Pore diameter of more than 100 microm is not requisite for bone ingrowth in rabbits

Impacts of permeability and effective diffusivity of porous scaffolds on bone ingrowth: In silico and in vivo analyses

The permeability and the effective diffusivity of a porous scaffold are critical in the bone-ingrowth process. However, design guidelines for porous structures are still lacking due to inadequate understanding of the complex physiological processes involved. In this study, a model integrating the fundamental biological processes of bone regeneration was constructed to investigate the roles of permeability and effective diffusivity in regulating bone deposition in scaffolds. The in silico analysis results were confirmed in vivo by examining bone depositions in three diamond lattice scaffolds manufactured using selective laser melting. The findings show that the scaffolds with better permeability and effective diffusivity had deeper bone ingrowth and greater bone volume. Compared to permeability, effective diffusivity exhibited greater sensitivity to the orientation of porous structures, and bone ingrowth was deeper in the directions with higher effective diffusivity in spite of identical pore size. A 4.8-fold increase in permeability and a 1.6-fold increase in effective diffusivity by changing the porous structure led to a 1.5-fold increase in newly formed bone. The effective diffusivity of the porous scaffold affects the distribution of osteogenic growth factor, which in turn impacts cell migration and bone deposition through chemotaxis effects. Therefore, effective diffusivity may be a more suitable indicator for porous scaffolds because our study shows changes in this parameter determine changes in bone distribution and bone volume.

Controlled Mechanical Property Gradients Within a Digital Light Processing Printed Hydrogel-Composite Osteochondral Scaffold

Tissue engineered scaffolds are needed to support physiological loads and emulate the micrometer-scale strain gradients within tissues that guide cell mechanobiological responses. We designed and fabricated micro-truss structures to possess spatially varying geometry and controlled stiffness gradients. Using a custom projection microstereolithography (μSLA) system, using digital light projection (DLP), and photopolymerizable poly(ethylene glycol) diacrylate (PEGDA) hydrogel monomers, three designs with feature sizes < 200 μm were formed: (1) uniform structure with 1 MPa structural modulus ( E ) designed to match equilibrium modulus of healthy articular cartilage, (2) E  = 1 MPa gradient structure designed to vary strain with depth, and (3) osteochondral bilayer with distinct cartilage ( E  = 1 MPa) and bone ( E  = 7 MPa) layers. Finite element models (FEM) guided design and predicted the local mechanical environment. Empty trusses and poly(ethylene glycol) norbornene hydrogel-infilled composite trusses were compressed during X-ray microscopy (XRM) imaging to evaluate regional stiffnesses. Our designs achieved target moduli for cartilage and bone while maintaining 68-81% porosity. Combined XRM imaging and compression of empty and hydrogel-infilled micro-truss structures revealed regional stiffnesses that were accurately predicted by FEM. In the infilling hydrogel, FEM demonstrated the stress-shielding effect of reinforcing structures while predicting strain distributions. Composite scaffolds made from stiff μSLA-printed polymers support physiological load levels and enable controlled mechanical property gradients which may improve in vivo outcomes for osteochondral defect tissue regeneration. Advanced 3D imaging and FE analysis provide insights into the local mechanical environment surrounding cells in composite scaffolds.

Forged to heal: The role of metallic cellular solids in bone tissue engineering

Metallic cellular solids, made of biocompatible alloys like titanium, stainless steel, or cobalt-chromium, have gained attention for their mechanical strength, reliability, and biocompatibility. These three-dimensional structures provide support and aid tissue regeneration in orthopedic implants, cardiovascular stents, and other tissue engineering cellular solids. The design and material chemistry of metallic cellular solids play crucial roles in their performance: factors such as porosity, pore size, and surface roughness influence nutrient transport, cell attachment, and mechanical stability, while their microstructure imparts strength, durability and flexibility. Various techniques, including additive manufacturing and conventional fabrication methods, are utilized for producing metallic biomedical cellular solids, each offering distinct advantages and drawbacks that must be considered for optimal design and manufacturing. The combination of mechanical properties and biocompatibility makes metallic cellular solids superior to their ceramic and polymeric counterparts in most load bearing applications, in particular under cyclic fatigue conditions, and more in general in application that require long term reliability. Although challenges remain, such as reducing the production times and the associated costs or increasing the array of available materials, metallic cellular solids showed excellent long-term reliability, with high survival rates even in long term follow-ups.

Development of Bioactive Scaffolds for Orthopedic Applications by Designing Additively Manufactured Titanium Porous Structures: A Critical Review

We overview recent findings achieved in the field of model-driven development of additively manufactured porous materials for the development of a new generation of bioactive implants for orthopedic applications. Porous structures produced from biocompatible titanium alloys using selective laser melting can present a promising material to design scaffolds with regulated mechanical properties and with the capacity to be loaded with pharmaceutical products. Adjusting pore geometry, one could control elastic modulus and strength/fatigue properties of the engineered structures to be compatible with bone tissues, thus preventing the stress shield effect when replacing a diseased bone fragment. Adsorption of medicals by internal spaces would make it possible to emit the antibiotic and anti-tumor agents into surrounding tissues. The developed internal porosity and surface roughness can provide the desired vascularization and osteointegration. We critically analyze the recent advances in the field featuring model design approaches, virtual testing of the designed structures, capabilities of additive printing of porous structures, biomedical issues of the engineered scaffolds, and so on. Special attention is paid to highlighting the actual problems in the field and the ways of their solutions.

