3D printing of metal–organic framework incorporated porous scaffolds to promote osteogenic differentiation and bone regeneration

3D-Printed MOF Monoliths: Fabrication Strategies and Environmental Applications

Metal-organic frameworks (MOFs) have been extensively considered as one of the most promising types of porous and crystalline organic-inorganic materials, thanks to their large specific surface area, high porosity, tailorable structures and compositions, diverse functionalities, and well-controlled pore/size distribution. However, most developed MOFs are in powder forms, which still have some technical challenges, including abrasion, dustiness, low packing densities, clogging, mass/heat transfer limitation, environmental pollution, and mechanical instability during the packing process, that restrict their applicability in industrial applications. Therefore, in recent years, attention has focused on techniques to convert MOF powders into macroscopic materials like beads, membranes, monoliths, gel/sponges, and nanofibers to overcome these challenges.Three-dimensional (3D) printing technology has achieved much interest because it can produce many high-resolution macroscopic frameworks with complex shapes and geometries from digital models. Therefore, this review summarizes the combination of different 3D printing strategies with MOFs and MOF-based materials for fabricating 3D-printed MOF monoliths and their environmental applications, emphasizing water treatment and gas adsorption/separation applications. Herein, the various strategies for the fabrication of 3D-printed MOF monoliths, such as direct ink writing, seed-assisted in-situ growth, coordination replication from solid precursors, matrix incorporation, selective laser sintering, and digital light processing, are described with the relevant examples. Finally, future directions and challenges of 3D-printed MOF monoliths are also presented to better plan future trajectories in the shaping of MOF materials with improved control over the structure, composition, and textural properties of 3D-printed MOF monoliths.

Functionalized BP@(Zn+Ag)/EPLA Nanofibrous Scaffolds Fabricated by Cryogenic 3D Printing for Bone Tissue Engineering

This study fabricates a functionalized scaffold by cryogenic three-dimensional (3D) printing using an aminated poly-L-lactic acid (EPLA) solution containing nanosilver/zinc-coated black phosphorus (BP@(Zn+Ag)) nanocomposites. The nanocomposites are prepared by a green method of in situ photodeposition of silver and zinc nanoparticles (AgNPs and ZnNPs) on BP nanosheets (BPNs) under visible light irradiation without any chemical reductant. Scanning electron microscope (SEM) and X-ray energy dispersive spectrometer (EDS) confirm the uniform distribution of BP@(Zn+Ag) nanoparticles in the EPLA nanofibrous matrix. The in vitro tests show that the fabricated BP@(Zn+Ag)/EPLA nanofibrous scaffold exhibits excellent antibacterial activity (over 96%) against E. coli and S. aureus, as well as enhanced cell viability and osteogenic activity to facilitate the growth and differentiation of osteoblasts. The in vivo rat calvarial defect model also demonstrates that the BP@(Zn+Ag)/EPLA nanofibrous scaffold promotes new bone tissue formation around the implant site. Therefore, the prepared multifunctional 3D printed BP@(Zn+Ag)/EPLA nanofibrous scaffold has great potential for bone tissue engineering (BTE) applications.

Mechanotransducive surfaces for enhanced cell osteogenesis, a review

Novel strategies employing mechano-transducing materials eliciting biological outcomes have recently emerged for controlling cellular behaviour. Targeted cellular responses are achieved by manipulating physical, chemical, or biochemical modification of material properties. Advances in techniques such as nanopatterning, chemical modification, biochemical molecule embedding, force-tuneable materials, and artificial extracellular matrices are helping understand cellular mechanotransduction. Collectively, these strategies manipulate cellular sensing and regulate signalling cascades including focal adhesions, YAP-TAZ transcription factors, and multiple osteogenic pathways. In this minireview, we are providing a summary of the influence that these materials, particularly titanium-based orthopaedic materials, have on cells. We also highlight recent complementary methodological developments including, but not limited to, the use of metabolomics for identification of active biomolecules that drive cellular differentiation.

Developing a Selection Framework for Zinc Ion-Based Biomaterial Design: Guided by the Biosafety Assessment of ZIF-8 and ZnO

In recent years, nanomaterials have gained widespread use in the biomedical field, with ZIF-8 and ZnO emerging as promising candidates due to their remarkable performance in osteogenesis, angiogenesis, and antimicrobial therapy. However, before advancing these nanomaterials for clinical applications, it is imperative to evaluate their biocompatibility. In particular, comparing nanomaterials with similar biomedical functions is crucial for identifying the most suitable nanomaterials for further development and market entry. Our study aimed to compare the biocompatibility of nano-ZIF-8 and nano-ZnO under the same conditions. We found that nano-ZIF-8 exhibited lower toxicity both in vitro and in vivo compared to nano-ZnO. To gain insights into the underlying mechanisms responsible for this difference, we conducted further experiments to investigate lysosome damage, mitochondrial change, and the occurrence of ferroptosis. Additionally, we performed transcriptome sequencing to analyze the expression of relevant genes, thereby providing robust validation for our findings. In summary, our study highlighted the importance of evaluating nanomaterials with similar biomedical effects. Through this comparative study, we have not only shed light on the superior biocompatibility of nano-ZIF-8 over nano-ZnO, but also contributed valuable insights and methodological references for future material screening endeavors. Ultimately, our study served as a stepping stone toward the development of safer and more effective nanomaterials for various biomedical applications.

3D printing of MOF-reinforced methacrylated gelatin scaffolds for bone regeneration

Scaffolds based on gelatin (Gel) play a crucial role in bone tissue engineering. However, the low mechanical properties, rapid biodegradation rate, insufficient osteogenic activity and lacking anti-infective properties limit their applications in bone regeneration. Herein, the incorporation of ibuprofen (IBU)-loaded zeolitic imidazolate framework-8 (ZIF-8) in a methacrylated gelatin (GelMA) matrix was proposed as a simple and effective strategy to develop the IBU-ZIF-8@GelMA scaffolds for enhanced bone regeneration capacity. Results indicated that the IBU-loaded ZIF-8 nanoparticles with tiny particle sizes were uniformly distributed in the GelMA matrix of the IBU-ZIF-8@GelMA scaffolds, and the IBU-loaded ZIF-8 growing in the scaffolds enabled the controlled and sustained releasing of Zn2+ and IBU in pH = 5.5 over a long period for efficient bone repair and long-term anti-inflammatory activity. Furthermore, the doping of the IBU-loaded ZIF-8 nanoparticles efficiently enhanced the compression performance of the GelMA scaffolds. In vitro studies indicated that the prepared scaffolds presented no cytotoxicity to MC3T3-E1 cells and the released Zn2+ during the degradation of the scaffolds promoted MC3T3-E1 cell osteogenic differentiation. Thus, the drug-loaded ZIF-8 modified 3D printed GelMA scaffolds demonstrated great potential in treating bone defects.

