An Amorphous Peri-Implant Ligament with Combined Osteointegration and Energy-Dissipation

Elytra-inspired zirconium phosphate nanonetwork: Toward high-quality osseointegration and physical-chemical-mechanical bond at the interface for zirconia-based dental materials

Yttria-stabilized zirconia (YSZ) is widely used in dental implants and prostheses due to its excellent aesthetic and restorative properties. However, its bio-inert surface limits early osseointegration and weakens bonding strengths with porcelain veneer/resin cement. Inspired by the structure of beetle elytra, this work proposes a novel strategy involving a self-assembled trabecular-honeycomb biomimetic zirconium phosphate (ZrP) nanonetwork to modify YSZ surfaces. This approach simultaneously enhances energy dissipation, interfacial bonding, and osseointegration. The pore size of ZrP nanonetwork was precisely controlled by adjusting reaction temperatures (120 °C and 160 °C) and phosphoric acid concentrations (1.0 wt% and 2.5 wt%). Compared to conventional YSZ, the ZrP nanonetworks achieved remarkable improvements in bond strength, showing increases of 111 % with porcelain veneer and 336 % with resin cement. These enhancements are attributed to multiscale physical-chemical-mechanical interactions, including micromechanical anchoring, chemical bonding via phosphate groups, and energy dissipation through topological optimization. In vitro studies demonstrated that large-pore-size nanonetworks promote osteogenic differentiation of osteoblasts and modulate macrophage polarization toward the M2 phenotype, fostering an immune environment conducive to bone regeneration. In vivo experiments further validated the superior osseointegration and bone regeneration capacities of the large-pore-size ZrP nanonetwork. Collectively, this biomimetic ZrP nanonetwork-modified YSZ, with its exceptional physical-chemical-mechanical bonding properties, osseointegration potential, and immune-modulating capabilities, represents a groundbreaking advancement in zirconia-based material for dental implants and prostheses.

Bioactive protein/polysaccharide hydrogel functionalized bone implants surface for enhanced osteogenesis

Bone implants play a critical role in the treatment of orthopedic diseases, however, conventional polymer or ceramic or metal implants possess various problems in enhancing bone repair and osteointegration. Recent years, the bioactive bone implants with biomimetic mechanical surface with natural extracellular matrix has shown promising role in reinforcing bone integration and regeneration. Biomedical hydrogels coating strategy has attracted much attention in bone implants modification, due to their adjustable surface biomechanics, bioactivities and drug release ability. Based on the principles of mechanical compatibility for biodegradable scaffold materials, it facilitates a "soft-hard synergy" in bone repair. This review provides an overview of recent advances in the field of hydrogel modification for bone implants, including the polysaccharide hydrogels (such as chitosan, alginate, and hyaluronic acid) and protein hydrogels (such as gelatin and collagen). Furthermore, this review explores the current understanding of the biomechanical mechanisms underlying bone formation in hydrogel-modified implants within the body, presents the challenges and future directions in this field. This study integrates engineering, developmental biology, and clinical perspectives, offering unique insights for the development of functional strategies for bone implants aimed at enhancing the treatment of orthopedic diseases.

Enhancing titanium dioxide nanotube array stability on dental implants through laser lithography-assisted microline patterning

