Challenging applicability of ISO 10993-5 for calcium phosphate biomaterials evaluation: Towards more accurate in vitro cytotoxicity assessment

Research on biomaterials typically starts with cytocompatibility evaluation, using the ISO 10993-5 standard as a reference that relies on extract tests to determine whether the material is safe (cell metabolic activity should exceed 70 %). However, the generalized approach within the standard may not accurately reflect the material's behavior in direct contact with cells, raising concerns about its effectiveness. Calcium phosphates (CaPs) are a group of materials that, despite being highly biocompatible and promoting bone formation, still exhibit inconsistencies in basic cytotoxicity evaluations. Hence, in order to test the cytocompatibility dependence on different experimental setups and material-cell interactions, we used amorphous calcium phosphate, α-tricalcium phosphate, hydroxyapatite, and octacalcium phosphate (0.1 mg/mL to 5 mg/mL) with core cell lines of bone microenvironment: mesenchymal stem cells, osteoblast-like and endothelial cells. All materials have been characterized for their physicochemical properties before and after cellular contact and once in vitro assays were finalized, groups identified as 'cytotoxic' were further analyzed using a modified Annexin V apoptosis assay to accurately determine cell death. The obtained results showed that indirect contact following ISO standards had no sensitivity of tested cells to the materials, but direct contact tests at physiological concentrations revealed decreased metabolic activity and viability. In summary, our findings offer valuable guidelines for handling biomaterials, especially in powder form, to better evaluate their biological properties and avoid false negatives commonly associated with the traditional standard approach.

Incorporating strontium enriched amorphous calcium phosphate granules in collagen/collagen-magnesium-hydroxyapatite osteochondral scaffolds improves subchondral bone repair

Osteochondral defect repair with a collagen/collagen-magnesium-hydroxyapatite (Col/Col-Mg-HAp) scaffold has demonstrated good clinical results. However, subchondral bone repair remained suboptimal, potentially leading to damage to the regenerated overlying neocartilage. This study aimed to improve the bone repair potential of this scaffold by incorporating newly developed strontium (Sr) ion enriched amorphous calcium phosphate (Sr-ACP) granules (100-150 μm). Sr concentration of Sr-ACP was determined with ICP-MS at 2.49 ± 0.04 wt%. Then 30 wt% ACP or Sr-ACP granules were integrated into the scaffold prototypes. The ACP or Sr-ACP granules were well embedded and distributed in the collagen matrix demonstrated by micro-CT and scanning electron microscopy/energy dispersive x-ray spectrometry. Good cytocompatibility of ACP/Sr-ACP granules and ACP/Sr-ACP enriched scaffolds was confirmed with in vitro cytotoxicity assays. An overall promising early tissue response and good biocompatibility of ACP and Sr-ACP enriched scaffolds were demonstrated in a subcutaneous mouse model. In a goat osteochondral defect model, significantly more bone was observed at 6 months with the treatment of Sr-ACP enriched scaffolds compared to scaffold-only, in particular in the weight-bearing femoral condyle subchondral bone defect. Overall, the incorporation of osteogenic Sr-ACP granules in Col/Col-Mg-HAp scaffolds showed to be a feasible and promising strategy to improve subchondral bone repair.

Doxorubicin loaded octacalcium phosphate particles as controlled release drug delivery systems: Physico-chemical characterization, in vitro drug release and evaluation of cell death pathway

Mastering new and efficient ways to obtain successful drug delivery systems (DDS) with controlled release became a paramount quest in the scientific community. Increase of malignant bone tumors and the necessity to optimize an approach of localized drug delivery require research to be even more intensified. Octacalcium phosphate (OCP), with a number of advantages over current counterparts is extensively used in bone engineering. The aim of the present research was to synthesize bioactive and biocompatible doxorubicin (DOX) containing OCP particles. DOX-OCP was successfully obtained in situ in an exhaustive range of added drug (1-20 wt%, theoretical loading). Based on XRD, above 10 wt% of DOX, OCP formation was inhibited and the obtained product was low crystalline α-TCP. In-vitro drug release was performed in pH 7.4 and 6.0. In both pH environments DOX had a continuous release over six weeks. However, the initial drug burst for pH 7.4, in the first 24 h, ranged from 15.9 ± 1.3 % to 33.5 ± 12 % and for pH 6.0 23.7 ± 1.5 % to 36.2 ± 12 %.The DOX-OCP exhibited an inhibitory effect on viability of osteosarcoma cell lines MG63, U2OS and HOS. In contrast, MC3T3-E1 cells (IC50 > 0.062 µM) displayed increased viability and proliferation from 3rd to 7th day. Testing of the DDS on ferroptotic markers (CHAC1, ACSL4 and PTGS2) showed that OCP-DOX does not induce ferroptotic cell death. Moreover, the evaluation of protein levels of cleaved PARP, by western blotting analysis, corroborated that apoptosis is the main pathway of programmed cell death in osteosarcoma cells induced by DOX-OCP.