Challenges and Opportunities in Preserving Key Structural Features of 3D-Printed Metal/Covalent Organic Framework

Metal-organic framework (MOF) and covalent organic framework (COF) are a huge group of advanced porous materials exhibiting attractive and tunable microstructural features, such as large surface area, tunable pore size, and functional surfaces, which have significant values in various application areas. The emerging 3D printing technology further provides MOF and COFs (M/COFs) with higher designability of their macrostructure and demonstrates large achievements in their performance by shaping them into advanced 3D monoliths. However, the currently available 3D printing M/COFs strategy faces a major challenge of severe destruction of M/COFs' microstructural features, both during and after 3D printing. It is envisioned that preserving the microstructure of M/COFs in the 3D-printed monolith will bring a great improvement to the related applications. In this overview, the 3D-printed M/COFs are categorized into M/COF-mixed monoliths and M/COF-covered monoliths. Their differences in the properties, applications, and current research states are discussed. The up-to-date advancements in paste/scaffold composition and printing/covering methods to preserve the superior M/COF microstructure during 3D printing are further discussed for the two types of 3D-printed M/COF. Throughout the analysis of the current states of 3D-printed M/COFs, the expected future research direction to achieve a highly preserved microstructure in the 3D monolith is proposed.

Application of metal-organic frameworks-based functional composite scaffolds in tissue engineering

With the rapid development of materials science and tissue engineering, a variety of biomaterials have been used to construct tissue engineering scaffolds. Due to the performance limitations of single materials, functional composite biomaterials have attracted great attention as tools to improve the effectiveness of biological scaffolds for tissue repair. In recent years, metal-organic frameworks (MOFs) have shown great promise for application in tissue engineering because of their high specific surface area, high porosity, high biocompatibility, appropriate environmental sensitivities and other advantages. This review introduces methods for the construction of MOFs-based functional composite scaffolds and describes the specific functions and mechanisms of MOFs in repairing damaged tissue. The latest MOFs-based functional composites and their applications in different tissues are discussed. Finally, the challenges and future prospects of using MOFs-based composites in tissue engineering are summarized. The aim of this review is to show the great potential of MOFs-based functional composite materials in the field of tissue engineering and to stimulate further innovation in this promising area.

Metal-organic framework-based platforms for implantation applications: recent advances and challenges

The development of minimally invasive technology has promoted the widespread use of implant interventional materials, which play an important role in alleviating patients' pain during and after surgery. Metal-organic frameworks (MOFs) and their related hybrids formed by bridging ligands and metal nodes via covalent bonds represent one of the smart platforms in implant interventional fields due to their large surface area, adjustable compositions and structures, biodegradability, etc. Significant progresses in the implantation application of MOF-based materials have been achieved recently, but these studies are still in the initial stage. This review highlights the recent advances of MOFs and their related hybrids in orthopedic implantation, cardio-vascular implantation, neural tissue engineering, and biochemical sensing. Each correction between the structural features of MOFs and their corresponding implanted works is highlighted. Finally, the confronting challenges and future perspectives in the implant interventional field are discussed.

New insights into nanotherapeutics for periodontitis: a triple concerto of antimicrobial activity, immunomodulation and periodontium regeneration

Periodontitis is a chronic inflammatory disease caused by the local microbiome and the host immune response, resulting in periodontal structure damage and even tooth loss. Scaling and root planning combined with antibiotics are the conventional means of nonsurgical treatment of periodontitis, but they are insufficient to fully heal periodontitis due to intractable bacterial attachment and drug resistance. Novel and effective therapeutic options in clinical drug therapy remain scarce. Nanotherapeutics achieve stable cell targeting, oral retention and smart release by great flexibility in changing the chemical composition or physical characteristics of nanoparticles. Meanwhile, the protectiveness and high surface area to volume ratio of nanoparticles enable high drug loading, ensuring a remarkable therapeutic efficacy. Currently, the combination of advanced nanoparticles and novel therapeutic strategies is the most active research area in periodontitis treatment. In this review, we first introduce the pathogenesis of periodontitis, and then summarize the state-of-the-art nanotherapeutic strategies based on the triple concerto of antibacterial activity, immunomodulation and periodontium regeneration, particularly focusing on the therapeutic mechanism and ingenious design of nanomedicines. Finally, the challenges and prospects of nano therapy for periodontitis are discussed from the perspective of current treatment problems and future development trends.

Zeolite imidazolate framework-8 in bone regeneration: A systematic review

Zeolite imidazolate framework-8 (ZIF-8) is a biomaterial that has been increasingly studied in recent years. It has several applications such as bone regeneration, promotion of angiogenesis, drug loading, and antibacterial activity, and exerts multiple effects to deal with various problems in the process of bone regeneration. This systematic review aims to provide an overview of the applications and effectiveness of ZIF-8 in bone regeneration. A search of papers published in the PubMed, Web of Science, Embase, and Cochrane Library databases revealed 532 relevant studies. Title, abstract, and full-text screening resulted in 39 papers being included in the review, including 39 in vitro and 22 animal studies. Appropriate concentrations of nano ZIF-8 can promote cell proliferation and osteogenic differentiation by releasing Zn2+ and entering the cell, whereas high doses of ZIF-8 are cytotoxic and inhibit osteogenic differentiation. In addition, five studies confirmed that ZIF-8 exhibits good vasogenic activity. In all in vivo experiments, nano ZIF-8 promoted bone formation. These results indicate that, at appropriate concentrations, materials containing ZIF-8 promote bone regeneration more than materials without ZIF-8, and with characteristics such as promoting angiogenesis, drug loading, and antibacterial activity, it is expected to show promising applications in the field of bone regeneration. STATEMENT OF SIGNIFICANCE: This manuscript reviewed the use of ZIF-8 in bone regeneration, clarified the biocompatibility and effectiveness in promoting bone regeneration of ZIF-8 materials, and discussed the possible mechanisms and factors affecting its promotion of bone regeneration. Overall, this study provides a better understanding of the latest advances in the field of bone regeneration of ZIF-8, serves as a design guide, and contributes to the design of future experimental studies.

