Advances in guided bone regeneration membranes: a comprehensive review of materials and techniques

Guided tissue/bone regeneration (GTR/GBR) is a widely used technique in dentistry to facilitate the regeneration of damaged bone and tissue, which involves guiding materials that eventually degrade, allowing newly created tissue to take its place. This comprehensive review the evolution of biomaterials for guided bone regeneration that showcases a progressive shift from non-resorbable to highly biocompatible and bioactive materials, allowing for more effective and predictable bone regeneration. The evolution of biomaterials for guided bone regeneration GTR/GBR has marked a significant progression in regenerative dentistry and maxillofacial surgery. Biomaterials used in GBR have evolved over time to enhance biocompatibility, bioactivity, and efficacy in promoting bone growth and integration. This review also probes into several promising fabrication techniques like electrospinning and latest 3D printing fabrication techniques, which have shown potential in enhancing tissue and bone regeneration processes. Further, the challenges and future direction of GTR/GBR are explored and discussed.

Bone Tissue Engineering and Nanotechnology: A Promising Combination for Bone Regeneration

Large bone defects are the leading contributor to disability worldwide, affecting approximately 1.71 billion people. Conventional bone graft treatments show several disadvantages that negatively impact their therapeutic outcomes and limit their clinical practice. Therefore, much effort has been made to devise new and more effective approaches. In this context, bone tissue engineering (BTE), involving the use of biomaterials which are able to mimic the natural architecture of bone, has emerged as a key strategy for the regeneration of large defects. However, although different types of biomaterials for bone regeneration have been developed and investigated, to date, none of them has been able to completely fulfill the requirements of an ideal implantable material. In this context, in recent years, the field of nanotechnology and the application of nanomaterials to regenerative medicine have gained significant attention from researchers. Nanotechnology has revolutionized the BTE field due to the possibility of generating nanoengineered particles that are able to overcome the current limitations in regenerative strategies, including reduced cell proliferation and differentiation, the inadequate mechanical strength of biomaterials, and poor production of extrinsic factors which are necessary for efficient osteogenesis. In this review, we report on the latest in vitro and in vivo studies on the impact of nanotechnology in the field of BTE, focusing on the effects of nanoparticles on the properties of cells and the use of biomaterials for bone regeneration.

Resorbable GBR Scaffolds in Oral and Maxillofacial Tissue Engineering: Design, Fabrication, and Applications

Guided bone regeneration (GBR) is a promising technique in bone tissue engineering that aims to replace lost or injured bone using resorbable scaffolds. The promotion of osteoblast adhesion, migration, and proliferation is greatly aided by GBR materials, and surface changes are critical in imitating the natural bone structure to improve cellular responses. Moreover, the interactions between bioresponsive scaffolds, growth factors (GFs), immune cells, and stromal progenitor cells are essential in promoting bone regeneration. This literature review comprehensively discusses various aspects of resorbable scaffolds in bone tissue engineering, encompassing scaffold design, materials, fabrication techniques, and advanced manufacturing methods, including three-dimensional printing. In addition, this review explores surface modifications to replicate native bone structures and their impact on cellular responses. Moreover, the mechanisms of bone regeneration are described, providing information on how immune cells, GFs, and bioresponsive scaffolds orchestrate tissue healing. Practical applications in clinical settings are presented to underscore the importance of these principles in promoting tissue integration, healing, and regeneration. Furthermore, this literature review delves into emerging areas of metamaterials and artificial intelligence applications in tissue engineering and regenerative medicine. These interdisciplinary approaches hold immense promise for furthering bone tissue engineering and improving therapeutic outcomes, leading to enhanced patient well-being. The potential of combining material science, advanced manufacturing, and cellular biology is showcased as a pathway to advance bone tissue engineering, addressing a variety of clinical needs and challenges. By providing this comprehensive narrative, a detailed, up-to-date account of resorbable scaffolds' role in bone tissue engineering and their transformative potential is offered.

