Bioactive and biodegradable nanocomposites and hybrid biomaterials for bone regeneration

Translation of nanotechnology-based implants for orthopedic applications: current barriers and future perspective

The objective of bioimplant engineering is to develop biologically compatible materials for restoring, preserving, or altering damaged tissues and/or organ functions. The variety of substances used for orthopedic implant applications has been substantially influenced by modern material technology. Therefore, nanomaterials can mimic the surface properties of normal tissues, including surface chemistry, topography, energy, and wettability. Moreover, the new characteristics of nanomaterials promote their application in sustaining the progression of many tissues. The current review establishes a basis for nanotechnology-driven biomaterials by demonstrating the fundamental design problems that influence the success or failure of an orthopedic graft, cell adhesion, proliferation, antimicrobial/antibacterial activity, and differentiation. In this context, extensive research has been conducted on the nano-functionalization of biomaterial surfaces to enhance cell adhesion, differentiation, propagation, and implant population with potent antimicrobial activity. The possible nanomaterials applications (in terms of a functional nanocoating or a nanostructured surface) may resolve a variety of issues (such as bacterial adhesion and corrosion) associated with conventional metallic or non-metallic grafts, primarily for optimizing implant procedures. Future developments in orthopedic biomaterials, such as smart biomaterials, porous structures, and 3D implants, show promise for achieving the necessary characteristics and shape of a stimuli-responsive implant. Ultimately, the major barriers to the commercialization of nanotechnology-derived biomaterials are addressed to help overcome the limitations of current orthopedic biomaterials in terms of critical fundamental factors including cost of therapy, quality, pain relief, and implant life. Despite the recent success of nanotechnology, there are significant hurdles that must be overcome before nanomedicine may be applied to orthopedics. The objective of this review was to provide a thorough examination of recent advancements, their commercialization prospects, as well as the challenges and potential perspectives associated with them. This review aims to assist healthcare providers and researchers in extracting relevant data to develop translational research within the field. In addition, it will assist the readers in comprehending the scope and gaps of nanomedicine's applicability in the orthopedics field.

The Clinical Use of Osteobiologic and Metallic Biomaterials in Orthopedic Surgery: The Present and the Future

As the area and range of surgical treatments in the orthopedic field have expanded, the development of biomaterials used for these treatments has also advanced. Biomaterials have osteobiologic properties, including osteogenicity, osteoconduction, and osteoinduction. Natural polymers, synthetic polymers, ceramics, and allograft-based substitutes can all be classified as biomaterials. Metallic implants are first-generation biomaterials that continue to be used and are constantly evolving. Metallic implants can be made from pure metals, such as cobalt, nickel, iron, or titanium, or from alloys, such as stainless steel, cobalt-based alloys, or titanium-based alloys. This review describes the fundamental characteristics of metals and biomaterials used in the orthopedic field and new developments in nanotechnology and 3D-printing technology. This overview discusses the biomaterials that clinicians commonly use. A complementary relationship between doctors and biomaterial scientists is likely to be necessary in the future.

The controlled release, bioactivity and osteogenic gene expression of Quercetin-loaded gelatin/tragacanth/ nano-hydroxyapatite bone tissue engineering scaffold

In this study, a Gelatin/Tragacanth/Nano-hydroxyapatite scaffold was fabricated via freeze-drying method. A highly porous scaffold with an average pore diameter of 142 µm and porosity of 86% was found by the micro-computed tomography. The mean compressive strength of the scaffold was about 1.5 MPa, a value in the range of the spongy bone. The scaffold lost 10 wt.% of its initial weight after 28 days soaking in PBS that shows a fair degradation rate for a bone tissue engineering scaffold. Apatite formation ability of the scaffold was confirmed via scanning electron microscopy, X-ray diffraction and Fourier transforming infrared spectroscopy, after 28 days soaking in simulated body fluid. The scaffold was able to deliver 93% of the loaded drug, Quercetin, during 120 h in phosphate-buffered solution, in a sustainable manner. The MTT assay using human bone mesenchymal stem cells showed 84% cell viability of the Quercetin-loaded scaffold. The expression of the osteogenic genes including Col I, Runx-2, BGLAP (gene of osteocalcin), bFGF, SP7 (gene of osterix) and SPP1 (gene of osteopontin) were all upregulated when Quercetin was loaded on the scaffold, which indicates the synergetic effect of the drug and the scaffold.

Bioactive glass-based organic/inorganic hybrids: an analysis of the current trends in polymer design and selection

Bioactive glass-based organic/inorganic hybrids are a family of materials holding great promise in the biomedical field. Developed from bioactive glasses following recent advances in sol-gel and polymer chemistry, they can overcome many limitations of traditional composites typically used in bone repair and orthopedics. Thanks to their unique molecular structure, hybrids are often characterized by synergistic properties that go beyond a mere combination of their two components; it is possible to synthesize materials with a wide variety of mechanical and biological properties. The polymeric component, in particular, can be tailored to prepare tough, load-bearing materials, or rubber-like elastomers. It can also be a key factor in the determination of a wide range of interesting biological properties. In addition, polymers can also be used within hybrids as carriers for therapeutic ions (although this is normally the role of silica). This review offers a brief look into the history of hybrids, from the discovery of bioactive glasses to the latest developments, with a particular emphasis on polymer design and chemistry. First the benefits and limitations of hybrids will be discussed and compared with those of alternative approaches (for instance, nanocomposites). Then, key advances in the field will be presented focusing on the polymeric component: its chemistry, its physicochemical and biological advantages, its drawbacks, and selected applications. Comprehensive tables summarizing all the polymers used to date to fabricate sol-gel hybrids for biomedical applications are also provided, to offer a handbook of all the available candidates for hybrid synthesis. In addition to the current trends, open challenges and possible avenues of future development are proposed.