Zinc-based biomaterials for bone repair and regeneration: mechanism and applications

Zinc (Zn) is one of the most important trace elements in the human body and plays a key role in various physiological processes, especially in bone metabolism. Zn-containing materials have been reported to enhance bone repair through promoting cell proliferation, osteogenic activity, angiogenesis, and inhibiting osteoclast differentiation. Therefore, Zn-based biomaterials are potential substitutes for traditional bone grafts. In this review, the specific mechanisms of bone formation promotion by Zn-based biomaterials were discussed, and recent developments in their application in bone tissue engineering were summarized. Moreover, the challenges and perspectives of Zn-based biomaterials were concluded, revealing their attractive potential and development directions in the future.

Osseointegration of functionally graded Ti6Al4V porous implants: Histology of the pore network

The additive manufacturing of titanium into porous geometries offers a means to generate low-stiffness endosseous implants with a greater surface area available for osseointegration. In this work, selective laser melting was used to produce gyroid-based scaffolds with a uniform pore size of 300 μm or functionally graded pore size from 600 μm to 300 μm. Initial in vitro assessment with Saos-2 cells showed favourable cell proliferation at pore sizes of 300 and 600 μm. Following implantation into rabbit tibiae, early histological observations at four weeks indicated some residual inflammation alongside neovessel infiltration into the scaffold interior and some early apposition of mineralized bone tissue. At twelve weeks, both scaffolds were filled with a mixture of adipocyte-rich marrow, micro-capillaries, and mineralized bone tissue. X-ray microcomputed tomography showed a higher bone volume fraction (BV/TV) and percentage of bone-implant contact (BIC) in the implants with 300 μm pores than in the functionally graded specimens. In functionally graded specimens, localized BV/TV measurement was observed to be higher in the innermost region containing smaller pores (estimated at 300-400 μm) than in larger pores at the implant exterior. The unit cell topology of the porous implant was also observed to guide the direction of bone ingrowth by conducting along the implant struts. These results suggest that in vivo experimentation is necessary alongside parametric optimization of functionally graded porous implants to predict short-term and long-term bone apposition.

Neuro-Inspired Biomimetic Microreactor for Sensory Recovery and Hair Follicle Neogenesis under Skin Burns

Deep burns are one of the most severe skin wounds, with typical symptoms being a contradiction between initial severe pain and a subsequent loss of sensation. Although it has long been known that sensory nerves promote skin regeneration and modulate skin function, no proven burn management strategies target sensory nerves. Here, a neuro-inspired biomimetic microreactor is designed based on the immune escape outer membrane of neuroblastoma cells and neural-associated intracellular proteins. The microreactor is constructed on a metal-organic framework (MOF) with a neuroblastoma membrane coating the surface and intracellular proteins loaded inside, called Neuro-MOF. It is loaded into a therapeutic hydrogel and triggers the release of its content proteins upon excitation by near-infrared light. The proteins compensate the skin microenvironment for permanent neurological damage after burns to initiate peripheral nerve regeneration and hair follicle niche formation. In addition, the neuroblastoma cell membrane is displayed on the surface of the Neuro-MOF microreactor, decreasing its immunogenicity and suppressing local inflammation. In a mouse model of deep skin burns, the Neuro-MOF microreactor exhibited significant functional skin regeneration effects, particularly sensory recovery and hair follicle neogenesis.

Application of Zeolites and Zeolitic Imidazolate Frameworks in Dentistry-A Narrative Review

Zeolites and zeolitic imidazolate frameworks (ZIFs) are crystalline aluminosilicates with porous structure, which are closely linked with nanomaterials. They are characterized by enhanced ion exchange capacity, physical-chemical stability, thermal stability and biocompatibility, making them a promising material for dental applications. This review aimed to provide an overview of the application of zeolites and ZIFs in dentistry. The common zeolite compounds for dental application include silver zeolite, zinc zeolite, calcium zeolite and strontium zeolite. The common ZIFs for dental application include ZIF-8 and ZIF-67. Zeolites and ZIFs have been employed in various areas of dentistry, such as restorative dentistry, endodontics, prosthodontics, implantology, periodontics, orthodontics and oral surgery. In restorative dentistry, zeolites and ZIFs are used as antimicrobial additives in dental adhesives and restorative materials. In endodontics, zeolites are used in root-end fillings, root canal irritants, root canal sealers and bone matrix scaffolds for peri-apical diseases. In prosthodontics, zeolites can be incorporated into denture bases, tissue conditioners, soft denture liners and dental prostheses. In implantology, zeolites and ZIFs are applied in dental implants, bone graft materials, bone adhesive hydrogels, drug delivery systems and electrospinning. In periodontics, zeolites can be applied as antibacterial agents for deep periodontal pockets, while ZIFs can be embedded in guided tissue regeneration membranes and guided bone regeneration membranes. In orthodontics, zeolites can be applied in orthodontic appliances. Additionally, for oral surgery, zeolites can be used in oral cancer diagnostic marker membranes, maxillofacial prosthesis silicone elastomer and tooth extraction medicines, while ZIFs can be incorporated to osteogenic glue or used as a carrier for antitumour drugs. In summary, zeolites have a broad application in dentistry and are receiving more attention from clinicians and researchers.

Metal-organic frameworks functionalized biomaterials for promoting bone repair

Bone defects induced by bone trauma, tumors and osteoarthritis greatly affect the life quality and health of patients. The biomaterials with numerous advantages are becoming the most preferred options for repairing bone defects and treating orthopedic diseases. However, their repairing effects remains unsatisfactory, especially in bone defects suffering from tumor, inflammation, and/or bacterial infection. There are several strategies to functionalize biomaterials, but a more general and efficient method is essential for accomplishing the functionalization of biomaterials. Possessing high specific surface, high porosity, controlled degradability and variable composition, metal-organic frameworks (MOFs) materials are inherently advantageous for functionalizing biomaterials, with tremendous improvements having been achieved. This review summarizes recent progresses in MOFs functionalized biomaterials for promoting bone repair and therapeutic effects. In specific, by utilizing various properties of diverse MOFs materials, integrated MOFs functionalized biomaterials achieve enhanced bone regeneration, antibacterial, anti-inflammatory and anti-tumor functions. Finally, the summary and prospects of on the development of MOFs-functionalized biomaterials for promoting bone repair were discussed.

