Strontium-doped calcium silicate bioceramic with enhanced in vitro osteogenic properties

Synthesis of a Calcium Silicate Cement Containing a Calcinated Strontium Silicate Phase

Objectives

The positive effects of strontium on dental and skeletal remineralization have been confirmed in the literature. This study aimed to assess the properties of a calcium silicate cement (CSC) containing a sintered strontium silicate phase.

Materials and Methods

The calcium silicate and strontium silicate phases were synthesized by the sol-gel technique. Strontium silicate powder in 0 (CSC), 10 (CSC/10Sr), 20 (CSC/20Sr), and 30 (CSC/30Sr) weight percentages was mixed with calcium silicate powder. Calcium chloride was used in the liquid phase. X-ray diffraction (XRD) of specimens was conducted before and after hydration. The setting time and compressive strength were assessed at 1 and 7 days after setting. The set discs of the aforementioned groups were immersed in the simulated body fluid (SBF) for 1 and 7 days. The ion release profile was evaluated by inductively coupled plasma-optical emission spectrometry (ICP-OES). Biomineralization on the specimen surface was evaluated by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS). Data were analyzed by the Kolmogorov-Smirnov test, one-way and mixed ANOVA, Levene's test, and LSD post hoc test (P  < 0.05).

Results

Except for an increasement in the peak intensity of hydrated specimens, XRD revealed no other difference in the crystalline phases of hydrated and nonhydrated specimens. The compressive strength was not significantly different at 1 and 7 days in any group (P  > 0.05). The setting time significantly decreased by an increase in percentage of strontium (P  < 0.05). Release of Ca and Si ions significantly decreased by an increase in percentage of strontium (P  < 0.05). SEM/EDS showed the formation of calcium phosphate deposits at 1 and 7 days.

Conclusion

Incorporation of 10-30 wt% sintered strontium silicate phase as premixed in CSC can significantly decrease the setting time without compromising the compressive strength or biomineralization process of the cement.

Polysaccharide-bioceramic composites for bone tissue engineering: A review

Limitations associated with conventional bone substitutes such as autografts, increasing demand for bone grafts, and growing elderly population worldwide necessitate development of unique materials as bone graft substitutes. Bone tissue engineering (BTE) would ensure therapy advancement, efficiency, and cost-effective treatment modalities of bone defects. One way of engineering bone tissue scaffolds by mimicking natural bone tissue composed of organic and inorganic phases is to utilize polysaccharide-bioceramic hybrid composites. Polysaccharides are abundant in nature, and present in human body. Biominerals, like hydroxyapatite are present in natural bone and some of them possess osteoconductive and osteoinductive properties. Ion doped bioceramics could substitute protein-based biosignal molecules to achieve osteogenesis, vasculogenesis, angiogenesis, and stress shielding. This review is a systemic summary on properties, advantages, and limitations of polysaccharide-bioceramic/ion doped bioceramic composites along with their recent advancements in BTE.

Fabrication of highly ordered willemite/PCL bone scaffolds by 3D printing: Nanostructure effects on compressive strength and in vitro behavior

In this study, first willemite (Zn₂SiO₄) micro and nano-powders were synthesized by the sol-gel method. X-ray diffraction (XRD), transmission electron microscopy (TEM), and dynamic light scattering (DLS) were applied to characterize the crystalline phases and particle size of powders. Then polycaprolactone (PCL) polymer scaffolds containing 20 wt% willemite were successfully fabricated by the DIW 3D printing (direct ink writing) method. The effects of willemite particle size on compressive strength, elastic modulus, degradation rate, and bioactivity of the composite scaffolds were investigated. The results showed that nanoparticle willemite/PCL (NW/PCL) scaffolds had 33.1% and 58.1% higher compressive strength and the elastic modulus of NW/PCL were 1.14 and 2.45 times better compared to micron size willemite/PCL (MW/PCL) and pure PCL scaffolds, respectively. Scanning electron microscopy (SEM) images and Energy-dispersive X-ray spectroscopy map (EDS map) results indicated that willemite nanoparticles, unlike microparticles, were smoothly embedded in the scaffold struts. In vitro tests also revealed an improvement in bone-like apatite formation ability and an increase in the degradation rate up to 2.17% by decreasing the willemite particle size to 50 nm. In addition, NW/PCL rendered significant enhancement in cell viability and cell attachment during the culture of MG-63 human osteosarcoma cell line. Nanostructure had also a positive effect on ALP activity and biomineralization in vitro.