Harnessing the power of polyol-based polyesters for biomedical innovations: synthesis, properties, and biodegradation

Polyesters based on polyols have emerged as promising biomaterials for various biomedical applications, such as tissue engineering, drug delivery systems, and regenerative medicine, due to their biocompatibility, biodegradability, and versatile physicochemical properties. This review article provides an overview of the synthesis methods, performance, and biodegradation mechanisms of polyol-based polyesters, highlighting their potential for use in a wide range of biomedical applications. The synthesis techniques, such as simple polycondensation and enzymatic polymerization, allow for the fine-tuning of polyester structure and molecular weight, thereby enabling the tailoring of material properties to specific application requirements. The physicochemical properties of polyol-based polyesters, such as hydrophilicity, crystallinity, and mechanical properties, can be altered by incorporating different polyols. The article highlights the influence of various factors, such as molecular weight, crosslinking density, and degradation medium, on the biodegradation behavior of these materials, and the importance of understanding these factors for controlling degradation rates. Future research directions include the development of novel polyesters with improved properties, optimization of degradation rates, and exploration of advanced processing techniques for fabricating scaffolds and drug delivery systems. Overall, polyol-based polyesters hold significant potential in the field of biomedical applications, paving the way for groundbreaking advancements and innovative solutions that could revolutionize patient care and treatment outcomes.

In vivo evaluation of bone regeneration using ZIF8-modified polypropylene membrane in rat calvarium defects

AIM

The profound potential of zeolitic imidazolate framework 8 (ZIF8) thin film for inducing osteogenesis has been previously established under in vitro conditions. As the next step towards the clinical application of ZIF8-modified substrates in periodontology, this in vivo study aimed to evaluate the ability of the ZIF8 crystalline layer to induce bone regeneration in an animal model defect.

MATERIALS AND METHODS

Following the mechanical characterization of the membranes and analysing the in vitro degradation of the ZIF8 layer, in vivo bone regeneration was evaluated in a critical-sized (5-mm) rat calvarial bone defect model. For each animal, one defect was randomly covered with either a polypropylene (PP) or a ZIF8-modified membrane (n = 7 per group), while the other defect was left untreated as a control. Eight weeks post surgery, bone formation was assessed by microcomputed tomography scanning, haematoxylin and eosin staining and immunohistochemical analysis.

RESULTS

The ZIF8-modified membrane outperformed the PP membrane in terms of mechanical properties and revealed a trace Zn+2 release. Results of in vivo evaluation verified the superior barrier function of the ZIF8-coated membrane compared with pristine PP membrane. Compared with the limited marginal bone formation in the control and PP groups, the defect area was almost filled with mature bone in the ZIF8-coated membrane group.

CONCLUSIONS

Our results support the effectiveness of the ZIF8-coated membrane as a promising material for improving clinical outcomes of guided bone regeneration procedures, without using biological components.

Preparation and characterization of a new sustainable bio-based elastomer nanocomposites containing poly(glycerol sebacate citrate)/chitosan/n-hydroxyapatite for promising tissue engineering applications

Poly (glycerol sebacate citrate) (PGSC) has potential applications in tissue engineering due to its biodegradability and suitable elasticity. However, its applications are restricted owing to its acidity and high degradation rate. In this study, a new bio-nanocomposite based on PGSC has been synthesized by incorporating chitosan (CS) and various concentrations of hydroxyapatite nanoparticles (n-HA). It is assumed that the basicity of a CS and hydroxyl groups of n-HA will reduce the acidity of PGSC and control the rate of degradation. Also, the biocompatibility of n-HA and inherent hydrophilicity of CS can improve cell adhesion and proliferation of PGSC-based scaffolds. FTIR, XRD, FESEM, and EDX tests confirmed the synthesis of these nanocomposites and the interaction between each of the components. The results of the DMTA test also indicated the elastic behavior of the samples embedded with n-HA. The hydrophilicity assay demonstrated that the water contact angle of the scaffolds decreased as the concentration of n-HA augmented, and it reached the value of 44 ± 0.9° for nanocomposite containing 5 wt.% n-HA. The degradation rate of all PGSC nanocomposites was reduced due to the anionic groups of n-HA and CS. TGA assay indicated that the incorporation of n-HA led to the enhancement of scaffolds' thermal stability. Furthermore, the synergistic effect of CS and n-HA on the enhancement of protein adsorption and cell proliferation was confirmed through protein adhesion and MTT assay, respectively. Consequently, the addition of n-HA and CS perform the new bio-nanocomposites scaffolds based on PGSC with sufficient hydrophilicity, flexibility, and thermal stability in tissue engineering applications.

