Nanocomposites for bone tissue regeneration

Pioneering nanomedicine in orthopedic treatment care: a review of current research and practices

A developing use of nanotechnology in medicine involves using nanoparticles to administer drugs, genes, biologicals, or other materials to targeted cell types, such as cancer cells. In healthcare, nanotechnology has brought about revolutionary changes in the treatment of various medical and surgical conditions, including in orthopedic. Its clinical applications in surgery range from developing surgical instruments and suture materials to enhancing imaging techniques, targeted drug delivery, visualization methods, and wound healing procedures. Notably, nanotechnology plays a significant role in preventing, diagnosing, and treating orthopedic disorders, which is crucial for patients' functional rehabilitation. The integration of nanotechnology improves standards of patient care, fuels research endeavors, facilitates clinical trials, and eventually improves the patient's quality of life. Looking ahead, nanotechnology holds promise for achieving sustained success in numerous surgical disciplines, including orthopedic surgery, in the years to come. This review aims to focus on the application of nanotechnology in orthopedic surgery, highlighting the recent development and future perspective to bridge the bridge for clinical translation.

Enhancement of Bone Tissue Regeneration with Multi-Functional Nanoparticles by Coordination of Immune, Osteogenic, and Angiogenic Responses

Inorganic nanoparticles are promising materials for bone tissue engineering due to their chemical resemblance to the native bone structure. However, most studies are unable to capture the entirety of the defective environment, providing limited bone regenerative abilities. Hence, this study aims to develop a multifunctional nanoparticle to collectively control the defective bone niche, including immune, angiogenic, and osteogenic systems. The nanoparticles, self-assembled by biomimetic mineralization and tannic acid (TA)-mediated metal-polyphenol network (MPN), are released sustainably after the incorporation within a gelatin cryogel. The released nanoparticles display a reduction in M1 macrophages by means of reactive oxygen species (ROS) elimination. Consequently, osteoclast maturation is also reduced, which is observed by the minimal formation of multinucleated cells (0.4%). Furthermore, the proportion of M2 macrophages, osteogenic differentiation, and angiogenic potential are consistently increased by the effects of magnesium from the nanoparticles. This orchestrated control of multiple systems influences the in vivo vascularized bone regeneration in which 80% of the critical-sized bone defect is regenerated with new bones with mature lamellar structure and arteriole-scale micro-vessels. Altogether, this study emphasizes the importance of the coordinated modulation of immune, osteogenic, and angiogenic systems at the bone defect site for robust bone regeneration.

Preparation and characterization of novel poly (lactic acid)/calcium oxide nanocomposites by electrospinning as a potential bone tissue scaffold

Calcium oxide nanoparticles (n-CaO) ca. 22 nm were obtained from eggshell waste. The n-CaO was incorporated into the PLA matrix in 10 and 20 wt% of filler content by electrospinning process to get PLA/n-CaO fibers with homogenous morphology and diameter as a potential use in scaffold for bone tissue regeneration. The incorporation of n-CaO into PLA modifies the mechanical properties, having a reinforcement effect on the matrix. The Young modulus for PLA/n-CaO nanocomposites increased between 122 and 138 % concerning neat PLA fibers, showing a more rigid behavior. The PLA/n-CaO nanocomposite fibers showed in vitro bioactivity, capable of inducing the precipitation of hydroxyapatite (HA) layer in the fiber surface after seven days in SBF solution. The biocidal and biological properties of PLA/n-Cao with 20 wt% showed a 30 % reduction in bacterial viability against S. aureus and 11 % against E. coli after 6 h of bacterial exposure. Furthermore, the fibers did not show a cytotoxic effect on the bone marrow ST-2 cell line, allowing cell adhesion and proliferation in the RPMI medium. The PLA/n-CaO with 20 wt% of nanoparticles showed a higher capacity to promote osteogenic differentiation, significantly increasing the alkaline phosphatase (ALP) expression after seven days compared to PLA and cell control. The in vivo analysis corroborated the biocompatibility of the prepared scaffolds; the presence of n-CaO in PLA reduced the formation of fibrous encapsulation of the material, improving the healing process. These results validated using n-CaO to enhance the functionality of polymer matrices as a PLA, bringing bioactive, biocide, and biocompatible properties, opening a new and interesting route to develop new biomaterials as a scaffold for bone tissue engineering.

In situ activation of flexible magnetoelectric membrane enhances bone defect repair

For bone defect repair under co-morbidity conditions, the use of biomaterials that can be non-invasively regulated is highly desirable to avoid further complications and to promote osteogenesis. However, it remains a formidable challenge in clinical applications to achieve efficient osteogenesis with stimuli-responsive materials. Here, we develop polarized CoFe₂O₄@BaTiO₃/poly(vinylidene fluoridetrifluoroethylene) [P(VDF-TrFE)] core-shell particle-incorporated composite membranes with high magnetoelectric conversion efficiency for activating bone regeneration. An external magnetic field force conduct on the CoFe₂O₄ core can increase charge density on the BaTiO₃ shell and strengthens the β-phase transition in the P(VDF-TrFE) matrix. This energy conversion increases the membrane surface potential, which hence activates osteogenesis. Skull defect experiments on male rats showed that repeated magnetic field applications on the membranes enhanced bone defect repair, even when osteogenesis repression is elicited by dexamethasone or lipopolysaccharide-induced inflammation. This study provides a strategy of utilizing stimuli-responsive magnetoelectric membranes to efficiently activate osteogenesis in situ.