Additively manufactured Bi-functionalized bioceramics for reconstruction of bone tumor defects

Bone tissue exhibits critical factors for metastatic cancer cells and represents an extremely pleasant spot for further growth of tumors. The number of metastatic bone lesions and primary tumors that arise directly from cells comprised in the bone milieu is constantly increasing. Bioceramics have recently received significant attention in bone tissue engineering and local drug delivery applications. Additionally, additive manufacturing of bioceramics offers unprecedented advantages including the possibilities to fill irregular voids after the resection and fabricate patient-specific implants. Herein, we investigated the recent advances in additively manufactured bioceramics and ceramic-based composites that were used in the local bone tumor treatment and reconstruction of bone tumor defects. Furthermore, it has been extensively explained how to bi-functionalize ceramics-based biomaterials and what current limitations impede their clinical application. We have also discussed the importance of further development into ceramic-based biomaterials and molecular biology of bone tumors to: (1) discover new potential therapeutic targets to enhance conventional therapies, (2) local delivering of bio-molecular agents in a customized and "smart" way, and (3) accomplish a complete elimination of tumor cells in order to prevent tumor recurrence formation. We emphasized that by developing the research focus on the introduction of novel 3D-printed bioceramics with unique properties such as stimuli responsiveness, it will be possible to fabricate smart bioceramics that promote bone regeneration while minimizing the side-effects and effectively eradicate bone tumors while promoting bone regeneration. In fact, by combining all these therapeutic strategies and additive manufacturing, it is likely to provide personalized tumor-targeting therapies for cancer patients in the foreseeable future. STATEMENT OF SIGNIFICANCE: To increase the survival rates of cancer patients, different strategies such as surgery, reconstruction, chemotherapy, radiotherapy, etc have proven to be essential. Nonetheless, these therapeutic protocols have reached a plateau in their effectiveness due to limitations including drug resistance, tumor recurrence after surgery, toxic side-effects, and impaired bone regeneration following tumor resection. Hence, novel approaches to specifically and locally attack cancer cells, while also regenerating the damaged bony tissue, have being developed in the past years. This review sheds light to the novel approaches that enhance local bone tumor therapy and reconstruction procedures by combining additive manufacturing of ceramic biomaterials and other polymers, bioactive molecules, nanoparticles to affect bone tumor functions, metabolism, and microenvironment.

Application of bioactive metal ions in the treatment of bone defects

The treatment of bone defects is an important problem in clinical practice. The rapid development of bone tissue engineering (BTE) may provide a new method for bone defect treatment. Metal ions have been widely studied in BTE and demonstrated a significant effect in promoting bone tissue growth. Different metal ions can be used to treat bone defects according to specific conditions, including promoting osteogenic activity, inhibiting osteoclast activity, promoting vascular growth, and exerting certain antibacterial effects. Multiple studies have confirmed that metal ions-modified composite scaffolds can effectively promote bone defect healing. By studying current extensive research on metal ions in the treatment of bone defects, this paper reviews the mechanism of metal ions in promoting bone tissue growth, analyzes the loading mode of metal ions, and lists some specific applications of metal ions in different types of bone defects. Finally, this paper summarizes the advantages and disadvantages of metal ions and analyzes the future research trend of metal ions in BTE. This article can provide some new strategies and methods for future research and applications of metal ions in the treatment of bone defects.

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.

In Vivo Bone Tissue Engineering Strategies: Advances and Prospects

Reconstruction of critical-sized bone defects remains a tremendous challenge for surgeons worldwide. Despite the variety of surgical techniques, current clinical strategies for bone defect repair demonstrate significant limitations and drawbacks, including donor-site morbidity, poor anatomical match, insufficient bone volume, bone graft resorption, and rejection. Bone tissue engineering (BTE) has emerged as a novel approach to guided bone tissue regeneration. BTE focuses on in vitro manipulations with seed cells, growth factors and bioactive scaffolds using bioreactors. The successful clinical translation of BTE requires overcoming a number of significant challenges. Currently, insufficient vascularization is the critical limitation for viability of the bone tissue-engineered construct. Furthermore, efficacy and safety of the scaffolds cell-seeding and exogenous growth factors administration are still controversial. The in vivo bioreactor principle (IVB) is an exceptionally promising concept for the in vivo bone tissue regeneration in a predictable patient-specific manner. This concept is based on the self-regenerative capacity of the human body, and combines flap prefabrication and axial vascularization strategies. Multiple experimental studies on in vivo BTE strategies presented in this review demonstrate the efficacy of this approach. Routine clinical application of the in vivo bioreactor principle is the future direction of BTE; however, it requires further investigation for overcoming some significant limitations.