Titanium dioxide nanotube arrays (TNTs) generated in situ on the surface of dental implants have been shown to enhance bone integration for load-bearing support while managing load distribution and energy dissipation to prevent bone resorption from overload. However, their inadequate stability limits the clinical use of conventional TNTs. This study introduces an innovative approach to improve the mechanical stability of TNTs while maintaining their bone-integration efficiency. The method involved creating microline patterns on TNTs (L-TNTs), where the TNTs were embedded within grooves for enhanced protection. This was achieved through a combination of laser lithography-assisted microline patterning and anodization. Incorporation of microline patterns significantly increased the mechanical stability of the TNTs. This improvement was evidenced by multiple tests: peeling tests demonstrated the maximum adhesive strength of the L-TNTs increased by at least 50 %; friction-wear tests revealed narrower, shallower abrasion patterns and lower average friction coefficients; and ex vivo screw implant insertion and removal tests showed post-insertion, the nanotube structures in the TNTs peeled, whereas those in the L-TNTs remained intact. The L-TNTs also maintained their efficacy in promoting bone integration both in vitro and in vivo, establishing a robust platform for multifunctional implant investigation and advancing the practical application of TNTs. STATEMENT OF SIGNIFICANCE: This study presents a novel laser lithography-assisted micropatterning and anodization method for creating micro-lined titanium dioxide nanotube arrays (L-TNTs) on dental implants. Compared to conventional TNTs, L-TNTs enhanced adhesive strength and wear resistance while maintaining efficacy in promoting bone integration. This method enhances the mechanical stability of TNTs, facilitating its practical application in multifunctional dental implants.

Multiscale Engineered Bionic Solid-State Electrolytes Breaking the Stiffness-Damping Trade-Off

All-solid-state lithium metal batteries (LMBs) are regarded as next-generation devices for energy storage due to their safety and high energy density. The issues of Li dendrites and poor mechanical compatibility with electrodes present the need for developing solid-state electrolytes with high stiffness and damping, but it is a contradictory relationship. Here, inspired by the superstructure of tooth enamel, we develop a composite solid-state electrolyte composed of amorphous ceramic nanotube arrays intertwined with solid polymer electrolytes. This bionic electrolyte exhibits both high stiffness (Young's modulus=15 GPa, hardness=0.13 GPa) and damping (tanδ=0.08), breaking the trade-off. Thus, this composite electrolyte can not only inhibit Li dendrites growth but also ensure intimate contact with electrodes. Meanwhile, it also exhibits considerable Li+ transference number (0.62) and room temperature ionic conductivity (1.34×10-4 S cm-1), which is attributed to oxygen vacancies of the amorphous ceramic effectively decoupling the Li-TFSI ion pair. Consequently, the assembled Li symmetric battery shows an ultra-stable cycling (>2000 hours at 0.1 mA cm-2 at 60 °C, >500 hours at 0.1 mA cm-2 at 30 °C). Moreover, the LiFePO4/Li and LiNi0.8Co0.1Mn0.1O2/Li all-solid-state full cells both show excellent cycling performance. We demonstrate that this bionic strategy is a promising approach for the development of high-performance solid-state electrolytes.

Micro/Nanobiomimetic Iron-Based Scaffold Induces Vascularized Bone Regeneration To Repair Large Segmental Bone Defect in Load-Bearing Sites

Biodegradable scaffolds, including metals, ceramics, and polymers, show great potential in bone tissue regeneration. However, current biodegradable scaffolds do not simultaneously possess suitable mechanical properties, biodegradability and osteoinductivity, which severely limits their clinical application for large segmental bone defect repair. Herein, we developed a biomimetic and hierarchically micro-nanoporous iron-based scaffold utilizing a synergistic approach combining 3-dimensional printing, surface dealloying treatment and electrochemical deposition. Compared to traditional periodic lattice structures, the biomimetic scaffold with a stochastic lattice structure promised superior stress transfer efficiency. Cell experiments revealed that the biomimetic scaffold notably enhanced osteogenesis and angiogenesis in vitro via EGFR-mediated Ras/Raf/MAPK signaling. Upon implantation in a rat femoral condyle defect model, the scaffold achieved a dynamic equilibrium between in vivo material degradation and bone formation. More importantly, the study conducted in a large animal model with an extended cycle of up to 1 year demonstrated that bionic iron-based scaffolds effectively facilitated the repair and functional reconstruction of large bone defects in load-bearing regions by inducing vascularized bone regeneration. This study not only introduces a potential solution for addressing critical-sized bone defects in load-bearing regions but also provides a viable approach for the design of other biomimetic biomaterials.