Porous metal implants: processing, properties, and challenges

Porous and functionally graded materials have seen extensive applications in modern biomedical devices-allowing for improved site-specific performance; their appreciable mechanical, corrosive, and biocompatible properties are highly sought after for lightweight and high-strength load-bearing orthopedic and dental implants. Examples of such porous materials are metals, ceramics, and polymers. Although, easy to manufacture and lightweight, porous polymers do not inherently exhibit the required mechanical strength for hard tissue repair or replacement. Alternatively, porous ceramics are brittle and do not possess the required fatigue resistance. On the other hand, porous biocompatible metals have shown tailorable strength, fatigue resistance, and toughness. Thereby, a significant interest in investigating the manufacturing challenges of porous metals has taken place in recent years. Past research has shown that once the advantages of porous metallic structures in the orthopedic implant industry have been realized, their biological and biomechanical compatibility-with the host bone-has been followed up with extensive methodical research. Various manufacturing methods for porous or functionally graded metals are discussed and compared in this review, specifically, how the manufacturing process influences microstructure, graded composition, porosity, biocompatibility, and mechanical properties. Most of the studies discussed in this review are related to porous structures for bone implant applications; however, the understanding of these investigations may also be extended to other devices beyond the biomedical field.

Electrodeposited Zinc Coatings for Biomedical Application: Morphology, Corrosion and Biological Behaviour

The improvement of biodegradable metals is currently an active and promising research area for their capabilities in implant manufacturing. However, controlling their degradation rate once their surface is in contact with the physiological media is a challenge. Surface treatments are in the way of addressing the improvement of this control. Zinc is a biocompatible metal present in the human body as well as a metal widely used in coatings to prevent corrosion, due to its well-known metal protective action. These two outstanding characteristics make zinc coating worthy of consideration to improve the degradation behaviour of implants. Electrodeposition is one of the most practical and common technologies to create protective zinc coatings on metals. This article aims to review the effect of the different parameters involved in the electrochemical process on the topography and corrosion characteristics of the zinc coating. However, certainly, it also provides an actual and comprehensive description of the state-of-the-art of the use of electrodeposited zinc for biomedical applications, focusing on their capacity to protect against bacterial colonization and to allow cell adhesion and proliferation.

An overview of 3D printed metal implants in orthopedic applications: Present and future perspectives

With the ability to produce components with complex and precise structures, additive manufacturing or 3D printing techniques are now widely applied in both industry and consumer markets. The emergence of tissue engineering has facilitated the application of 3D printing in the field of biomedical implants. 3D printed implants with proper structural design can not only eliminate the stress shielding effect but also improve in vivo biocompatibility and functionality. By combining medical images derived from technologies such as X-ray scanning, CT, MRI, or ultrasonic scanning, 3D printing can be used to create patient-specific implants with almost the same anatomical structures as the injured tissues. Numerous clinical trials have already been conducted with customized implants. However, the limited availability of raw materials for printing and a lack of guidance from related regulations or laws may impede the development of 3D printing in medical implants. This review provides information on the current state of 3D printing techniques in orthopedic implant applications. The current challenges and future perspectives are also included.

Design of Ti64/Ta Hybrid Materials by Powder Metallurgy Mimicking Bone Structure

This work reports on the fabrication of a novel two-layer material composed of a porous tantalum core and a dense Ti6Al4V (Ti64) shell by powder metallurgy. The porous core was obtained by mixing Ta particles and salt space-holders to create large pores, the green compact was obtained by pressing. The sintering behavior of the two-layer sample was studied by dilatometry. The interface bonding between the Ti64 and Ta layers was analyzed by SEM, and the pore characteristics were analyzed by computed microtomography. Images showed that two distinct layers were obtained with a bonding achieved by the solid-state diffusion of Ta particles into Ti64 during sintering. The formation of β-Ti and α' martensitic phases confirmed the diffusion of Ta. The pore size distribution was in the size range of 80 to 500 µm, and a permeability value of 6 × 10^-10 m² was close to the trabecular bones one. The mechanical properties of the component were dominated mainly by the porous layer, and Young's modulus of 16 GPa was in the range of bones. Additionally, the density of this material (6 g/cm³) was much lower than the one of pure Ta, which helps to reduce the weight for the desired applications. These results indicate that structurally hybridized materials, also known as composites, with specific property profiles can improve the response to osseointegration for bone implant applications.

Calcium Phosphate Cements as Carriers of Functional Substances for the Treatment of Bone Tissue

Interest in calcium phosphate cements as materials for the restoration and treatment of bone tissue defects is still high. Despite commercialization and use in the clinic, the calcium phosphate cements have great potential for development. Existing approaches to the production of calcium phosphate cements as drugs are analyzed. A description of the pathogenesis of the main diseases of bone tissue (trauma, osteomyelitis, osteoporosis and tumor) and effective common treatment strategies are presented in the review. An analysis of the modern understanding of the complex action of the cement matrix and the additives and drugs distributed in it in relation to the successful treatment of bone defects is given. The mechanisms of biological action of functional substances determine the effectiveness of use in certain clinical cases. An important direction of using calcium phosphate cements as a carrier of functional substances is the volumetric incorporation of anti-inflammatory, antitumor, antiresorptive and osteogenic functional substances. The main functionalization requirement for carrier materials is prolonged elution. Various release factors related to the matrix, functional substances and elution conditions are considered in the work. It is shown that cements are a complex system. Changing one of the many initial parameters in a wide range changes the final characteristics of the matrix and, accordingly, the kinetics. The main approaches to the effective functionalization of calcium phosphate cements are considered in the review.