Physical and Chemical Characterization of Biomineralized Collagen with Different Microstructures

Mineralized collagen is the basic unit in hierarchically organized natural bone with different structures. Polyacrylic acid (PAA) and periodic fluid shear stress (FSS) are the most common chemical and physical means to induce intrafibrillar mineralization. In the present study, non-mineralized collagen, extrafibrillar mineralized (EM) collagen, intrafibrillar mineralized (IM) collagen, and hierarchical intrafibrillar mineralized (HIM) collagen induced by PAA and FSS were prepared, respectively. The physical and chemical properties of these mineralized collagens with different microstructures were systematically investigated afterwards. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) showed that mineralized collagen with different microstructures was prepared successfully. The pore density of the mineralized collagen scaffold is higher under the action of periodic FSS. Fourier transform infrared spectroscopy (FTIR) analysis showed the formation of the hydroxyapatite (HA) crystal. A significant improvement in the pore density, hydrophilicity, enzymatic stability, and thermal stability of the mineralized collagen indicated that the IM collagen under the action of periodic FSS was beneficial for maintaining collagen activity. HIM collagen fibers, which are prepared under the co-action of periodic FSS and sodium tripolyphosphate (TPP), may pave the way for new bone substitute material applications.

PCL/Si-Doped Multi-Phase Calcium Phosphate Scaffolds Derived from Cuttlefish Bone

Increasing attention is focused on developing biomaterials as temporary scaffolds that provide a specific environment and microstructure for bone tissue regeneration. The aim of the present work was to synthesize silicon-doped biomimetic multi-phase composite scaffolds based on bioactive inorganic phases and biocompatible polymers (poly(ε-caprolactone), PCL) using simple and inexpensive methods. Porous multi-phase composite scaffolds from cuttlefish bone were synthesized using a hydrothermal method and were further impregnated with (3-aminopropyl)triethoxysilane 1–4 times, heat-treated (1000 °C) and coated with PCL. The effect of silicon doping and the PCL coating on the microstructure and mechanical and biological properties of the scaffolds has been investigated. Multi-phase scaffolds based on calcium phosphate (hydroxyapatite, α-tricalcium phosphate, β-tricalcium phosphate) and calcium silicate (wollastonite, larnite, dicalcium silicate) phases were obtained. Elemental mapping revealed homogeneously dispersed silicon throughout the scaffolds, whereas silicon doping increased bovine serum albumin protein adsorption. The highly porous structure of cuttlefish bone was preserved with a composite scaffold porosity of ~78%. A compressive strength of ~1.4 MPa makes the obtained composite scaffolds appropriate for non-load-bearing applications. Cytocompatibility assessment by an MTT assay of human mesenchymal stem cells revealed the non-cytotoxicity of the obtained scaffolds.

Progress in Niobium Oxide-Containing Coatings for Biomedical Applications: A Critical Review

Typically, pure niobium oxide coatings are deposited on metallic substrates, such as commercially pure Ti, Ti6Al4 V alloys, stainless steels, niobium, TiNb alloy, and Mg alloys using techniques such as sputter deposition, sol-gel deposition, anodizing, and wet plasma electrolytic oxidation. The relative advantages and limitations of these coating techniques are considered, with particular emphasis on biomedical applications. The properties of a wide range of pure and modified niobium oxide coatings are illustrated, including their thickness, morphology, microstructure, elemental composition, phase composition, surface roughness and hardness. The corrosion resistance, tribological characteristics and cell viability/proliferation of the coatings are illustrated using data from electrochemical, wear resistance and biological cell culture measurements. Critical R&D needs for the development of improved future niobium oxide coatings, in the laboratory and in practice, are highlighted.

Collagen-based biocomposites inspired by bone hierarchical structures for advanced bone regeneration: ongoing research and perspectives

Bone is a hard-connective tissue composed of matrix, cells and bioactive factors with a hierarchical structure, where the matrix is mainly composed of type I collagen and hydroxyapatite. Collagen fibers assembled by collagen are the template for mineralization and make an important contribution to bone formation and the bone remodeling process. Therefore, collagen has been widely clinically used for bone/cartilage defect regeneration. However, pure collagen implants, such as collagen scaffolds or sponges, have limitations in the bone/cartilage regeneration process due to their poor mechanical properties and osteoinductivity. Different forms of collagen-based composites prepared by incorporating natural/artificial polymers or bioactive inorganic substances are characterized by their interconnected porous structure and promoting cell adhesion, while they improve the mechanical strength, structural stability and osteogenic activities of the collagen matrix. In this review, various forms of collagen-based biocomposites, such as scaffolds, sponges, microspheres/nanoparticles, films and microfibers/nanofibers prepared by natural/synthetic polymers, bioactive ceramics and carbon-based materials compounded with collagen are reviewed. In addition, the application of collagen-based biocomposites as cytokine, cell or drug (genes, proteins, peptides and chemosynthetic) delivery platforms for proangiogenesis and bone/cartilage tissue regeneration is also discussed. Finally, the potential application, research and development direction of collagen-based biocomposites in future bone/cartilage tissue regeneration are discussed.

Evaluation of the antibacterial properties and in-vitro cell compatibilities of doped copper oxide/hydroxyapatite composites

Mg, Zn and Ce-doped CuO/HA composites were prepared by a two-step sol-gel and hydrothermal process. SEM images showed a spherical appearance of HA and a needle-like morphology for doped CuO. XRD patterns revealed that all doped CuO/HA composites exhibited a hexagonal crystal structure of HA and a monoclinic crystal structure of CuO with no impurities. ICP analysis indicated that with the increase of loading amount of doped CuO, the concentrations of Cu²⁺ ions and doping ions released from composites increased. Moreover, CuO/HA composites exhibit improved antibacterial properties against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) as compared with HA. When the loading amount of doped CuO in composites increased to 15 wt%, the composites exhibited the best antibacterial activity and complete bacterial growth inhibition effect. Furthermore, the CCK-8 assay revealed that the doped CuO/HA composites are noncytotoxic and can promote the proliferation of osteosarcoma cells. This work highlights the potential of the doped CuO/HA composites with significant antibacterial activity, bioactivity and cell compatibility for potential biomedical applications in dental implants and bone regeneration.