Synthetic nanointerfacial bioengineering of Ti implants: on-demand regulation of implant-bone interactions for enhancing osseointegration

Titanium and its alloys are the most commonly used biometals for developing orthopedic implants to treat various forms of bone fractures and defects, but their clinical performance is still challenged by the unfavorable mechanical and biological interactions at the implant-tissue interface, which substantially impede bone healing at the defects and reduce the quality of regenerated bones. Moreover, the impaired osteogenesis capacity of patients under certain pathological conditions such as diabetes and osteoporosis may further impair the osseointegration of Ti-based implants and increase the risk of treatment failure. To address these issues, various modification strategies have been developed to regulate the implant-bone interactions for improving bone growth and remodeling in situ. In this review, we provide a comprehensive analysis on the state-of-the-art synthetic nanointerfacial bioengineering strategies for designing Ti-based biofunctional orthopedic implants, with special emphasis on the contributions to (1) promotion of new bone formation and binding at the implant-bone interface, (2) bacterial elimination for preventing peri-implant infection and (3) overcoming osseointegration resistance induced by degenerative bone diseases. Furthermore, a perspective is included to discuss the challenges and potential opportunities for the interfacial engineering of Ti implants in a translational perspective. Overall, it is envisioned that the insights in this review may guide future research in the area of biometallic orthopedic implants for improving bone repair with enhanced efficacy and safety.

Osteogenic tailoring of oriented bone matrix organization using on/off micropatterning for osteoblast adhesion on titanium surfaces

Titanium (Ti) implants are well known for their mechanical reliability and chemical stability, crucial for successful bone regeneration. Various shape control and surface modification techniques to enhance biological activity have been developed. Despite the crucial importance of the collagen/apatite bone microstructure for mechanical function, antimicrobial properties, and biocompatibility, precise and versatile pattern control for regenerating the microstructure remains challenging. Here, we developed a novel osteogenic tailoring stripe-micropatterned MPC-Ti substrate that induces genetic-level control of oriented bone matrix organization. This biomaterial was created by micropatterning 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer onto a titanium (Ti) surface through a selective photoreaction. The stripe-micropatterned MPC-Ti substrate establishes a distinct interface for cell adhesion, robustly inducing osteoblast cytoskeleton alignment through actin cytoskeletal alignment, and facilitating the formation of a bone-mimicking-oriented collagen/apatite tissue. Moreover, our study revealed that this bone alignment process is promoted through the activation of the Wnt/β-catenin signaling pathway, which is triggered by nuclear deformation induced by strong cellular alignment guidance. This innovative material is essential for personalized next-generation medical devices, offering high customizability and active restoration of the bone microstructure. STATEMENT OF SIGNIFICANCE: This study demonstrates a novel osteogenic tailoring stripe-micropatterned MPC-Ti substrate that induces osteoblast alignment and bone matrix orientation based on genetic mechanism. By employing a light-reactive MPC polymer, we successfully micropatterned the titanium surface, creating a biomaterial that stimulates unidirectional osteoblast alignment and enhances the formation of natural bone-mimetic anisotropic microstructures. The innovative approach of regulating cell adhesion and cytoskeletal alignment activates the Wnt/β-catenin signaling pathway, crucial for both bone differentiation and orientation. This study presents the first biomaterial that artificially induces the construction of mechanically superior anisotropic bone tissue, and it is expected to promote functional bone regeneration by enhancing bone differentiation and orientation-targeting both the quantity and quality of bone tissue.

Remodel Heterogeneous Electrical Microenvironment at Nano-Scale Interface Optimizes Osteogenesis by Coupling of Immunomodulation and Angiogenesis