Recent Advances in Processing of Titanium and Titanium Alloys through Metal Injection Molding for Biomedical Applications: 2013-2022

Metal injection molding (MIM) is one of the most widely used manufacturing processes worldwide as it is a cost-effective way of producing a variety of dental and orthopedic implants, surgical instruments, and other important biomedical products. Titanium (Ti) and Ti alloys are popular modern metallic materials that have revamped the biomedical sector as they have superior biocompatibility, excellent corrosion resistance, and high static and fatigue strength. This paper systematically reviews the MIM process parameters that extant studies have used to produce Ti and Ti alloy components between 2013 and 2022 for the medical industry. Moreover, the effect of sintering temperature on the mechanical properties of the MIM-processed sintered components has been reviewed and discussed. It is concluded that by appropriately selecting and implementing the processing parameters at different stages of the MIM process, defect-free Ti and Ti alloy-based biomedical components can be produced. Therefore, this present study could greatly benefit future studies that examine using MIM to develop products for biomedical applications.

Advances in Computational Techniques for Bio-Inspired Cellular Materials in the Field of Biomechanics: Current Trends and Prospects

Cellular materials have a wide range of applications, including structural optimization and biomedical applications. Due to their porous topology, which promotes cell adhesion and proliferation, cellular materials are particularly suited for tissue engineering and the development of new structural solutions for biomechanical applications. Furthermore, cellular materials can be effective in adjusting mechanical properties, which is especially important in the design of implants where low stiffness and high strength are required to avoid stress shielding and promote bone growth. The mechanical response of such scaffolds can be improved further by employing functional gradients of the scaffold's porosity and other approaches, including traditional structural optimization frameworks; modified algorithms; bio-inspired phenomena; and artificial intelligence via machine learning (or deep learning). Multiscale tools are also useful in the topological design of said materials. This paper provides a state-of-the-art review of the aforementioned techniques, aiming to identify current and future trends in orthopedic biomechanics research, specifically implant and scaffold design.

Multiscale Homogenization Techniques for TPMS Foam Material for Biomedical Structural Applications

Multiscale techniques, namely homogenization, result in significant computational time savings in the analysis of complex structures such as lattice structures, as in many cases it is inefficient to model a periodic structure in full detail in its entire domain. The elastic and plastic properties of two TPMS-based cellular structures, the gyroid, and the primitive surface are studied in this work through numerical homogenization. The study enabled the development of material laws for the homogenized Young's modulus and homogenized yield stress, which correlated well with experimental data from the literature. It is possible to use the developed material laws to run optimization analyses and develop optimized functionally graded structures for structural applications or reduced stress shielding in bio-applications. Thus, this work presents a study case of a functionally graded optimized femoral stem where it was shown that the porous femoral stem built with Ti-6Al-4V can minimize stress shielding while maintaining the necessary load-bearing capacity. It was shown that the stiffness of cementless femoral stem implant with a graded gyroid foam presents stiffness that is comparable to that of trabecular bone. Moreover, the maximum stress in the implant is lower than the maximum stress in trabecular bone.

Improving Biocompatibility for Next Generation of Metallic Implants

The increasing need for joint replacement surgeries, musculoskeletal repairs, and orthodontics worldwide prompts emerging technologies to evolve with healthcare's changing landscape. Metallic orthopaedic materials have a shared application history with the aerospace industry, making them only partly efficient in the biomedical domain. However, suitability of metallic materials in bone tissue replacements and regenerative therapies remains unchallenged due to their superior mechanical properties, eventhough they are not perfectly biocompatible. Therefore, exploring ways to improve biocompatibility is the most critical step toward designing the next generation of metallic biomaterials. This review discusses methods of improving biocompatibility of metals used in biomedical devices using surface modification, bulk modification, and incorporation of biologics. Our investigation spans multiple length scales, from bulk metals to the effect of microporosities, surface nanoarchitecture, and biomolecules such as DNA incorporation for enhanced biological response in metallic materials. We examine recent technologies such as 3D printing in alloy design and storing surface charge on nanoarchitecture surfaces, metal-on-metal, and ceramic-on-metal coatings to present a coherent and comprehensive understanding of the subject. Finally, we consider the advantages and challenges of metallic biomaterials and identify future directions.

Characterization of 3D printed biodegradable piezoelectric scaffolds for bone regeneration

OBJECTIVE

The primary objective of this research was to develop a poly(l-lactic acid) (PLLA) scaffold and evaluate critical characteristics essential for its biologic use as a craniofacial implant.

MATERIALS AND METHODS

PLLA scaffolds were designed and fabricated using fused deposition modeling technology. The surface morphology and microarchitecture were analyzed using scanning electron microscopy (SEM) and microCT, respectively. Crystallography, compressive modulus, and the piezoelectric potential generated upon mechanical distortion were characterized. Hydrolytic degradation was studied. MG63 osteoblast-like cell proliferation and morphology were assessed.