Surface Modification of Titanium Implants by Metal Ions and Nanoparticles for Biomedical Application

Implant surface modification can improve osseointegration and reduce peri-implant inflammation. Implant surfaces are modified with metals because of their excellent mechanical properties and significant functions. Metal surface modification is divided into metal ions and nanoparticle surface modification. These two methods function by adding a finishing metal to the surface of the implant, and both play a role in promoting osteogenic, angiogenic, and antibacterial properties. Based on this, the nanostructural surface changes confer stronger antibacterial and cellular affinity to the implant surface. The current paper reviews the forms, mechanisms, and applications of nanoparticles and metal ion modifications to provide a foundation for the surface modification of implants.

Drug-Delivery Nanoplatform with Synergistic Regulation of Angiogenesis-Osteogenesis Coupling for Promoting Vascularized Bone Regeneration

It has been confirmed that substantial vascularization is an effective strategy to heal large-scale bone defects in the field of bone tissue engineering. The local application of deferoxamine (DFO) is among the most common and effective methods for promoting the formation of blood vessels, although its short half-life in plasma, rapid clearance, and poor biocompatibility limit its therapeutic suitability. Herein, zeolitic imidazolate framework-8 (ZIF-8) was selected as a vehicle to extend the half-life of DFO. In the present study, a nano DFO-loaded ZIF-8 (DFO@ZIF-8) drug delivery system was established to promote angiogenesis-osteogenesis coupling. The nanoparticles were characterized, and their drug loading efficiency was examined to confirm the successful synthesis of nano DFO@ZIF-8. Additionally, due to the sustained release of DFO and Zn²⁺, DFO@ZIF-8 NPs were able to promote angiogenesis in human umbilical vein endothelial cells (HUVECs) culture and osteogenesis in bone marrow stem cells (BMSCs) in vitro. Furthermore, the DFO@ZIF-8 NPs promoted vascularization by enhancing the expression of type H vessels and a vascular network. The DFO@ZIF-8 NPs promoted bone regeneration in vivo by increasing the expression of OCN and BMP-2. RNA sequencing analysis revealed that the PI3K-AKT-MMP-2/9 and HIF-1α pathways were upregulated by DFO@ZIF-8 NPs in HUVECs, ultimately leading to the formation of new blood vessels. In addition, the mechanism by which DFO@ZIF-8 NPs promoted bone regeneration was potentially related to the synergistic effect of angiogenesis-osteogenesis coupling and Zn²⁺-mediation of the MAPK pathway. Taken together, DFO@ZIF-8 NPs, which were demonstrated to have low cytotoxicity and excellent coupling of angiogenesis and osteogenesis, represent a promising strategy for the reconstruction of critical-sized bone defects.

Applications of Stimuli-Responsive Hydrogels in Bone and Cartilage Regeneration

Bone and cartilage regeneration is an area of tremendous interest and need in health care. Tissue engineering is a potential strategy for repairing and regenerating bone and cartilage defects. Hydrogels are among the most attractive biomaterials in bone and cartilage tissue engineering, mainly due to their moderate biocompatibility, hydrophilicity, and 3D network structure. Stimuli-responsive hydrogels have been a hot topic in recent decades. They can respond to external or internal stimulation and are used in the controlled delivery of drugs and tissue engineering. This review summarizes current progress in the use of stimuli-responsive hydrogels in bone and cartilage regeneration. The challenges, disadvantages, and future applications of stimuli-responsive hydrogels are briefly described.

An efficient metal-organic framework-based drug delivery platform for synergistic antibacterial activity and osteogenesis

Bone implants for clinical application should be endowed with antibacterial activity, biocompatibility, and even osteogenesis-promoting properties. In this work, metal-organic framework (MOF) based drug delivery platform was used to modify titanium implants for improved clinical applicability. Methyl Vanillate@Zeolitic Imidazolate Framework-8 (MV@ZIF-8) was immobilized on the polydopamine (PDA) modified titanium. The sustainable release of the Zn²⁺ and MV causes substantial oxidative damage to Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). The increased reactive oxygen species (ROS) significantly up-regulates the expression of oxidative stress and DNA damage response genes. Meanwhile, the structural disruption of lipid membranes caused by the ROS, the damage caused by Zinc active sites and the damage accelerated by the MV are both involved in inhibiting bacterial proliferation. The up-regulated expression of the osteogenic-related genes and proteins indicated that the MV@ZIF-8 could effectively promote the osteogenic differentiation of the human bone mesenchymal stem cells (hBMSCs). RNA sequencing and Western blotting analysis revealed that the MV@ZIF-8 coating activates the canonical Wnt/β-catenin signaling pathway through the regulation of tumor necrosis factor (TNF) pathway, thereby promoting the osteogenic differentiation of the hBMSCs. This work demonstrates a promising application of the MOF-based drug delivery platform in bone tissue engineering.

One-Pot Facile Encapsulation of Dimethyloxallyl Glycine by Nanoscale Zeolitic Imidazolate Frameworks-8 for Enhancing Vascularized Bone Regeneration

In the process of bone tissue regeneration, regulation of osteogenesis-angiogenesis coupling is of great importance. Therefore, dimethyloxallyl glycine (DMOG) is loaded by nanoscale zeolitic imidazolate frameworks-8 (ZIF-8) to obtain a drug-loading system that can promote osteogenesis-angiogenesis coupling. Characterization of the drug-loading nanoparticles (DMOG@ZIF-8) reveals that DMOG is successfully loaded into ZIF-8 by two different methods, and the DMOG@ZIF-8 is prepared using the one-pot method (OD@ZIF-8) achieves higher loading efficiency and longer release time than those prepared using the post-loading method (PD@ZIF-8). In vitro studies found that DMOG@ZIF-8 significantly enhances the migration, tube formation, and angiogenesis-related protein secretion of human umbilical vein endothelial cells as well as the extracellular matrix mineralization, alkaline phosphatase activity, and osteogenesis-related protein secretion of bone marrow mesenchymal stem cells. Moreover, OD@ZIF-8 nanoparticles are more efficient than PD@ZIF-8 nanoparticles in induction of osteogenesis-angiogenesis coupling. Then, in vivo cranial critical defect model shows that the addition of OD@ZIF-8 significantly promotes vascularized bone formation as indicated by the results including microcomputed tomographic, histological and immunofluorescence staining, and so on. Taken together, loading ZIF-8 with DMOG may be a promising solution for critical-sized bone defect reconstruction and the one-pot method is preferred in the preparation of such drug-loading system.

