3D-Printed Functional Hydrogel by DNA-Induced Biomineralization for Accelerated Diabetic Wound Healing

Chronic wounds in diabetic patients are challenging because their prolonged inflammation makes healing difficult, thus burdening patients, society, and health care systems. Customized dressing materials are needed to effectively treat such wounds that vary in shape and depth. The continuous development of 3D-printing technology along with artificial intelligence has increased the precision, versatility, and compatibility of various materials, thus providing the considerable potential to meet the abovementioned needs. Herein, functional 3D-printing inks comprising DNA from salmon sperm and DNA-induced biosilica inspired by marine sponges, are developed for the machine learning-based 3D-printing of wound dressings. The DNA and biomineralized silica are incorporated into hydrogel inks in a fast, facile manner. The 3D-printed wound dressing thus generates provided appropriate porosity, characterized by effective exudate and blood absorption at wound sites, and mechanical tunability indicated by good shape fidelity and printability during optimized 3D printing. Moreover, the DNA and biomineralized silica act as nanotherapeutics, enhancing the biological activity of the dressings in terms of reactive oxygen species scavenging, angiogenesis, and anti-inflammation activity, thereby accelerating acute and diabetic wound healing. These bioinspired 3D-printed hydrogels produce using a DNA-induced biomineralization strategy are an excellent functional platform for clinical applications in acute and chronic wound repair.

Improved Biocompatibility of Intra-Arterial Poly-L-Lactic Acid Stent by Tantalum Ion Implantation : 3-Month Results in a Swine Model

Objective

Biodegradable poly-L-lactic acid (PLLA) with a highly biocompatible surface via tantalum (Ta) ion implantation can be an innovative solution for the problems associated with current biodegradable stents. The purpose of this study is to develop a Ta-implanted PLLA stent for clinical use and to investigate its biological performance capabilities.

Methods

A series of in vitro and in vivo tests were used to assess the biological performance of bare and Ta-implanted PLLA stents. The re-endothelialization ability and thrombogenicity were examined through in vitro endothelial cell and platelet adhesion tests. An in vivo swine model was used to evaluate the effects of Ta ion implantation on subacute restenosis and thrombosis. Angiographic and histologic evaluations were conducted at one, two and three months post-treatment.

Results

The Ta-implanted PLLA stent was successfully fabricated, exhibiting a smooth surface morphology and modified layer integration. After Ta ion implantation, the surface properties were more favorable for rapid endothelialization and for less platelet attachment compared to the bare PLLA stent. In an in vivo animal test, follow-up angiography showed no evidence of in-stent stenosis in either group. In a microscopic histologic examination, luminal thrombus formation was significantly suppressed in the Ta-implanted PLLA stent group according to the 2-month follow-up assessment (21.2% vs. 63.9%, p=0.005). Cells positive for CD 68, a marker for the monocyte lineage, were less frequently identified around the Ta-implanted PLLA stent in the 1-month follow-up assessments.

Conclusion

The use of a Ta-implanted PLLA stent appears to promote re-endothelialization and anti-thrombogenicity.

Bifunctional poly (l-lactic acid)/hydrophobic silica nanocomposite layer coated on magnesium stents for enhancing corrosion resistance and endothelial cell responses

