi shape memory alloy for bone scaffold

The abraded debris might cause osteocytic osteolysis on the interface between implants and bone tissues, thus inducing the subsequent mobilization of implants gradually and finally resulting in the failure of bone implants, which imposes restrictions on the applications of porous NiTi shape memory alloys (SMAs) scaffolds for bone tissue engineering. In this work, the effects of the annealing temperature, applied load, and porosity on the tribological behavior and wear resistance of three-dimensional porous NiTi SMA are investigated systematically. The porous structure and phase transformation during the exothermic process affect the tribological properties and wear mechanism significantly. In general, a larger porosity leads to better tribological resistance but sometimes, SMAs with small porosity possess better wear resistance than ones with higher porosity during the initial sliding stage. It can be ascribed to the better superelasticity of the former at the test temperature. The porous NiTi phase during the exothermic reaction also plays an important role in the wear resistance. Generally, porous NiTi has smaller friction coefficients under high loads due to stress-induced superelasticity. The wear mechanism is discussed based on plastic deformation and microcrack propagation.

Titanate nanowire scaffolds decorated with anatase nanocrystals show good protein adsorption and low cell adhesion capacity

BACKGROUND AND METHODS

In this report, layered microporous titanate nanowire scaffolds (TiNWs) were constructed via a hydrothermal route and then decorated with anatase nanocrystals (ANs@TiNWs) by immersion in TiCl(4) solution. The diameter and specific surface area of the ANs@TiNWs was measured. The TiNWs and ANs@TiNWs were then compared for their ability to adsorb protein and adhere to MG63 cells.

RESULTS

The diameter and specific surface area of the ANs@TiNWs were significantly larger than for TiNWs, and the ANs@TiNWs had an enhanced protein-adsorbing effect. It was found that the MG63 cells were less able to adhere to the flat titanium substrate than the TiNWs and ANs@TiNWs, and that this cell-repellant ability was greater with ANs@TiNWs. Other MG63 cell functions, proliferation in particular, were also inhibited by ANs@TiNWs.

CONCLUSION

ANs@TiNWs show a high protein adsorption and cell-repellant capacity which would be useful in drug delivery.

Material strategies for creating artificial cell-instructive niches

There has been a tremendous growth in the use of biomaterials serving as cellular scaffolds for tissue engineering applications. Recently, advanced material strategies have been developed to incorporate structural, mechanical, and biochemical signals that can interact with the cell and the in vivo environment in a biologically specific manner. In this article, strategies such as the use of composite materials and material processing methods to better mimic the extracellular matrix, integration of mechanical and topographical properties of materials in scaffold design, and incorporation of biochemical cues such as cytokines in tethered, soluble, or time-released forms are presented. Finally, replication of the dynamic forces and biochemical gradients of the in vivo cellular environment through the use of microfluidics is highlighted.

Functional biomaterials for cartilage regeneration

The injury and degeneration of articular cartilage and associated arthritis are leading causes of disability worldwide. Cartilage tissue engineering as a treatment modality for cartilage defects has been investigated for over 20 years. Various scaffold materials have been developed for this purpose, but has yet to achieve feasibility and effectiveness for widespread clinical use. Currently, the regeneration of articular cartilage remains a formidable challenge, due to the complex physiology of cartilage tissue and its poor healing capacity. Although intensive research has been focused on the developmental biology and regeneration of cartilage tissue and a diverse plethora of biomaterials have been developed for this purpose, cartilage regeneration is still suboptimal, such as lacking a layered structure, mechanical mismatch with native cartilage and inadequate integration between native tissue and implanted scaffold. The ideal scaffold material should have versatile properties that actively contribute to cartilage regeneration. Functional scaffold materials may overcome the various challenges faced in cartilage tissue engineering by providing essential biological, mechanical, and physical/chemical signaling cues through innovative design. This review thus focuses on the complex structure of native articular cartilage, the critical properties of scaffolds required for cartilage regeneration, present strategies for scaffold design, and future directions for cartilage regeneration with functional scaffold materials.