Biomaterials based on hyaluronic acid, collagen and peptides for three-dimensional cell culture and their application in stem cell differentiation

In recent decades, three-dimensional (3D) cell culture technologies have been developed rapidly in the field of tissue engineering and regeneration, and have shown unique advantages and great prospects in the differentiation of stem cells. Herein, the article reviews the progress and advantages of 3D cell culture technologies in the field of stem cell differentiation. Firstly, 3D cell culture technologies are divided into two main categories: scaffoldless and scaffolds. Secondly, the effects of hydrogels scaffolds and porous scaffolds on stem cell differentiation in the scaffold category were mainly reviewed. Among them, hydrogels scaffolds are divided into natural hydrogels and synthetic hydrogels. Natural materials include polysaccharides, proteins, and their derivatives, focusing on hyaluronic acid, collagen and polypeptides. Synthetic materials mainly include polyethylene glycol (PEG), polyacrylic acid (PAA), polyvinyl alcohol (PVA), etc. In addition, since the preparation techniques have a large impact on the properties of porous scaffolds, several techniques for preparing porous scaffolds based on different macromolecular materials are reviewed. Finally, the future prospects and challenges of 3D cell culture in the field of stem cell differentiation are reviewed. This review will provide a useful guideline for the selection of materials and techniques for 3D cell culture in stem cell differentiation.

Three-Dimensional Impression of Biomaterials for Alveolar Graft: Scoping Review

Craniofacial bone defects are one of the biggest clinical challenges in regenerative medicine, with secondary autologous bone grafting being the gold-standard technique. The development of new three-dimensional matrices intends to overcome the disadvantages of the gold-standard method. The aim of this paper is to put forth an in-depth review regarding the clinical efficiency of available 3D printed biomaterials for the correction of alveolar bone defects. A survey was carried out using the following databases: PubMed via Medline, Cochrane Library, Scopus, Web of Science, EMBASE, and gray literature. The inclusion criteria applied were the following: in vitro, in vivo, ex vivo, and clinical studies; and studies that assessed bone regeneration resorting to 3D printed biomaterials. The risk of bias of the in vitro and in vivo studies was performed using the guidelines for the reporting of pre-clinical studies on dental materials by Faggion Jr and the SYRCLE risk of bias tool, respectively. In total, 92 publications were included in the final sample. The most reported three-dimensional biomaterials were the PCL matrix, β-TCP matrix, and hydroxyapatite matrix. These biomaterials can be combined with different polymers and bioactive molecules such as rBMP-2. Most of the included studies had a high risk of bias. Despite the advances in the research on new three-dimensionally printed biomaterials in bone regeneration, the existing results are not sufficient to justify the application of these biomaterials in routine clinical practice.

Zeolites: A series of promising biomaterials in bone tissue engineering

As an important worldwide medical issue, bone defect exhibits a variety of physical and psychological consequences on sufferers. Some features of clinical treatments including bone grafting and limb shortening are not satisfactory. Recently, bone tissue engineering has been considered as the most effective approach to dealing with the issue of bone deformities. Meanwhile, a variety of biomaterials have been rationally designed and created for the bone regeneration and tissue repairing. Among all these admirable biomaterials for bone remodeling, zeolite-based materials can serve as efficient scaffold candidates with excellent osteo-inductivity. In addition, the porous nature and high biocompatibility of zeolites endow them with the ability as ideal substrates for cell adhesion and proliferation. More importantly, zeolites are investigated as potential coating materials for implants because they have been proven to increase osteo-conductivity and aid in local elastic modeling. Last but not least, zeolites can also be used to treat bone disorders and act as dietary supplements during the practical applications. Accordingly, numerous benefits of zeolite prompt us to summarize their recent biomedical progress including but not limited to the distinguishing characteristics, broad classifications, as well as promising usages in bone tissue engineering.

Nanomaterial integrated 3D printing for biomedical applications

3D printing technology, otherwise known as additive manufacturing, has provided a promising tool for manufacturing customized biomaterials for tissue engineering and regenerative medicine applications. A vast variety of biomaterials including metals, ceramics, polymers, and composites are currently being used as base materials in 3D printing. In recent years, nanomaterials have been incorporated into 3D printing polymers to fabricate innovative, versatile, multifunctional hybrid materials that can be used in many different applications within the biomedical field. This review focuses on recent advances in novel hybrid biomaterials composed of nanomaterials and 3D printing technologies for biomedical applications. Various nanomaterials including metal-based nanomaterials, metal-organic frameworks, upconversion nanoparticles, and lipid-based nanoparticles used for 3D printing are presented, with a summary of the mechanisms, functional properties, advantages, disadvantages, and applications in biomedical 3D printing. To finish, this review offers a perspective and discusses the challenges facing the further development of nanomaterials in biomedical 3D printing.

Metal-based nano-delivery platform for treating bone disease and regeneration

Owing to their excellent characteristics, such as large specific surface area, favorable biosafety, and versatile application, nanomaterials have attracted significant attention in biomedical applications. Among them, metal-based nanomaterials containing various metal elements exhibit significant bone tissue regeneration potential, unique antibacterial properties, and advanced drug delivery functions, thus becoming crucial development platforms for bone tissue engineering and drug therapy for orthopedic diseases. Herein, metal-based drug-loaded nanomaterial platforms are classified and introduced, and the achievable drug-loading methods are comprehensively generalized. Furthermore, their applications in bone tissue engineering, osteoarthritis, orthopedic implant infection, bone tumor, and joint lubrication are reviewed in detail. Finally, the merits and demerits of the current metal-based drug-loaded nanomaterial platforms are critically discussed, and the challenges faced to realize their future applications are summarized.