Personalized 3D printed bone scaffolds: A review

3D printed bone scaffolds have the potential to replace autografts and allografts because of advantages such as unlimited supply and the ability to tailor the scaffolds' biochemical, biological and biophysical properties. Significant progress has been made over the past decade in additive manufacturing techniques to 3D print bone grafts, but challenges remain in the lack of manufacturing techniques that can recapitulate both mechanical and biological functions of native bones. The purpose of this review is to outline the recent progress and challenges of engineering an ideal synthetic bone scaffold and to provide suggestions for overcoming these challenges through bioinspiration, high-resolution 3D printing, and advanced modeling techniques. The article provides a short overview of the progress in developing the 3D printed scaffolds for the repair and regeneration of critical size bone defects. STATEMENT OF SIGNIFICANCE: Treatment of critical size bone defects is still a tremendous clinical challenge. To address this challenge, diverse sets of advanced manufacturing approaches and materials have been developed for bone tissue scaffolds. 3D printing has sparked much interest because it provides a close control over the scaffold's internal architecture and in turn its mechanical and biological properties. This article provides a critical overview of the relationships between material compositions, printing techniques, and properties of the scaffolds and discusses the current technical challenges facing their successful translation to the clinic. Bioinspiration, high-resolution printing, and advanced modeling techniques are discussed as future directions to address the current challenges.

Fabrication of functional and nano-biocomposite scaffolds using strontium-doped bredigite nanoparticles/polycaprolactone/poly lactic acid via 3D printing for bone regeneration

Bone tissue engineering is a field to manufacture scaffolds for bone defects that cannot repair without medical interventions. Ceramic nanoparticles such as bredigite have importance roles in bone regeneration. We synthesized a novel strontium (Sr) doped bredigite (Bre) nanoparticles (BreSr) and then developed new nanocomposite scaffolds using polycaprolactone (PCL), poly lactic acid (PLA) by the 3D-printing technique. Novel functional nanoparticles were synthesized and characterized using field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), and energy dispersive spectroscopy (EDS: map). The nanoparticles were uniformly distributed in the polymer matrix composites. The 3D- printed scaffolds were investigated using scanning electron microscopy (SEM), X-ray diffraction (XRD), attenuated total reflection-fourier transform infrared (ATR-FTIR), degradation rate porosity, mechanical tests, apatite formation and cell culture. Degradation rate and mechanical strength were increased in the PLA/PCL/Bre-5%Sr nanocopmposite scaffolds.. Hydroxyapatite crystals were also created on the scaffold surface in the bioactivity test. The scaffolds supported viability and proliferation of human osteoblasts. Gene expression and calcium deposition in the samples containing nanoparticles indicated statistical different than the scaffolds without nanoparticles. The nanocomposite scaffolds were implanted into the critical-sized calvarial defects in rat for 3 months. The scaffolds containing Bre-Sr ceramic nanoparticles exhibited the best potential to regenerate bone tissue.

Strontium Functionalized in Biomaterials for Bone Tissue Engineering: A Prominent Role in Osteoimmunomodulation

With the development of bone tissue engineering bio-scaffold materials by adding metallic ions to improve bone healing have been extensively explored in the past decades. Strontium a non-radioactive element, as an essential osteophilic trace element for the human body, has received widespread attention in the medical field due to its superior biological properties of inhibiting bone resorption and promoting osteogenesis. As the concept of osteoimmunology developed, the design of orthopedic biomaterials has gradually shifted from “immune-friendly” to “immunomodulatory” with the aim of promoting bone healing by modulating the immune microenvironment through implanted biomaterials. The process of bone healing can be regarded as an immune-induced procedure in which immune cells can target the effector cells such as macrophages, neutrophils, osteocytes, and osteoprogenitor cells through paracrine mechanisms, affecting pathological alveolar bone resorption and physiological bone regeneration. As a kind of crucial immune cell, macrophages play a critical role in the early period of wound repair and host defense after biomaterial implantation. Despite Sr-doped biomaterials being increasingly investigated, how extracellular Sr²⁺ guides the organism toward favorable osteogenesis by modulating macrophages in the bone tissue microenvironment has rarely been studied. This review focuses on recent knowledge that the trace element Sr regulates bone regeneration mechanisms through the regulation of macrophage polarization, which is significant for the future development of Sr-doped bone repair materials. We will also summarize the primary mechanism of Sr²⁺ in bone, including calcium-sensing receptor (CaSR) and osteogenesis-related signaling pathways.