Design of novel functionalized collagen-chitosan-MBG scaffolds for enhancing osteoblast differentiation in BMSCs

Collagen and chitosan are two different kinds of natural biodegradable polymers commonly used in the regeneration of bone defects. Mesoporous bioactive glass (MBG) is a type of favorable bone filler which can effectively constitute an enlarged microenvironment to facilitate an exchange of important factors between the cells and scaffolds. Here we prepared a collagen-chitosan-MBG (C-C-MBG) scaffold which displayed significantly increased proliferation, differentiation and mineralization in bone mesenchymal stem cells (BMSCs). Additionally, we found that the scaffold can stimulate extra-cellular signal regulated kinase 1/2 (Erk1/2) activated Runx2 pathway, which is the predominant signaling pathway involved in osteoblast differentiation. Consistently, we observed that the scaffold can markedly enhance the expression ofType I collagen, Osteopontin(Opn), andRunx2, which are important osteoblastic marker genes implicated in the process of osteoblast differentiation. Therefore, we conclude that the composite scaffold can significantly promote the differentiation of BMSCs into osteoblasts by activating Erk1/2-Runx2 pathway. Our finding thereby implies that the C-C-MBG scaffold can possibly act as a potential biomaterial in the bone regeneration.

Remediation of emerging environmental pollutants: A review based on advances in the uses of eco-friendly biofabricated nanomaterials

The increased environmental pollutants due to anthropogenic activities are posing an adverse effects and threat on various biotic forms on the planet. Heavy metals and certain organic pollutants by their toxic persistence in the environment are regarded as significant pollutants worldwide. In recent years, pollutants exist in various forms in the environment are difficult to eliminate by traditional technologies due to various drawbacks. This has lead to shifting of research for the development of cost-effective and efficient technologies for the remediation of environmental pollutants. The adaption of adsorption phenomenon from the traditional technologies with the modification of adsorbents at nanoscale is the trended research for mitigating the environmental pollutants with petite environmental concerns. Over the past decade, the hidden potentials of biological sources for the biofabrication of nanomaterials as bequeathed rapid research for remediating the environmental pollution in a sustainable manner. The biofabricated nanomaterials possess an inimitable phenomenon such as photo and enzymatic catalysis, electrostatic interaction, surface active site interactions, etc., contributing for the detoxification of various pollutants. With this background, the current review highlights the emerging biofabricated nano-based adsorbent materials and their underlying mechanisms addressing the environmental remediation of persistent organic pollutants, heavy metal (loid)s, phytopathogens, special attention to the reduction of pathogen-derived toxins and air pollutants. Each category is illustrated with suitable examples, fundamental mechanism, and graphical representations, along with societal applications. Finally, the future and sustainable development of eco-friendly biofabricated nanomaterial-based adsorbents is discussed.

Recent Progress on Biodegradable Tissue Engineering Scaffolds Prepared by Thermally-Induced Phase Separation (TIPS)

Porous biodegradable scaffolds provide a physical substrate for cells allowing them to attach, proliferate and guide the formation of new tissues. A variety of techniques have been developed to fabricate tissue engineering (TE) scaffolds, among them the most relevant is the thermally-induced phase separation (TIPS). This technique has been widely used in recent years to fabricate three-dimensional (3D) TE scaffolds. Low production cost, simple experimental procedure and easy processability together with the capability to produce highly porous scaffolds with controllable architecture justify the popularity of TIPS. This paper provides a general overview of the TIPS methodology applied for the preparation of 3D porous TE scaffolds. The recent advances in the fabrication of porous scaffolds through this technique, in terms of technology and material selection, have been reviewed. In addition, how properties can be effectively modified to serve as ideal substrates for specific target cells has been specifically addressed. Additionally, examples are offered with respect to changes of TIPS procedure parameters, the combination of TIPS with other techniques and innovations in polymer or filler selection.

Melt Electrospinning of Polymers: Blends, Nanocomposites, Additives and Applications

Melt electrospinning has been developed in the last decade as an eco-friendly and solvent-free process to fill the gap between the advantages of solution electrospinning and the need of a cost-effective technique for industrial applications. Although the benefits of using melt electrospinning compared to solution electrospinning are impressive, there are still challenges that should be solved. These mainly concern to the improvement of polymer melt processability with reduction of polymer degradation and enhancement of fiber stability; and the achievement of a good control over the fiber size and especially for the production of large scale ultrafine fibers. This review is focused in the last research works discussing the different melt processing techniques, the most significant melt processing parameters, the incorporation of different additives (e.g., viscosity and conductivity modifiers), the development of polymer blends and nanocomposites, the new potential applications and the use of drug-loaded melt electrospun scaffolds for biomedical applications.