Metallic Nanosystems in the Development of Antimicrobial Strategies with High Antimicrobial Activity and High Biocompatibility

Antimicrobial resistance is a major and growing global problem and new approaches to combat infections caused by antibiotic resistant bacterial strains are needed. In recent years, increasing attention has been paid to nanomedicine, which has great potential in the development of controlled systems for delivering drugs to specific sites and targeting specific cells, such as pathogenic microbes. There is continued interest in metallic nanoparticles and nanosystems based on metallic nanoparticles containing antimicrobial agents attached to their surface (core shell nanosystems), which offer unique properties, such as the ability to overcome microbial resistance, enhancing antimicrobial activity against both planktonic and biofilm embedded microorganisms, reducing cell toxicity and the possibility of reducing the dosage of antimicrobials. The current review presents the synergistic interactions within metallic nanoparticles by functionalizing their surface with appropriate agents, defining the core structure of metallic nanoparticles and their use in combination therapy to fight infections. Various approaches to modulate the biocompatibility of metallic nanoparticles to control their toxicity in future medical applications are also discussed, as well as their ability to induce resistance and their effects on the host microbiome.

Poly (Butylene Succinate)/Silicon Nitride Nanocomposite with Optimized Physicochemical Properties, Biocompatibility, Degradability, and Osteogenesis for Cranial Bone Repair

Congenital disease, tumors, infections, and trauma are the main reasons for cranial bone defects. Herein, poly (butylene succinate) (PB)/silicon nitride (Si₃N₄) nanocomposites (PSC) with Si3N4 content of 15 w% (PSC15) and 30 w% (PSC30) were fabricated for cranial bone repair. Compared with PB, the compressive strength, hydrophilicity, surface roughness, and protein absorption of nanocomposites were increased with the increase in Si₃N₄ content (from 15 w% to 30 w%). Furthermore, the cell adhesion, multiplication, and osteoblastic differentiation on PSC were significantly enhanced with the Si₃N₄ content increasing in vitro. PSC30 exhibited optimized physicochemical properties (compressive strength, surface roughness, hydrophilicity, and protein adsorption) and cytocompatibility. The m-CT and histological results displayed that the new bone formation for SPC30 obviously increased compared with PB, and PSC30 displayed proper degradability (75.3 w% at 12 weeks) and was gradually replaced by new bone tissue in vivo. The addition of Si₃N₄ into PB not only optimized the surface performances of PSC but also improved the degradability of PSC, which led to the release of Si ions and a weak alkaline environment that significantly promoted cell response and tissue regeneration. In short, the enhancements of cellular responses and bone regeneration of PSC30 were attributed to the synergism of the optimized surface performances and slow release of Si ion, and PSC30 were better than PB. Accordingly, PSC30, with good biocompatibility and degradability, displayed a promising and huge potential for cranial bone construction.

Elastin-like Polypeptides in Development of Nanomaterials for Application in the Medical Field

Elastin-like polypeptides (ELPs) are biopolymers formed by amino acid sequences derived from tropoelastin. These biomolecules can be soluble below critical temperatures, forming aggregates at higher temperatures, which makes them an interesting source for the design of different nanobiomaterials. These nanobiomaterials can be obtained from heterologous expression in several organisms such as bacteria, fungi, and plants. Thanks to the many advantages of ELPs, they have been used in the biomedical field to develop nanoparticles, nanofibers, and nanocomposites. These nanostructures can be used in multiple applications such as drug delivery systems, treatments of type 2 diabetes, cardiovascular diseases, tissue repair, and cancer therapy. Thus, this review aims to shed some light on the main advances in elastin-like-based nanomaterials, their possible expression forms, and importance to the medical field.

Functionalized graphene oxide as a vehicle for targeted drug delivery and bioimaging applications

Graphene oxide (GO) has attracted tremendous attention as a most promising nanomaterial among the carbon family since it emerged as a polynomial functional tool with rational applications in diverse fields such as biomedical engineering, electrocatalysis, biosensing, energy conversion, and storage devices. Despite having certain limitations due to its irreversible aggregation performance owing largely to the strong van der Waals interactions, efforts have been made to smartly engineer its surface chemistry for realistic multimodal applications. The use of such GO-based engineered devices has increased rapidly in the last few years, principally due to its excellent properties, such as huge surface area, honeycomb-like structure allowing vacant interstitial space to accommodate compounds, sp2 hybridized carbon, improved biocompatibility and cell surface penetration due to electronic interactions. Amongst multifaceted GO dynamics, in this review, attempts are made to discuss the advanced applications of GO or graphene-based materials (GBNs) in the biomedical field involving drug or therapeutic gene delivery, dual drug or drug-gene combination targeting, special delivery of drug cocktails to the brain, stimuli-responsive release of molecular payloads, and Janus-structured smart applications for polar-nonpolar combination drug loading followed by targeting together with smart bioimaging approaches. In addition, the advantages of duel-drug delivery systems are discussed in detail. We also discuss various electronic mechanisms, and detailed surface engineering to meet microcosmic criteria for its utilization, various novel implementations of engineered GO as mentioned above, together with discussions of its inevitable toxicity or disadvantages. We hope that the target audience, belonging to biomedical engineering, pharmaceutical or material science fields, may acquire relevant information from this review which may help them design future studies in this field.