Biodegradable and Biocompatible Adhesives for the Effective Stabilisation, Repair and Regeneration of Bone

Bone defects and complex fractures present significant challenges for orthopaedic surgeons. Current surgical procedures involve the reconstruction and mechanical stabilisation of complex fractures using metal hardware (i.e., wires, plates and screws). However, these procedures often result in poor healing. An injectable, biocompatible, biodegradable bone adhesive that could glue bone fragments back together would present a highly attractive solution. A bone adhesive that meets the many clinical requirements for such an application has yet to be developed. While synthetic and biological polymer-based adhesives (e.g., cyanoacrylates, PMMA, fibrin, etc.) have been used effectively as bone void fillers, these materials lack biomechanical integrity and demonstrate poor injectability, which limits the clinical effectiveness and potential for minimally invasive delivery. This systematic review summarises conventional approaches and recent developments in the area of bone adhesives for orthopaedic applications. The required properties for successful bone repair adhesives, which include suitable injectability, setting characteristics, mechanical properties, biocompatibility and an ability to promote new bone formation, are highlighted. Finally, the potential to achieve repair of challenging bone voids and fractures as well as the potential of new bioinspired adhesives and the future directions relating to their clinical development are discussed.

Effect of PEG grafting density on surface properties of polyurethane substrata and the viability of osteoblast and fibroblast cells

The surface of Tecoflex SG-80A Polyurethane (PU) films was modified by grafting polyethylene glycol (PEG) chains at three different molar amounts (0.05, 0.10, and 0.15 mmol). The resulting substrata were characterized by FTIR-ATR, TGA, AFM, SEM and contact angle to assess the surface modifications occurred during the grafting reactions. Osteoblasts and fibroblasts were cultured with PU extracts for 24 h, and their cell viability and morphology were evaluated by CellTiterBlue assay, Crystal Violet staining and Live/Dead assay. FTIR and TGA results indicated that PEG chains were successfully grafted onto PU surfaces, specifically in the hard segment of PU forming allophanate groups as the PEG grafting density increased. SEM and AFM images suggest that PU substrata were partially covered by PEG, increasing the dispersive and basic components of the PU surface energy. It was found that extracts from PEG-grafted polyurethanes increased the osteoblast viability, although fibroblasts viability remained constant regardless PEG grafting density; in spite of this both cells presented a more spread morphology at the lower PEG grafting density. Our results showed that surface energy of PU substrata can be tuned by PEG grafting density; also, the PEG leached tends to increase the pH of culture medium which leads to a higher viability of osteoblasts; nevertheless, PEG grafting density should be optimized to promote a healthy cell morphology as alterations in its morphology were detected at higher concentrations. Graphical abstract.

Biodegradable Elastomers and Gels for Elastic Electronics

Biodegradable electronics are considered as an important bio-friendly solution for electronic waste (e-waste) management, sustainable development, and emerging implantable devices. Elastic electronics with higher imitative mechanical characteristics of human tissues, have become crucial for human-related applications. The convergence of biodegradability and elasticity has emerged a new paradigm of next-generation electronics especially for wearable and implantable electronics. The corresponding biodegradable elastic materials are recognized as a key to drive this field toward the practical applications. The review first clarifies the relevant concepts including biodegradable and elastic electronics along with their general design principles. Subsequently, the crucial mechanisms of the degradation in polymeric materials are discussed in depth. The diverse types of biodegradable elastomers and gels for electronics are then summarized. Their molecular design, modification, processing, and device fabrication especially the structure-properties relationship as well as recent advanced are reviewed in detail. Finally, the current challenges and the future directions are proposed. The critical insights of biodegradability and elastic characteristics in the elastomers and gel allows them to be tailored and designed more effectively for electronic applications.

