Development of Phosphatized Calcium Carbonate Biominerals as Bioactive Bone Graft Substitute Materials, Part I: Incorporation of Magnesium and Strontium Ions

Bio-Informed Porous Mineral-Based Composites

Certain biominerals, such as sea sponges and echinoderm skeletons, display a fascinating combination of mechanical properties and adaptability due to the well-defined structures spanning various length scales. These materials often possess high density normalized mechanical properties because they contain well-defined pores. The density-normalized mechanical properties of synthetic minerals are often inferior because the pores are stochastically distributed, resulting in an inhomogeneous stress distribution. The mechanical properties of synthetic materials are limited by the degree of structural and compositional control currently available fabrication methods offer. In the first part of this review, examples of structural elements nature uses to impart exceptional density normalized Young's moduli to its porous biominerals are showcased. The second part highlights recent advancements in the fabrication of bio-informed mineral-based composites possessing pores with diameters that span a wide range of length scales. The influence of the processing of mineral-based composites on their structures and mechanical properties is summarized. Thereby, it is aimed at encouraging further research directed to the sustainable, energy-efficient fabrication of synthetic lightweight yet stiff mineral-based composites.

Sea Urchin Spine Embedded in the Sole of the Foot: Eight-Year Radiographic Follow-Up Without Removal

When sea urchin puncture injuries occur during coastal recreation or work activities, they often affect extremities, such as hands and feet. There is a plethora of information on treatments for these puncture injuries, with the most common among medical professionals being the removal of all partially embedded spines and the removal of as many fully embedded spines as possible. When the spines are deeply embedded and/or fragmented, they might not be removed, especially when they are not located in critical areas such as tendons or joints. This reflects the generally held notion that smaller spines and spine fragments will eventually dissolve or be absorbed. Here we report an unusual case where the tip of a sea urchin spine became embedded in the soft tissue of the sole of the foot of a 21-year-old male after he stepped on one after falling off a kayak off the coast of Oahu, Hawai'i. The deeply embedded spine was not removed. By three weeks after the injury, the patient did not have any symptoms, and eight years later, he was still symptom-free. Radiographs taken one year after the injury showed that the spine had fragmented into two pieces. The smaller piece was about 15% of the size of the original embedded spine, and it had apparently been absorbed (it was not seen on final radiographs eight years later). Analysis of radiographs eight years after the injury showed that the main or large spine fragment was still distinctly detectable in the soft tissue; there was no visible evidence that it had undergone significant absorption or migrated from the original location. The absence of any obvious radiographic rarefaction over eight years is contrary to the lore that sea urchin spines that remain in human soft tissue will exhibit significant, or complete, absorption or dissolution over months to a few years.

Marine-Originated Materials and Their Potential Use in Biomedicine

Aquatic habitats cover almost 70% of the Earth, containing several species contributing to marine biodiversity. Marine and aquatic organisms are rich in chemical compounds that can be widely used in biomedicine (dentistry, pharmacy, cosmetology, etc.) as alternative raw biomaterials or in food supplements. Their structural characteristics make them promising candidates for tissue engineering approaches in regenerative medicine. Thus, seaweeds, marine sponges, arthropods, cnidaria, mollusks, and the biomaterials provided by them, such as alginate, vitamins, laminarin, collagen, chitin, chitosan, gelatin, hydroxyapatite, biosilica, etc., are going to be discussed focusing on the biomedical applications of these marine-originated biomaterials. The ultimate goal is to highlight the sustainability of the use of these biomaterials instead of conventional ones, mainly due to the antimicrobial, anti-inflammatory, anti-aging and anticancer effect.