Apatite/Chitosan Composites Formed by Cold Sintering for Drug Delivery and Bone Tissue Engineering Applications

In the biomedical field, nanocrystalline hydroxyapatite is still one of the most attractive candidates as a bone substitute material due to its analogies with native bone mineral features regarding chemical composition, bioactivity and osteoconductivity. Ion substitution and low crystallinity are also fundamental characteristics of bone apatite, making it metastable, bioresorbable and reactive. In the present work, biomimetic apatite and apatite/chitosan composites were produced by dissolution-precipitation synthesis, using mussel shells as a calcium biogenic source. With an eye on possible bone reconstruction and drug delivery applications, apatite/chitosan composites were loaded with strontium ranelate, an antiosteoporotic drug. Due to the metastability and temperature sensitivity of the produced composites, sintering could be carried out by conventional methods, and therefore, cold sintering was selected for the densification of the materials. The composites were consolidated up to ~90% relative density by applying a uniaxial pressure up to 1.5 GPa at room temperature for 10 min. Both the synthesised powders and cold-sintered samples were characterised from a physical and chemical point of view to demonstrate the effective production of biomimetic apatite/chitosan composites from mussel shells and exclude possible structural changes after sintering. Preliminary in vitro tests were also performed, which revealed a sustained release of strontium ranelate for about 19 days and no cytotoxicity towards human osteoblastic-like cells (MG63) exposed up to 72 h to the drug-containing composite extract.

Fusion and classification algorithm of octacalcium phosphate production based on XRD and FTIR data

The present manuscript tested an automated analysis sequence to provide a decision support system to track the OCP synthesis from [Formula: see text]-TCP over time. Initially, the XRD and FTIR signals from a hundredfold scaled-up hydrolysis of OCP from [Formula: see text]-TCP were fused and modeled by the curve fitting based on the significantly established maxima from the literature and nine features extracted from the fitted shapes. Afterward, the analysis sequence enclosed the machine learning techniques for feature ranking, spatial filtering, and dimensionality reduction to support the automatic recognition of the synthesis stages. The proposed analysis pipeline for OCP identification might be the foundation for a decision support system explicitly targeting OCP synthesis. Future projects will exploit the suggested methodology for pinpointing the OCP production over time (including the intermediary phases present in the OCP formation) and for evaluating whether biological variables might be merged with biomaterial properties to build a unified model of tissue response to the implant.

Small organic molecules containing amorphous calcium phosphate: synthesis, characterization and transformation

As the primary solid phase, amorphous calcium phosphate (ACP) is a pivotal precursor in cellular biomineralization. The intrinsic interplay between ACP and Howard factor underscores the significance of understanding their association for advancing biomimetic ACP development. While organic compounds play established roles in biomineralization, this study presents the synthesis of ACP with naturally occurring organic compounds (ascorbate, glutamate, and itaconate) ubiquitously found in mitochondria and vital for bone remodeling and healing. The developed ACP with organic compounds was meticulously characterized using XRD, FTIR, and solid-state 13C and 31P NMR. The morphological analysis revealed the characteristic spherical morphology with particle size close to 20 nm of all synthesized ACP variants. Notably, the type of organic compound strongly influences true density, specific surface area, particle size, and transformation. The in vitro analysis was performed with MC3T3-E1 cells, indicating the highest cell viability with ACP_ASC (ascorbate), followed by ACP_ITA (itaconate). The lowest cell viability was observed with 10 %w/v of ACP_GLU (glutamate); however, 1 %w/v of ACP_GLU was cytocompatible. Further, the effect of small organic molecules on the transformation of ACP to low crystalline apatite (Ap) was examined in Milli-Q® water, PBS, and α-MEM.

Calcium Phosphates Enhanced with Liposomes - The Future of Bone Regeneration and Drug Delivery

Effective healing and regeneration of various bone defects is still a major challenge and concern in modern medicine. Calcium phosphates have emerged as extensively studied bone substitute materials due to their structural and chemical resemblance to the mineral phase of bone, along with their versatile properties. Calcium phosphates present promising biological characteristics that make them suitable for bone substitution, but a critical limitation lies in their low osteoinductivity. To supplement these materials with properties that promote bone regeneration, prevent infections, and cure bone diseases locally, calcium phosphates can be biologically and therapeutically modified. A promising approach involves combining calcium phosphates with drug-containing liposomes, renowned for their high biocompatibility and ability to provide controlled and sustained drug delivery. Surprisingly, there is a lack of research focused on liposome-calcium phosphate composites, where liposomes are dispersed within a calcium phosphate matrix. This raises the question of why such studies are limited. In order to provide a comprehensive overview of existing liposome and calcium phosphate composites as bioactive substance delivery systems, the authors review the literature exploring the interactions between calcium phosphates and liposomes. Additionally, it seeks to identify potential interactions between calcium ions and liposomes, which may impact the feasibility of developing liposome-containing calcium phosphate composite materials. Liposome capacity to protect bioactive compounds and facilitate localized treatment can be particularly valuable in scenarios involving bone regeneration, infection prevention, and the management of bone diseases. This review explores the implications of liposomes and calcium phosphate material containing liposomes on drug delivery, bioavailability, and stability, offering insights into their advantages.