Low temperature hybrid 3D printing of hierarchically porous bone tissue engineering scaffolds with in situ delivery of osteogenic peptide and mesenchymal stem cells

Comparing to other conventional fabrication techniques, 3D printing is advantageous in producing bone tissue engineering scaffolds with customized shape, tailored pore size/porosity, required mechanical properties and even desirable biomolecule delivery capability. However, towards scaffolds with a large volume, it is highly difficult to enable seed cells to migrate to the central region of the scaffolds, resulting in an inhomogeneous cell distribution, and hence lowering the bone forming ability. To address this problem, in this investigation, cell-laden bone tissue engineering scaffolds consisting of osteogenic peptide loaded β-tricalcium phosphate/poly(lactic-co-glycolic acid) (OP/TCP/PLGA) nanocomposite scaffolds and rat bone marrow derived mesenchymal stem cells (rBMSCs)-laden Gelatin/GelMA hydrogel fillers were produced through a "dual-nozzle" cryogenic hybrid 3D printing. The cell-laden scaffolds exhibited a bi-phasic structure and were mechanically similar to human cancellous bone. OP can be released from the hybrid scaffolds in a sustained manner. rBMSCs laden in the hydrogel patterns exhibited a high viability during and after cryogenic hybrid 3D printing process and can be further released from the hydrogel struts and achieve cell anchorage on the surface of adjacent OTP struts. The OP released from OTP struts enhanced rBMSCs proliferation. Comparing to rBMSC-laden hybrid scaffolds without OP incorporation, the rBMSC-laden hybrid scaffolds incorporated with OP significantly up-regulated the osteogenic differentiation of rBMSCs, by showing a higher level of alkaline phosphatase (ALP) expression and calcium deposition. This "proof-ofconcept" study provided a facile method to form cell-laden bone tissue engineering scaffolds with not only required mechanical strength, biomimetic structure and prolonged biomolecule release but also excellent cell delivery capability with uniform cell distribution.

Current status and prospects of metal-organic frameworks for bone therapy and bone repair

With the development of society, traumatic bone defects caused by accidents, diseases and surgeries have become common, eventually resulting in an increase in bone defects. The treatment of bone defects is characterized by a long period of treatment, high cost and uncontrollable outcomes. Also, it results in complications such as infection and bone discontinuity. Hence, due to this situation, the physical, mental and financial aspects of the patient are severely affected. What's more, such outcomes pose a challenge to orthopaedic surgeons. As a result, bone therapy and bone repair have become a hot topic of interest. In repairing bone defects, materials other than autogenous bone are still unable to provide good biocompatibility, osteogenesis, osteoconductivity and osteoinduction properties at the same time. In addition, the scarcity of autologous bone sources has forced the search for new autologous bone replacement materials. Metal organic frameworks (MOFs) are a new class of developed functional materials that have been widely used in the biomedical field during the recent years due to their porous nature, large specific surface area and diverse structures. With the progress in the investigation into bone treatment and repair, more and more investigators are using MOFs in bone therapy and bone repair. With these viewpoints, in the present perspective, the use of MOFs in bone therapy and bone repair has been summarized, and an insight into the future of MOFs in bone therapy and bone repair has been provided.

Tailorable 3DP Flexible Scaffolds with Porosification of Filaments Facilitate Cell Ingrowth and Biomineralized Deposition

Facilitating cell ingrowth and biomineralized deposition inside filaments of 3DP scaffolds are an ideal bone repair strategy. Here, 3D printed PLGA/HA scaffolds with hydroxyapatite content of 50% (P5H5) and 70% (P3H7) were prepared by optimizing 3D printing inks, which exhibited good tailorability and foldability to meet clinical maneuverability. The supercritical CO2 foaming technology further endowed the filaments of P5H5 with a richer interconnected pore structure (P5H5-C). The finite element and computational fluid dynamics simulation analysis indicated that the porosification could effectively reduce the stress concentration at the filament junction and improved the overall permeability of the scaffold. The results of in vitro experiments confirmed that P5H5-C promoted the adsorption of proteins on the surface and inside of filaments, accelerated the release of Ca and P ions, and significantly upregulated osteogenesis (Col I, ALP, and OPN)- and angiogenesis (VEGF)-related gene expression. Subcutaneous ectopic osteogenesis experiments in nude mice further verified that P5H5-C facilitated cell growth inside filaments and biomineralized deposition, as well as significantly upregulated the expression of osteogenesis- and angiogenesis-related genes (Col I, ALP, OCN, and VEGF) and protein secretion (ALP, RUNX2, and VEGF). The porosification of filaments by supercritical CO2 foaming provided a new strategy for accelerating osteogenesis of 3DP implants.

Biodegradable Zn-Cu-Fe Alloy as a Promising Material for Craniomaxillofacial Implants: An in vitro Investigation into Degradation Behavior, Cytotoxicity, and Hemocompatibility

Zinc-based nanoparticles, nanoscale metal frameworks and metals have been considered as biocompatible materials for bone tissue engineering. Among them, zinc-based metals are recognized as promising biodegradable materials thanks to their moderate degradation rate ranging between magnesium and iron. Nonetheless, materials’ biodegradability and the related biological response depend on the specific implant site. The present study evaluated the biodegradability, cytocompatibility, and hemocompatibility of a hot-extruded zinc-copper-iron (Zn-Cu-Fe) alloy as a potential biomaterial for craniomaxillofacial implants. Firstly, the effect of fetal bovine serum (FBS) on in vitro degradation behavior was evaluated. Furthermore, an extract test was used to evaluate the cytotoxicity of the alloy. Also, the hemocompatibility evaluation was carried out by a modified Chandler-Loop model. The results showed decreased degradation rates of the Zn-Cu-Fe alloy after incorporating FBS into the medium. Also, the alloy exhibited acceptable toxicity towards RAW264.7, HUVEC, and MC3T3-E1 cells. Regarding hemocompatibility, the alloy did not significantly alter erythrocyte, platelet, and leukocyte counts, while the coagulation and complement systems were activated. This study demonstrated the predictable in vitro degradation behavior, acceptable cytotoxicity, and appropriate hemocompatibility of Zn-Cu-Fe alloy; therefore, it might be a candidate biomaterial for craniomaxillofacial implants.