[Advantages and challenges of carbon nanotubes as bone repair materials]

With the in-depth research on bone repair process, and the progress in bone repair materials preparation and characterization, a variety of artificial bone substitutes have been fully developed in the treatment of bone related diseases such as bone defects. However, the current various natural or synthetic biomaterials are still unable to achieve the structure and properties of natural bone. Carbon nanotubes (CNTs) have provided a new direction for the development of new materials in the field of bone repair due to their excellent structural stability, mechanical properties, and functional group modifiability. Moreover, CNTs and their composites have broad prospects in the design of bone repair materials and as drug delivery carriers. This paper describes the advantages of CNTs related to bone tissue regeneration from the aspects of morphology, chemistry, mechanics, electromagnetism, and biosafety, as well as the application of CNTs in drug delivery carriers and reinforcement components of scaffold materials. In addition, the potential problems and prospects of CNTs in bone regenerative medicine are discussed.

Nanomaterial-based scaffolds for bone tissue engineering and regeneration

The global incidence of bone tissue injuries has been increasing rapidly in recent years, making it imperative to develop suitable bone grafts for facilitating bone tissue regeneration. It has been demonstrated that nanomaterials/nanocomposites scaffolds can more effectively promote new bone tissue formation compared with micromaterials. This may be attributed to their nanoscaled structural and topological features that better mimic the physiological characteristics of natural bone tissue. In this review, we examined the current applications of various nanomaterial/nanocomposite scaffolds and different topological structures for bone tissue engineering, as well as the underlying mechanisms of regeneration. The potential risks and toxicity of nanomaterials will also be critically discussed. Finally, some considerations for the clinical applications of nanomaterials/nanocomposites scaffolds for bone tissue engineering are mentioned.

All-Aqueous-Processed Injectable In Situ Forming Macroporous Silk Gel Scaffolds for Minimally Invasive Intracranial and Osteological Therapies

Hydrogels are widely utilized in regenerative medicine for drug delivery and tissue repair due to their superior biocompatibility and high similarity to the extracellular matrix. For minimally invasive therapies, in situ forming gel scaffolds are desirable, but technical challenges remain to be overcome to achieve the balance between tissue-like strength and cell-sized porosity, especially for intracranial and osteological therapies. Here, a new method-inspired by the liquid crystalline spinning process in natural silk fibers-is reported for preparing injectable silk gel scaffolds with favorable preclinical efficacy and unique characteristics including 1) in situ gelling for minimally invasive surgeries, 2) controllable porosity for efficient cellular infiltration and desirable degradation, 3) resilient and tunable mechanical properties that are compatible with the modulus regime of native soft tissues, and 4) all-aqueous processing that avoids toxic solvents and enables facile loading of bioactive agents. Moreover, hierarchically structured heterogeneous silk gel scaffolds with variable porosity and bioactive agent gradients within 3D matrices can be achieved for sustained drug release and guided tissue regeneration. Preclinical efficacy studies in rodent models show efficient bacterium and glioma inhibition and positive effects on bone regeneration and vascularization.

Effect of zirconia-mullite incorporated biphasic calcium phosphate/biopolymer composite scaffolds for bone tissue engineering

New bioactive scaffolds with improved mechanical properties, biocompatibility and providing structural support for bone tissue are being developed for use in the treatment of bone defects. In this study, we have synthesized bioactive scaffolds consisting of biphasic calcium phosphate (BCP) and zirconia-Mullite (2ZrO₂·[3Al₂O₃ ·2 SiO₂] (ZAS)) (BCPZAS) combined with polymers matrix of polycaprolactone (PCL)-alginate (Alg)-chitosan (Chi) (Chi/Alg-PCL) (BCPZAS@Chi/Alg-PCL). The composite material scaffolds were prepared by a blending technique. The microstructure, mechanical, bioactivity and in vitro biological properties with different ratios of BCP to ZAS of 1:0, 3:1, 1:1, 1:3 and 0:1 wt% in polymer matrix were analyzed. Microstructure analysis showed a successful incorporation of the BCPZAS particles with an even distribution of them within the polymer matrix. The mechanical properties were found to gradually decrease with increasing the ratio of ZAS particles in the scaffolds. The highest compressive strength was 42.96 ± 1.01MPa for the 3:1 wt% BCP to ZAS mixing. Bioactivity test, the BCPZAS@Chi/Alg-PCL composite could induce apatite formation in simulate body fluid (SBF). In-vitro experiment using UMR-106 osteoblast-like cells on BCPZAS@Chi/Alg-PCL composite scaffold showed that there is cell attachment to the scaffolds with proliferation. These experimental results demonstrate that the BCPZAS@Chi/Alg-PCL composite especially for the BCP:ZAS at 3:1 wt% could be utilized as a scaffold for bone tissue engineering applications.