RESULTS

The porosity of the scaffolds was 73%, with an average pore size of 450 µm and an average scaffold fiber thickness of 130 µm. The average compressive modulus was 244 MPa, and the scaffolds generated an electric potential of 25 mV upon cyclic/repeated loading. The crystallinity reduced from 27.5% to 13.9% during the 3D printing process. The hydrolytic degradation was minimal during a 12-week period. Osteoblast-like cells did not attach to the uncoated scaffold but attached well after coating the scaffold with fibrinogen. They then proliferated to cover the complete scaffold by Day 14.

CONCLUSION

The PLLA scaffolds were designed and printed, proving the feasibility of 3D printing as a method of fabricating PLLA scaffolds. The elastic modulus was comparable to that of trabecular bone, and the piezoelectric properties of the PLLA were retained after 3D printing. The scaffolds were cytocompatible. These 3D-printed PLLA scaffolds showed promising properties akin to the natural bone, and they warrant further investigation for bone regeneration.

Sintering Analysis of Porous Ti/xTa Alloys Fabricated from Elemental Powders

The present work is focused on developing Ti-xTa porous alloys processed by the space holder method and solid-state sintering. The volume fraction of Ta ranged between 20 and 30 wt.%. The sintering kinetics was evaluated by dilatometry tests. Sintered materials were characterized by SEM, XRD and computed tomography. Porosity features and permeability were determined from 3D images, and their mechanical properties were evaluated from microhardness and compression tests. The sintering behavior and the final microstructure are driven by the Ta diffusion into the Ti, slowing down the densification and modifying the transition temperature of α-to-β. Due to β-stabilization, martensite α' was obtained after sintering. Mechanical properties are reduced because of the β-stabilization and pore addition, being predominantly the pore effect. Permeability depended on the pore characteristics, finding values close to the human bones. It was concluded that powder metallurgy generates highly TixTa alloys with a combination of α, β and α' Ti phases as well as remaining Ta particles that are beneficial to improve the biocompatibility and osseointegration of such materials. Being the Ti25Ta40salt alloy the most suitable for orthopedic implants because of its characteristics and properties.

Ti64/20Ag Porous Composites Fabricated by Powder Metallurgy for Biomedical Applications

We present a novel Ti64/20Ag highly porous composite fabricated by powder metallurgy for biomedical applications and provide an insight into its microstructure and mechanical proprieties. In this work, the Ti64/20Ag highly porous composites were successfully fabricated by the space holder technique and consolidated by liquid phase sintering, at lower temperatures than the ones used for Ti64 materials. The sintering densification was evaluated by dilatometry tests and the microstructural characterization and porosity features were determined by scanning electron microscopy and computed microtomography. Permeability was estimated by numerical simulations on the 3D real microstructure. Mechanical properties were evaluated by simple compression tests. Densification was achieved by interparticle pore filling with liquid Ag that does not drain to the large pores, with additional densification due to the macroscopical deformation of large pores. Pore characteristics are closely linked to the pore formers and the permeability was highly increased by increasing the pore volume fraction, mainly because the connectivity was improved. As expected, with the increase in porosity, the mechanical properties decreased. These results permitted us to gain a greater understanding of the microstructure and to confirm that we developed a promising Ti64/20Ag composite, showing E of 7.4 GPa, σ_y of 123 MPa and permeability of 3.93 × 10^-11 m². Enhanced adaptability and antibacterial proprieties due to Ag were obtained for bone implant applications.

Design and Validation of Additively Manufactured Metallic Cellular Scaffold Structures for Bone Tissue Engineering

Bone-related defects that cannot heal without significant surgical intervention represent a significant challenge in the orthopedic field. The use of implants for these critical-sized bone defects is being explored to address the limitations of autograft and allograft options. Three-dimensional cellular structures, or bone scaffolds, provide mechanical support and promote bone tissue formation by acting as a template for bone growth. Stress shielding in bones is the reduction in bone density caused by the difference in stiffness between the scaffold and the surrounding bone tissue. This study aimed to reduce the stress shielding and introduce a cellular metal structure to replace defected bone by designing and producing a numerically optimized bone scaffold with an elastic modulus of 15 GPa, which matches the human’s cortical bone modulus. Cubic cell and diagonal cell designs were explored. Strut and cell dimensions were numerically optimized to achieve the desired structural modulus. The resulting scaffold designs were produced from stainless steel using laser powder bed fusion (LPBF). Finite element analysis (FEA) models were validated through compression testing of the printed scaffold designs. The structural configuration of the scaffolds was characterized with scanning electron microscopy (SEM). Cellular struts were found to have minimal internal porosity and rough surfaces. Strut dimensions of the printed scaffolds were found to have variations with the optimized computer-aided design (CAD) models. The experimental results, as expected, were slightly less than FEA results due to structural relative density variations in the scaffolds. Failure of the structures was stretch-dominated for the cubic scaffold and bending-dominated for the diagonal scaffold. The torsional and bending stiffnesses were numerically evaluated and showed higher bending and torsional moduli for the diagonal scaffold. The study successfully contributed to minimizing stress shielding in bone tissue engineering. The study also produced an innovative metal cellular structure that can replace large bone segments anywhere in the human body.