Silk Fibroin/Collagen Blended Membrane Fabricated via a Green Papermaking Method for Potential Guided Bone Regeneration Application: In Vitro and In Vivo Evaluation

Guided bone regeneration (GBR) technology is a commonly used surgical procedure for the repair of damaged periodontal tissues. Poor mechanical property and rapid degradation rate are the major reasons for GBR membrane failure in clinical applications. Herein, we applied a green papermaking method to fabricate silk fibroin (SF) membranes blended with collagen and tested their performance. The results showed that the blended SF75 (SF and collagen in a weight ratio of 75:25) membranes are biocompatible with good mechanical properties in the wet condition and appropriate biodegradation rate. MC3T3-E1 osteoblast cell adhesion and proliferation on the membranes were improved by the hybrid biological functions of SF and collagen. Subcutaneous implantation in rats for 9 weeks demonstrated that the membranes induced a less severe inflammatory response. The biodegradation time of the SF75 membranes was appropriate for tissue regeneration. This research, for the first time, reports a blended membrane prepared from silk fibroin and collagen with an ecofriendly method, which shows promise for application in guided bone regeneration.

A Review: Optimization for Poly(glycerol sebacate) and Fabrication Techniques for Its Centered Scaffolds

Poly(glycerol sebacate) (PGS), an emerging promising thermosetting polymer synthesized from sebacic acid and glycerol, has attracted considerable attention due to its elasticity, biocompatibility, and tunable biodegradation properties. But it also has some drawbacks such as harsh synthesis conditions, rapid degradation rates, and low stiffness. To overcome these challenges and optimize PGS performance, various modification methods and fabrication techniques for PGS-based scaffolds have been developed in recent years. Outlining the current modification approaches of PGS and summarizing the fabrication techniques for PGS-based scaffolds are of great importance to accelerate the development of new materials and enable them to be appropriately used in potential applications. Thus, this review comprehensively overviews PGS derivatives, PGS composites, PGS blends, processing for PGS-based scaffolds, and their related applications. It is envisioned that this review could instruct and inspire the design of the PGS-based materials and facilitate tissue engineering advances into clinical practice.

Poly(Glycerol Sebacate) in Biomedical Applications-A Review of the Recent Literature

Poly(glycerol sebacate) (PGS) continues to attract attention for biomedical applications owing to its favorable combination of properties. Conventionally polymerized by a two-step polycondensation of glycerol and sebacic acid, variations of synthesis parameters, reactant concentrations or by specific chemical modifications, PGS materials can be obtained exhibiting a wide range of physicochemical, mechanical, and morphological properties for a variety of applications. PGS has been extensively used in tissue engineering (TE) of cardiovascular, nerve, cartilage, bone and corneal tissues. Applications of PGS based materials in drug delivery systems and wound healing are also well documented. Research and development in the field of PGS continue to progress, involving mainly the synthesis of modified structures using copolymers, hybrid, and composite materials. Moreover, the production of self-healing and electroactive materials has been introduced recently. After almost 20 years of research on PGS, previous publications have outlined its synthesis, modification, properties, and biomedical applications, however, a review paper covering the most recent developments in the field is lacking. The present review thus covers comprehensively literature of the last five years on PGS-based biomaterials and devices focusing on advanced modifications of PGS for applications in medicine and highlighting notable advances of PGS based systems in TE and drug delivery.

