Extrusion-based 3D printing of biodegradable, osteogenic, paramagnetic, and porous FeMn-akermanite bone substitutes

The development of biodegradable Fe-based bone implants has rapidly progressed in recent years. Most of the challenges encountered in developing such implants have been tackled individually or in combination using additive manufacturing technologies. Yet not all the challenges have been overcome. Herein, we present porous FeMn-akermanite composite scaffolds fabricated by extrusion-based 3D printing to address the unmet clinical needs associated with Fe-based biomaterials for bone regeneration, including low biodegradation rate, MRI-incompatibility, mechanical properties, and limited bioactivity. In this research, we developed inks containing Fe, 35 wt% Mn, and 20 or 30 vol% akermanite powder mixtures. 3D printing was optimized together with the debinding and sintering steps to obtain scaffolds with interconnected porosity of 69%. The Fe-matrix in the composites contained the γ-FeMn phase as well as nesosilicate phases. The former made the composites paramagnetic and, thus, MRI-friendly. The in vitro biodegradation rates of the composites with 20 and 30 vol% akermanite were respectively 0.24 and 0.27 mm/y, falling within the ideal range of biodegradation rates for bone substitution. The yield strengths of the porous composites stayed within the range of the values of the trabecular bone, despite in vitro biodegradation for 28 d. All the composite scaffolds favored the adhesion, proliferation, and osteogenic differentiation of preosteoblasts, as revealed by Runx2 assay. Moreover, osteopontin was detected in the extracellular matrix of cells on the scaffolds. Altogether, these results demonstrate the remarkable potential of these composites in fulfilling the requirements of porous biodegradable bone substitutes, motivating future in vivo research. STATEMENT OF SIGNIFICANCE: We developed FeMn-akermanite composite scaffolds by taking advantage of the multi-material capacity of extrusion-based 3D printing. Our results demonstrated that the FeMn-akermanite scaffolds showed an exceptional performance in fulfilling all the requirements for bone substitution in vitro, i.e., a sufficient biodegradation rate, having mechanical properties in the range of trabecular bone even after 4 weeks biodegradation, paramagnetic, cytocompatible and most importantly osteogenic. Our results encourage further research on Fe-based bone implants in in vivo.

Cost-effective akermanite derived from industrial waste for working electrodes in supercapacitor applications

The aim of this study is the synthesis of an akermanite (Ca2MgSi2O7) material by sol–gel method using industrial waste (fly ash (FA) and ground-granulated blast furnace slag (GGBS)) as an initial precursor for the first time.

Laser Sintering Approaches for Bone Tissue Engineering

The adoption of additive manufacturing (AM) techniques into the medical space has revolutionised tissue engineering. Depending upon the tissue type, specific AM approaches are capable of closely matching the physical and biological tissue attributes, to guide tissue regeneration. For hard tissue such as bone, powder bed fusion (PBF) techniques have significant potential, as they are capable of fabricating materials that can match the mechanical requirements necessary to maintain bone functionality and support regeneration. This review focuses on the PBF techniques that utilize laser sintering for creating scaffolds for bone tissue engineering (BTE) applications. Optimal scaffold requirements are explained, ranging from material biocompatibility and bioactivity, to generating specific architectures to recapitulate the porosity, interconnectivity, and mechanical properties of native human bone. The main objective of the review is to outline the most common materials processed using PBF in the context of BTE; initially outlining the most common polymers, including polyamide, polycaprolactone, polyethylene, and polyetheretherketone. Subsequent sections investigate the use of metals and ceramics in similar systems for BTE applications. The last section explores how composite materials can be used. Within each material section, the benefits and shortcomings are outlined, including their mechanical and biological performance, as well as associated printing parameters. The framework provided can be applied to the development of new, novel materials or laser-based approaches to ultimately generate bone tissue analogues or for guiding bone regeneration.