Medical Applications of Porous Biomaterials: Features of Porosity and Tissue-Specific Implications for Biocompatibility

Porosity is an important material feature commonly employed in implants and tissue scaffolds. The presence of material voids permits the infiltration of cells, mechanical compliance, and outward diffusion of pharmaceutical agents. Various studies have confirmed that porosity indeed promotes favorable tissue responses, including minimal fibrous encapsulation during the foreign body reaction (FBR). However, increased biofilm formation and calcification is also described to arise due to biomaterial porosity. Additionally, the relevance of host responses like the FBR, infection, calcification, and thrombosis are dependent on tissue location and specific tissue microenvironment. In this review, the features of porous materials and the implications of porosity in the context of medical devices is discussed. Common methods to create porous materials are also discussed, as well as the parameters that are used to tune pore features. Responses toward porous biomaterials are also reviewed, including the various stages of the FBR, hemocompatibility, biofilm formation, and calcification. Finally, these host responses are considered in tissue specific locations including the subcutis, bone, cardiovascular system, brain, eye, and female reproductive tract. The effects of porosity across the various tissues of the body is highlighted and the need to consider the tissue context when engineering biomaterials is emphasized.

In vitro and in vivo Repair Effects of the NCF-Col-NHA Aerogel Scaffold Loaded With SOST Monoclonal Antibody and SDF-1 in Steroid-Induced Osteonecrosis

In the current study, we synthesized nanocellulose (NCF)-collagen (Col)-nano hydroxyapatite (NHA) organic-inorganic hybrid aerogels loaded with stromal cell derived factor-1 (SDF-1) and sclerostin monoclonal antibody (SOST McAb) and investigated their ability to repair steroid-induced osteonecrosis. Rabbit bone marrow mesenchymal stem cells (BMSCs) and human vascular endothelial cells (HUVECs) were used for the in vitro study. A rabbit steroid-induced osteonecrosis model was used for the in vivo study. The best elastic modulus reached 12.95 ± 4.77 MPa with a mean compressive property of 0.4067 ± 0.084 MPa for the scaffold containing 100% mass fraction. The average pore diameter of the aerogel was 75 ± 18 µm with a porosity of more than 90% (96.4 ± 1.6%). The aerogel-loaded SDF-1 and SOST were released at 40–50% from the material within the initial 3 h and maintained a stable release for more than 21 days. The in vitro study showed osteogenesis and vascularization capabilities of the scaffold. The in vivo study showed that rabbits received implantation of the scaffold with SOST McAb and SDF-1 showed the best osteogenesis of the osteonecrosis zone in the femoral head. Imaging examination revealed that most of the necrotic area of the femoral head was repaired. These results suggest that this hybrid aerogel scaffold could be used for future steroid-induced osteonecrosis repair.

Bioactive and antimicrobial macro-/micro-nanoporous selective laser melted Ti-6Al-4V alloy for biomedical applications

Metal Additive Manufacturing (AM) technology is an emerging technology in biomedical field due to its unique ability to manufacture customized implants [Patients-specific Implants (PSIs)] replicating the complex bone structure from the relevant metal powders. PSIs could be developed through any AM technology, but the ultimate challenge lies in integrating the metallic implant with the living bone. Considering this aspect, in the present study, Ti alloy (Ti–6Al–4V) powder has been used to fabricate scaffolds of channel type macropores with 0–60% porosity using selective laser melting (SLM) and subsequent post-treatments paving way for surface microporosities. Surface chemical and subsequent heat treatments were carried out on thus developed Ti alloy scaffolds to improve its bioactivity, antibacterial activity and osteoblastic cell compatibility. NaOH and subsequent Ca(NO₃)₂/AgNO₃ treatment induced the formation of a nanoporous network structure decorated with Ca–Ag ions. Ag nanoparticles covering the entire scaffold provided antibacterial activity and the presence of Ca²⁺ ions with anatase TiO₂ layer further improved the bioactivity and osteoblastic cell compatibility of the scaffold. Therefore, SLM technology combined with heat treatment and surface modification could be effectively utilized to create macro-micro-nano structure scaffolds of Ti alloy that are bioactive, antibacterial, and cytocompatible.

Three-Dimensional Printing of Large-Scale, High-Resolution Bioceramics with Micronano Inner Porosity and Customized Surface Characterization Design for Bone Regeneration

Three-dimensional printing technologies have opened up new possibilities for manufacturing bioceramics with complex shapes in a completely digital fabrication process. Some bioceramics have demonstrated elaborate design and high resolution in their small parts through digital light projection (DLP) printing. However, it is still a challenge to prepare large-scale, high-precision ceramics that can effectively regulate the bioactivity of materials. In this study, we fabricated a large-scale hydroxyapatite porous bioceramic (length >150 mm) using DLP. This bioceramic had highly micronanoporous surface structures (printing resolution <65 μm), which could be controlled by adjusting the solid content and sintering process. Both in vitro and in vivo results indicated that the designed bioceramic had promising bone regeneration ability. This study provides significant evidence for exploring the effects of microenvironments on bone tissue regeneration. These results indicated that DLP technology has the potential to produce large-scale bone tissue engineering scaffolds with accurate porosity.

Fabrication of porous TiO2 foams by powder metallurgy technique and study of bulk crushing strength for biomedical application

Despite the importance of porous titanium oxide (PA-TiO2) in diverse functional applications, very little information is available on the compatible mechanical properties for potential biomedical applications. In this study, PA-TiO2 foam was synthesized using space-holding powder metallurgy and sintering methods to produce interconnected opened-cell structure with surface morphology of mountain-like features associated with the extensive rift valley system. Three different types of PA-TiO2 foams with porosities of 35-52% and mean pore diameter of 190-210 μm were fabricated for evaluating the effect of porosity on mechanical properties of bulk PA-TiO2. The modulus of elasticity of PA-TiO2 foams exhibited in the range of 45-262 MPa which was within the range of modulus of elasticity of human cancellous bone. Cytotoxicity test is performed in vitro analysis to observe the effect of cell toxicity to produce osteointegration when used as implantable materials. There was no cytotoxicity effect found and remarkable cell growth was observed for human cancerous (HeLa) cell line. However, there was no cytotoxicity effect found and cell growth was not observed for Vero cell line. This study suggested that PA-TiO2 facilitates cell growth without spreading toxicity and has mechanical properties of cancellous bone. Hence, it has potential application as implant and medical devices in biomedical applications.