Two-dimensional metal-organic frameworks: from synthesis to bioapplications

As a typical class of crystalline porous materials, metal-organic framework possesses unique features including versatile functionality, structural and compositional tunability. After being reduced to two-dimension, ultrathin metal-organic framework layers possess more external excellent properties favoring various technological applications. In this review article, the unique structural properties of the ultrathin metal-organic framework nanosheets benefiting from the planar topography were highlighted, involving light transmittance, and electrical conductivity. Moreover, the design strategy and versatile fabrication methodology were summarized covering discussions on their applicability and accessibility, especially for porphyritic metal-organic framework nanosheet. The current achievements in the bioapplications of two-dimensional metal-organic frameworks were presented comprising biocatalysis, biosensor, and theranostic, with an emphasis on reactive oxygen species-based nanomedicine for oncology treatment. Furthermore, current challenges confronting the utilization of two-dimensional metal-organic frameworks and future opportunities in emerging research frontiers were presented.

UiO-66 metal-organic framework as a double actor in chitosan scaffolds: Antibiotic carrier and osteogenesis promoter

Metal-organic frameworks (MOFs) have recently emerged as a useful class of nanostructures with well-suited characteristics for drug delivery applications, due to the high surface area and pore size for efficient loading. Despite their use as a nano-carrier for controlled delivery of various types of drugs, the inherent osteo-conductive properties have stolen a great attention as a growing area of investigation. Here, we evaluated the double function of UiO-66 MOF structure as a carrier for fosfomycin antibiotic and also as an osteogenic differentiation promoter when introduced in 3D chitosan scaffolds, for the first time. Our results revealed that the wet-spun chitosan scaffolds containing fosfomycin loaded UiO-66 nanocrystals (CHI/UiO-66/FOS) possessed fiber mesh structure with integrated micro-scale fibers and increased mechanical strength. In vitro antibacterial studies indicated that CHI/UiO-66/FOS scaffolds showed bactericidal activity against Staphylococcus aureus. Moreover, the scaffolds were biocompatible to MC3T3-E1 pre-osteoblasts and significantly up-regulated the expression of osteogenesis-related genes and facilitated the extracellular matrix mineralization, in vitro. Taken together, our results demonstrate UiO-66 MOFs can present double functionality and CHI/UiO-66/FOS scaffolds hold a significant potential to be further explored as an alternative approach in treating infected bone defects like osteomyelitis.

Application and Development of Modern 3D Printing Technology in the Field of Orthopedics

3D printing, also known as additive manufacturing, is a technology that uses a variety of adhesive materials such as powdered metal or plastic to construct objects based on digital models. Recently, 3D printing technology has been combined with digital medicine, materials science, cytology, and other multidisciplinary fields, especially in the field of orthopedic built-in objects. The development of advanced 3D printing materials continues to meet the needs of clinical precision medicine and customize the most suitable prosthesis for everyone to improve service life and satisfaction. This article introduces the development of 3D printing technology and different types of materials. We also discuss the shortcomings of 3D printing technology and the current challenges, including the poor bionics of 3D printing products, lack of ideal bioinks, product safety, and lack of market supervision. We also prospect the future development trends of 3D printing.

Nine days extended release of adenosine from biocompatible MOFs under biologically relevant conditions

Adenosine is a small molecule directly involved in maintaining homeostasis under pathological and stressful conditions. Due to its rapid metabolism, delivery vehicles capable of exhibiting extended release of adenosine are of paramount interest. Herein, we demonstrate a superior long-term (9 days) release profile of adenosine from biocompatible MOFs in a physiologically relevant environment. The key to the biocompatibility of MOFs is their stability under biologically relevant conditions. This study additionally highlights the interplay between the chemical stability of prototypal MOFs, assessed under physiological conditions, and their cytotoxicity profiles. Cytotoxicity of the prototypal Zn-based MOF (ZIF-8) and three Zr-based MOFs (UiO-66, UiO-66-NH₂, and MOF-801) on six cell types was assessed. The cell types selected were valve interstitial cells (VICs), valve endothelial cells (VECs), adipose tissue-derived stem cells (ADSCs), and cell lines U937, THP1, and HeLa. Zr-based MOFs demonstrated a wide tolerance range in the cell culture cytotoxicity assays, demonstrating cell viability up to a very high dose of ∼1000 μg mL^-1, as compared to ZIF-8 which showed notable cytotoxicity in as little as ∼100 μg mL^-1 dose. This study demonstrates, for the first time, the utilization of biocompatible MOFs for adenosine delivery as well as establishes a direct link between structural instability in the cell culture medium and the observed cytotoxicity of the studied MOFs.

Clinically relevant preclinical animal models for testing novel cranio-maxillofacial bone 3D-printed biomaterials

Bone tissue engineering is a rapidly developing field with potential for the regeneration of craniomaxillofacial (CMF) bones, with 3D printing being a suitable fabrication tool for patient-specific implants. The CMF region includes a variety of different bones with distinct functions. The clinical implementation of tissue engineering concepts is currently poor, likely due to multiple reasons including the complexity of the CMF anatomy and biology, and the limited relevance of the currently used preclinical models. The 'recapitulation of a human disease' is a core requisite of preclinical animal models, but this aspect is often neglected, with a vast majority of studies failing to identify the specific clinical indication they are targeting and/or the rationale for choosing one animal model over another. Currently, there are no suitable guidelines that propose the most appropriate animal model to address a specific CMF pathology and no standards are established to test the efficacy of biomaterials or tissue engineered constructs in the CMF field. This review reports the current clinical scenario of CMF reconstruction, then discusses the numerous limitations of currently used preclinical animal models employed for validating 3D-printed tissue engineered constructs and the need to reduce animal work that does not address a specific clinical question. We will highlight critical research aspects to consider, to pave a clinically driven path for the development of new tissue engineered materials for CMF reconstruction.

A periodontal tissue regeneration strategy via biphasic release of zeolitic imidazolate framework-8 and FK506 using a uniaxial electrospun Janus nanofiber

Guided tissue regeneration (GTR) strategies are an effective approach to repair periodontal defects by using GTR membranes. However, commercial GTR membranes still have limitations in periodontal tissue regeneration owing to lack of antibacterial and osteogenic properties. The development of novel Janus nanofibers with biphasic release characteristics based on the therapeutic needs of GTR is essential to tackle this issue. Here, we developed a multifunctional Janus nanofiber via uniaxial electrospinning, with zeolitic imidazolate framework-8 nanoparticle (ZIF-8 NP) loading in the hydrophilic polyvinylpyrrolidone (PVP) part and FK506 embedding in the hydrophobic polycaprolactone (PCL) part. The release of Zn²⁺ conformed to the Ritger-Peppas kinetics which could effectively prevent bacterial infection, and the release profile of FK506 was fitted to a first-order equation which could provide persistent osteogenic stimulation for osteogenesis. The periodontal tissue regeneration data from a rat periodontitis model revealed that the multifunctional electrospun Janus nanofibers could be used as an effective bioplatform to restore alveolar bone impairment, compared with the control group. In summary, the Janus nanofibers with biphasic release characteristics quickly exert antibacterial function as well as continuously provide a microenvironment beneficial to the osteogenesis process, demonstrating its great potential for GTR treatment in dental clinic applications.