Cell-Laden 3D Printed GelMA/HAp and THA Hydrogel Bioinks: Development of Osteochondral Tissue-like Bioinks

Osteochondral (OC) disorders such as osteoarthritis (OA) damage joint cartilage and subchondral bone tissue. To understand the disease, facilitate drug screening, and advance therapeutic development, in vitro models of OC tissue are essential. This study aims to create a bioprinted OC miniature construct that replicates the cartilage and bone compartments. For this purpose, two hydrogels were selected: one composed of gelatin methacrylate (GelMA) blended with nanosized hydroxyapatite (nHAp) and the other consisting of tyramine-modified hyaluronic acid (THA) to mimic bone and cartilage tissue, respectively. We characterized these hydrogels using rheological testing and assessed their cytotoxicity with live-dead assays. Subsequently, human osteoblasts (hOBs) were encapsulated in GelMA-nHAp, while micropellet chondrocytes were incorporated into THA hydrogels for bioprinting the osteochondral construct. After one week of culture, successful OC tissue generation was confirmed through RT-PCR and histology. Notably, GelMA/nHAp hydrogels exhibited a significantly higher storage modulus (G') compared to GelMA alone. Rheological temperature sweeps and printing tests determined an optimal printing temperature of 20 °C, which remained unaffected by the addition of nHAp. Cell encapsulation did not alter the storage modulus, as demonstrated by amplitude sweep tests, in either GelMA/nHAp or THA hydrogels. Cell viability assays using Ca-AM and EthD-1 staining revealed high cell viability in both GelMA/nHAp and THA hydrogels. Furthermore, RT-PCR and histological analysis confirmed the maintenance of osteogenic and chondrogenic properties in GelMA/nHAp and THA hydrogels, respectively. In conclusion, we have developed GelMA-nHAp and THA hydrogels to simulate bone and cartilage components, optimized 3D printing parameters, and ensured cell viability for bioprinting OC constructs.

Human Osteoblasts' Response to Biomaterials for Subchondral Bone Regeneration in Standard and Aggressive Environments

Osteochondral lesions, when not properly treated, may evolve into osteoarthritis (OA), especially in the elderly population, where altered joint function and quality are usual. To date, a collagen/collagen-magnesium-hydroxyapatite (Col/Col-Mg-HAp) scaffold (OC) has demonstrated good clinical results, although suboptimal subchondral bone regeneration still limits its efficacy. This study was aimed at evaluating the in vitro osteogenic potential of this scaffold, functionalized with two different strategies: the addition of Bone Morphogenetic Protein-2 (BMP-2) and the incorporation of strontium (Sr)-ion-enriched amorphous calcium phosphate (Sr-ACP) granules. Human osteoblasts were seeded on the functionalized scaffolds (OC+BMP-2 and OC+Sr-ACP, compared to OC) under stress conditions reproduced with the addition of H2O2 to the culture system, as well as in normal conditions, and evaluated in terms of morphology, metabolic activity, gene expression, and matrix synthesis. The OC+BMP-2 scaffold supported a better osteoblast morphology and stimulated scaffold colonization, cell activity, and extracellular matrix secretion, especially in the stressed culture environment but also in normal culture conditions, with increased expression of genes related to osteoblast differentiation. In conclusion, the incorporation of BMP-2 into the Col/Col-Mg-HAp scaffold also represents an improvement of the osteochondral scaffold in more challenging conditions, supporting further preclinical studies to optimize it for use in clinical practice.

Octacalcium Phosphate-Laden Hydrogels on 3D-Printed Titanium Biomaterials Improve Corrosion Resistance in Simulated Biological Media

The inflammatory-associated corrosion of metallic dental and orthopedic implants causes significant complications, which may result in the implant's failure. The corrosion resistance can be improved with coatings and surface treatments, but at the same time, it might affect the ability of metallic implants to undergo proper osteointegration. In this work, alginate hydrogels with and without octacalcium phosphate (OCP) were made on 3D-printed (patterned) titanium alloys (Ti Group 2 and Ti-Al-V Group 23) to enhance their anticorrosion properties in simulated normal, inflammatory, and severe inflammatory conditions in vitro. Alginate (Alg) and OCP-laden alginate (Alg/OCP) hydrogels were manufactured on the surface of 3D-printed Ti substrates and were characterized with wettability analysis, XRD, and FTIR. The electrochemical characterization of the samples was carried out with open circuit potential, potentiodynamic polarization, and electrochemical impedance spectroscopy (EIS). It was observed that the hydrophilicity of Alg/OCP coatings was higher than that of pure Alg and that OCP phase crystallinity was increased when samples were subjected to simulated biological media. The corrosion resistance of uncoated and coated samples was lower in inflammatory and severe inflammatory environments vs. normal media, but the hydrogel coatings on 3D-printed Ti layers moved the corrosion potential towards more nobler values, reducing the corrosion current density in all simulated solutions. These measurements revealed that OCP particles in the Alg hydrogel matrix noticeably increased the electrical charge transfer resistance at the substrate and coating interface more than with Alg hydrogel alone.