Additive manufacturing of bioactive and biodegradable porous iron-akermanite composites for bone regeneration

Advanced additive manufacturing techniques have been recently used to tackle the two fundamental challenges of biodegradable Fe-based bone-substituting materials, namely low rate of biodegradation and insufficient bioactivity. While additively manufactured porous iron has been somewhat successful in addressing the first challenge, the limited bioactivity of these biomaterials hinder their progress towards clinical application. Herein, we used extrusion-based 3D printing for additive manufacturing of iron-matrix composites containing silicate-based bioceramic particles (akermanite), thereby addressing both of the abovementioned challenges. We developed inks that carried iron and 5, 10, 15, or 20 vol% of akermanite powder mixtures for the 3D printing process and optimized the debinding and sintering steps to produce geometrically-ordered iron-akermanite composites with an open porosity of 69-71%. The composite scaffolds preserved the designed geometry and the original α-Fe and akermanite phases. The in vitro biodegradation rates of the composites were improved as much as 2.6 times the biodegradation rate of geometrically identical pure iron. The yield strengths and elastic moduli of the scaffolds remained within the range of the mechanical properties of the cancellous bone, even after 28 days of biodegradation. The composite scaffolds (10-20 vol% akermanite) demonstrated improved MC3T3-E1 cell adhesion and higher levels of cell proliferation. The cellular secretion of collagen type-1 and the alkaline phosphatase activity on the composite scaffolds (10-20 vol% akermanite) were, respectively higher than and comparable to Ti6Al4V in osteogenic medium. Taken together, these results clearly show the potential of 3D printed porous iron-akermanite composites for further development as promising bone substitutes. STATEMENT OF SIGNIFICANCE: : Porous iron matrix composites containing akermanite particles were produced by means of multi-material additive manufacturing to address the two fundamental challenges associated with biodegradable iron-based biomaterials, namely very low rate of biodegradation and insufficient bioactivity. Our porous iron-akermanite composites exhibited enhanced biodegradability and superior bioactivity compared to porous monolithic iron scaffolds. The murine bone cells proliferated on the composite scaffolds, and secreted the collagen type-1 matrix that stimulated bony-like mineralization. The results show the exceptional potential of the developed porous iron-based composite scaffolds for application as bone substitutes.

Engineered titania nanomaterials in advanced clinical applications

Significant advancement in the field of nanotechnology has raised the possibility of applying potent engineered biocompatible nanomaterials within biological systems for theranostic purposes. Titanium dioxide (titanium(IV) oxide/titania/TiO₂) has garnered considerable attention as one of the most extensively studied metal oxides in clinical applications. Owing to the unique properties of titania, such as photocatalytic activity, excellent biocompatibility, corrosion resistance, and low toxicity, titania nanomaterials have revolutionized therapeutic approaches. Additionally, titania provides an exceptional choice for developing innovative medical devices and the integration of functional moieties that can modulate the biological responses. Thus, the current review aims to present a comprehensive and up-to-date overview of TiO₂-based nanotherapeutics and the corresponding future challenges.

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Recent years have witnessed surging demand for bone repair/regeneration implants due to the increasing number of bone defects caused by trauma, cancer, infection, and arthritis worldwide. In addition to bone autografts and allografts, biomaterial substitutes have been widely used in clinical practice. Personalized implants with precise and personalized control of shape, porosity, composition, surface chemistry, and mechanical properties will greatly facilitate the regeneration of bone tissue and satiate the clinical needs. Additive manufacturing (AM) techniques, also known as 3D printing, are drawing fast growing attention in the fabrication of implants or scaffolding materials due to their capability of manufacturing complex and irregularly shaped scaffolds in repairing bone defects in clinical practice. This review aims to provide a comprehensive overview of recent progress in the development of materials and techniques used in the additive manufacturing of bone scaffolds. In addition, clinical application, pre-clinical trials and future prospects of AM based bone implants are also summarized and discussed.

Fabrication, Mechanical Properties and In-Vitro Behavior of Akermanite Bioceramic

Pure nanocrystalline akermanite (Ca₂MgSi₂O₇) powder was synthesized by mechanical activation with subsequent annealing of talc, calcium carbonate, and silicate powders as the initial materials. Powder samples were characterized by X-ray diffractometry (XRD), scanning electron microscopy (SEM), thermogravimetric analysis (TGA), and transmission electron microscopy (TEM) techniques. The results showed that pure nanocrystalline akermanite with a crystalline size of 35 nm was synthesized after ball milling the initial powders for 20 h with subsequent annealing at 900 °C for 1 h. Mechanical properties of bulk akermanite samples were studied as well. The results showed that the produced akermanite tablets sintered at 1200 °C for 5 h had a Young's modulus of 3800 MPa, an ultimate compressive strength of 24.7 MPa, and a density of 2.489 g/cm³. The in-vitro behavior of the produced akermanite was evaluated by soaking the samples in an SBF solution. The results showed that the produced akermanite had the apatite formation ability on its surface and can be a good candidate for bone tissue engineering applications.