Biodegradable magnesium (Mg)-based vascular stents can overcome the limitations of conventional permanent metallic stents, such as late in-stent restenosis and thrombosis, but still have difficulty retarding degradation while providing adequate mechanical support to the blood vessel. We incorporated silica nanoparticles surface-functionalized with hexadecyltrimethoxysilane (mSiNP) into a poly (l-lactic acid) (PLLA) coating as a physical barrier to disturb the penetration of the corrosive medium as well as a bioactive source that releases silicon ions capable of stimulating endothelial cells. The corrosion resistance and biocompatibility of this bifunctional PLLA/mSiNP nanocomposite coating were investigated using different weight ratios of mSiNP. The nanocomposite coating containing more than 10 wt% of the mSiNP (PLLA/10mSiNP and PLLA/20mSiNP) significantly delayed the corrosion of the Mg substrate and exhibited favorable endothelial cell responses, compared to the pure PLLA coating. Specifically, the calculated corrosion rates of PLLA/10mSiNP and PLLA/20mSiNP decreased by half, indicating the durability of the coating after immersion in simulated body fluid for 12 days. Based on the in vitro cellular response, the incorporation of the mSiNPs into the PLLA coating significantly improved the endothelial cell responses to the Mg substrate, showing better initial cell surface coverage, migration, and proliferation rate than those of pure PLLA. These results indicate that the PLLA/mSiNP nanocomposite coatings have significant potential to improve the corrosion resistance and vascular compatibility of biodegradable Mg-based vascular stents.

Freeform 3D printing of vascularized tissues: Challenges and strategies

In recent years, freeform three-dimensional (3D) printing has led to significant advances in the fabrication of artificial tissues with vascularized structures. This technique utilizes a supporting matrix that holds the extruded printing ink and ensures shape maintenance of the printed 3D constructs within the prescribed spatial precision. Since the printing nozzle can be translated omnidirectionally within the supporting matrix, freeform 3D printing is potentially applicable for the fabrication of complex 3D objects, incorporating curved, and irregular shaped vascular networks. To optimize freeform 3D printing quality and performance, the rheological properties of the printing ink and supporting matrix, and the material matching between them are of paramount importance. In this review, we shall compare conventional 3D printing and freeform 3D printing technologies for the fabrication of vascular constructs, and critically discuss their working principles and their advantages and disadvantages. We also provide the detailed material information of emerging printing inks and supporting matrices in recent freeform 3D printing studies. The accompanying challenges are further discussed, aiming to guide freeform 3D printing by the effective design and selection of the most appropriate materials/processes for the development of full-scale functional vascularized artificial tissues.

Powder based additive manufacturing for biomedical application of titanium and its alloys: a review

Powder based additive manufacturing (AM) technology of Ti and its alloys has received great attention in biomedical applications owing to its advantages such as customized fabrication, potential to be cost-, time-, and resource-saving. The performance of additive manufactured implants or scaffolds strongly depends on various kinds of AM technique and the quality of Ti and its alloy powders. This paper has specifically covered the process of commonly used powder-based AM technique and the powder production of Ti and its alloy. The selected techniques include laser-based powder bed fusion of metals (PBF-LB/M), electron beam powder bed fusion of metals (PBF-EB/M), and directed energy deposition utilized in the production of the biomaterials are discussed as well as the powder fed system of binder jetting. Moreover, titanium based powder production methods such as gas atomization, plasma atomization, and plasma rotating electrode process are also discussed.

3D Freeform Printing of Nanocomposite Hydrogels through in situ Precipitation in Reactive Viscous Fluid

Composite hydrogels have gained great attention as three-dimensional (3D) printing biomaterials because of their enhanced intrinsic mechanical strength and bioactivity compared to pure hydrogels. In most conventional printing methods for composite hydrogels, particles are preloaded in ink before printing, which often reduces the printability of composite ink with little mechanical improvement due to poor particle-hydrogel interaction of physical mixing. In contrast, the in situ incorporation of nanoparticles into a hydrogel during 3D printing achieves uniform distribution of particles with remarkable mechanical reinforcement, while precursors dissolved in inks do not influence the printing process. Herein, we introduced a "printing in liquid" technique coupled with a hybridization process, which allows 3D freeform printing of nanoparticle-reinforced composite hydrogels. A viscoplastic matrix for this printing system provides not only support for printed hydrogel filaments but also chemical reactants to induce various reactions in printed objects for in situ modification. Nanocomposite hydrogel scaffolds were successfully fabricated through this 3D freeform printing of hyaluronic acid (HAc)-alginate (Alg) hydrogel inks through a two-step crosslinking strategy. The first ionic crosslinking of Alg provided structural stability during printing, while the secondary crosslinking of photo-curable HAc improved the mechanical and physiological stability of the nanocomposite hydrogels. For in situ precipitation during 3D printing, phosphate ions were dissolved in the hydrogel ink and calcium ions were added to the viscoplastic matrix. The composite hydrogels demonstrated a significant improvement in mechanical strength, biostability, as well as biological performance compared to pure HAc. Moreover, the multi-material printing of composites with different calcium phosphate contents was achieved by adjusting the ionic concentration of inks. Our method greatly accelerates the 3D printing of various functional or hybridized materials with complex geometries through the design and modification of printing materials coupled with in situ post-printing functionalization and hybridization in reactive viscoplastic matrices.