Application of Inorganic Nanocomposite Hydrogels in Bone Tissue Engineering

Bone defects caused by trauma and surgery are common clinical problems encountered by orthopedic surgeons. Thus, a hard-textured, natural-like biomaterial that enables encapsulated cells to obtain the much-needed biophysical stimulation and produce functional bone tissue is needed. Incorporating nanomaterials into cell-laden hydrogels is a straightforward tactic for producing tissue engineering structures that integrate perfectly with the body and for tailoring the material characteristics of hydrogels without hindering nutrient exchange with the surroundings. In this review, recent developments in inorganic nanocomposite hydrogels for bone tissue engineering that are of vital importance but have not yet been comprehensively reviewed are summarized.

Photopolymerizable Biomaterials and Light-Based 3D Printing Strategies for Biomedical Applications

Since the advent of additive manufacturing, known commonly as 3D printing, this technology has revolutionized the biofabrication landscape and driven numerous pivotal advancements in tissue engineering and regenerative medicine. Many 3D printing methods were developed in short course after Charles Hull first introduced the power of stereolithography to the world. However, materials development was not met with the same enthusiasm and remained the bottleneck in the field for some time. Only in the past decade has there been deliberate development to expand the materials toolbox for 3D printing applications to meet the true potential of 3D printing technologies. Herein, we review the development of biomaterials suited for light-based 3D printing modalities with an emphasis on bioprinting applications. We discuss the chemical mechanisms that govern photopolymerization and highlight the application of natural, synthetic, and composite biomaterials as 3D printed hydrogels. Because the quality of a 3D printed construct is highly dependent on both the material properties and processing technique, we included a final section on the theoretical and practical aspects behind light-based 3D printing as well as ways to employ that knowledge to troubleshoot and standardize the optimization of printing parameters.

Characterization of Gelatin/Gellan Gum/Glycol Chitosan Ternary Hydrogel for Retinal Pigment Epithelial Tissue Reconstruction Materials

The cellular transplantation approach to treat damaged or diseased retina is limited because of poor survival, distribution, and integration of cells after implantation to the sub-retinal space. To overcome this, it is important to develop a cell delivery system. In this study, a ternary hydrogel of gelatin (Ge)/gellan gum (GG)/glycol chitosan (CS) is suggested as a cell carrier for retinal tissue engineering (TE). Physicochemical properties such as porosity, swelling, sol fraction, and weight loss were measured. The mechanical study was performed with compressive strength and viscosity to confirm applicability in retinal TE. An in vitro experiment was carried out by encapsulating ARPE-19 in the designed hydrogel to measure viability and expression of retinal pigment epithelium-specific proteins and genes. The results showed that the ternary hydrogel system improves the mechanical properties and stability of the composite. Cell growth, survival, adhesion, and migration were enhanced as the CS was incorporated into the matrix. In particular, real-time polymerase chain reaction analysis showed a markedly improved specific gene expression rate in the Ge/GG/CS. Therefore, it is expected that the ternary system suggested in this study can be used as a promising material for retinal TE.

Prolonged Biodegradation and Improved Mechanical Stability of Collagen via Vapor-Phase Ti Stitching for Long-Term Tissue Regeneration

Collagen, one of the most popular biomedical materials, exhibits rapid biodegradation accompanied by a notable decrease of mechanical stability in the human body. This is a key challenge for its use in large-sized tissue regeneration, which takes a long time. In order to resolve this problem, we introduced vapor-phase titanium (Ti) derivatives into the interchain regions in collagen via TiO₂ atomic layer deposition (ALD), which has been widely used for thin-film deposition. The introduced Ti simultaneously enhanced both the tensile strength (∼384.45 MPa) and Young's modulus (∼1.56 GPa) by approximately 29 and 26% compared to the pristine commercial collagen membrane. In vitro tests demonstrated that approximately 31% of Ti-infiltrated collagen is retained after 4 weeks, whereas the pristine commercial collagen rapidly degrades by up to 90% within 1 week. The in vivo biodegradation rate was greatly improved and inversely proportional to the number of TiO₂ ALD cycles. Moreover, bone mineralization, which is observed during the late stage of bone healing, appeared only in the Ti-infiltrated collagen. We believe that our simple vapor-phase treatment method could be widely used with xenograft materials, which typically require adequate biodegradation rates and stable mechanical properties.