Is Silver the New Gold? A Systematic Review of the Preclinical Evidence of Its Use in Bone Substitutes as Antiseptic

Antibiotic-laden bone substitutes represent a viable option in the treatment of bone and joint infections with bone defects. In particular, the addition of silver ions or silver nanoparticles to bone substitutes to achieve local antiseptic activity could represent a further contribution, also helping to prevent bacterial resistance to antibiotics. An in-depth search of the main scientific databases was performed regarding the use of silver compounds for bone substitution. The available evidence is still limited to the preclinical level: 22 laboratory studies, 2 animal models, and 3 studies, with both in vitro and in vivo analysis, were found on the topic. Numerous biomaterials have been evaluated. In vitro studies confirmed that silver in bone substitutes retains the antibacterial activity already demonstrated in coatings materials. Cytotoxicity was generally found to be low and only related to silver concentrations higher than those sufficient to achieve antibacterial activity. Instead, there are only a few in vivo studies, which appear to confirm antibacterial efficacy, although there is insufficient evidence on the pharmacokinetics and safety profile of the compounds investigated. In conclusion, research on bone substitutes doped with silver is in its early stages, but the preliminary findings seem promising.

A Comparative EPR Study of Non-Substituted and Mg-Substituted Hydroxyapatite Behaviour in Model Media and during Accelerated Ageing

To assess the application potential of novel biomaterials, their behaviour in model media and upon sterilization should be investigated, as well as the stability related to their storage conditions. Such data are lacking for Mg-substituted HAP (Mg-HAP). Therefore, the changes in the local structure of non-substituted and Mg-HAP after irradiation and immersion in corrected simulated fluid and saline solution for 28 days were followed by electron paramagnetic resonance (EPR) spectroscopy for the first time. To better understand the stability of radical species induced by sterilization, EPR spectra of samples kept for 2 h at temperatures up to 373 K were recorded to provide an insight into the stability of the sample storage conditions by the accelerated aging method. Samples were characterized by PXRD, FTIR, SEM, EDS, AAS and TGA. Results confirmed that irradiation does not induce changes in the composition or the structure of any of the investigated materials. Fading or the complete disappearance of radical signals in the EPR spectra after immersion in both media was accompanied by the disappearance of other phases formed as a minor byproduct in the synthesis of substituted HAP, as confirmed by PXRD and FTIR analysis. Obtained results confirm the great potential of Mg-HAPs for biomedical applications, although closer attention should be given to the processes related to sample storage stability at different temperatures.

Progressive Osteolysis After Use of Synthetic Bone Graft Substitute

Benign bone tumors are commonly treated with intralesional curettage and bone graft, with autogenous bone graft being the gold standard. However, autogenous bone graft has its limitation, and artificial bone graft substitutes were developed as an alternative. PRO-DENSE™ (Wright Medical Technology, Arlington, Tennessee) is a calcium sulfate and calcium phosphate mixed bone graft substitute that is biodegradable and osteoconductive, which has made them a popular choice among surgeons. However, long-term studies of this treatment method for benign tumors are still limited.

In this report, we present a case of progressive femoral neck osteolysis caused by an inflammatory reaction to PRO-DENSE™ two years after intralesional curettage and bone grafting of a benign bone tumor. 

A twenty-one-year-old female with fibrous dysplasia underwent intralesional curettage with the use of PRO-DENSE™ bone substitute to fill the cavitary defect. She developed an inflammatory reaction to the bone graft substitute leading to increasing pain and osteolysis requiring a reoperation.

Bone graft substitute has many advantages; however, they should be used with discretion due to many unknown regarding their safety and long-term outcomes.

Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments

After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.

Promoting hidden natural design templates in wasted shells of the mantis shrimp into valuable biogenic composite

The mineralized cuticle of the mantis shrimps Squilla Mantis which serve as natural hammers, spears and armors, have attracted research attention from various fields due to its amazing mechanical properties which were studied from evolutionary and ecological points of view. Here we aimed to valorize the astonishing mantis shrimp shell waste resulted from fishery and seafood industry as valuable biogenic composite derived from nature, potentially re-usable for novel, smart materials or added-value by-products, aspect which was not deeply considered before. Employing multi-laser Raman spectroscopy and imaging, supported by x-ray diffraction and high-resolution electron microscopy, we discover that the peripheral segments anatomically known as claws and telson, featured completely different composition and morphology, suggesting different applicability. The claw presents a bulk Mg-CaCO₃ structure reinforced with fluorapatite coating, while the carotenoid-rich telson presents a porous and anisotropic structure of an amorphous mixture of CaCO₃ and CaPO₄ in gradient deposition on the chitin-protein scaffold. Resonance Raman spectroscopy showed concentrated pools of astaxanthin carotenoid within the bright red spots visible on telson, Based on our findings, we discuss this material's potential for selective applicability, as a natural source of phosphate-carbonate minerals, antioxidants, biofertilizer, pollutant adsorbent, valuable material for regenerative medicine or even as a cell culture substrate. Knowledge-based approach on this bio-template is the basis for smart recycling of such fishery waste for sustainable development, by opening channels for blue bioeconomy avenue.