Natural Polymeric Scaffolds in Bone Regeneration

Despite considerable advances in microsurgical techniques over the past decades, bone tissue remains a challenging arena to obtain a satisfying functional and structural restoration after damage. Through the production of substituting materials mimicking the physical and biological properties of the healthy tissue, tissue engineering strategies address an urgent clinical need for therapeutic alternatives to bone autografts. By virtue of their structural versatility, polymers have a predominant role in generating the biodegradable matrices that hold the cells in situ to sustain the growth of new tissue until integration into the transplantation area (i.e., scaffolds). As compared to synthetic ones, polymers of natural origin generally present superior biocompatibility and bioactivity. Their assembly and further engineering give rise to a wide plethora of advanced supporting materials, accounting for systems based on hydrogels or scaffolds with either fibrous or porous architecture. The present review offers an overview of the various types of natural polymers currently adopted in bone tissue engineering, describing their manufacturing techniques and procedures of functionalization with active biomolecules, and listing the advantages and disadvantages in their respective use in order to critically compare their actual applicability potential. Their combination to other classes of materials (such as micro and nanomaterials) and other innovative strategies to reproduce physiological bone microenvironments in a more faithful way are also illustrated. The regeneration outcomes achieved in vitro and in vivo when the scaffolds are enriched with different cell types, as well as the preliminary clinical applications are presented, before the prospects in this research field are finally discussed. The collection of studies herein considered confirms that advances in natural polymer research will be determinant in designing translatable materials for efficient tissue regeneration with forthcoming impact expected in the treatment of bone defects.

Nanostructured Materials for Artificial Tissue Replacements

This paper review current trends in applications of nanomaterials in tissue engineering. Nanomaterials applicable in this area can be divided into two groups: organic and inorganic. Organic nanomaterials are especially used for the preparation of highly porous scaffolds for cell cultivation and are represented by polymeric nanofibers. Inorganic nanomaterials are implemented as they stand or dispersed in matrices promoting their functional properties while preserving high level of biocompatibility. They are used in various forms (e.g., nano- particles, -tubes and -fibers)-and when forming the composites with organic matrices-are able to enhance many resulting properties (biologic, mechanical, electrical and/or antibacterial). For this reason, this contribution points especially to such type of composite nanomaterials. Basic information on classification, properties and application potential of single nanostructures, as well as complex scaffolds suitable for 3D tissues reconstruction is provided. Examples of practical usage of these structures are demonstrated on cartilage, bone, neural, cardiac and skin tissue regeneration and replacements. Nanomaterials open up new ways of treatments in almost all areas of current tissue regeneration, especially in tissue support or cell proliferation and growth. They significantly promote tissue rebuilding by direct replacement of damaged tissues.

Mechanical properties of nanocomposite biomaterials improved by extrusion during direct ink writing

In this study, single filaments of acrylated epoxidized soybean oil (AESO)/polyethylene glycol diacrylate (PEGDA)/nanohydroxyapatite (nHA)-based nanocomposites intended for bone defect repair have displayed significant improvement of their mechanical properties when extruded through smaller needle gauges before UV curing. These nanocomposite inks can be deposited layer-by-layer during direct ink writing (DIW) - a form of additive manufacturing. Single filaments were prepared by extruding the nanocomposite ink through needles with varying diameters from 0.21 mm to 0.84 mm and then UV cured. Filaments and cast specimens were tensile tested to determine elastic modulus, strength and toughness. The cured nanocomposite filaments were further characterized using thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), Fourier-transform infrared (FTIR) spectroscopy, and scanning electron microscopy (SEM). SEM confirmed that the hydroxyapatite nanoparticles were well dispersed in the polymer matrices. The ultimate tensile strength and moduli increased as the diameter of the extrusion needle was decreased. These correlated with increased matrix crystallinity and fewer defects. For instance, filaments extruded through 0.84 mm diameter needles had ultimate tensile stress and modulus of 26.3 ± 2.8 MPa and 885 ± 100 MPa, respectively, whereas, filaments extruded through 0.21 mm needles had ultimate tensile stress and modulus of 48.9 ± 4.0 MPa and 1696 ± 172 MPa, respectively. This study has demonstrated enhanced mechanical properties resulting from extrusion-based direct ink writing of a new AESO-PEGDA-nHA nanocomposite biomaterial intended for biomedical applications. These enhanced properties are the result of fewer defects and increased crystallinity. A means of achieving mechanical properties suitable for repairing bone defects is apparent.

A modular strategy for fabrication of responsive nanocomposites using functionalized oligocaprolactones and hydroxyapatite nanoparticles

A systematic approach was used to fabricate a modulated supramolecular nanocomposite with a bioactivity characteristic and an exciting self-healing ability.

Applications of Carbon Nanotubes in Bone Tissue Regeneration and Engineering: Superiority, Concerns, Current Advancements, and Prospects

With advances in bone tissue regeneration and engineering technology, various biomaterials as artificial bone substitutes have been widely developed and innovated for the treatment of bone defects or diseases. However, there are no available natural and synthetic biomaterials replicating the natural bone structure and properties under physiological conditions. The characteristic properties of carbon nanotubes (CNTs) make them an ideal candidate for developing innovative biomimetic materials in the bone biomedical field. Indeed, CNT-based materials and their composites possess the promising potential to revolutionize the design and integration of bone scaffolds or implants, as well as drug therapeutic systems. This review summarizes the unique physicochemical and biomedical properties of CNTs as structural biomaterials and reinforcing agents for bone repair as well as provides coverage of recent concerns and advancements in CNT-based materials and composites for bone tissue regeneration and engineering. Moreover, this review discusses the research progress in the design and development of novel CNT-based delivery systems in the field of bone tissue engineering.