Amorphous Calcium Phosphate and Amorphous Calcium Phosphate Carboxylate: Synthesis and Characterization

Amorphous calcium phosphate (ACP) is the first solid phase precipitated from a supersaturated calcium phosphate solution. Naturally, ACP is formed during the initial stages of biomineralization and stabilized by an organic compound. Carboxylic groups containing organic compounds are known to regulate the nucleation and crystallization of hydroxyapatite. Therefore, from a biomimetic point of view, the synthesis of carboxylate ions containing ACP (ACPC) is valuable. Usually, ACP is synthesized with fewer steps than ACPC. The precipitation reaction of ACP is rapid and influenced by pH, temperature, precursor concentration, stirring conditions, and reaction time. Due to phosphates triprotic nature, controlling pH in a multistep approach becomes tedious. Here, we developed a new ACP and ACPC synthesis approach and thoroughly characterized the obtained materials. Results from vibration spectroscopy, nuclear magnetic resonance (NMR), X-ray photoelectron spectroscopy (XPS), true density, specific surface area, and ion release studies have shown a difference in the physiochemical properties of the ACP and ACPC. Additionally, the effect of a carboxylic ion type on the physiochemical properties of ACPC was characterized. All of the ACPs and ACPCs were synthesized in sterile conditions, and in vitro analysis was performed using MC-3T3E1 cells, revealing the cytocompatibility of the synthesized ACPs and ACPCs, of which the ACPC synthesized with citrate showed the highest cell viability.

Activated Carbon and Clay Pellets Coated with Hydroxyapatite for Heavy Metal Removal: Characterization, Adsorption, and Regeneration

In the present work, activated-carbon-containing pellets were preparedby direct chemical activation of sawdust, using clays as a binder. The obtained pellets (ACC) were coated with hydroxyapatite (HAp) nanoparticles (ACC-HAp) to improve adsorption towards Pb(II), Cu(II), Zn(II), and Ni(II). The pellets were characterized by scanning electron microscopy (SEM), by Fourier transform infrared spectroscopy (FTIR), and with a gas sorptometer. The effect of pH, contact time, and initial concentration on adsorption performance was investigated. Additionally, desorption studies were performed, and the regeneration influence on compressive strength and repeated Pb(II) adsorption was investigated. The results showed that, after coating ACC pellets with HAp nanoparticles, the adsorption capacity increased for all applied heavy metal ions. Pb(II) was adsorbed the most, and the best results were achieved at pH 6. The adsorption process followed the pseudo-second-order kinetic model. The adsorption isotherm of Pb(II) is better fitted to the Langmuir model, showing the maximum adsorption capacity of 56 and 47 mg/g by ACC-HAp and ACC pellets, respectively. The desorption efficiency of Pb(II)-loaded ACC-HAp pellets increased by lowering the pH of the acid, resulting in the dissolution of the HAp coating. The best desorption results were achieved with HCl at pH 1 and 1.5. Therefore, the regeneration procedure consisted of desorption, rinsing with distilled water, and re-coating with HAp nanoparticles. After the regeneration process, the Pb(II) adsorption was not affected. However, the desorption stage within the regeneration process decreased the compressive strength of the pellets.

Role of carboxylic organic molecules in interfibrillar collagen mineralization

Bone is a composite material made up of inorganic and organic counterparts. Most of the inorganic counterpart accounts for calcium phosphate (CaP) whereas the major organic part is composed of collagen. The interfibrillar mineralization of collagen is an important step in the biomineralization of bone and tooth. Studies have shown that synthetic CaP undergoes auto-transformation to apatite nanocrystals before entering the gap zone of collagen. Also, the synthetic amorphous calcium phosphate/collagen combination alone is not capable of initiating apatite nucleation rapidly. Therefore, it was understood that there is the presence of a nucleation catalyst obstructing the auto-transformation of CaP before entering the collagen gap zone and initiating rapid nucleation after entering the collagen gap zone. Therefore, studies were focused on finding the nucleation catalyst responsible for the regulation of interfibrillar collagen mineralization. Organic macromolecules and low-molecular-weight carboxylic compounds are predominantly present in the bone and tooth. These organic compounds can interact with both apatite and collagen. Adsorption of the organic compounds on the apatite nanocrystal governs the nucleation, crystal growth, lattice orientation, particle size, and distribution. Additionally, they prevent the auto-transformation of CaP into apatite before entering the interfibrillar compartment of the collagen fibril. Therefore, many carboxylic organic compounds have been utilized in developing CaP. In this review, we have covered different carboxylate organic compounds governing collagen interfibrillar mineralization.

Gallium-Doped Hydroxyapatite Shows Antibacterial Activity against Pseudomonas aeruginosa without Affecting Cell Metabolic Activity

Calcium phosphates (CaPs) have been used in bone regeneration for decades. Among the described CaPs, synthetic hydroxyapatite (HAp) has a chemical composition similar to that of natural bone. Gallium-containing compounds have been studied since the 1970s for the treatment of autoimmune diseases and have shown beneficial properties, such as antibacterial activity and inhibition of osteoclast activity. In this study, we synthesized hydroxyapatite (HAp) powder with Ga doping ratios up to 6.9 ± 0.5 wt% using the wet chemical precipitation method. The obtained products were characterized using XRD, BET, FTIR, and ICP-MS. Ga³⁺ ion release was determined in the cell culture media for up to 30 days. Antibacterial activity was assessed against five bacterial species: Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes. The biocompatibility of the GaHAp samples was determined in human fibroblasts (hTERT-BJ1) through direct and indirect tests. The structure of the synthesized products was characteristic of HAp, as revealed with XRD and FTIR, although the addition of Ga caused a decrease in the crystallite size. Ga³⁺ was released from GaHAp paste in a steady manner, with approximately 40% being released within 21 days. GaHAp with the highest gallium contents, 5.5 ± 0.1 wt% and 6.9 ± 0.5 wt%, inhibited the growth of all five bacterial species, with the greatest activity being against Pseudomonas aeruginosa. Biocompatibility assays showed maintained cell viability (~80%) after seven days of indirect exposure to GaHAp. However, when GaHAp with Ga content above 3.3 ± 0.4 wt% was directly applied on the cells, a decrease in metabolic activity was observed on the seventh day. Overall, these results show that GaHAp with Ga content below 3.3 ± 0.4 wt% has attractive antimicrobial properties, without affecting the cell metabolic activity, creating a material that could be used for bone regeneration and prevention of infection.