Fabrication of porous gehlenite coating on Al2O3-ZrO2-SiC composite ceramics and its in vitro biological activities

Porous gehlenite coatings on Al₂O₃-ZrO₂-SiC composite ceramics were prepared by electro-spraying technique combined with reactive sintering method. The influences of gehlenite coating on the mechanical property of the ceramics and biological activity of the coating were investigated. The results indicated that the gehlenite coating has limited influences on flexural strength and fracture toughness of the ceramics, and the coating has elastic modulus of 82 GPa, hardness of 2.2 GPa, and adhesive strength of 1512 mN, suggesting its potential application in load-bearing ceramic implants. Simulated body fluid soaking test, CCK-8 and alkaline phosphatase activity assay demonstrated that the porous gehlenite coating has strong mineralization ability, which promotes proliferation and differentiation of MC3T3-E1 cells. These excellent biological performances can be attributed to the synergistic effect of the porous surface of the coating and its release of Ca²⁺ and Si⁴⁺.

Development of a bioactive and radiopaque bismuth doped baghdadite ceramic for bone tissue engineering

Baghdadite (Ca₃ZrSi₂O₉, BAG), is a Zr-doped calcium silicate that has outstanding bioactivity both in vitro and in vivo. Bioceramic scaffolds should be sufficiently radiopaque to be distinguishable in vivo from surrounding bone structures. To enhance the radiopacity of BAG, this study investigated the effect of incorporating bismuth ions into its crystalline structure (Bi_xCa_3-xZrSi₂O₉, x = 0, 0.1, 0.2, 0.5; BAG, Bi0.1-BAG, Bi0.2-BAG, Bi0.5-BAG, respectively). Monophasic baghdadite was retained after bismuth ion incorporation up to x = 0.2 at calcination temperatures of 1350 °C. When pressed and sintered, energy dispersive x-ray spectroscopy showed that BAG and Bi0.1-BAG retained crystalline homogeneity, but Bi0.2-BAG formed zirconium-rich crystalline regions. BAG, Bi0.1-BAG and Bi0.2-BAG exhibited non-degradation after 56 days of immersion in culture medium. Bi0.1-BAG exhibited the lowest change in culture medium pH (+0.0), compared to BAG (+0.7) and Bi0.2-BAG (+0.2) after 56 days of culture media immersion. Bi0.1-BAG exhibited similar strength and modulus to BAG (σ: 200-290 MPa; E: 4-5 GPa), and significantly higher compressive strength and modulus versus Bi0.2-BAG (σ: 150-200 MPa; E: 3.5-4 GPa) across 56 days of aqueous immersion. In vitro studies using primary human bone derived cells (HOBs) demonstrated a significant increase in HOBs proliferation when cultured on Bi0.1-BAG for seven days compared to BAG and Bi0.2-BAG. Importantly, Bi0.1-BAG showed increased radiopacity by ~33%, when compared to BAG, and by ~115% when compared to biphasic calcium phosphate. The properties of Bi0.1-BAG show promise for its use as a bioactive ceramic with sufficient radiopacity for treatment of bone defects.

Enhancement of osteoporotic bone regeneration by strontium-substituted 45S5 bioglass via time-dependent modulation of autophagy and the Akt/mTOR signaling pathway

Osteoporosis (OP) is a major systemic bone disease leading to an imbalance in bone homeostasis which remains a challenge in the current treatment of bone defects. Our previous studies on strontium (Sr) doping apparently stimulated osteogenesis of bioceramics, which suggested a promising strategy for the treatment of bone defects. However, the potential effects and the underlying mechanisms of Sr-doping on osteoporotic bone defects still remain unclear. Autophagy is a conventional self-degradation process of cells involved in bone homeostasis and regeneration under physiological and pathological conditions. Therefore, it is essential to design appropriate biomaterials and investigate the associated osteogenic mechanisms via autophagy. Based on this hypothesis, Sr-doped 45S5 bioglass (Sr/45S5) was fabricated, and ovariectomy bone marrow-derived mesenchymal stem cells (OVX-BMSCs) were applied as the in vitro cell culture model. First, the optimal Sr-doping concentration of 10 mol% was screened by cell proliferation, ALP staining, alizarin red S staining and the real-time PCR assay. Then, the results of western blot (WB) analysis showed that Sr-induced osteogenic differentiation of OVX-BMSCs was associated with time-dependent modulation of autophagy and related to the AKT/mTOR signaling pathway. Meanwhile, the autophagy in Sr-induced osteogenic differentiation of OVX-BMSCs was detected by WB, immunofluorescence staining and transmission electron microscopy. Furthermore, the effect of osteogenic differentiation of OVX-BMSCs has been significantly inhibited by the administration of autophagy inhibitors and the AKT/mTOR pathway inhibitors, respectively, in the early and late periods of osteogenic differentiation. Finally, the results of the model of femoral condyle defects in OVX-rats indicated that Sr10/45S5 granules remarkably enhanced bone regeneration which provided the evidences in vivo. Our research indicates that Sr-doping provides a promising strategy to promote osteogenic differentiation of OVX-BMSCs and bone regeneration in osteoporotic bone defects via early improvement of autophagy and late activation of the Akt/mTOR signaling pathway.