Composite Membranes of Poly(ε-caprolactone) with Bisphosphonate-Loaded Bioactive Glasses for Potential Bone Tissue Engineering Applications

Poly(ε-caprolactone) (PCL) is a bioresorbable synthetic polyester with numerous biomedical applications. PCL membranes show great potential in guided tissue regeneration because they are biocompatible, occlusive and space maintaining, but lack osteoconductivity. Therefore, two different types of mesoporous bioactive glasses (SiO2-CaO-P2O5 and SiO2-SrO-P2O5) were synthesized and incorporated in PCL thin membranes by spin coating. To enhance the osteogenic effect of resulting membranes, the bioglasses were loaded with the bisphosphonate drug ibandronate prior to their incorporation in the polymeric matrix. The effect of the composition of the bioglasses as well as the presence of absorbed ibandronate on the physicochemical, cell attachment and differentiation properties of the PCL membranes was evaluated. Both fillers led to a decrease of the crystallinity of PCL, along with an increase in its hydrophilicity and a noticeable increase in its bioactivity. Bioactivity was further increased in the presence of a Sr substituted bioglass loaded with ibandronate. The membranes exhibited excellent biocompatibility upon estimation of their cytotoxicity on Wharton's Jelly Mesenchymal Stromal Cells (WJ-SCs), while they presented higher osteogenic potential in comparison with neat PCL after WJ-SCs induced differentiation towards bone cells, which was enhanced by a possible synergistic effect of Sr and ibandronate.

Hybrid polymer biomaterials for bone tissue regeneration

Native tissues possess unparalleled physiochemical and biological functions, which can be attributed to their hybrid polymer composition and intrinsic bioactivity. However, there are also various concerns or limitations over the use of natural materials derived from animals or cadavers, including the potential immunogenicity, pathogen transmission, batch to batch consistence and mismatch in properties for various applications. Therefore, there is an increasing interest in developing degradable hybrid polymer biomaterials with controlled properties for highly efficient biomedical applications. There have been efforts to mimic the extracellular protein structure such as nanofibrous and composite scaffolds, to functionalize scaffold surface for improved cellular interaction, to incorporate controlled biomolecule release capacity to impart biological signaling, and to vary physical properties of scaffolds to regulate cellular behavior. In this review, we highlight the design and synthesis of degradable hybrid polymer biomaterials and focus on recent developments in osteoconductive, elastomeric, photoluminescent and electroactive hybrid polymers. The review further exemplifies their applications for bone tissue regeneration.

Preparation and properties of multi-walled carbon nanotubes and eggshell dual-modified polycaprolactone composite scaffold

The combination of double-fillers with synthetic polymers has been an attractive route for developing bone scaffolds. In this article, polycaprolactone (PCL) scaffolds were produced using a selective laser sintering (SLS) technique; multi-walled carbon nanotubes (MWCNTs) and eggshell (ES) were used as two fillers to improve their mechanical and osteogenic properties. The crystal phase, morphology, hydrophilicity, biocompatibility and mechanical properties of the composite scaffold were detected using X-ray diffraction, scanning electron microscope, water contact angle tester and in vitro cell test, respectively. Results show that ES improved the hydrophilicity and biocompatibility of the scaffolds obviously, whereas MWCNTs enhanced their compression and tensile strength. The PCL/ES/MWCNTs composited scaffold prepared by SLS possess excellent biocompatibility and mechanical strength, showing a potential application for bone repair.

Fabrication of biocomposite scaffolds made with modified hydroxyapatite inclusion of chitosan-grafted-poly(methyl methacrylate) for bone tissue engineering

In the present study, composite scaffolds of chitosan-graft-poly(methyl methacrylate) (Chi-g-PMMA) and mineral ions-loaded hydroxyapatite (mHA) (obtained by the hydrothermal treatment of hydroxyapatite (HA) in a simulated body fluid (SBF) solution (mHA@Chi-g-PMMA)) were prepared by the blending method. The physical properties, bioactivity, biological properties and their capabilities for sustained drug and protein release were studied. Physicochemical analysis showed a successful incorporation of the mineral ions in the HA particles and a good distribution of the mHA within the Chi-g-PMMA polymer matrix. The compressive strength and the Young's modulus were 15.760 ± 0.718 and 658.452 ± 17.020 MPa, respectively. In bioactivity studies, more apatite formation on the surface were seen after immersion in the SBF solution. In vitro growth experiments using UMR-106 osteoblast-like cells on the mHA@Chi-g-PMMA scaffold case showed that the attachment, viability and proliferation of the cells on the scaffolds had improved after 7 d of immersion. The in vitro release of two compounds (the cancer drug, doxorubicin (DOX)) and bovine serum albumin (BSA)), which had been attached to separate mHA@Chi-g-PMMA scaffolds, were studied to determine their suitability as drug delivery vehicles. It was found that the sustained release of DOX was 73.95% and of BSA was 57.27% after 25 h of incubation. These experimental results demonstrated that the mHA@Chi-g-PMMA composite can be utilized as a scaffold for bone cells ingrowth and also be used for drug delivery during the bone repairing.