Bioactive Zinc(II) complex incorporated PCL/gelatin electrospun nanofiber enhanced bone tissue regeneration

Bone tissue regeneration is augmented by biocompatible nanofiber scaffolds, that supports reliable and enhanced bone formation. Zinc is an essential mineral that is vital for routine skeletal growth and it emerges to be able to improve bone regeneration. Phytochemicals, particularly flavonoids have achieved prominent interest for their therapeutic ability, they have demonstrated promising effects on bone by encouraging osteoblastogenesis, which finally leads to bone formation. In this study, we have synthesized bioactive zinc(II) quercetin complex material and used for nanofibers scaffold fabrication to enhance bone tissue regeneration property. Two derivatives of zinc(II) quercetin complexes [(Zn(quercetin) (H₂O)₂) (Zn+Q), and Zn(quercetin)(phenanthroline) (Zn+Q(PHt)) have been synthesized and characterized using UV-Visible spectrophotometer and Fourier Transform-IR spectroscopy. The UV-Visible absorption and IR spectra prove the B-ring chelation of the flavonoid quercetin to zinc(II) rather C-ring chelation. The potential ability of the above synthesized metal complexes on osteogenesis and angiogenesis have been studied. Besides the bioactivity of the metal complexes, the control quercetin has also been examined. The chick embryo chorioallantoic membrane (CAM) assay demonstrated that the angiogenic parameters were increased by the (Zn+Q(PHt)) complex. Amongst, (Zn+Q(PHt)) complex showed significant activity and thereby this complex has been further examined for the bone tissue activity by incorporating the complex into a nanofiber through electrospinning method. At the molecular level, Runx2, mRNA and protein, ALP and type 1 collagen mRNAs, and osteoblast-specific microRNA, pre-mir-15b were examined using real time RT-PCR and Western blot assay. Histology studies showed that the (PCL/gelatin/Zn+Q(PHt)) was biocompatibility in-ovo. Overall, the present study showed that quercetin-zinc complex (Zn+Q(PHt)) incorporated into PCL/gelatin nanofiber can act as a pharmacological agent for treating bone associated defects and promote bone regeneration.

Preparation of PBS/PLLA/HAP Composites by the Solution Casting Method: Mechanical Properties and Biocompatibility

The use of biodegradable polymeric scaffolds for tissue regeneration is becoming a common practice in the clinic. Therefore, an inclined trend is developing with regards to improving the mechanical properties of these scaffolds. Here, we aim to improve the mechanical properties of poly (butylene succinate) (PBS)/poly (l-lactic acid) (PLLA) blends by incorporating hydroxyapatite nanoparticles (HAP) in the blends to form composites. PBS/PLLA = 100/0, 95/5, 90/10, 85/15, and 0/100 wt% blends, along-with the loadings of a few mg of HAPs, were prepared using the solution casting method. A scanning electron microscope showed the voids and droplets, indicating the immiscibility of blends. Due to this immiscibility, the tensile strength values of the blends were found to be in between that of pure PBS (42.85 MPa) and pure PLLA (31.39 MPa). HAPs act as a compatibilizer by incorporating themselves in the voids and spaces caused by the immiscibility, thus increasing the overall tensile strength of the resulting composite to a certain extent, e.g., the tensile strength of PBS/PLLA = 95/5 loaded with 50 mg HAPs was found to be 51.16 MPa. The structural analysis employing the X-ray diffraction (XRD) patterns confirmed the formation of polymer blends and composites. The contact angle analysis showed that the addition of HAPs increased the hydrophilicity of the resulting composites. Selective samples were investigated based on mechanical properties to see if the blends and composites are biocompatible. The obtained results showed that all of the samples with better mechanical properties demonstrated good biocompatibility. This indicates the effectiveness of scaffolds for tissue regeneration.

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.

Composite Hydrogels in Three-Dimensional in vitro Models

3-dimensional (3D) in vitro models were developed in order to mimic the complexity of real organ/tissue in a dish. They offer new possibilities to model biological processes in more physiologically relevant ways which can be applied to a myriad of applications including drug development, toxicity screening and regenerative medicine. Hydrogels are the most relevant tissue-like matrices to support the development of 3D in vitro models since they are in many ways akin to the native extracellular matrix (ECM). For the purpose of further improving matrix relevance or to impart specific functionalities, composite hydrogels have attracted increasing attention. These could incorporate drugs to control cell fates, additional ECM elements to improve mechanical properties, biomolecules to improve biological activities or any combinations of the above. In this Review, recent developments in using composite hydrogels laden with cells as biomimetic tissue- or organ-like constructs, and as matrices for multi-cell type organoid cultures are highlighted. The latest composite hydrogel systems that contain nanomaterials, biological factors, and combinations of biopolymers (e.g., proteins and polysaccharide), such as Interpenetrating Networks (IPNs) and Soft Network Composites (SNCs) are also presented. While promising, challenges remain. These will be discussed in light of future perspectives toward encompassing diverse composite hydrogel platforms for an improved organ environment in vitro.

Biodegradable poly(l-lactide)/calcium phosphate composites with improved properties for orthopedics: Effect of filler and polymer crystallinity

Biodegradable poly(l-lactide)/calcium phosphate composites are promising materials for fabrication of bone fixation implants with improved properties. Multistage compounding was proposed as an efficient method for the preparation of biodegradable poly(l-lactide)/calcium phosphate composites with submicron filler dispersion and mechanical characteristics similar to native bone. The improvement of the characteristics is caused both by the filler itself and by the increase of polymer crystallinity due to the nucleation effect. The technique allows to fabricate biodegradable composites with controlled properties by varying concentration and type of the filler as well as degree of PLLA matrix crystallinity. Animal studies revealed that all the composites were biocompatible and non-toxic.