3D Freeform Printing of Nanocomposite Hydrogels through in situ Precipitation in Reactive Viscous Fluid

Composite hydrogels have gained great attention as three-dimensional (3D) printing biomaterials because of their enhanced intrinsic mechanical strength and bioactivity compared to pure hydrogels. In most conventional printing methods for composite hydrogels, particles are preloaded in ink before printing, which often reduces the printability of composite ink with little mechanical improvement due to poor particle-hydrogel interaction of physical mixing. In contrast, the in situ incorporation of nanoparticles into a hydrogel during 3D printing achieves uniform distribution of particles with remarkable mechanical reinforcement, while precursors dissolved in inks do not influence the printing process. Herein, we introduced a "printing in liquid" technique coupled with a hybridization process, which allows 3D freeform printing of nanoparticle-reinforced composite hydrogels. A viscoplastic matrix for this printing system provides not only support for printed hydrogel filaments but also chemical reactants to induce various reactions in printed objects for in situ modification. Nanocomposite hydrogel scaffolds were successfully fabricated through this 3D freeform printing of hyaluronic acid (HAc)-alginate (Alg) hydrogel inks through a two-step crosslinking strategy. The first ionic crosslinking of Alg provided structural stability during printing, while the secondary crosslinking of photo-curable HAc improved the mechanical and physiological stability of the nanocomposite hydrogels. For in situ precipitation during 3D printing, phosphate ions were dissolved in the hydrogel ink and calcium ions were added to the viscoplastic matrix. The composite hydrogels demonstrated a significant improvement in mechanical strength, biostability, as well as biological performance compared to pure HAc. Moreover, the multi-material printing of composites with different calcium phosphate contents was achieved by adjusting the ionic concentration of inks. Our method greatly accelerates the 3D printing of various functional or hybridized materials with complex geometries through the design and modification of printing materials coupled with in situ post-printing functionalization and hybridization in reactive viscoplastic matrices.

Ta ion implanted nanoridge-platform for enhanced vascular responses

Bare metal stents are commonly used in interventional cardiology; they provide successful treatment because of their excellent mechanical properties, expandability ratios, and flexibility. However, their insufficient vascular affinity can induce the development of neointimal hyperplasia following arterial injury and subsequent smooth muscle cell overgrowth in the lumen of a stented vessel. Nanoengineering of the bare metal stent surface is a valuable strategy for eliciting favorable vascular responses. In this study, we introduce a target-ion-induced plasma sputtering (TIPS) technique to fabricate a platform with a favorable endothelial environment. This technique enables the simple single-step production of a Ta-implanted nanoridged surface on a stent with a complex 3D geometry that shows a clear tendency to become oriented parallel to the direction of blood flow. Moreover, the nanoridges developed show good structural integrity and mechanical stability, resulting in apparently stable morphologies under high strain rates. In vitro cellular responses to the Co-Cr, such as endothelialization, platelet activation, and blood coagulation, are considerably altered after TIPS treatment; endothelium formation is rapid and surface thrombogenicity is low. An in vivo rabbit iliac artery model is used to confirm that the nanoridged surface facilitates rapid re-endothelialization and limits the formation of neointima compared to the bare stent. These results indicate that the Ta ion implanted nanoridge platform fabricated using the TIPS technique has immense potential as a solution for in-stent restenosis and ensuring the long-term patency of bare metal stents.