Immunomodulation is essential for implants to regulate tissue regeneration, while bioelectricity plays a fundamental role in regulating immune activities. Under natural preferences, the bone matrix electrical microenvironment is heterogeneous in the nanoscale, which provides fundamental electrical cues to regulate bone immunity and regenerative repair. However, remodeling bone nanoscale heterogeneous electrical microenvironment remains a challenge, and the underlying immune modulation mechanism remains to be explored. In this research, in situ discretely distributed nano-heterojunctions are constructed on titanium oxide nanofibers to mimic the heterogeneous electrical microenvironment exhibited by bone collagen fibers. The material is identified to directly regulate calcium ion channeling for anti-inflammatory polarization of macrophages. Surprisingly, the highly biomimetic heterogeneous electrical microenvironment can induce a pro-angiogenic phenotypic transformation of macrophages, leading to enhanced neo-vascularization at the early stage of osteogenesis. Mechanistic exploration identifies that PI3K signaling pathway-mediated FGF2 secretion may partially explain for strengthened coupling of immunomodulation and angiogenesis, which optimizes subsequent bone regeneration. These findings highlight the significance of biomimetic heterogeneous electrical cues on immune-modulation and provide a design principle for future electroactive implant materials.

A microenvironment responsive polyetheretherketone implant with antibacterial and osteoimmunomodulatory properties facilitates osseointegration

Failure of intraosseous prostheses is primarily attributed to implant loosening and infections. Current primary therapeutic modalities, such as antibiotics and local debridement, not only face challenges in thoroughly eliminating obstinate adhered bacteria but also encounter difficulties in ameliorating undue inflammatory reactions and regenerating impaired peri-implant bone tissues. Polyetheretherketone (PEEK) has excellent mechanical and physicochemical characteristics and has been used extensively as a medical biomaterial. However, the limited bactericidal and osseointegrative activities of bioinert PEEK restrict its clinical application. Herein, a microenvironment responsive coating with immobilised immunomodulatory magnesium ions (Mg2+) and disinfectant cerium oxide nanoparticles (CNPs) is designed via ion coordination mediated by polydopamine (PDA) and electrospinning based on collagen structure-bionic silk fibroin (SF). By utilising the pH responsiveness of SF, CNPs exhibit potent antibacterial effects in an acidic environment (pH 5.0) caused by local bacterial infection. Due to the chelation interaction with PDA and the constraint of SF, Mg2+ is slowly released, ameliorating the local immune microenvironment and boosting osteogenesis by upregulating M2 phenotype macrophages. Bioinformatics analysis indicates that the inflammation is suppressed via the NF-κB signaling pathway. Overall, this SF-based coating maximizes the synergistic effect of CNPs and Mg2+, offering enhanced antibacterial and osteoimmunomodulatory bioactivity for successful implantation.

Unveiling the governing role of 'remodeling triangle area' in soft-hard tissue interface equilibrium for metal implants advancement

Metal implants holds significant promise for diverse fixed prostheses. However, their long-term reliability and broader application are hindered by challenges related to the disequilibrium at the soft-hard tissue interface. By using anti-inflammatory (PDA/IL4) and pro-inflammatory (PDA/LPS/IFNγ) coatings to modulate distinct immune characteristics, we discovered a dynamic bioactive structure at the soft-hard tissue interface around metal implant, which we have named the 'Remodeling Triangle Area' (RTA). We further demonstrate that the RTA can be influenced by the PDA/IL4 coating to favor a phenotype that enhances both innate and adaptive immunity. This leads to stronger epithelial adhesion, the formation of dense connective tissue via IGF1 secretion, and a more balanced soft-hard tissue interface through the OPG/RANKL axis. Conversely, the PDA/LPS/IFNγ coating shifts the RTA towards a phenotype that activates the innate immune response. This results in a less cohesive tissue structure and bone resorption, characterized by reduced IGF1 secretion and an imbalanced OPG/RANKL axis. Over all, our study introduces the novel concept termed the 'Remodeling Triangle Area' (RTA), an immune-rich anatomical region located at the nexus of the implant interface, epithelial, connective, and bone tissue, which becomes highly interactive post-implantation to modulate the soft-hard tissue interface equilibrium. We believe that an RTA-centric, immunomodulatory approach has the potential to revolutionize the design of next-generation metal implants, providing unparalleled soft-hard tissue interface equilibrium properties.