The Significance and Utilisation of Biomimetic and Bioinspired Strategies in the Field of Biomedical Material Engineering: The Case of Calcium Phosphat-Protein Template Constructs

This review provides a summary of recent research on biomimetic and bioinspired strategies applied in the field of biomedical material engineering and focusing particularly on calcium phosphate-protein template constructs inspired by biomineralisation. A description of and discussion on the biomineralisation process is followed by a general summary of the application of the biomimetic and bioinspired strategies in the fields of biomedical material engineering and regenerative medicine. Particular attention is devoted to the description of individual peptides and proteins that serve as templates for the biomimetic mineralisation of calcium phosphate. Moreover, the review also presents a description of smart devices including delivery systems and constructs with specific functions. The paper concludes with a summary of and discussion on potential future developments in this field.

Osteogenic and antibacterial dual functions of a novel levofloxacin loaded mesoporous silica microspheres/nano-hydroxyapatite/polyurethane composite scaffold

Lev/MSNs/n-HA/PU has been proved to be a novel scaffold material to treat bone defect caused by chronic osteomyelitis. We have previously identified that this material can effectively treat chronic osteomyelitis caused by Staphylococcus aureusin vivo. However, the potential mechanisms of antibacterial and osteogenic induction properties remain unclear. Thus, for osteogenesis property, immunohistochemistry, PCR, and Western blot were performed to detect the expression of osteogenic markers. Furthermore, flow cytometry and TUNEL were applied to analyze MC3T3-E1 proliferation and apoptosis. For antibacterial property, the material was co-cultivated with bacteria, bacterial colony forming units was counted and the release time of the effective levofloxacin was assayed by agar disc-diffusion test. Moreover, scanning electron microscope was applied to observe adhesion of bacteria. In terms of osteogenic induction, we found BMSCs adherently grew more prominently on Lev/MSNs/n-HA/PU. Lev/MSNs/n-HA/PU also enhanced the expression of osteogenic markers including OCN and COL1α1, as well as effectively promoted the transition from G1 phase to G2 phase. Furthermore, Lev/MSNs/n-HA/PU could reduce apoptosis of MC3T3-E1. Besides, both Lev/MSNs/n-HA/PU and n-HA/PU materials could inhibit bacterial colonies, while Lev/MSNs/n-HA/PU possessed a stronger antibacterial activities, and lower bacterial adhesion than n-HA/PU. These results illustrated that Lev/MSNs/n-HA/PU composite scaffold possess favorable compatibility in vitro, which induce osteogenic differentiation of MSCs, promote proliferation and differentiation of MC3T3-E1, and inhibit apoptosis. Moreover, clear in vitro antibacterial effect of Lev/MSNs/n-HA/PU was also observed. In summary, this study replenishes the potential of Lev/MSNs/n-HA/PU composite scaffold possess dual functions of anti-infection and enhanced osteogenesis for future clinical application.

Bone Repair and Regenerative Biomaterials: Towards Recapitulating the Microenvironment

Biomaterials and tissue engineering scaffolds play a central role to repair bone defects. Although ceramic derivatives have been historically used to repair bone, hybrid materials have emerged as viable alternatives. The rationale for hybrid bone biomaterials is to recapitulate the native bone composition to which these materials are intended to replace. In addition to the mechanical and dimensional stability, bone repair scaffolds are needed to provide suitable microenvironments for cells. Therefore, scaffolds serve more than a mere structural template suggesting a need for better and interactive biomaterials. In this review article, we aim to provide a summary of the current materials used in bone tissue engineering. Due to the ever-increasing scientific publications on this topic, this review cannot be exhaustive; however, we attempted to provide readers with the latest advance without being redundant. Furthermore, every attempt is made to ensure that seminal works and significant research findings are included, with minimal bias. After a concise review of crystalline calcium phosphates and non-crystalline bioactive glasses, the remaining sections of the manuscript are focused on organic-inorganic hybrid materials.

Mechanical properties of bioactive glasses, ceramics, glass-ceramics and composites: State-of-the-art review and future challenges

The repair and restoration of bone defects in orthopaedic and dental surgery remains a major challenge despite advances in surgical procedures and post-operative treatments. Bioactive glasses, ceramics, glass-ceramics and composites show considerable potential for such applications as they can promote bone tissue regeneration. This paper presents an overview of the mechanical properties of various bioactive materials, which have the potential for bone regeneration. It also identifies current strategies for improving the mechanical properties of these novel materials, as these are rarely ideal as direct replacements for human bone. For this reason bioactive organic-inorganic composites and hybrids that have tailorable mechanical properties are of particular interest. The inorganic component (bioactive glass, ceramic or glass-ceramic) can provide both strength and bioactivity, while the organic component can add structural reinforcement, toughness and processability. Another topic presented in this paper includes 3D porous scaffolds that act as a template for cell attachment, proliferation and bone growth. Mechanical limitations of existing glass and ceramic scaffolds are discussed, along with the relevant challenges and strategies for further improvement. Advantages and disadvantages of different bioactive materials are critically examined. This paper is focused on optimization of biomaterials properties, in particular mechanical properties and bioactivity.