3D-printed composite, calcium silicate ceramic doped with CaSO4·2H2O: Degradation performance and biocompatibility

Calcium silicate is a common implant material with excellent mechanical strength and good biological activity. In recent years, the addition of strengthening materials to calcium silicate has been proven to promote bone tissue regeneration, but its degradation properties require further improvements. In this paper, calcium silicate was used as the matrix, and 10 wt% hydroxyapatite and 10 wt% strontium phosphate were added to im prove the biological activity of the scaffold. The effect of adding different amounts of calcium sulfate dihydrate (CaSO₄·2H₂O) on the degradation of the scaffold was explored. A porous ceramic scaffold was prepared by digital light processing (DLP) technology, and its performance was evaluated. Cell experiments showed that the addition of calcium sulfate improved cell proliferation and differentiation. Simulated body fluid (SBF) immersion tests showed that small amounts of apatite deposits appeared on the fourth day, larger deposits appeared on the 14th day, and degradation occurred on the surface after 28 days of immersion. Mechanical tests showed that the addition of 5 wt% CaSO₄·2H₂O improved the compressibility of the composite. After soaking in SBF for 14 days, it retained its compressive strength (11.8 MPa), which meets the requirements of cancellous bone, demonstrating its potential application value for bone repair.

Rational design of nonstoichiometric bioceramic scaffolds via digital light processing: tuning chemical composition and pore geometry evaluation

Bioactive ceramics are promising candidates as 3D porous substrates for bone repair in bone regenerative medicine. However, they are often inefficient in clinical applications due to mismatching mechanical properties and compromised biological performances. Herein, the additional Sr dopant is hypothesized to readily adjust the mechanical and biodegradable properties of the dilute Mg-doped wollastonite bioceramic scaffolds with different pore geometries (cylindrical-, cubic-, gyroid-) by ceramic stereolithography. The results indicate that the compressive strength of Mg/Sr co-doped bioceramic scaffolds could be tuned simultaneously by the Sr dopant and pore geometry. The cylindrical-pore scaffolds exhibit strength decay with increasing Sr content, whereas the gyroid-pore scaffolds show increasing strength and Young's modulus as the Sr concentration is increased from 0 to 5%. The ion release could also be adjusted by pore geometry in Tris buffer, and the high Sr content may trigger a faster scaffold bio-dissolution. These results demonstrate that the mechanical strengths of the bioceramic scaffolds can be controlled from the point at which their porous structures are designed. Moreover, scaffold bio-dissolution can be tuned by pore geometry and doping foreign ions. It is reasonable to consider the nonstoichiometric bioceramic scaffolds are promising for bone regeneration, especially when dealing with pathological bone defects.

Tough magnesium phosphate-based 3D-printed implants induce bone regeneration in an equine defect model

One of the important challenges in bone tissue engineering is the development of biodegradable bone substitutes with appropriate mechanical and biological properties for the treatment of larger defects and those with complex shapes. Recently, magnesium phosphate (MgP) doped with biologically active ions like strontium (Sr²⁺) have shown to significantly enhance bone formation when compared with the standard calcium phosphate-based ceramics. However, such materials can hardly be shaped into large and complex geometries and more importantly lack the adequate mechanical properties for the treatment of load-bearing bone defects. In this study, we have fabricated bone implants through extrusion assisted three-dimensional (3D) printing of MgP ceramics modified with Sr²⁺ ions (MgPSr) and a medical-grade polycaprolactone (PCL) polymer phase. MgPSr with 30 wt% PCL (MgPSr-PCL30) allowed the printability of relevant size structures (>780 mm³) at room temperature with an interconnected macroporosity of approximately 40%. The printing resulted in implants with a compressive strength of 4.3 MPa, which were able to support up to 50 cycles of loading without plastic deformation. Notably, MgPSr-PCL30 scaffolds were able to promote in vitro bone formation in medium without the supplementation with osteo-inducing components. In addition, long-term in vivo performance of the 3D printed scaffolds was investigated in an equine tuber coxae model over 6 months. The micro-CT and histological analysis showed that implantation of MgPSr-PCL30 induced bone regeneration, while no bone formation was observed in the empty defects. Overall, the novel polymer-modified MgP ceramic material and extrusion-based 3D printing process presented here greatly improved the shape ability and load-bearing properties of MgP-based ceramics with simultaneous induction of new bone formation.