Nanoparticles and their effects on differentiation of mesenchymal stem cells

Over the past decades, advancements in nanoscience and nanotechnology have resulted in numerous nanomedicine platforms. Various nanoparticles, which exhibit many unique properties, play increasingly important roles in the field of biomedicine to realize the potential of nanomedicine. Due to the capacity of self-renewal and multilineage mesenchymal differentiation, mesenchymal stem cells (MSCs) have been widely used in the area of regenerative medicine and in clinical applications due to their potential to differentiate into various lineages. There are several factors that impact the differentiation of MSCs into different lineages. Many types of biomaterials such as polymers, ceramics, and metals are commonly applied in tissue engineering and regenerative therapies, and they are continuously refined over time. In recent years, along with the rapid development of nanotechnology and nanomedicine, nanoparticles have been playing more and more important roles in the fields of biomedicine and bioengineering. The combined use of nanoparticles and MSCs in biomedicine requires greater knowledge of the effects of nanoparticles on MSCs. This review focuses on the effects of four inorganic or metallic nanoparticles (hydroxyapatite, silica, silver, and calcium carbonate), which are widely used as biomaterials, on the osteogenic and adipogenic differentiation of MSCs. In this review, the cytotoxicity of these four nanoparticles, their effects on osteogenic/adipogenic differentiation of MSCs and the signalling pathways or transcription factors involved are summarized. In addition, the chemical composition, size, shape, surface area, surface charge and surface chemistry of nanoparticles, have been reported to impact cellular behaviours. In this review, we particularly emphasize the influence of their size on cellular responses. We envision our review will provide a theoretical basis for the combined application of MSCs and nanoparticles in biomedicine.

MgCl2 promotes mouse mesenchymal stem cell osteogenic differentiation by activating the p38/Osx/Runx2 signaling pathway

Magnesium, an important inorganic mineral component in bones, enhances osteoblast adhesion and osteogenic gene expression. Mg2+‑containing hydroxyapatite promotes mouse mesenchymal stem cell (MMSC) osteogenic differentiation. In the present study, MMSCs were cultured in media containing different concentrations of MgCl2 (0 and 20 mM) for different time periods. Western blotting and reverse transcription‑quantitative PCR were performed to determine the expression levels of phosphorylated (p)‑p38 mitogen‑activated protein kinase (MAPK), the osteoblast‑specific transcription factor Osterix (Osx), runt‑related transcription factor 2 (Runx2), and p38 downstream genes, such as 27 kDa heat shock protein (hsp27), activating transcription factor 4 (Atf4), myocyte enhancer factor 2C (Mef2c) and CCAAT/enhancer‑binding protein homologous protein (Ddit3). The facilitatory effect of MgCl2 on MMSC osteogenic differentiation was assessed via Alizarin Red staining. The results suggested that MgCl2 increased p38 phosphorylation compared with the control group. Downstream genes of the p38 signaling pathway, including Osx and Runx2, as well as several osteogenesis‑associated downstream target genes, including Hsp27, Atf4, Ddit3 and Mef2c, were significantly upregulated in the Mg2+‑treated group compared with the control group. The increased osteogenic differentiation in the Mg2+‑treated group was significantly attenuated in MMSCs treated with SB203580, a specific inhibitor of the p38 signaling pathway. The results suggested that appropriate concentrations of MgCl2 promoted MMSC osteogenic differentiation via regulation of the p38/Osx/Runx2 signaling pathway.