Enhanced bioactivity of titanium-coated polyetheretherketone implants created by a high-temperature 3D printing process

Polyetheretherketone (PEEK), one of the potential alternatives to metallic materials for implants, necessarily involves high temperature process conditions to be three-dimensionally (3D) printed. We developed a 3D printing setup equipped with thermally stabilized modules of the printing nozzle and building chamber, by which the PEEK implants could be successfully manufactured. Under optimized printing conditions, the maximal mechanical strength of the 3D printed sample attained over 80% of the original bulk property of PEEK. To enhance the interfacial biocompatibility, the as-printed implants were postprocessed with titanium (Ti) sputtering. The Ti-coated surfaces were evaluated through characterization studies of x-ray diffraction spectra, microscopic topographies, and wetting properties. For the in vitro tests, preosteoblasts were cultured on the developed PEEK-Ti structures and evaluated in terms of cell adhesion, proliferation, and osteogenic differentiation. In addition, the bone regeneration capability of the PEEK-Ti implants was confirmed by animal experiments using a rabbit tibia defect model for a period of 12 weeks. In the overall in vitro and in vivo tests, we confirmed the superior bioactivities of the Ti-modified and 3D printed interface by comparisons between the samples of machined and printed samples with or without Ti coating. Taken together, the comprehensive manufacturing approaches that involve 3D printing and biocompatible postprocessing are expected to have universal applicability in a wide range of bone tissue engineering.

Enhanced Osseointegration Ability of Poly(lactic acid) via Tantalum Sputtering-Based Plasma Immersion Ion Implantation

Poly(lactic acid) (PLA) is the most utilized biodegradable polymer in orthopedic implant applications because of its ability to replace regenerated bone tissue via continuous degradation over time. However, the poor osteoblast affinity for PLA results in a high risk of early implant failure, and this issue remains one of the most difficult challenges with this technology. In this study, we demonstrate the use of a new technique in which plasma immersion ion implantation (PIII) is combined with a conventional DC magnetron sputtering. This technique, referred to as sputtering-based PIII (S-PIII), makes it possible to produce a tantalum (Ta)-implanted PLA surface within 30 s without any tangible degradation or deformation of the PLA substrate. Compared to a Ta-coated PLA surface, the Ta-implanted PLA showed twice the surface roughness and substantially enhanced adhesion stability in dry and wet conditions. The strong hydrophobic surface properties and biologically relatively inert chemical structure of PLA were ameliorated by Ta S-PIII treatment, which produced a moderate hydrophilic surface and enhanced cell-material interactions. Furthermore, in an in vivo evaluation in a rabbit distal femur implantation model, Ta-implanted PLA demonstrated significantly enhanced osseointegration and osteogenesis compared with bare PLA. These results indicate that the Ta-implanted PLA has great potential for orthopedic implant applications.

Plant seed-inspired cell protection, dormancy, and growth for large-scale biofabrication

Biofabrication technologies have endowed us with the capability to fabricate complex biological constructs. However, cytotoxic biofabrication conditions have been a major challenge for their clinical application, leading to a trade-off between cell viability and scalability of biofabricated constructs. Taking inspiration from nature, we proposed a cell protection strategy which mimicks the protected and dormant state of plant seeds in adverse external conditions and their germination in response to appropriate environmental cues. Applying this bioinspired strategy to biofabrication, we successfully preserved cell viability and enhanced the seeding of cell-laden biofabricated constructs via a cytoprotective pyrogallol (PG)-alginate encapsulation system. Our cytoprotective encapsulation technology utilizes PG-triggered sporulation and germination processes to preserve cells, is mechanically robust, chemically resistant, and highly customizable to adequately match cell protectability with cytotoxicity of biofabrication conditions. More importantly, the facile and tunable decapsulation of our PG-alginate system allows for effective germination of dormant cells, under typical culture conditions. With this approach, we have successfully achieved a biofabrication process which is reproducible, scalable, and provided a practical solution for off-the-shelf availability, shipping and temporary storage of fabricated bio-constructs.