Vascularized bone regeneration accelerated by 3D-printed nanosilicate-functionalized polycaprolactone scaffold

Critical oral-maxillofacial bone defects, damaged by trauma and tumors, not only affect the physiological functions and mental health of patients but are also highly challenging to reconstruct. Personalized biomaterials customized by 3D printing technology have the potential to match oral-maxillofacial bone repair and regeneration requirements. Laponite (LAP) nanosilicates have been added to biomaterials to achieve biofunctional modification owing to their excellent biocompatibility and bioactivity. Herein, porous nanosilicate-functionalized polycaprolactone (PCL/LAP) was fabricated by 3D printing technology, and its bioactivities in bone regeneration were investigated in vitro and in vivo. In vitro experiments demonstrated that PCL/LAP exhibited good cytocompatibility and enhanced the viability of bone marrow mesenchymal stem cells (BMSCs). PCL/LAP functioned to stimulate osteogenic differentiation of BMSCs at the mRNA and protein levels and elevated angiogenic gene expression and cytokine secretion. Moreover, BMSCs cultured on PCL/LAP promoted the angiogenesis potential of endothelial cells by angiogenic cytokine secretion. Then, PCL/LAP scaffolds were implanted into the calvarial defect model. Toxicological safety of PCL/LAP was confirmed, and significant enhancement of vascularized bone formation was observed. Taken together, 3D-printed PCL/LAP scaffolds with brilliant osteogenesis to enhance bone regeneration could be envisaged as an outstanding bone substitute for a promising change in oral-maxillofacial bone defect reconstruction.

3D Printed Composite Scaffolds in Bone Tissue Engineering: A systematic review

OBJECTIVE

This study aimed to analyze the effect of fabrication factors on both biological and physico-chemical features of 3-dimensional (3D) printed composite scaffolds.

METHOD

Electronic search was done according to the PRISMA guideline in PubMed and Scopus databases limited to English articles published until May 2021.Studies in which composite scaffolds were fabricated through computer-aided design and computer-aided manufacturing (CAD-CAM)-based methods were included.Articles regarding the features of the scaffolds fabricated through indirect techniques were excluded.

RESULTS

Full text of 121 studies were reviewed, and 69 met the inclusion criteria. According to analyzed studies, PCL and HA were the most commonly used polymer and ceramic,respectively. Besides,the Solvent-based technique was the most commonly used composition technique, which enabled preparing blends with high concentrations of ceramic materials. The most common fabrication method used in the included studies was Fused deposition modeling (FDM).The addition of bio-ceramics enhanced the mechanical features and the biological behaviors of the printed scaffolds in a ratio-dependent manner. However,studies that analyzed the effect of ceramic weight ratio showed that scaffolds with the highest ceramic content did not necessarily possess the optimal biological and non-biological features.

CONCLUSION

The biological and physico-chemical behaviors of the scaffold can be affected by pre-printing factors, including utilized materials, composition techniques, and fabrication methods. Fabricating scaffolds with high mineral content as of the natural bone may not provide the optimal condition for bone formation. Therefore, it is recommended that future studies compare the efficiency of different kinds of biomaterials rather than different weight ratios of one type.

Effects of Raster Angle and Material Components on Mechanical Properties of Polyether-Ether-Ketone/Calcium Silicate Scaffolds

Polyetheretherketone (PEEK) was widely used in the fabrication of bone substitutes for its excellent chemical resistance, thermal stability and mechanical properties that were similar to those of natural bone tissue. However, the biological inertness restricted the osseointegration with surrounding bone tissue. In this study, calcium silicate (CS) was introduced to improve the bioactivity of PEEK. The PEEK/CS composites scaffolds with CS contents in gradient were fabricated with different raster angles via fused filament fabrication (FFF). With the CS content ranging from 0 to 40% wt, the crystallinity degree (from 16% to 30%) and surface roughness (from 0.13 ± 0.04 to 0.48 ± 0.062 μm) of PEEK/CS scaffolds was enhanced. Mechanical testing showed that the compressive modulus of the PEEK/CS scaffolds could be tuned in the range of 23.3–541.5 MPa. Under the same printing raster angle, the compressive strength reached the maximum with CS content of 20% wt. The deformation process and failure modes could be adjusted by changing the raster angle. Furthermore, the mapping relationships among the modulus, strength, raster angle and CS content were derived, providing guidance for the selection of printing parameters and the control of mechanical properties.

Personalized three-dimensional printed polyether-ether-ketone prosthesis for reconstruction after subtotal removal of chronic clavicle osteomyelitis: A case report

RATIONALE

Three-dimensional (3D) printing has attracted wide attention for its potential and abilities in the assistance of surgical planning and the development of personalized prostheses. We herewith report a unique case of chronic clavicle osteomyelitis treated with a two-stage subtotal clavicle reconstruction using a 3D printed polyether-ether-ketone (PEEK) prosthesis.

PATIENT CONCERNS

A 23-year-old Chinese female presented to our clinic complaining about a progressive pain of her right clavicle for about 1 year.

DIAGNOSES

Chronic clavicle osteomyelitis confirmed by percutaneous biopsy and lesion biopsy.

INTERVENTIONS

This patient accepted a long-term conservative treatment, which did not gain satisfactory outcomes. Thus, a subtotal removal and two-stage reconstruction of the right clavicle with a 3D-printed polyether-ether-ketone prosthesis stabilized by screw fixation system was performed.

OUTCOMES

At 2-year follow-up, complete pain relief and satisfactory functional recovery of her right shoulder were observed.

LESSONS

Personalized 3D printed prosthesis is an effective and feasible method for reconstruction of complex bone defects.

MOF/COF-based materials using 3D printing technology: applications in water treatment, gas removal, biomedical, and electronic industries

We have considered the newest outcomes in the uses of 3D-printed COF- and MOF-based materials for diverse applications.