Bioactive Tetracalcium Phosphate Scaffolds Fabricated by Selective Laser Sintering for Bone Regeneration Applications

Tetracalcium phosphate (TTCP), a potential biological scaffold material, has attracted increasing interest for bone regeneration applications due to its good biodegradability and biocompatibility. In this research, three-dimensional porous TTCP scaffolds were manufactured via selective laser sintering (SLS), and an in-depth and meticulous study on the influence of laser power on the microstructure and mechanical properties of TTCP scaffolds was performed. The results showed that the TTCP particles fused together and formed a solid object due to the decrease in the number of micro-pores in the scaffold as the laser power increased from 6 W to 9 W. The maximum compressive strength that the scaffold could withstand and the strength of the fracture toughness were 11.87 ± 0.64 MPa and 1.12 ± 0.1 MPa·m^1/2, respectively. When the laser power increased from 9 W to 10 W, the TTCP grains grew abnormally, resulting in diminished mechanical properties. The bioactivity tests showed that the surfaces of the scaffolds were entirely covered by bone-like apatite layers after soaking in simulated body fluid (SBF) for three days, indicating that the scaffolds exhibit excellent bioactivity. Moreover, cell experiments showed that the TTCP scaffolds had good biocompatibility. This study indicated that SLS-fabricated TTCP scaffolds may be a promising candidate for bone regeneration applications.

Characterizations and interfacial reinforcement mechanisms of multicomponent biopolymer based scaffold

It is difficult for a single component biopolymer to meet the requirements of scaffold at present. The development of multicomponent biopolymer based scaffold provides an effective method to solve the issue based on the advantages of each kind of the biomaterials. However, the compatibility between different components might be very poor due to the difficulties in forming strong interfacial bonding, and thereby significantly degrading the integrated mechanical properties of the scaffold. In recent years, interface phase introduction, surface modification and in situ growth have been the major strategies for enhancing interfacial bonding. This article presents a comprehensive overview on the research in the area of constructing multicomponent biopolymer based scaffold and reinforcing their interfacial properties, and more importantly, the interfacial bonding mechanisms are systematically summarized. Detailly, interface phase introduction can build a bridge between biopolymer and other components to form strong interface bonding with the two phases under the action of interface phase. Surface modification can graft organic molecules or polymers containing functional groups onto other components to crosslink with biopolymer. In situ growth can directly in situ synthesize other components with the action of nucleating agent serving as an adherent platform for the nucleation and growth of other components to biopolymer surface by chemical bonding. In addition, the mechanical properties (including strength and modulus) and biological properties (including bioactivity, cytocompatibility and biosensing in vitro, and tissue compatibility, bone regeneration capacity in vivo) of multicomponent biopolymer based scaffold after interfacial reinforcing are also reviewed and discussed. Finally, suggestions for further research are given with highlighting the need for specific investigations to assess the interface formation, structure, properties, and more in vivo studies of scaffold before applications.

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.

Effects of incorporation of 2.5 and 5 wt% TiO2 nanotubes on fracture toughness, flexural strength, and microhardness of denture base poly methyl methacrylate (PMMA)

PURPOSE

The aim of this preliminary study was to investigate, for the first time, the effects of addition of titania nanotubes (n-TiO2) to poly methyl methacrylate (PMMA) on mechanical properties of PMMA denture base.

MATERIALS AND METHODS

TiO2 nanotubes were prepared using alkaline hydrothermal process. Obtained nanotubes were assessed using FESEM-EDX, XRD, and FT-IR. For 3 experiments of this study (fracture toughness, three-point bending flexural strength, and Vickers microhardness), 135 specimens were prepared according to ISO 20795-1:2013 (n of each experiment=45). For each experiment, PMMA was mixed with 0% (control), 2.5 wt%, and 5 wt% nanotubes. From each TiO2:PMMA ratio, 15 specimens were fabricated for each experiment. Effects of n-TiO2 addition on 3 mechanical properties were assessed using Pearson, ANOVA, and Tukey tests.

RESULTS

SEM images of n-TiO2 exhibited the presence of elongated tubular structures. The XRD pattern of synthesized n-TiO2 represented the anatase crystal phase of TiO2. Moderate to very strong significant positive correlations were observed between the concentration of n-TiO2 and each of the 3 physicomechanical properties of PMMA (Pearson's P value ≤.001, correlation coefficient ranging between 0.5 and 0.9). Flexural strength and hardness values of specimens modified with both 2.5 and 5 wt% n-TiO2 were significantly higher than those of control (P≤.001). Fracture toughness of samples reinforced with 5 wt% n-TiO2 (but not those of 2.5% n-TiO2) was higher than control (P=.002).