Biomimetic porous Mg with tunable mechanical properties and biodegradation rates for bone regeneration

The medical applications of porous Mg scaffolds are limited owing to its rapid corrosion, which dramatically decreases the mechanical strength of the scaffold. Mimicking the bone structure and composition can improve the mechanical and biological properties of porous Mg scaffolds. The Mg structure can also be coated with HA by an aqueous precipitation coating method to enhance both the corrosion resistance and the biocompatibility. However, due to the brittleness of HA coating layer, cracks tend to form in the HA coating layer, which may influence the corrosion and biological functionality of the scaffold. Consequently, in this study, hybrid poly(ether imide) (PEI)-SiO₂ layers were applied to the HA-coated biomimetic porous Mg to impart the structure with the high corrosion resistance associated with PEI and excellent bioactivity with SiO₂. The porosity of the Mg was controlled by adjusting the concentration of the sodium chloride (NaCl) particles used in the fabrication via the space-holder method. The mechanical measurements showed that the compressive strength and stiffness of the biomimetic porous Mg increased as the portion of the dense region increased. In addition, following results show that HA/(PEI-SiO₂) hybrid-coated biomimetic Mg is a promising biodegradable scaffold for orthopedic applications. In-vitro testing revealed that the proposed hybrid coating reduced the degradation rate and facilitated osteoblast spreading compared to HA- and HA/PEI-coating scaffolds. Moreover, in-vivo testing with a rabbit femoropatellar groove model showed improved tissue formation, reduced corrosion and degradation, and improved bone formation on the scaffold. STATEMENT OF SIGNIFICANCE: Porous Mg is a promising biodegradable scaffold for orthopedic applications. However, there are limitations in applying porous Mg for an orthopedic biomaterial due to its poor mechanical properties and susceptibility to rapid corrosion. Here, we strategically designed the structure and coating layer of porous Mg to overcome these limitations. First, porous Mg was fabricated by mimicking the bone structure which has a combined structure of dense and porous regions, thus resulting in an enhancement of mechanical properties. Furthermore, the biomimetic porous Mg was coated with HA/(PEI-SiO₂) hybrid layer to improve both corrosion resistance and biocompatibility. As the final outcome, with tunable mechanical and biodegradable properties, HA/(PEI-SiO₂)-coated biomimetic porous Mg could be a promising candidate material for load-bearing orthopedic applications.

Reduced fibrous capsule formation at nano-engineered silicone surfaces via tantalum ion implantation

Nano-engineered surface of silicone implant improves the biocompatibility and suppresses the fibrous capsule formation which is the most common side effect of polymeric implants.

3D printing of hydrogel composite systems: Recent advances in technology for tissue engineering

Three-dimensional (3D) printing of hydrogels is now an attractive area of research due to its capability to fabricate intricate, complex and highly customizable scaffold structures that can support cell adhesion and promote cell infiltration for tissue engineering. However, pure hydrogels alone lack the necessary mechanical stability and are too easily degraded to be used as printing ink. To overcome this problem, significant progress has been made in the 3D printing of hydrogel composites with improved mechanical performance and biofunctionality. Herein, we provide a brief overview of existing hydrogel composite 3D printing techniques including laser based-3D printing, nozzle based-3D printing, and inkjet printer based-3D printing systems. Based on the type of additives, we will discuss four main hydrogel composite systems in this review: polymer- or hydrogel-hydrogel composites, particle-reinforced hydrogel composites, fiber-reinforced hydrogel composites, and anisotropic filler-reinforced hydrogel composites. Additionally, several emerging potential applications of hydrogel composites in the field of tissue engineering and their accompanying challenges are discussed in parallel.