Composite Fiber Networks Based on Polycaprolactone and Bioactive Glass-Ceramics for Tissue Engineering Applications

In this work, composite fibers connected in three-dimensional porous scaffolds were fabricated by electrospinning, starting from polycaprolactone and inorganic powders synthesized by the sol-gel method. The aim was to obtain materials dedicated to the field of bone regeneration, with controllable properties of bioresorbability and bioactivity. The employed powders were nanometric and of a glass-ceramic type, a fact that constitutes the premise of a potential attachment to living tissue in the physiological environment. The morphological characterization performed on the composite materials validated both the fibrous character and oxide powder distribution within the polymer matrix. Regarding the biological evaluation, the period of immersion in simulated body fluid led to the initiation of polymer degradation and a slight mineralization of the embedded particles, while the osteoblast cells cultured in the presence of these scaffolds revealed a spatial distribution at different depths and a primary networking tendency, based on the composites’ geometrical and dimensional features.

Recent developments in strontium-based biocomposites for bone regeneration

Recent advances in biomaterial designing techniques offer immense support to tailor biomimetic scaffolds and to engineer the microstructure of biomaterials for triggering bone regeneration in challenging bone defects. The current review presents the different categories of recently explored strontium-integrated biomaterials, including calcium silicate, calcium phosphate, bioglasses and polymer-based synthetic implants along with their in vivo bone formation efficacies and/or in vitro cell responses. The role and significance of controlled drug release scaffold/carrier design in strontium-triggered osteogenesis was also comprehensively described. Furthermore, the effects of stem cells and growth factors on bone remodeling are also elucidated.

Effect of ethanol/TEOS ratios and amount of ammonia on the properties of copper-doped calcium silicate nanoceramics

Calcium magnesium silicate glasses could be suggested for the synthesis of scaffolds for hard tissue regeneration, as they present a high residual glassy phase, high hardness values and hydroxyapatite-forming ability. The use of trace elements in the human body, such as Cu, could improve the biological performance of such glasses, as Cu is known to play a significant role in angiogenesis. Nano-bioceramics are preferable compared to their micro-scale counterparts, because of their increased surface area, which improves both mechanical properties and apatite-forming ability due to the increased nucleation sites provided, their high diffusion rates, reduced sintering time or temperature, and high mechanical properties. The aim of the present work was the evaluation of the effect of different ratios of Ethanol/TEOS and total amount of the inserted ammonia to the particle size, morphology and bioactive, hemolytic and antibacterial behavior of nanoparticles in the quaternary system SiO₂-CaO-MgO-CuO. Different ratios of Ethanol/TEOS and ammonia amount affected the size and morphology of bioactive nanopowders. The optimum materials were synthesized with the highest ethanol/TEOS ratio and ammonia amount as verified by the enhanced apatite-forming ability and antibacterial and non-hemolytic properties.

Effect of Strontium Substitution on the Physicochemical Properties and Bone Regeneration Potential of 3D Printed Calcium Silicate Scaffolds

In this study, we synthesized strontium-contained calcium silicate (SrCS) powder and fabricated SrCS scaffolds with controlled precise structures using 3D printing techniques. SrCS scaffolds were shown to possess increased mechanical properties as compared to calcium silicate (CS) scaffolds. Our results showed that SrCS scaffolds had uniform interconnected macropores (~500 µm) with a compressive strength 2-times higher than that of CS scaffolds. The biological behaviors of SrCS scaffolds were assessed using the following characteristics: apatite-precipitating ability, cytocompatibility, proliferation, and osteogenic differentiation of human mesenchymal stem cells (MSCs). With CS scaffolds as controls, our results indicated that SrCS scaffolds demonstrated good apatite-forming bioactivity with sustained release of Si and Sr ions. The in vitro tests demonstrated that SrCS scaffolds possessed excellent biocompatibility which in turn stimulated adhesion, proliferation, and differentiation of MSCs. In addition, the SrCS scaffolds were able to enhance MSCs synthesis of osteoprotegerin (OPG) and suppress macrophage colony-stimulating factor (M-CSF) thus disrupting normal bone homeostasis which led to enhanced bone formation over bone resorption. Implanted SrCS scaffolds were able to promote new blood vessel growth and new bone regeneration within 4 weeks after implantation in critical-sized rabbit femur defects. Therefore, it was shown that 3D printed SrCS scaffolds with specific controllable structures can be fabricated and SrCS scaffolds had enhanced mechanical property and osteogenesis behavior which makes it a suitable potential candidate for bone regeneration.