Injectable ultrasound-powered bone-adhesive nanocomposite hydrogel for electrically accelerated irregular bone defect healing

The treatment of critical-size bone defects with irregular shapes remains a major challenge in the field of orthopedics. Bone implants with adaptability to complex morphological bone defects, bone-adhesive properties, and potent osteogenic capacity are necessary. Here, a shape-adaptive, highly bone-adhesive, and ultrasound-powered injectable nanocomposite hydrogel is developed via dynamic covalent crosslinking of amine-modified piezoelectric nanoparticles and biopolymer hydrogel networks for electrically accelerated bone healing. Depending on the inorganic-organic interaction between the amino-modified piezoelectric nanoparticles and the bio-adhesive hydrogel network, the bone adhesive strength of the prepared hydrogel exhibited an approximately 3-fold increase. In response to ultrasound radiation, the nanocomposite hydrogel could generate a controllable electrical output (-41.16 to 61.82 mV) to enhance the osteogenic effect in vitro and in vivo significantly. Rat critical-size calvarial defect repair validates accelerated bone healing. In addition, bioinformatics analysis reveals that the ultrasound-responsive nanocomposite hydrogel enhanced the osteogenic differentiation of bone mesenchymal stem cells by increasing calcium ion influx and up-regulating the PI3K/AKT and MEK/ERK signaling pathways. Overall, the present work reveals a novel wireless ultrasound-powered bone-adhesive nanocomposite hydrogel that broadens the therapeutic horizons for irregular bone defects.

Physicochemical understanding of biomineralization by molecular vibrational spectroscopy: From mechanism to nature

The process and mechanism of biomineralization and relevant physicochemical properties of mineral crystals are remarkably sophisticated multidisciplinary fields that include biology, chemistry, physics, and materials science. The components of the organic matter, structural construction of minerals, and related mechanical interaction, etc., could help to reveal the unique nature of the special mineralization process. Herein, the paper provides an overview of the biomineralization process from the perspective of molecular vibrational spectroscopy, including the physicochemical properties of biomineralized tissues, from physiological to applied mineralization. These physicochemical characteristics closely to the hierarchical mineralization process include biological crystal defects, chemical bonding, atomic doping, structural changes, and content changes in organic matter, along with the interface between biocrystals and organic matter as well as the specific mechanical effects for hardness and toughness. Based on those observations, the special physiological properties of mineralization for enamel and bone, as well as the possible mechanism of pathological mineralization and calcification such as atherosclerosis, tumor micro mineralization, and urolithiasis are also reviewed and discussed. Indeed, the clearly defined physicochemical properties of mineral crystals could pave the way for studies on the mechanisms and applications.

2D Amorphous Iron Selenide Sulfide Nanosheets for Stable and Rapid Sodium-Ion Storage

Sodium ion batteries (SIBs) suffer from large electrode volume change and sluggish redox kinetics for the relatively large ionic radius of sodium ions, raising a significant challenge to improve their long-term cyclability and rate capacity. Here, it is proposed to apply 2D amorphous iron selenide sulfide nanosheets (a-FeSeS NSs) as an anode material for SIBs and demonstrate that they exhibit remarkable rate capability of 528.7 mAh g-1 at 1 A g-1 and long-life cycle (10 000 cycles) performance (300.4 mAh g-1 ). This performance is much more superior to that of the previously reported Fe-based anode materials, which is attributed to their amorphous structure that alleviates volume expansion of electrode, 2D nature that facilitates electrons/ions transfer, and the S/Se double anions that offer more reaction sites and stabilize the amorphous structure. Such a 2D amorphous strategy provides a fertile platform for structural engineering of other electrode materials, making a more secure energy prospect closer to a reality.