A three-dimensional hydroxyapatite/polyacrylonitrile composite scaffold designed for bone tissue engineering

In recent years, various composite scaffolds based on hydroxyapatite have been developed for bone tissue engineering. However, the poor cell survival micro-environment is still the major problem limiting their practical applications in bone repairing and regeneration. In this study, we fabricated a class of fluffy and porous three-dimensional composite fibrous scaffolds consisting of hydroxyapatite and polyacrylonitrile by employing an improved electrospinning technique combined with a bio-mineralization process. The fluffy structure of the hydroxyapatite/polyacrylonitrile composite scaffold ensured the cells would enter the interior of the scaffold and achieve a three-dimensional cell culture. Bone marrow mesenchymal stem cells were seeded into the scaffolds and cultured for 21 days in vitro to evaluate the response of cellular morphology and biochemical activities. The results indicated that the bone marrow mesenchymal stem cells showed higher degrees of growth, osteogenic differentiation and mineralization than those cultured on the two-dimensional hydroxyapatite/polyacrylonitrile composite membranes. The obtained results strongly supported the fact that the novel three-dimensional fluffy hydroxyapatite/polyacrylonitrile composite scaffold had potential application in the field of bone tissue engineering.

A fluffy and porous (3D) HA composite fibrous scaffold was fabricated by employing an improved electrospinning technique combined with a bio-mineralization process.

Biomaterials for Regenerative Medicine: Historical Perspectives and Current Trends

Biomaterials are key components in tissue engineering and regenerative medicine applications, with the intended purpose of reducing the burden of disease and enhancing the quality of life of a large number of patients. The success of many regenerative medicine strategies, such as cell-based therapies, artificial organs, and engineered living tissues, is highly dependent on the ability to design or produce suitable biomaterials that can support and guide cells during tissue healing and remodelling processes. This chapter presents an overview about basic research concerning the use of different biomaterials for tissue engineering and regenerative medicine applications. Starting from a historical perspective, the chapter introduces the basic principles of designing biomaterials for tissue regeneration approaches. The main focus is set on describing the main classes of biomaterials that have been applied in regenerative medicine, including natural and synthetic polymers, bioactive ceramics, and composites. For each class of biomaterials, some of the most important physicochemical and biological properties are presented. Finally, some challenges and concerns that remain in this field are presented and discussed.

Innovative biodegradable poly(L-lactide)/collagen/hydroxyapatite composite fibrous scaffolds promote osteoblastic proliferation and differentiation

The development of an artificial bone graft which can promote the regeneration of fractures or diseased bones is currently the most challenging aspect in bone tissue engineering. To achieve the purpose of promoting bone proliferation and differentiation, the artificial graft needs have a similar structure and composition of extracellular matrix. One-step electrospinning method of biocomposite nanofibers containing hydroxyapatite (HA) nanoparticles and collagen (Coll) were developed for potential application in bone tissue engineering. Nanocomposite scaffolds of poly(L-lactide) (PLLA), PLLA/HA, PLLA/Coll, and PLLA/Coll/HA were fabricated by electrospinning. The morphology, diameter, elements, hydrophilicity, and biodegradability of the composite scaffolds have been investigated. The biocompatibility of different nanocomposite scaffolds was assessed using mouse osteoblasts MC3T3-E1 in vitro, and the proliferation, differentiation, and mineralization of cells on different nanofibrous scaffolds were investigated. The results showed that PLLA/Coll/HA nanofiber scaffolds enhanced cell adhesion, spreading, proliferation, differentiation, mineralization, and gene expression of osteogenic markers compared to other scaffolds. In addition, the nanofibrous scaffolds maintained a stable composition at the beginning of the degradation period and morphology wastage and weight loss were observed when incubated for up to 80 days in physiological simulated conditions. The PLLA/Coll/HA composite nanofibrous scaffolds could be a potential material for guided bone regeneration.

A review of fibrin and fibrin composites for bone tissue engineering

Tissue engineering has emerged as a new treatment approach for bone repair and regeneration seeking to address limitations associated with current therapies, such as autologous bone grafting. While many bone tissue engineering approaches have traditionally focused on synthetic materials (such as polymers or hydrogels), there has been a lot of excitement surrounding the use of natural materials due to their biologically inspired properties. Fibrin is a natural scaffold formed following tissue injury that initiates hemostasis and provides the initial matrix useful for cell adhesion, migration, proliferation, and differentiation. Fibrin has captured the interest of bone tissue engineers due to its excellent biocompatibility, controllable biodegradability, and ability to deliver cells and biomolecules. Fibrin is particularly appealing because its precursors, fibrinogen, and thrombin, which can be derived from the patient's own blood, enable the fabrication of completely autologous scaffolds. In this article, we highlight the unique properties of fibrin as a scaffolding material to treat bone defects. Moreover, we emphasize its role in bone tissue engineering nanocomposites where approaches further emulate the natural nanostructured features of bone when using fibrin and other nanomaterials. We also review the preparation methods of fibrin glue and then discuss a wide range of fibrin applications in bone tissue engineering. These include the delivery of cells and/or biomolecules to a defect site, distributing cells, and/or growth factors throughout other pre-formed scaffolds and enhancing the physical as well as biological properties of other biomaterials. Thoughts on the future direction of fibrin research for bone tissue engineering are also presented. In the future, the development of fibrin precursors as recombinant proteins will solve problems associated with using multiple or single-donor fibrin glue, and the combination of nanomaterials that allow for the incorporation of biomolecules with fibrin will significantly improve the efficacy of fibrin for numerous bone tissue engineering applications.