Sudoku of porous, injectable calcium phosphate cements – Path to osteoinductivity

With the increase of global population, people's life expectancy is growing as well. Humans tend to live more active lifestyles and, therefore, trauma generated large defects become more common. Instances of tumour resection or pathological conditions and complex orthopaedic issues occur more frequently increasing necessity for bone substitutes. Composition of calcium phosphate cements (CPCs) is comparable to the chemical structure of bone minerals. Their ability to self-set and resorb in vivo secures a variety of potential applications in bone regeneration. Despite the years-long research and several products already reaching the market, finding the right properties for calcium phosphate cement to be osteoinductive and both injectable and suitable for clinical use is still a sudoku. This article is focused on injectable, porous CPCs, reviewing the latest developments on the path toward finding osteoinductive material, which is suitable for injection.

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Phase separation is an essential factor to be improved to obtain injectable material; several methods have been proposed.

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Osteoinductive bone substitutes – possible solution for bad mechanical performance of CPCs.

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Osteoinductivity of CPC could be attained even without the addition of different supplements.

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Less complex composition of CPC – potentially reduced price of the final product and wider availability on the market.

Gallium containing calcium phosphates: potential antibacterial agents or fictitious truth

Amidst an ever-increasing demand for the enhancement of the lifestyle and the modulation of modern diseases, the functionalization of biomaterials is of utmost importance. One of the leading materials for the aforementioned purpose have been calcium phosphates (CaPs). They have been widely used in bone regeneration displaying favourable regenerative potential and biological properties. Many studies have placed their entire focus on facilitating the osteogenic differentiation of stem cells and bone progenitor cells, while the aspect of antibacterial properties has been surmounted. Nevertheless, increasing antibiotic resistance of bacteria requires the development of new materials and the usage of alternative approaches such as ion doping. Gallium (Ga) has been the potential star on the rise among the ions. However, the obstacle that accompanies gallium is the scarcity of research performed and the variety of amalgamations. The question that imposes itself is how a growing field of therapeutics can be further entwined with advances in material science, and how will the incorporation of gallium bring a new outlook. The present study offers a comprehensive overview of state-of-the-art gallium containing calcium phosphates (GaCaPs), their synthesis methods, antibacterial properties, and biocompatibility. Considering their vast potential as antibacterial agents, the need for a methodical perspective is highly necessary to determine if it is a direction on the brink of recognition or a fruitless endeavour. STATEMENT OF SIGNIFICANCE: : Although several studies have been published on various metal ions-containing calcium phosphates, to this date there is no systematic overview pointing out the properties and benefits of gallium containing calcium phosphates. Here we offer a critical overview, including synthesis, structure and biological properties of gallium containing calcium phosphates.

Calcium Phosphate/Hyaluronic Acid Composite Hydrogels for Local Antiosteoporotic Drug Delivery

Despite the bone ability of self-regeneration, large bone defects require surgical intervention. Likewise, when it comes to osteoporotic bone fractures, new approaches should be considered a supportive mechanism for the surgery. In recent years, more and more attention has been attracted to advanced drug delivery systems for local osteoporosis treatment, combining appropriate biomaterials with antiosteoporotic drugs, allowing simultaneously to regenerate the bone and locally treat the osteoporosis. Within the current research, hyaluronic acid/strontium ranelate (HA/SrRan), HA/calcium phosphate nanoparticles (HA/CaP NPs), and HA/CaP NPs/SrRan hydrogels were prepared. The effect of CaP and SrRan presence in the composites on the swelling behavior, gel fraction, molecular structure, microstructure, and SrRan and Sr2+ release, as well as in vitro cell viability was evaluated. Obtained results revealed that the route of CaP nanoparticle incorporation into the HA matrix had a significant effect on the hydrogel gel fraction, rheological properties, swelling behavior, and microstructure. Nevertheless, it had a negligible effect on the release kinetics of SrRan and Sr2+. The highest cell (3T3) viability (>80%) was observed for HA hydrogels, with and without SrRan. Moreover, the positive effect of SrRan on 3T3 cells was also demonstrated, showing a significant increase (up to 50%) in cell viability if the used concentrations of SrRan were in the range of 0.05–0.2 μg/ml.