Finite element study on the influence of pore size and structure on stress shielding effect of additive manufactured spinal cage

The stress shielding effect occurs when the orthopedic implant reduces the load delivered to the bone, causing inefficient stress transfer to the host bone. The usage of porous additive manufactured (AM) cages reduces the stress shielding effect and promotes bone ingrowth also. The purpose of this work is to study the stress and deformation on porous hybrid spinal cages under different loading conditions using Finite Element Analysis (FEA). The spinal cages consisting of three porous structures with pore sizes ranging from 0.4 to 0.6 mm were investigated for stress shielding and fatigue strength. The results showed a significant reduction in stress shielding for the studied designs and conclude that the pore size has a greater significant effect on stress shielding than the porous structure in spinal cages.

Shaping collagen for engineering hard tissues: Towards a printomics approach

Hard tissue engineering has evolved over the past decades, with multiple approaches being explored and developed. Despite the rapid development and success of advanced 3D cell culture, 3D printing technologies and material developments, a gold standard approach to engineering and regenerating hard tissue substitutes such as bone, dentin and cementum, has not yet been realised. One such strategy that differs from conventional regenerative medicine approach of other tissues, is the in vitro mineralisation of collagen templates in the absence of cells. Collagen is the most abundant protein within the human body and forms the basis of all hard tissues. Once mineralised, collagen provides important support and protection to humans, for example in the case of bone tissue. Multiple in vitro fabrication strategies and mineralisation approaches have been developed and their success in facilitating mineral deposition on collagen to achieve bone-like scaffolds evaluated. Critical to the success of such fabrication and biomineralisation approaches is the collagen template, and its chemical composition, organisation, and density. The key factors that influence such properties are the collagen processing and fabrication techniques utilised to create the template, and the mineralisation strategy employed to deposit mineral on and throughout the templates. However, despite its importance, relatively little attention has been placed on these two critical factors. Here, we critically examine the processing, fabrication and mineralisation strategies that have been used to mineralise collagen templates, and offer insights and perspectives on the most promising strategies for creating mineralised collagen scaffolds. STATEMENT OF SIGNIFICANCE: In this review, we highlight the critical need to fabricate collagen templates with advanced processing techniques, in a manner that achieves biomimicry of the hierarchical collagen structure, prior to utilising in vitro mineralisation strategies. To this end, we focus on the initial collagen that is selected, the extraction techniques used and the native fibril forming potential retained to create reconstituted collagen scaffolds. This review synthesises current best practises in material sourcing, processing, mineralisation strategies and fabrication techniques, and offers insights into how these can best be exploited in future studies to successfully mineralise collagen templates.

Pharmaceutical electrospinning and 3D printing scaffold design for bone regeneration

Bone regenerative engineering provides a great platform for bone tissue regeneration covering cells, growth factors and other dynamic forces for fabricating scaffolds. Diversified biomaterials and their fabrication methods have emerged for fabricating patient specific bioactive scaffolds with controlled microstructures for bridging complex bone defects. The goal of this review is to summarize the points of scaffold design as well as applications for bone regeneration based on both electrospinning and 3D bioprinting. It first briefly introduces biological characteristics of bone regeneration and summarizes the applications of different types of material and the considerations for bone regeneration including polymers, ceramics, metals and composites. We then discuss electrospinning nanofibrous scaffold applied for the bone regenerative engineering with various properties, components and structures. Meanwhile, diverse design in the 3D bioprinting scaffolds for osteogenesis especially in the role of drug and bioactive factors delivery are assembled. Finally, we discuss challenges and future prospects in the development of electrospinning and 3D bioprinting for osteogenesis and prominent strategies and directions in future.

In vivo evaluation of deer antler trabecular bone as a reconstruction material for bone defects

Availability of graft materials to fill up osseous defects has always been a concern in orthopaedic surgeries. Deer antler material is a primary bone structure that is easy to collect and could serve as a xenograft. This study examines the behaviour of red deer antler trabecular cylinders in critical size distal femoral epiphyseal defects in 11 rabbits, and evaluates the effect of the decellularization protocols. Two preparation regimes (A and B) were used, with and without lipids and proteins. Radiographs were taken immediately after surgery and after euthanasia 12 weeks post-implantation. Histological evaluation was performed on non-decalcified 10-μm sections with a van Gieson picro-fuchsin staining protocol. A region of interest was defined for each histological section, evaluating the inflammatory reaction, the fibrosis process, and the osteogenesis. Each histological section was microradiographed to evaluate bone contact, presence of synostosis, remodelling and ossification processes. All antler cylinders were successfully implanted. Final radiographic analysis demonstrated osteointegration of most implants at various stages. Light to moderate inflammation around the grafts was noted with only one case showing full encapsulation. A variable degree of intimacy between implant and host bone was evidenced, with bone remodelling and osteogenesis of various intensity being present in all implanted sites. No differences were found between group A and B. Removal of lipids and proteins in the grafts surprisingly did not seem to matter. Decellularization and sterilization protocols may be advocated. Although it presents several limitations, this study shows some promising results regarding antler trabecular bone osteointegration.