Functional calcium phosphate composites in nanomedicine

Calcium phosphate (CaP) materials have many peculiar and intriguing properties. In nature, CaP is found in nanostructured form embedded in a soft proteic matrix as the main mineral component of bones and teeth. The extraordinary stoichiometric flexibility, the different stabilities exhibited by its different forms as a function of pH and the highly dynamic nature of its surface ions, render CaP one of the most versatile materials for nanomedicine. This review summarizes some of the guidelines so far emerged for the synthesis of CaP composites in aqueous media that endow the material with tailored crystallinity, morphology, size, and functional properties. First, we introduce very briefly the areas of application of CaP within the nanomedicine field. Then through some selected examples, we review some synthetic routes where the presence of functional units (small templating molecules like surfactants, or oligomers and polymers) assists the synthesis and at the same time impart the functionality or the responsiveness desired for the end-application of the material. Finally, we illustrate two examples from our laboratory, where CaP is decorated by biologically active polymers or prepared within a thermo- and magneto-responsive hydrogel, respectively.

Chitosan nanocomposites based on distinct inorganic fillers for biomedical applications

Chitosan (CHI), a biocompatible and biodegradable polysaccharide with the ability to provide a non-protein matrix for tissue growth, is considered to be an ideal material in the biomedical field. However, the lack of good mechanical properties limits its applications. In order to overcome this drawback, CHI has been combined with different polymers and fillers, leading to a variety of chitosan-based nanocomposites. The extensive research on CHI nanocomposites as well as their main biomedical applications are reviewed in this paper. An overview of the different fillers and assembly techniques available to produce CHI nanocomposites is presented. Finally, the properties of such nanocomposites are discussed with particular focus on bone regeneration, drug delivery, wound healing and biosensing applications.

Novel biodegradable star-shaped polylactide scaffolds for bone regeneration fabricated by two-photon polymerization

AIM

To assess the properties of 3D biodegradable scaffolds fabricated from novel star-shaped poly(D,L-lactide) (SSL) materials for bone tissue regeneration.

MATERIALS & METHODS

The SSL polymer was synthesized using an optimized synthetic procedure and applied for scaffold fabrication by the two-photon polymerization technique. The osteogenic differentiation was controlled using human adipose-derived stem cells cultured for 28 days. The SSL scaffolds with or without murine MSCs were implanted into the cranial bone of C57/Bl6 mice.

RESULTS

The SSL scaffolds supported differentiation of human adipose-derived stem cells toward the osteogenic lineage in vitro. The SSL scaffolds with murine MSCs enhanced the mineralized tissue formation.

CONCLUSION

The SSL scaffolds provide a beneficial microenvironment for the osteogenic MSCs' differentiation in vitro and support de novo bone formation in vivo.

Hydroxyapatite-modified gelatin bioinks for bone bioprinting

In bioprinting approaches, the choice of bioink plays an important role since it must be processable with the selected printing method, but also cytocompatible and biofunctional. Therefore, a crosslinkable gelatin-based ink was modified with hydroxyapatite (HAp) particles, representing the composite buildup of natural bone. The inks’ viscosity was significantly increased by the addition of HAp, making the material processable with extrusion-based methods. The storage moduli of the formed hydrogels rose significantly, depicting improved mechanical properties. A cytocompatibility assay revealed suitable ranges for photoinitiator and HAp concentrations. As a proof of concept, the modified ink was printed together with cells, yielding stable three-dimensional constructs containing a homogeneously distributed mineralization and viable cells.

BONE BIOMECHANICAL MODELING BASED ON CELLULAR STRUCTURE: METHODS AND EVALUATION

The aim of this study is to establish a biomechanical model of bone on the basis of cellular structure and then to evaluate its accuracy for the clinical application. The thighbone of swine was scanned by computed tomography (CT). The resulting sectional images were input into MIMICS10.01 to generate a three-dimensional geometric model. A biomechanical model of bone was built on the basis of cellular structure, and calculations of the model were implemented in MATLAB with the finite element method. With this cellular mechanics model, axial compression load was simulated, and load–axial and load–transverse strain at the measurement points were detected. To evaluate the model, a mechanics model derived from an empirical formula was simulated under the same conditions, and an actual biomechanical experiment was also conducted. The simulated results obtained from the two models were then compared with the test results, indicating that the simulated results for the cellular model were closer to the test results than those for the empirical mechanics model. Therefore, the proposed cellular mechanics model shows advantages in accuracy and scope of application for bone modeling.

Two-Photon Lithography of 3D Nanocomposite Piezoelectric Scaffolds for Cell Stimulation

In this letter, we report on the fabrication, the characterization, and the in vitro testing of structures suitable for cell culturing, prepared through two-photon polymerization of a nanocomposite resist. More in details, commercially available Ormocomp has been doped with piezoelectric barium titanate nanoparticles, and bioinspired 3D structures resembling trabeculae of sponge bone have been fabricated. After an extensive characterization, preliminary in vitro testing demonstrated that both the topographical and the piezoelectric cues of these scaffolds are able to enhance the differentiation process of human SaOS-2 cells.

Nanomedicine applications in orthopedic medicine: state of the art

The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges.

Design of biocomposite materials for bone tissue regeneration

Several synthetic scaffolds are being developed using polymers, ceramics and their composites to overcome the limitations of auto- and allografts. Polymer-ceramic composites appear to be the most promising bone graft substitute since the natural bone itself is a composite of collagen and hydroxyapatite. Ceramics provide strength and osteoconductivity to the scaffold while polymers impart flexibility and resorbability. Natural polymers have an edge over synthetic polymers because of their biocompatibility and biological recognition property. But, very few natural polymer-ceramic composites are available as commercial products, and those few are predominantly based on type I collagen. Disadvantages of using collagen include allergic reactions and pathogen transmission. The commercial products also lack sufficient mechanical properties. This review summarizes the recent developments of biocomposite materials as bone scaffolds to overcome these drawbacks. Their characteristics, in vitro and in vivo performance are discussed with emphasis on their mechanical properties and ways to improve their performance.