Tough Photo-Cross-Linked PCL-Hydroxyapatite Composites for Bone Tissue Engineering

Acrylate-based photo-cross-linked poly(ε-caprolactone) (PCL) tends to show low elongation and strength. Incorporation of osteo-inductive hydroxyapatite (HAp) further enhances this effect, which limits its applicability in bone tissue engineering. To overcome this, the thiol-ene click reaction is introduced for the first time in order to photo-cross-link PCL composites with 0, 10, 20, and 30 wt % HAp nanoparticles. It is demonstrated that the elongation at break and ultimate strength increase 10- and 2-fold, respectively, when the photopolymerization mechanism is shifted from a radical chain-growth (i.e., acrylate cross-linking) toward a radical step-growth polymerization (i.e., thiol-ene cross-linking). Additionally, it is illustrated that osteoblasts can attach to and proliferate on the surface of the photo-cross-linked PCL-HAp composites. Finally, the incorporation of HAp nanoparticles is shown to reduce the ALP activity of osteoblasts. Overall, thiol-ene cross-linked PCL-HAp composites can be considered as promising potential materials for bone tissue engineering.

Nanosized calcium deficient hydroxyapatites for tooth enamel protection

Calcium phosphates (CaP) are extensively studied as additives to dental care products for tooth enamel protection against caries. However, it is not clear yet whether substituted CaP could provide better enamel protection. In this study we produced, characterized and tested in vitro substituted and co‐substituted calcium deficient hydroxyapatite (CDHAp) with Sr²⁺ and F⁻ ions. X‐ray powder diffractometry, Fourier transformation infrared spectroscopy, scanning electron microscopy, energy‐dispersive X‐ray analysis, Brunauer–Emmett–Teller were used to characterize synthesized powders and also cytotoxicity was evaluated. pH = f(t) test was performed to estimate, weather synthesized CDHAp suspensions are able to increase pH of experimental media after acid addition. Synthesis products were incorporated into paste to perform in vitro remineralization on the bovine enamel. In addition to mentioned instrumental methods, profilometry was used for evaluation of remineralised enamel samples. The obtained results confirmed formation of CDHAp substituted with 1.5–1.6 wt% of fluoride and 7.4–7.8 wt% of strontium. pH = f(t) experiment pointed out that pH increased by approximately 0.3 within 10 min after acid addition for all CDHAp suspensions. A new layer of the corresponding CDHAp was formed on the enamel. Its thickness increased by 0.8 ± 0.1 μm per day and reached up to 5.8 μm after 7 days. Additionally, octa calcium phosphates were detected on the surface of control samples. In conclusion, we can assume that CDHAp substituted with Sr²⁺ and/or F⁻ could be used as an effective additive to dental care products promoting formation of protecting layer on the enamel, but there was no significant difference among sample groups.

Octacalcium phosphate: Innovative vehicle for the local biologically active substance delivery in bone regeneration

Disadvantages of conventional drug delivery systems (DDS), such as systemic circulation, interaction with physiochemical factors, reduced bioavailability, and insufficient drug concentration at bone defect site, have underlined the importance of developing efficacious local drug delivery systems. Octacalcium phosphate (OCP) is presumed to be the precursor of biologically formed apatite, owing to its similarity to hydroxyapatite (HAp) and readiness to convert to it. Specific crystal structure of OCP is constructed of compiled apatite layers and water layers, which make possible the incorporation of various ions in its structure, making it feasible to alter the overall effect OCP has in the system. Next to that intrinsic property, characteristics as high solubility, biodegradability and osteoconductivity have made it indispensable to tailor OCP as a carrier material. In this review, we present the main characteristics and progress done on utilizing OCP as an innovative vehicle and provide suggestions for possible research pathways and advantages for local drug delivery in bone tissue engineering. STATEMENT OF SIGNIFICANCE: Octacalcium phosphate (OCP), being a precursor to biologically formed apatite, has many assets when compared to other calcium phosphates. Owing to its highly pertinent structure, it is being used as a vehicle for biologically active substances or ions for bone regeneration. However, orchestrating drug delivery systems with OCP, in order to achieve the best possible outcome, is still a pioneering concept, and the all-encompassing data is still scarce. Although several articles have been published on this matter, to this date there is no systematic overview pointing out the benefits that OCP can bring in the field of drug delivery. Here we offer a comprehensive overview, starting from the OCP synthesis to its structure, morphology, and the biological significance OCP has.

Incorporation of Barium Ions into Biomaterials: Dangerous Liaison or Potential Revolution?

In the present manuscript, a brief overview on barium, its possible utilization, and the aftermath of its behavior in organisms has been presented. As a bivalent cation, barium has the potential to be used in a myriad of biochemical reactions. A number of studies have exhibited both the unwanted outcome barium displayed and the advantages of barium laden compounds, tested in in vitro and in vivo settings. The plethora of prospective manipulations covered the area of hydrogels and calcium phosphates, with an end goal of examining barium's future in the tissue engineering. However, majority of data revert to the research conducted in the 20th century, without investigating the mechanisms of action using current state-of-the-art technology. Having this in mind, set of questions that are needed for possible future research arose. Can barium be used as a substitute for other biologically relevant divalent cations? Will the incorporation of barium ions hamper the execution of the essential processes in the organism? Most importantly, can the benefits outweigh the harm?