Multiscale porosity in a 3D printed gellan-gelatin composite for bone tissue engineering

The aim of this work was to develop a complex-shaped gelatin-gellan composite scaffold with multiscale porosity using a combination of cryogenic 3D printing and lyophilization for bone tissue engineering. Cryogenic 3D printing was used to fabricate a low-concentration composite of complex-shaped macroporous gelatin-gellan structures with a pore size of 919 ± 89 µm. This was followed by lyophilization to introduce micropores of size 20-250 µm and nanometre-level surface functionalities, thus achieving a hierarchical porous structure. These multiscale porous scaffolds (GMu) were compared with two other types of scaffolds having only microporosity (GMi) and macroporosity (GMa) with regard to their physical andin vitrobiological properties. GMu scaffolds were found to be better than GMi and GMa in terms of swelling percentage, degradation rate, uniform pore distribution, cellular infiltration, attachment, proliferation, protein generation and mineralization. In conclusion, we have developed a controlled hierarchical bone-like structure, biomimicking natural bone, together with a reproducible process of manufacture by coupling soft hydrogel 3D printing with lyophilization. This enables the development of complex-shaped patient-specific 3D printed hydrogel scaffolds with enhanced performancein vitroand great potential in the fields of tissue engineering, bioprinting and regenerative medicine.

A Review on Design and Mechanical Properties of Additively Manufactured NiTi Implants for Orthopedic Applications

NiTi alloy has a wide range of applications as a biomaterial due to its high ductility, low corrosion rate, and favorable biocompatibility. Although Young’s modulus of NiTi is relatively low, it still needs to be reduced; one of the promising ways is by introducing porous structure. Traditional manufacturing processes, such as casting, can hardly produce complex porous structures. Additive manufacturing (AM) is one of the most advanced manufacturing technologies that can solve impurity issues, and selective laser melting (SLM) is one of the well-known methods. This paper reviews the developments of AM-NiTi with a particular focus on SLM-NiTi utilization in biomedical applications. Correspondingly, this paper aims to describe the three key factors, including powder preparation, processing parameters, and gas atmosphere during the overall process of porous NiTi. The porous structure design is of vital importance, so the unit cell and pore parameters are discussed. The mechanical properties of SLM-NiTi, such as hardness, compressive strength, tensile strength, fatigue behavior, and damping properties and their relationship with design parameters are summarized. In the end, it points out the current challenges. Considering the increasing application of NiTi implants, this review paper may open new frontiers for advanced and modern designs.

Scanning Electron Microscopic Evaluation of the Internal Fit Accuracy of 3D-Printed Biphasic Calcium Phosphate Block: An Ex Vivo Pilot Study

The aim of this study was to assess the internal fit accuracy of a three-dimensional (3D)-printed biphasic calcium phosphate (BCP) block compared with a 3D-milled poly methyl methacrylate (PMMA) block by scanning electron microscope (SEM) analysis. In a total of 20 porcine rib bones, two different types of defects having two adjacent walls and a floor were produced: a defect with a flat floor (flat defect; N = 10) and a defect with a concave floor (curved defect; N = 10). Each defect was grafted with either the 3D-printed BCP block or the 3D-milled PMMA block fabricated following the computer aided design. The defects were then cut cross-sectionally and evaluated under the SEM. The extents of internal contact and gap were measured and statistically analyzed (p < 0.05). All blocks in both BCP and PMMA groups were successfully fit to the flat and curved defects. The internal contact ratio was significantly higher in the BCP group (flat defect: 0.47 ± 0.10; curved defect: 0.29 ± 0.05) compared with the PMMA group (flat defect: 0.21 ± 0.13; curved defect: 0.17 ± 0.04; p < 0.05). The internal gap area was similar between the two groups regardless of the defect types (p > 0.05). The internal fit accuracy of the 3D-printed BCP block was reliable in both the flat and curved defects when compared with the accuracy of the 3D-milled PMMA block.

Additive Manufacturing of Porous Ti6Al4V Alloy: Geometry Analysis and Mechanical Properties Testing

This work is devoted to the research of porous titanium alloy structures suitable for use in biomedical applications. Mechanical properties were examined on six series of samples with different structures and porosity via static compressive test to identify the type of structure suitable for elimination of the “stress shielding” effect. In addition, high porosity is desirable due to the overgrowth of bone tissue into the internal structure of the implant. The samples were made of titanium alloy Ti6Al4V by using selective laser melting (SLM) additive manufacturing. The series of samples differ from each other in pore size (200, 400, and 600 µm) and porous structure topology (cubic or trabecular). The actual weight of all samples, which plays an important role in identifying other characteristics, was determined. Compressive tests were focused on the detection of maximum stress. The highest porosity and thus the lowest weight were achieved in the samples with a trabecular structure and 600 µm pore size. All tested samples reached optimal values of maximum stress and tensile strength. The most appropriate mechanical properties were observed for samples with a 200 µm pore diameter and cubic structure.