CONCLUSION

Titania nanotubes were successfully introduced for the first time as a means of enhancing the hardness, flexural strength, and fracture toughness of denture base PMMA.

Poly(lactic-co-glycolic acid)(PLGA)/TiO2 nanotube bioactive composite as a novel scaffold for bone tissue engineering: In vitro and in vivo studies

The aim of this study was to synthesize and characterize novel three-dimensional porous scaffolds made of poly (lactic-co-glycolic acid)/TiO₂ nanotube (TNT) composite microspheres for bone tissue engineering applications. The incorporation of TNT greatly increases mechanical properties of PLGA/TNT microsphere-sintered scaffold. The experimental results exhibit that the PLGA/0.5 wt% TNT scaffold sintered at 100 °C for 3 h showed the best mechanical properties and a proper pore structure for tissue engineering. Biodegradation test ascertained that the weight of both PLGA and PLGA/PLGA/0.5 wt% TiO₂ nanotube composites slightly reduced during the first 4 weeks following immersion in SBF solution. Moreover, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and alkaline phosphatase activity (ALP activity) results represent increased cell viability for PLGA/0.5%TNT composite scaffold in comparison to the control group. In vivo studies show the amount of bone formation for PLGA/TNT was approximately twice of pure PLGA. Vivid histologic images of the newly generated bone on the implants further supported our test results. Eventually, a mathematical model showed that both PLGA and PLGA/TNT scaffolds' mechanical properties follow an exponential trend with time as their degradation occurs. By a three-dimensional finite element model, a more monotonous distribution of stress was present in the scaffold due to the presence of TNT with a reduction in maximum stress on bone.

Doped Calcium Silicate Ceramics: A New Class of Candidates for Synthetic Bone Substitutes

Doped calcium silicate ceramics (DCSCs) have recently gained immense interest as a new class of candidates for the treatment of bone defects. Although calcium phosphates and bioactive glasses have remained the mainstream of ceramic bone substitutes, their clinical use is limited by suboptimal mechanical properties. DCSCs are a class of calcium silicate ceramics which are developed through the ionic substitution of calcium ions, the incorporation of metal oxides into the base binary xCaO-ySiO₂ system, or a combination of both. Due to their unique compositions and ability to release bioactive ions, DCSCs exhibit enhanced mechanical and biological properties. Such characteristics offer significant advantages over existing ceramic bone substitutes, and underline the future potential of adopting DCSCs for clinical use in bone reconstruction to produce improved outcomes. This review will discuss the effects of different dopant elements and oxides on the characteristics of DCSCs for applications in bone repair, including mechanical properties, degradation and ion release characteristics, radiopacity, and biological activity (in vitro and in vivo). Recent advances in the development of DCSCs for broader clinical applications will also be discussed, including DCSC composites, coated DCSC scaffolds and DCSC-coated metal implants.

Design and Fabrication of 3D printed Scaffolds with a Mechanical Strength Comparable to Cortical Bone to Repair Large Bone Defects

A challenge in regenerating large bone defects under load is to create scaffolds with large and interconnected pores while providing a compressive strength comparable to cortical bone (100-150 MPa). Here we design a novel hexagonal architecture for a glass-ceramic scaffold to fabricate an anisotropic, highly porous three dimensional scaffolds with a compressive strength of 110 MPa. Scaffolds with hexagonal design demonstrated a high fatigue resistance (1,000,000 cycles at 1-10 MPa compressive cyclic load), failure reliability and flexural strength (30 MPa) compared with those for conventional architecture. The obtained strength is 150 times greater than values reported for polymeric and composite scaffolds and 5 times greater than reported values for ceramic and glass scaffolds at similar porosity. These scaffolds open avenues for treatment of load bearing bone defects in orthopaedic, dental and maxillofacial applications.

Diopside modified porous polyglycolide scaffolds with improved properties

In this research, diopside was incorporated into PGA scaffolds for enhancing mechanical and biological properties. The porous scaffolds were fabricated via selective laser sintering.

45S5 Bioglass analogue reinforced akermanite ceramic favorable for additive manufacturing mechanically strong scaffolds

Mechanically strong akermanite-based porous bioceramic scaffolds with appreciable bioactivity and biodegradation were developedviaextrusion 3D-printing followed by a low-melt bioactive glass-assisted pressureless sintering process.