Preparation of a Ceramic Matrix Composite Made of Hydroxyapatite Nanoparticles and Polylactic Acid by Consolidation of Composite Granules

Composites made of a biodegradable polymer, e.g., polylactic acid (PLA) and hydroxyapatite nanoparticles (HAP NPs) are promising orthopedic materials. There is a particular need for biodegradable hybrid nanocomposites with strong mechanical properties. However, obtaining such composites is challenging, since nanoparticles tend to agglomerate, and it is difficult to achieve good bonding between the hydrophilic ceramic and the hydrophobic polymer. This paper describes a two-step technology for obtaining a ceramic matrix composite. The first step is the preparation of composite granules. The granules are obtained by infiltration of porous granules of HAP NPs with PLA through high-pressure infiltration. The homogeneous ceramic-polymer granules are 80 μm in diameter, and the composite granules are 80 wt% HAP NPs. The second step is consolidation of the granules using high pressure. This is performed in three variants: Uniaxial pressing with the pressure of up to 1000 MPa at room temperature, warm isostatic compaction (75 MPa at 155 °C), and a combination of the two methods. The combined methods result in the highest densification (99%) and strongest mechanical properties; the compressive strength is 374 MPa. The structure of the ceramic matrix composite is homogeneous. Good adhesion between the inorganic and the organic component is observable using scanning electron microscopy.

Advanced Mg, Zn, Sr, Si Multi-Substituted Hydroxyapatites for Bone Regeneration

Purpose

Compositional tailoring is gaining more attention in the development of advanced biomimetic nanomaterials. In this study, we aimed to prepare advanced multi-substituted hydroxyapatites (ms-HAPs), which show similarity with the inorganic phase of bones and might have therapeutic potential for bone regeneration.

Materials

Novel nano hydroxyapatites substituted simultaneously with divalent cations: Mg²⁺ (1.5%), Zn²⁺ (0.2%), Sr²⁺ (5% and 10%), and Si (0.2%) as orthosilicate (SiO₄^4-) were designed and successfully synthesized for the first time.

Methods

The ms-HAPs were obtained via a wet-chemistry precipitation route without the use of surfactants, which is a safe and ecologically friendly method. The composition of synthesized materials was determined by inductively coupled plasma optical emission spectrometry (ICP-OES). The materials were characterized by X-ray powder diffraction (XRD), FT-IR and FT-Raman spectroscopy, BET measurements and by imaging techniques using high-resolution TEM (HR-TEM), FE-SEM coupled with EDX, and atomic force microscopy (AFM). The ion release was measured in water and in simulated body fluid (SBF).

Results

Characterization methods confirmed the presence of the unique phase of pure stoichiometric HAP structure and high compositional purity of all synthesized nanomaterials. The doping elements influenced the crystallite size, the crystallinity, lattice parameters, morphology, particle size and shape, specific surface area, and porosity. Results showed a decrease in both nanoparticle size and crystallinity degree, coupled with an increase in specific surface area of these advanced ms-HAP materials, in comparison with pure stoichiometric HAP. The release of biologically important ions was confirmed in different liquid media, both in static and simulated dynamic conditions.

Conclusion

The incorporation of the four substituting elements into the HAP structure is demonstrated. Synthesized nanostructured ms-HAP materials might inherit the in vivo effects of substituting functional elements and properties of hydroxyapatite for bone healing and regeneration. Results revealed a rational tailoring approach for the design of a next generation of bioactive ms-HAPs as promising candidates for bone regeneration.

In vitro comparison of 3D printed polylactic acid/hydroxyapatite and polylactic acid/bioglass composite scaffolds: Insights into materials for bone regeneration

3D printing of polylactic acid (PLA) and hydroxyapatite (HA) or bioglass (BG) bioceramics composites is the most promising technique for artificial bone construction. However, HA and BG have different chemical composition as well as different bone regeneration inducing mechanisms. Thus, it is important to compare differentiation processes induced by 3D printed PLA + HA and PLA + BG scaffolds in order to evaluate the strongest osteoconductive and osteoinductive properties possessing bioceramics. In this study, we analysed porous PLA + HA (10%) and PLA + BG (10%) composites' effect on rat's dental pulp stem cells fate in vitro. Obtained results indicated, that PLA + BG scaffolds lead to weaker cell adhesion and proliferation than PLA + HA. Nevertheless, osteoinductive and other biofriendly properties were more pronounced by PLA + BG composites. Overall, the results showed a strong advantage of bioceramic BG against HA, thus, 3D printed PLA + BG composite scaffolds could be a perspective component for patient-specific, cheaper and faster artificial bone tissue production.

Bone Loss around Dental Implants 5 Years after Implantation of Biphasic Calcium Phosphate (HAp/βTCP) Granules

Biphasic calcium phosphate ceramic granules (0.5-1.0 mm) with a hydroxyapatite and β-tricalcium phosphate ratio of 90/10 were used. Biphasic calcium phosphate ceramic granules produced in the Riga Technical University, Riga Rudolph Cimdins Biomaterials Innovation and Development Centre, were used for filling the bone loss on 18 patients with peri-implantitis. After 5 years at the minimum, clinical and 3D cone-beam computed tomography control was done. Clinical situation confirmed good stability of implants without any signs of inflammation around. Radiodensity of the previous gap and alveolar bone horizontally from middle point of dental implants showed similar radiodensity as in normal alveolar bone. This trial is registered with ISRCTN13514478.