The summary of the most important cell-biomaterial interactions that need to be considered during in vitro biocompatibility testing of bone scaffolds for tissue engineering applications

Tissue engineered products (TEPs), which mean biomaterials containing either cells or growth factors or both cells and growth factors, may be used as an alternative to the autografts taken directly from the bone of the patients. Nevertheless, the use of TEPs needs much more understanding of biointeractions between biomaterials and eukaryotic cells. Despite the possibility of the use of in vitro cellular models for initial evaluation of the host response to the implanted biomaterial, it is observed that most researchers use cell cultures only for the evaluation of cytotoxicity and cell proliferation on the biomaterial surface, and then they proceed to animal models and in vivo testing of bone implants without fully utilizing the scientific potential of in vitro models. In this review, the most important biointeractions between eukaryotic cells and biomaterials were discussed, indicating molecular mechanisms of cell adhesion, proliferation, and biomaterial-induced activation of immune cells. The article also describes types of cellular models which are commonly used for biomaterial testing and highlights the possibilities and drawbacks of in vitro tests for biocompatibility evaluation of novel scaffolds. Finally, the review summarizes recent findings concerning the use of adult mesenchymal stem cells for TEP generation and compares the potential of bone marrow- and adipose tissue-derived stem cells in regenerative medicine applications.

Novel Pathway for Efficient Covalent Modification of Polyester Materials of Different Design to Prepare Biomimetic Surfaces

To form modern materials with biomimic surfaces, the novel pathway for surface functionalization with specific ligands of well-known and widely used polyester-based rigid media was developed and optimized. Two types of material bases, namely, poly(lactic acid) and poly(ε-caprolactone), as well as two types of material design, e.g., supermacroporous matrices and nanoparticles (NPs), were modified via covalent attachment of preliminary oxidized polyvinylsaccharide poly(2-deoxy-N-methacryloylamido-d-glucose) (PMAG). This polymer, being highly biocompatible and bioinspired, was used to enhance hydrophilicity of the polymer surface and to provide the elevated concentration of reactive groups required for covalent binding of bioligands of choice. The specialties of the interaction of PMAG and its preliminary formed bioconjugates with a chemically activated polyester surface were studied and thoroughly discussed. The supermacroporous materials modified with cell adhesion motifs and Arg-Gly-Asp-containing peptide (RGD-peptide) were tested in the experiments on bone tissue engineering. In turn, the NPs were modified with bioligands ("self-peptide" or camel antibodies) to control their phagocytosis that can be important, for example, for the preparation of drug delivery systems.

Highly Transparent, Strong, and Flexible Films with Modified Cellulose Nanofiber Bearing UV Shielding Property

This work investigates multifunctional composite films synthesized with cellulose nanofibers (CNFs) and poly(vinyl alcohol) (PVA). First, TEMPO-oxidized CNFs were modified in the heterogeneous phase with benzophenone, diisocyanate, and epoxidized soybean oil via esterification reactions. A thorough characterization was carried out via elemental analysis as well as FT-IR and X-ray photoelectron spectroscopies and solid-state NMR. Following, the surface-modified CNFs were combined with PVA to endow composite films with UV-absorbing capabilities while increasing their thermomechanical strength and maintaining a high light transmittance. Compared to neat PVF films, the tensile strength, Young modulus, and elongation of the films underwent dramatic increases upon addition of the reinforcing phase (maximum values of ∼96 MPa, ∼ 714 MPa, and ∼350%, respectively). A high UV blocking performance, especially in the UVB region, was observed for the introduced multifunctional PVA films at CNF loadings below 5 wt %. The trade-off between modified nanofibril function as interfacial reinforcement and aggregation leads to an optimum loading. The results indicate promising applications, for example, in active packaging.

Preparation and characterization of folic acid functionalized bioactive glass for targeted delivery and sustained release of methotrexate

We have successfully prepared a novel targeted drug delivery system, composed of folic acid (FA) as targeting molecule, methotrexate (MTX) as anticancer drug, and bioactive glass (BG) as carrier. The BG nanoparticles were synthesized by sol-gel method with the dodecylamine as template. The surface of BG nanoparticles was grafted with amino groups by (3-aminopropyl) triethoxysilane, then, FA and MTX were covalently conjugated to the surface of modified BG through amidation reaction, so FA functionalized BG (BG-FA) and targeted drug delivery system (MTX-BG-FA) were prepared. The physicochemical properties of BG, BG-NH₂ , and BG-FA were characterized by various methods, such as X-ray diffraction, scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, ultraviolet-visible, and so on. Moreover, the drug release results showed that the MTX-BG-FA had sustained release property because of the peptide bond between MTX and BG-FA. And the cytocompatibility evaluation demonstrated that the BG and BG-FA were biocompatible and BG-FA even could promote cell proliferation, while the MTX-BG-FA had high cytotoxicity owning to the sustained release of anticancer drug. From the above, it could be concluded that MTX-BG-FA could kill tumor cells targetedly and sustainedly, which made it a good cancer targeted therapy material. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 319-329, 2019.