The Production of Porous Hydroxyapatite Scaffolds with Graded Porosity by Sequential Freeze-Casting

Porous hydroxyapatite (HA) scaffolds with porosity-graded structures were fabricated by sequential freeze-casting. The pore structures, compressive strengths, and biocompatibilities of the fabricated porous HA scaffolds were evaluated. The porosities of the inner and outer layers of the graded HA scaffolds were controlled by adjusting the initial HA contents of the casting slurries. The interface between the dense and porous parts was compact and tightly adherent. The porosity and compressive strengths of the scaffold were controlled by the relative thicknesses of the dense/porous parts. In addition, the porous HA scaffolds showed good biocompatibility in terms of preosteoblast cell attachment and proliferation. The results suggest that porous HA scaffolds with load-bearing parts have potential as bone grafts in hard-tissue engineering.

Enhancement of osseointegration by direct coating of rhBMP-2 on target-ion induced plasma sputtering treated SLA surface for dental application

Owing to the excellent bioactive properties of recombinant human bone morphogenetic proteins (rhBMPs), dentistry considers them as a fascinating adjuvant alternative for enhancing bone regeneration and bone-to-implant junction in the early implantation stages. However, stable loading and delivery efficiency of rhBMPs on the implant surfaces involve major concerns because of the harsh wearing condition under load during implantation. In this study, to achieve successful rhBMP-2 delivery, a nanoporous surface structure is introduced on the sandblasting with large grit and acid-etching (SLA)-treated titanium (Ti) surface via the tantalum (Ta) target-ion induced plasma sputtering (TIPS) technique. Unlike oxidation-induced surface nanoporous fabrications on a Ti surface, TIPS-treated surfaces provide excellent structural unity of the nanoporous structure with the substrate due to their etching-based fabrication mechanism. SLA/TIPS-treated Ti exhibits distinct nanoporous structures on the microscale surface geometry and better hydrophilicity compared with SLA-treated Ti. A sufficiently empty nanoporous surface structure combined with the hydrophilic property of SLA/TIPS-treated Ti facilitates the formation of a thick and uniform coating layer of rhBMP-2 on the surface without any macro- and microcoagulation. Compared with the SLA-treated Ti surface, the amount of coated rhBMP-2 increases up to 63% on the SLA/TIPS-treated Ti surface. As a result, the in vitro pre-osteoblast cell response of the SLA/TIPS-treated Ti surface, especially cell adhesion and differentiation behaviors, improves remarkably. A bone-regenerating direct comparison between the rhBMP-2-coated SLA-treated and SLA/TIPS-treated Ti is conducted on a defective dog mandible model. After 8 weeks of implantation surgery, SLA/TIPS-treated Ti with rhBMP-2 exhibits a better degree of contact area for the implanted bone, which mineralizes new bones around the implant. Quantitative results of bone-in-contact ratio and new bone volume also show significantly higher values for the SLA/TIPS-treated Ti with the rhBMP-2 specimen. These results confirm that an SLA/TIPS-treated surface is a suitable rhBMP-2 carrier for a dental implant to achieve early and strong osseointegration of Ti dental implants.

Poly(ether imide)-silica hybrid coatings for tunable corrosion behavior and improved biocompatibility of magnesium implants

Magnesium (Mg) and its alloys have gained considerable attention as a promising biomaterial for bioresorbable orthopedic implants, but the corrosion behavior of Mg-based implants is still the major issue for clinical use. In order to improve the corrosion stability and implant-tissue interfaces of these implants, methods for coating Mg have been actively investigated. In this study, poly(ether imide) (PEI)-silica hybrid material was coated on Mg, for the tunable degradation and enhanced biological behavior. Homogeneous PEI-silica hybrid materials with various silica contents were coated on Mg substrates without any cracks, where silica nanoparticles were well dispersed in the PEI matrix without significant particle agglomeration up the 30 vol% silica. The hybrid coatings maintained good adhesion strength of PEI to Mg. The corrosion rate of hybrid-coated Mg was increased along with the increment of the silica content, due to improved hydrophilicity of the hybrid coating layers. Moreover, the biocompatibility of the hybrid-coated Mg specimens was significantly improved, mainly due to the higher Mg ion concentrations associated with faster corrosion, compared to PEI-coated Mg. Therefore, PEI-silica hybrid systems have significant potential as a coating material of Mg for load-bearing orthopedic applications by providing tunable corrosion behavior and enhanced biological performance.