Biomaterials for Bone Regenerative Engineering

Strategies for bone tissue regeneration have been continuously evolving for the last 25 years since the introduction of the "tissue engineering" concept. The convergence of the life, physical, and engineering sciences has brought in several advanced technologies available to tissue engineers and scientists. This resulted in the creation of a new multidisciplinary field termed as "regenerative engineering". In this article, the role of biomaterials in bone regenerative engineering is systematically reviewed to elucidate the new design criteria for the next generation of biomaterials for bone regenerative engineering. The exemplary design of biomaterials harnessing various materials characteristics towards successful bone defect repair and regeneration is highlighted. Particular attention is given to the attempts of incorporating advanced materials science, stem cell technologies, and developmental biology into biomaterials design to engineer and develop the next generation bone grafts.

In vitro cytocompatibility of one-dimensional and two-dimensional nanostructure-reinforced biodegradable polymeric nanocomposites

This study investigates the in vitro cytocompatibility of one-dimensional and two-dimensional (1D and 2D) carbon and inorganic nanomaterial reinforced polymeric nanocomposites fabricated using biodegradable polymer poly (propylene fumarate), crosslinking agent N-vinyl pyrrolidone (NVP) and following nanomaterials: single and multiwalled carbon nanotubes, single and multiwalled graphene oxide nanoribbons, graphene oxide nanoplatelets, molybdenum disulfide nanoplatelets, or tungsten disulfide nanotubes dispersed between 0.02 and 0.2 wt% concentrations in the polymer. The extraction media of unreacted components, crosslinked nanocomposites and their degradation products were examined for effects on viability and attachment using two cell lines: NIH3T3 fibroblasts and MC3T3 preosteoblasts. The extraction media of unreacted PPF/NVP elicited acute dose-dependent cytotoxicity attributed to leaching of unreacted components into cell culture media. However, extraction media of crosslinked nanocomposites showed no dose dependent adverse effects. Further, all crosslinked nanocomposites showed high viability (78-100%), high cellular attachment (40-55%), and spreading that was confirmed by confocal and scanning electron microscopy. Degradation products of nanocomposites showed a mild dose-dependent cytotoxicity possibly due to acidic degradation components of PPF. In general, compared to PPF control, none of the nanocomposites showed significant differences in cellular response to unreacted components, crosslinked nanocomposites and their degradation products. Initial minor cytotoxic response and lower cell attachment numbers were observed only for a few nanocomposite groups; these effects were absent at later time points for all PPF nanocomposites. The favorable cytocompatibility results for all the nanocomposites opens avenues for in vivo safety and efficacy studies for bone tissue engineering applications.

Human stem cells for craniomaxillofacial reconstruction

Human stem cell research represents an exceptional opportunity for regenerative medicine and the surgical reconstruction of the craniomaxillofacial complex. The correct architecture and function of the vastly diverse tissues of this important anatomical region are critical for life supportive processes, the delivery of senses, social interaction, and aesthetics. Craniomaxillofacial tissue loss is commonly associated with inflammatory responses of the surrounding tissue, significant scarring, disfigurement, and psychological sequelae as an inevitable consequence. The in vitro production of fully functional cells for skin, muscle, cartilage, bone, and neurovascular tissue formation from human stem cells, may one day provide novel materials for the reconstructive surgeon operating on patients with both hard and soft tissue deficit due to cancer, congenital disease, or trauma. However, the clinical translation of human stem cell technology, including the application of human pluripotent stem cells (hPSCs) in novel regenerative therapies, faces several hurdles that must be solved to permit safe and effective use in patients. The basic biology of hPSCs remains to be fully elucidated and concerns of tumorigenicity need to be addressed, prior to the development of cell transplantation treatments. Furthermore, functional comparison of in vitro generated tissue to their in vivo counterparts will be necessary for confirmation of maturity and suitability for application in reconstructive surgery. Here, we provide an overview of human stem cells in disease modeling, drug screening, and therapeutics, while also discussing the application of regenerative medicine for craniomaxillofacial tissue deficit and surgical reconstruction.

Osteoblasts growth behaviour on bio-based calcium carbonate aragonite nanocrystal

Calcium carbonate (CaCO3) nanocrystals derived from cockle shells emerge to present a good concert in bone tissue engineering because of their potential to mimic the composition, structure, and properties of native bone. The aim of this study was to evaluate the biological response of CaCO3 nanocrystals on hFOB 1.19 and MC3T3 E-1 osteoblast cells in vitro. Cell viability and proliferation were assessed by MTT and BrdU assays, and LDH was measured to determine the effect of CaCO3 nanocrystals on cell membrane integrity. Cellular morphology was examined by SEM and fluorescence microscopy. The results showed that CaCO3 nanocrystals had no toxic effects to some extent. Cell proliferation, alkaline phosphatase activity, and protein synthesis were enhanced by the nanocrystals when compared to the control. Cellular interactions were improved, as indicated by SEM and fluorescent microscopy. The production of VEGF and TGF-1 was also affected by the CaCO3 nanocrystals. Therefore, bio-based CaCO3 nanocrystals were shown to stimulate osteoblast differentiation and improve the osteointegration process.