The Impact of Hybrid Nano-Materials in Tooth Tissue Restoration

Tooth loss due to dental diseases, caries, and other related pathological conditions has plagued people and is the most prevalent cause of human organ failure. Billions of people have suffered from losing teeth and dental diseases so that generating natural dental tissues are more appreciated than artificial tooth implantation. The aspiration among the dentists to restore this loss biologically is the genesis of the tooth regeneration. Current trends initiate tissue engineering with a concept of functional restoration of tissue and organ defects by the triad of biomaterial scaffolds, growth factors, and stem cells (Rosa et al. 2012). This paper, therefore, focuses on the significance of nanostructured hybrid materials in the tooth regeneration through tissue engineering. For this purpose, literature was examined and studies on nanomorphological features of stem cells, dental tissues found within the oral area, the signaling molecules utilized in the tissue engineering, and the hybrid scaffolds that guide reconstructions of periodontal tissues were selected for the review. The nanodentistry has been potential, undoubtedly, to achieve almost perfect dental health in the nearest future. However, the success will largely be determined by human requirements and resource supply (technology, economy, and time). Finally, the future and actual potentials of nanotechnologies pertaining tissue engineering will be applied in dentistry (Mitziadis, Woloszyk, & Jimenez-Rojo, 2012).Keywords: Stem cells; scaffolds; nanomaterials; hybrid materials, tissue engineering; dentistry; signaling molecules.

Zero-dimensional, one-dimensional, two-dimensional and three-dimensional biomaterials for cell fate regulation

The interaction of biological cells with artificial biomaterials is one of the most important issues in tissue engineering and regenerative medicine. The interaction is strongly governed by physical and chemical properties of the materials and displayed with differentiated cellular behaviors, including cell self-renewal, differentiation, reprogramming, dedifferentiation, or transdifferentiation as a result. A number of engineered biomaterials with micro- or nano-structures have been developed to mimic structural components of cell niche and specific function of extra cellular matrix (ECM) over past two decades. In this review article, we briefly introduce the fabrication of biomaterials and their classification into zero-dimensional (0D), one-dimensional (1D), two-dimensional (2D) and three-dimensional (3D) ones. More importantly, the influence of different biomaterials on inducing cell self-renewal, differentiation, reprogramming, dedifferentiation, and transdifferentiation was discussed based on the progress at 0D, 1D, 2D and 3D levels, following which the current research limitations and research perspectives were provided.

Fabrication of a biomimetic ZeinPDA nanofibrous scaffold impregnated with BMP-2 peptide conjugated TiO2 nanoparticle for bone tissue engineering

A biomimetic Zein polydopamine based nanofiber scaffold was fabricated to deliver bone morphogenic protein-2 (BMP-2) peptide conjugated titanium dioxide nanoparticles in a sustained manner for investigating its osteogenic differentiation potential. To prolong its retention time at the target site, BMP-2 peptide has been conjugated to titanium dioxide nanoparticles owing to its high surface to volume ratio. The effect of biochemical cues from BMP-2 peptide and nanotopographical stimulation of electrospun Zein polydopamine nanofiber were examined for its enhanced osteogenic expression of human fetal osteoblast cells. The sustained delivery of bioactive signals, improved cell adhesion, mineralization, and differentiation could be attributed to its highly interconnected nanofibrous matrix with unique material composition. Further, the expression of osteogenic markers revealed that the fabricated nanofibrous scaffold possess better cell-biomaterial interactions. These promising results demonstrate the potential of the composite nanofibrous scaffold as an effective biomaterial substrate for bone regeneration.

Biomaterials based strategies for rotator cuff repair

Tearing of the rotator cuff commonly occurs as among one of the most frequently experienced tendon disorders. While treatment typically involves surgical repair, failure rates to achieve or sustain healing range from 20 to 90%. The insufficient capacity to recover damaged tendon to heal to the bone, especially at the enthesis, is primarily responsible for the failure rates reported. Various types of biomaterials with special structures have been developed to improve tendon-bone healing and tendon regeneration, and have received considerable attention for replacement, reconstruction, or reinforcement of tendon defects. In this review, we first give a brief introduction of the anatomy of the rotator cuff and then discuss various design strategies to augment rotator cuff repair. Furthermore, we highlight current biomaterials used for repair and their clinical applications as well as the limitations in the literature. We conclude this article with challenges and future directions in designing more advanced biomaterials for augmentation of rotator cuff repair.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

Mineralization potential of cellulose-nanofibrils reinforced gelatine scaffolds for promoted calcium deposition by mesenchymal stem cells

Cellulose-nanofibrils (CNFs) enriched gelatine (GEL) scaffolds were fabricated in-situ by the combined freeze-thawing process and carbodiimide crosslinking chemistry. The original- and variously surface anionised CNFs (carboxylated/CNF-COOH/, and phosphonated with 3-AminoPropylphosphoric Acid/CNF-COOH-ApA/) were used in order to tune the scaffolds' biomimetic structure towards a more intensive mineralization process. The pore size reduction (from 208±35μm to 91±35μm) after 50% v/v of CNFs addition to GEL was identified, while separated pore-walls' alignment vs. shorter, dense and elongated pores are observed when using 80% v/v of original-CNFs vs. anionised-CNFs, all of them possessed osteoid-like compressive strength (0.025-0.40MPa) and elasticity (0.04-0.15MPa). While randomly distributed Ca²⁺-deficient hydroxyapatite/HAp/(Ca/P≈1.4) aggregates were identified in the case of original-CNF prevalent scaffolds after four weeks of incubation in SBF, the more uniform and intensified deposition with HAp-like (Ca/P≈1.69) structures were established using CNF-COOH-Apa. The growth of Mesenchymal Stem Cells (MSCs) was observed on all CNF-containing scaffolds, resulting in more extensive Ca²⁺ deposition compared to the positive control or pure GEL scaffold. Among them, the scaffold prepared with the 50% v/v CNF-COOH-ApA showed significantly increased mineralization kinetic as well as the capacity for bone-like patterning in bone tissue regeneration.