MgF2-coated porous magnesium/alumina scaffolds with improved strength, corrosion resistance, and biological performance for biomedical applications

Porous magnesium (Mg) has recently emerged as a promising biodegradable alternative to biometal for bone ingrowth; however, its low mechanical properties and high corrosion rate in biological environments remain problematic. In this study, porous magnesium was implemented in a scaffold that closely mimics the mechanical properties of human bones with a controlled degradation rate and shows good biocompatibility to match the regeneration rate of bone tissue at the affected site. The alumina-reinforced Mg scaffold was produced by spark plasma sintering and coated with magnesium fluoride (MgF2) using a hydrofluoric acid solution to regulate the corrosion rate under physiological conditions. Sodium chloride granules (NaCl), acting as space holders, were leached out to achieve porous samples (60%) presenting an average pore size of 240 μm with complete pore interconnectivity. When the alumina content increased from 0 to 5 vol%, compressive strength and stiffness rose considerably from 9.5 to 13.8 MPa and from 0.24 to 0.40 GPa, respectively. Moreover, the biological response evaluated by in vitro cell test and blood test of the MgF2-coated porous Mg composite was enhanced with better corrosion resistance compared with that of uncoated counterparts. Consequently, MgF2-coated porous Mg/alumina composites may be applied in load-bearing biodegradable implants.

Large-scale nanopatterning of metal surfaces by target-ion induced plasma sputtering (TIPS)

Target-ion Induced Plasma Sputtering (TIPS) can produce large-scale, self-assembled nanopatterns on metals and alloys in one step at low cost.

Creation of nanoporous TiO2 surface onto polyetheretherketone for effective immobilization and delivery of bone morphogenetic protein

This study evaluated the utility of the creation of a nanoporous TiO2 surface to enhance the in vitro biocompatibility and in vivo osseoconductivity of polyetheretherketone (PEEK) implants by providing favorable sites for the effective immobilization of bone morphogenetic protein-2 (BMP-2). A uniform nanoporous TiO2 layer with a pore diameter of ∼70 nm was successfully created by anodizing a Ti film, which had been deposited onto a PEEK substrate via electron beam (e-beam) evaporation technique. This nanoporous, hydrophilic TiO2 surface enabled the efficient immobilization of BMP-2, resulting in a remarkable enhancement in in vitro biocompatibility that was assessed in terms of cell attachment, proliferation, and differentiation. The in vivo animal tests also confirmed that the nanoporous TiO2 surface immobilized with BMP-2 could significantly enhance the osseoconductivity of PEEK implants. The BMP-immobilized PEEK implant with the nanoporous TiO2 surface showed much higher bone-to-implant contact (BIC) ratio (60%) than the bare PEEK (30%), PEEK with the nanoporous TiO2 surface (50%) and even BMP-immobilized PEEK without the nanoporous TiO2 surface (32%).