How Amorphous Nanomaterials Enhanced Electrocatalytic, SERS, and Mechanical Properties

There is ever-growing research interest in nanomaterials because of the unique properties that emerge on the nanometer scale. While crystalline nanomaterials have received a surge of attention for exhibiting state-of-the-art properties in various fields, their amorphous counterparts have also attracted attention in recent years owing to their unique structural features that crystalline materials lack. In short, amorphous nanomaterials only have short-range order at the atomic scale, and their atomic packing lacks long-range periodic arrangement, in which the coordinatively unsaturated environment, isotropic atomic structure, and modulated electron state all contribute to their outstanding performance in various applications. Given their intriguing characteristics, we herein present a series of representative works to elaborate on the structural advantages of amorphous nanomaterials as well as their enhanced electrocatalytic, surface-enhanced Raman scattering (SERS), and mechanical properties, thereby elucidating the underlying structure-function relationship. We hope that this proposed relationship will be universally applicable, thus encouraging future work in the design of amorphous materials that show promising performance in a wide range of fields.

Variation in stress distribution modified by mandibular material property: a 3D finite element analysis

BACKGROUND

Temporomandibular joint disorder (TMD) is a common oral and maxillary facial disease. Finite element method (FEM) has been widely used in TMD studies. Material assignment significantly affects FEM results. The differences in the methods of material assignment used in previous studies have not been comprehensively assessed for further calculations.

METHODS

The mandible material modelling approaches were of four types, namely: uniform modelling with (A) cortical bone; and (B) cancellous bone; (C) semi-uniform modelling with division of cortical and cancellous bone; and (D) non-uniform modelling with Computed tomography (CT) gray value related modulus. Meanwhile, the Young's modulus of values ranging from 20 to 300 GPa were considered for the teeth. Ten modellings were used to analyze and discuss the differences in contact pressure and contact force.

RESULTS

(1) The increase in teeth elastic modulus increased the maximum contact pressure on the alveolar bone and contact force on teeth, but induced insignificant stress variation on the temporomandibular joint; (2) The location of the maximum contact pressure was steady for all four modelling approaches of the mandibular material. However, the maximum contact pressure and contact force exhibited an insignificant difference.

CONCLUSIONS

Teeth with a higher elastic modulus significantly enhanced the stress concentration in the alveolar bone; in contrast, it induced minor variations in the temporomandibular joint stress states. The extreme stress regions predicted by the four mandibular models were consistent with the actual damaged regions. However, non-uniform modellings based on CT values could better describe the mechanical properties of the human bone, which should be primarily considered.

Plasma polymerized bio-interface directs fibronectin adsorption and functionalization to enhance "epithelial barrier structure" formation via FN-ITG β1-FAK-mTOR signaling cascade

BACKGROUND

Transepithelial medical devices are increasing utilized in clinical practices. However, the damage of continuous natural epithelial barrier has become a major risk factor for the failure of epithelium-penetrating implants. How to increase the "epithelial barrier structures" (focal adhesions, hemidesmosomes, etc.) becomes one key research aim in overcoming this difficulty. Directly targeting the in situ "epithelial barrier structures" related proteins (such as fibronectin) absorption and functionalization can be a promising way to enhance interface-epithelial integration.

METHODS

Herein, we fabricated three plasma polymerized bio-interfaces possessing controllable surface chemistry. Their capacity to adsorb and functionalize fibronectin (FN) from serum protein was compared by Liquid Chromatography-Tandem Mass Spectrometry. The underlying mechanisms were revealed by molecular dynamics simulation. The response of gingival epithelial cells regarding the formation of epithelial barrier structures was tested.

RESULTS

Plasma polymerized surfaces successfully directed distinguished protein adsorption profiles from serum protein pool, in which plasma polymerized allylamine (ppAA) surface favored adsorbing adhesion related proteins and could promote FN absorption and functionalization via electrostatic interactions and hydrogen bonds, thus subsequently activating the ITG β1-FAK-mTOR signaling and promoting gingival epithelial cells adhesion.

CONCLUSION

This study offers an effective perspective to overcome the current dilemma of the inferior interface-epithelial integration by in situ protein absorption and functionalization, which may advance the development of functional transepithelial biointerfaces. Tuning the surface chemistry by plasma polymerization can control the adsorption of fibronectin and functionalize it by exposing functional protein domains. The functionalized fibronectin can bind to human gingival epithelial cell membrane integrins to activate epithelial barrier structure related signaling pathway, which eventually enhances the formation of epithelial barrier structure.