Current Stage of Marine Ceramic Grafts for 3D Bone Tissue Regeneration

Bioceramic scaffolds are crucial in tissue engineering for bone regeneration. They usually provide hierarchical porosity, bioactivity, and mechanical support supplying osteoconductive properties and allowing for 3D cell culture. In the case of age-related diseases such as osteoarthritis and osteoporosis, or other bone alterations as alveolar bone resorption or spinal fractures, functional tissue recovery usually requires the use of grafts. These bone grafts or bone void fillers are usually based on porous calcium phosphate grains which, once disposed into the bone defect, act as scaffolds by incorporating, to their own porosity, the intergranular one. Despite their routine use in traumatology and dental applications, specific graft requirements such as osteoinductivity or balanced dissolution rate are still not completely fulfilled. Marine origin bioceramics research opens the possibility to find new sources of bone grafts given the wide diversity of marine materials still largely unexplored. The interest in this field has also been urged by the limitations of synthetic or mammalian-derived grafts already in use and broadly investigated. The present review covers the current stage of major marine origin bioceramic grafts for bone tissue regeneration and their promising properties. Both products already available on the market and those in preclinical phases are included. To understand their clear contribution to the field, the main clinical requirements and the current available biological-derived ceramic grafts with their advantages and limitations have been collected.

Phase-specific bioactivity and altered Ostwald ripening pathways of calcium carbonate polymorphs in simulated body fluid

Calcium carbonate is an abundant biomineral, and already archeological records demonstrate its bioactivity and applicability for osseo-integrative implants. Its solubility, which is generally higher than those of calcium phosphates, depends on its polymorph turning calcium carbonate into a promising biomaterial with tunable bioresorption rate. However, the phase-dependent bioactivity of calcium carbonate, i.e., its osteoconductivity, is still insufficiently characterized. In this study, we address this issue by monitoring the behavior of the four most important calcium carbonate phases, i.e., calcite, aragonite, vaterite, and amorphous calcium carbonate, in simulated body fluid solution at 37 °C. Our results demonstrate that the thermodynamically stable calcite phase is essentially inert. In contrast, the metastable phases aragonite and vaterite are bioactive, thus promoting the formation of calcium phosphate. Amorphous calcium carbonate (ACC) shows prominent bioactivity accompanied by pronounced redissolution processes. Mg-stabilized ACC was additionally tested since its increased stability eases formulation and handling in future applications. It is highly bioactive and, moreover, the additional release of Mg promotes cell viability. Overall, our results demonstrate that bioactivity of calcium carbonate is phase-dependent, allowing tailored response and bioactivity of future calcareous biomaterials. Our results also reveal that phosphate ions strongly interfere with Ostwald-Lussac step ripening of calcium carbonate, kinetically stabilizing metastable polymorphs such as vaterite and aragonite; this is a distinctive feature of the calcium carbonate mineral system which clearly has to be considered in future applications of calcium carbonate as a bioceramic.

Development of Phosphatized Calcium Carbonate Biominerals as Bioactive Bone Graft Substitute Materials, Part II: Functionalization with Antibacterial Silver Ions

Porous calcium phosphate (CaP) materials as bone graft substitutes can be prepared from Ca carbonate biomineral structures by hydrothermal conversion into pseudomorphic CaP scaffolds. The present study aims at furnishing such phosphatized Ca carbonate biomineral (PCCB) materials with antibacterial Ag ions in order to avoid perisurgical wound infections. Prior to this study, PCCB materials with Mg and/or Sr ions incorporated for stimulating bone formation were prepared from coral skeletons and sea urchin spines as starting materials. The porous PCCB materials were treated with aqueous solutions of Ag nitrate with concentrations of 10 or 100 mmol/L, resulting in the formation of Ag phosphate nanoparticles on the sample surfaces through a replacement reaction. The materials were characterized using scanning electron microscopy (SEM) energy-dispersive X-ray spectroscopy (EDS) and X-ray diffractometry (XRD). In contact with Ringer`s solution, the Ag phosphate nanoparticles dissolved and released Ag ions with concentrations up to 0.51 mg/L, as shown by atomic absorption spectroscopy (AAS) analyses. In tests against Pseudomonas aeruginosa and Staphylococcus aureus on agar plates, antibacterial properties were similar for both types of Ag-modified PCCB materials. Concerning the antibacterial performance, the treatment with AgNO₃ solutions with 10 mmol/L was almost as effective as with 100 mmol/L.