Immunohistochemical evaluation after Sr-enriched biphasic ceramic implantation in rabbits femoral neck: comparison of seven different bone conditions

Strontium (Sr) has shown effectiveness for stimulating bone remodeling. Nevertheless, the exact therapeutic values are not established yet. Authors hypothesized that local application of Sr-enriched ceramics would enhance bone remodeling in constant osteoporosis of rabbits' femoral neck bone. Seven different bone conditions were analyzed: ten healthy rabbits composed a control group, while other twenty underwent ovariectomy and were divided into three groups. Bone defect was filled with hydroxyapatite 30% (HAP) and tricalcium phosphate 70% (TCP) granules in 7 rabbits, 5% of Sr-enriched HAP/TCP granules in 7, but sham defect was left unfilled in 6 rabbits. Bone samples were obtained from operated and non-operated legs 12 weeks after surgery and analyzed by histomorphometry and immunohistochemistry (IMH). Mean trabecular bone area in control group was 0.393 mm2, in HAP/TCP - 0.226 mm2, in HAP/TCP/Sr - 0.234 mm2 and after sham surgery - 0.242 mm2. IMH revealed that HAP/TCP/Sr induced most noticeable increase of nuclear factor kappa beta 105 (NFkB 105), osteoprotegerin (OPG), osteocalcin (OC), bone morphogenetic protein 2/4 (BMP 2/4), collagen type 1α (COL-1α), interleukin 1 (IL-1) with comparison to intact leg; NFkB 105 and OPG rather than pure HAP/TCP or sham bone. We concluded that Sr-enriched biomaterials induce higher potential to improve bone regeneration than pure bioceramics in constant osteoporosis of femoral neck bone. Further studies on bigger osteoporotic animals using Sr-substituted orthopedic implants for femoral neck fixation should be performed to confirm valuable role in local treatment of osteoporotic femoral neck fractures in humans.

Biodegradable Materials and Metallic Implants-A Review

Recent progress made in biomaterials and their clinical applications is well known. In the last five decades, great advances have been made in the field of biomaterials, including ceramics, glasses, polymers, composites, glass-ceramics and metal alloys. A variety of bioimplants are currently used in either one of the aforesaid forms. Some of these materials are designed to degrade or to be resorbed inside the body rather than removing the implant after its function is served. Many properties such as mechanical properties, non-toxicity, surface modification, degradation rate, biocompatibility, and corrosion rate and scaffold design are taken into consideration. The current review focuses on state-of-the-art biodegradable bioceramics, polymers, metal alloys and a few implants that employ bioresorbable/biodegradable materials. The essential functions, properties and their critical factors are discussed in detail, in addition to their challenges to be overcome.

Strontium and strontium ranelate: Historical review of some of their functions

The review covers historical and last decade's scientific literature on the biological and clinical role of strontium (Sr) and strontium ranelate (Sr RAN). It enrols the description of the main effects of Sr on supportive tissue, its proven and possible morphopathogenetical mechanisms and the interaction with the bone, and especially focuses on the Sr ability to inhibit osteoclasts and affect the programmed cell death. The main experimental and clinical experience regarding the Sr RAN influence in the treatment of osteoporosis and the search for correct doses is also highlighted. The review gives insight into the role of Sr/Sr RAN on stem cells, apoptosis, animal and clinical research.

In-vitro bioactivity, biocompatibility and dissolution studies of diopside prepared from biowaste by using sol-gel combustion method

Diopside was synthesized from biowaste (Eggshell) by sol-gel combustion method at low calcination temperature and the influence of two different fuels (urea, l-alanine) on the phase formation temperature, physical and biological properties of the resultant diopside was studied. The synthesized materials were characterized by heating microscopy, FTIR, XRD, BET, SEM and EDAX techniques. BET analysis reveals particles were of submicron size with porosity in the nanometer range. Bone-like apatite deposition ability of diopside scaffolds was examined under static and circulation mode of SBF (Simulated Body Fluid). It was noticed that diopside has the capability to deposit HAP (hydroxyapatite) within the early stages of immersion. ICP-OES analysis indicates release of Ca, Mg, Si ions and removal of P ions from the SBF, but in different quantities from diopside scaffolds. Cytocompatability studies on human bone marrow stromal cells (hBMSCs) revealed good cellular attachment on the surface of diopside scaffolds and formation of extracellular matrix (ECM). This study suggests that the usage of eggshell biowaste as calcium source provides an effective substitute for synthetic starting materials to fabricate bioproducts for biomedical applications.

Fabrication, Properties and Applications of Dense Hydroxyapatite: A Review

In the last five decades, there have been vast advances in the field of biomaterials, including ceramics, glasses, glass-ceramics and metal alloys. Dense and porous ceramics have been widely used for various biomedical applications. Current applications of bioceramics include bone grafts, spinal fusion, bone repairs, bone fillers, maxillofacial reconstruction, etc. Amongst the various calcium phosphate compositions, hydroxyapatite, which has a composition similar to human bone, has attracted wide interest. Much emphasis is given to tissue engineering, both in porous and dense ceramic forms. The current review focusses on the various applications of dense hydroxyapatite and other dense biomaterials on the aspects of transparency and the mechanical and electrical behavior. Prospective future applications, established along the aforesaid applications of hydroxyapatite, appear to be promising regarding bone bonding, advanced medical treatment methods, improvement of the mechanical strength of artificial bone grafts and better in vitro/in vivo methodologies to afford more particular outcomes.