Bioinspired Nanonetwork Hydroxyapatite from Block Copolymer Templated Synthesis for Mechanical Metamaterials

Inspired by Mantis shrimp, this work aims to suggest a bottom-up approach for the fabrication of nanonetwork hydroxyapatite (HAp) thin film using self-assembled polystyrene-block-polydimethylsiloxane (PS-b-PDMS) block copolymer (BCP) with a diamond nanostructure as a template for templated sol-gel reaction. By introducing poly(vinylpyrrolidone) (PVP) into precursors of calcium nitrate tetrahydrate and triethyl phosphite, which limits the growth of forming HAp nanoparticles, well-ordered nanonetwork HAp thin film can be fabricated. Based on nanoindentation results, the well-ordered nanonetwork HAp shows high energy dissipation compared to the intrinsic HAp. Moreover, the uniaxial microcompression test for the nanonetwork HAp shows high energy absorption per volume and high compression strength, outperforming many cellular materials due to the topologic effect of the well-ordered network at the nanoscale. This work highlights the potential of exploiting BCP templated synthesis to fabricate ionic solid materials with a well-ordered nanonetwork monolith, giving rise to the brittle-to-ductile transition, and thus appealing mechanical properties with the character of mechanical metamaterials.

Role of Inorganic Amorphous Constituents in Highly Mineralized Biomaterials and Their Imitations

A highly mineralized biomaterial is one kind of biomaterial that usually possesses a high content of crystal minerals and hierarchical microstructure, exhibiting excellent mechanical properties to support the living body. Recent studies have revealed the presence of inorganic amorphous constituents (IAC) either during the biomineralization process or in some mature bodies, which heavily affects the formation and performance of highly mineralized biomaterials. These results are surprising given the preceding intensive research into the microstructure design of these materials. Herein, we highlight the role of IAC in highly mineralized biomaterials. We focused on summarizing works demonstrating the presence or phase transformation of IAC and discussed in detail how IAC affects the formation and performance of highly mineralized biomaterials. Furthermore, we described some imitations of highly mineralized biomaterials that use IAC as the synthetic precursor or final strengthening phase. Finally, we briefly summarized the role of IAC in biomaterials and provided an outlook on the challenges and opportunities for future IAC and IAC-containing bioinspired materials researches.

Bioheterojunction-Engineered Polyetheretherketone Implants With Diabetic Infectious Micromilieu Twin-Engine Powered Disinfection for Boosted Osteogenicity

Diabetic infectious micromilieu (DIM) leads to a critical failure rate of osseointegration by virtue of two main peculiarities: high levels of topical glucose and inevitable infection. To tackle the daunting issue, a bioheterojunction-engineered orthopedic polyetheretherketone (PEEK) implant consisting of copper sulfide/graphene oxide (CuS/GO) bioheterojunctions (bioHJs) and glucose oxidase (GOx) is conceived and developed for DIM enhanced disinfection and boosted osseointegration. Under hyperglycemic micromilieu, GOx can convert surrounding glucose into hydrogen peroxide (H₂ O₂ ). Then, upon infectious micromilieu, the bioHJs enable the catalyzation of H₂ O₂ to highly germicidal hydroxyl radical (·OH). As a result, the engineered implants massacre pathogenic bacteria through DIM twin-engine powered photo-chemodynamic therapy in vitro and in vivo. In addition, the engineered implants considerably facilitate cell viability and osteogenic activity of osteoblasts under a hyperglycemic microenvironment via synergistic induction of copper ions (Cu²⁺ ) and GO. In vivo studies using bone defect models of diabetic rats at 4 and 8 weeks further authenticate that bioHJ-engineering PEEK implants substantially elevate their osseointegration through biofilm elimination and vascularization, as well as macrophage reprogramming. Altogether, the present study puts forward a tactic that arms orthopedic implants with DIM twin-engine powered antibacterial and formidable osteogenic capacities for diabetic stalled osseointegration.