Bone morphogenic protein-2 (BMP-2) loaded hybrid coating on porous hydroxyapatite scaffolds for bone tissue engineering

In this study, a silica xerogel-chitosan hybrid is utilized as a coating material to incorporate bone morphogenic protein-2 (BMP-2) on a porous hydroxyapatite (HA) scaffold for bone tissue engineering. BMP-2 is known as a therapeutic agent for improving bone regeneration and repair. Silica xerogel-chitosan hybrids have been used for the delivery of a growth factor as well as osteoconductive coatings. The biological properties of the hybrid coating incorporated with BMP-2 were evaluated in terms of the BMP-2 release behavior, osteoblastic cellular responses and in vivo performance. BMP-2 was continuously released from the hybrid coating layer on the porous HA scaffold for up to 6 weeks. The hybrid coating containing BMP-2 showed significantly enhanced osteoblastic cell responses in comparison with the hybrid coating and HA substrate. Consequently, new bone formation was significantly increased within the hybrid coating containing BMP-2. These results reveal that the hybrid coating containing BMP-2 has the potential to be used as a bone implant, whose osteogenic properties are promoted by the release of BMP-2 in a controlled manner for a prolonged period of time.

Fibrous membrane of nano-hybrid poly-L-lactic acid/silica xerogel for guided bone regeneration

Nanofibrous membranes, consisting of a poly(L-lactic acid) (PLLA)-silica xerogel hybrid material, were successfully fabricated from a hybrid sol using the electrospinning technique for guided bone regeneration (GBR) application. These hybrid nanofibers exhibited a homogeneous and continuous morphology, with a nano-sized dispersed silica xerogel phase in the PLLA fiber matrix. The mechanical properties, such as the tensile strength and the elastic modulus, were improved as the silica xerogel content increased up to 40%. All of the hybrid membranes exhibited highly hydrophilic surfaces and good proliferation levels. After culturing for 13 days, the cells that were cultured on the hybrid membranes exhibited a significantly higher ALP activity compared to the pure PLLA membrane. Moreover, the in vivo animal experiments that used the rat calvarial defect model revealed a remarkably improved bone regeneration ability for the hybrid membrane compared to pure PLLA. These results demonstrated the feasibility of these hybrid membranes for efficient GBR.

Nanostructured poly(epsilon-caprolactone)-silica xerogel fibrous membrane for guided bone regeneration

A novel fibrous membrane was developed for guided bone regeneration (GBR) through electrospinning a uniform poly(epsilon-caprolactone) (PCL)-silica hybrid sol. The membrane was composed of fibers with a mean diameter of approximately 400 nm. The hybrid fibers were nano-sized with uniform patterns throughout the fibers, in contrast to the homogeneous structure of pure PCL fibers. The tensile strengths and elastic moduli of the membranes were significantly enhanced with increasing silica content up to 40%. The surfaces of the hybrid membranes were highly hydrophilic with a water contact angle of almost zero. The hybrid membranes possessed excellent in vitro cellular responses in terms of proliferation and differentiation of pre-osteoblast cells. The in vivo animal tests not only confirmed excellent biocompatibility but also revealed bioresorbability of the membranes. These mechanical and biomedical properties make the hybrid membranes very attractive as GBR applications.

Systematic methodology for the design of a flexible keel for energy-storing prosthetic feet

An effective design method is suggested for a flexible keel design for energy-storing prosthetic feet (ESPF). The basic, two-dimensional shape of the keel is based on anthropometric data and normal gait analysis available in the literature. Cost function is defined for the performance evaluation of the keel. Five factors and five levels of their effect on the performance of the keel are established. By use of an orthogonal array table, 25 trials of dynamic simulations of prosthetic walking are designed, from among 3,125 possible combinations, dramatically reducing the number of total simulations needed to examine sufficiently the contribution of each factor to cost function. A prosthetic walking model is built, and a dynamic simulation of prosthetic walking is performed using the finite element method. The contribution of each factor to cost function is investigated by an analysis of variance (ANOVA), and the average main effects of factors for cost function are calculated. The optimum combination of factor levels is obtained by minimisation of cost function. To examine the structural safety of the keel, the deformation and stress distribution of the keel are investigated by static analysis, and failure indices are calculated by three failure criteria. Finally, the optimum flexible keel is designed with increased energy storage capacity, without failure, and suitable for more active prosthetic walking; the recoverable strain energy stored in the optimum ESPF keel is 25.8J.