Structure-function assessment of 3D-printed porous scaffolds by a low-cost/open source fused filament fabrication printer

Additive manufacturing encompasses a plethora of techniques to manufacture structures from a computational model. Among them, fused filament fabrication (FFF) relies on heating thermoplastics to their fusion point and extruding the material through a nozzle in a controlled pattern. FFF is a suitable technique for tissue engineering, given that allows the fabrication of 3D-scaffolds, which are utilized for tissue regeneration purposes. The objective of this study is to assess a low-cost/open-source 3D printer (In-House), by manufacturing both solid and porous samples with relevant microarchitecture in the physiological range (100-500 μm pore size), using an equivalent commercial counterpart for comparison. For this, compressive tests in solid and porous scaffolds manufactured in both printers were performed, comparing the results with finite element analysis (FEA) models. Additionally, a microarchitectural analysis was done in samples from both printers, comparing the measurements of both pore size and porosity to their corresponding computer-aided design (CAD) models. Moreover, a preliminary biological assessment was performed using scaffolds from our In-House printer, measuring cell adhesion efficiency. Finally, Fourier transform infrared spectroscopy - attenuated total reflectance (FTIR-ATR) was performed to evaluate chemical changes in the material (polylactic acid) after fabrication in each printer. The results show that the In-House printer achieved generally better mechanical behavior and resolution capacity than its commercial counterpart, by comparing with their FEA and CAD models, respectively. Moreover, a preliminary biological assessment indicates the feasibility of the In-House printer to be used in tissue engineering applications. The results also show the influence of pore geometry on mechanical properties of 3D-scaffolds and demonstrate that properties such as the apparent elastic modulus (E_app) can be controlled in 3D-printed scaffolds.

Rolled-Up Metal Oxide Microscaffolds to Study Early Bone Formation at Single Cell Resolution

Titanium and its alloys are frequently used to replace structural components of the human body due to their high mechanical strength, low stiffness, and biocompatibility. In particular, the use of porous materials has improved implant stabilization and the promotion of bone. However, it remains unclear which material properties and geometrical cues are optimal for a proper osteoinduction and osseointegration. To that end, transparent tubular microscaffolds are fabricated, mimicking the typical pores of structural implants, with the aim of studying early bone formation and cell-material interactions at the single cell level. Here, a β-stabilized alloy Ti-45Nb (wt%) is used for the microscaffold's fabrication due to its elastic modulus close to that of natural bone. Human mesenchymal stem cell migration, adhesion, and osteogenic differentiation is thus investigated, paying particular attention to the CaP formation and cell-body crystallization, both analyzed via optical and electron microscopy. It is demonstrated that the developed platform is suited for the long-term study of living single cells in an appropriate microenvironment, obtaining in the process deeper insights on early bone formation and providing cues to improve the stability and biocompatibility of current structural implants.

Current interpretations on the in vivo response of bone to additively manufactured metallic porous scaffolds: A review

Recent advances in the field of metallic additive manufacturing have expanded production capabilities for bone implants to include porous lattice structures. While traditional models of de novo bone formation can be applied to fully dense implant materials, their applicability to the interior of porous materials has not been well-characterized. Unlike other reviews that focus on materials and mechanical properties of lattice structures, this review compiles biological performance from in vivo studies in pre-clinical models only. First, we introduce the most common lattice geometry designs employed in vivo and discuss some of their fabrication advantages and limitations. Then lattice geometry is correlated to quantitative (histomorphometric) and qualitative (histological) assessments of osseointegration. We group studies according to two common implant variables: pore size and percent porosity, and explore the extent of osseointegration using common measures, including bone-implant contact (BIC), bone area (BA), bone volume/total volume (BV/TV) and biomechanical stability, for various animal models and implantation times. Based on this, trends related to in vivo bone formation on the interior of lattice structures are presented. Common challenges with lattice structures are highlighted, including nonuniformity of bone growth through the entirety of the lattice structure due to occlusion effects and avascularity. This review paper identifies a lack of systematic in vivo studies on porous AM implants to target optimum geometric design, including pore shape, size, and percent porosity in controlled animal models and critical-sized defects. Further work focusing on surface modification strategies and systematic geometric studies to homogenize in vivo bone growth through the scaffold interior are recommended to increase implant stability in the early stages of osseointegration.

In vitro and 48 weeks in vivo performances of 3D printed porous Fe-30Mn biodegradable scaffolds

Porous Fe-Mn biodegradable scaffolds fabricated by 3D printing are considered as a promising alternative biomaterial for repairing load-bearing bone defects. However, the mechanical adaptability, the thoughtful in vitro biocompatibility and especially the long-term in vivo osseointegration and biodegradation performances have not been investigated to date. Herein, the porous Fe-30Mn biodegradable scaffolds fabricated by selective laser melting (SLM) had the adjustable elastic modulus ranging from 10.04 GPa to 14.88 GPa by regulating the porosity from 37.89% to 47.17%. In vitro indirect and direct cytotoxicity as well as cell adhesion experiments demonstrated biocompatibility and a large number of cells with stretched filopodia adhered to the scaffolds. 48 weeks in vivo experiments showed that the scaffolds had no harm to liver and kidney, and exhibited long-term in vivo osseointegration performance. Volumes of the scaffolds decreased by 10.1-20.9%, and the retrieved scaffolds showed decreased elastic modulus (decreased by 34.1-42.3%) and yield strength (decreased by 15.8-23.3%) after the 48 weeks in vivo degradation. The Fe-30Mn-femoral condyle complex maintained the same level of stiffness as intact controls during 48 weeks. In summary, the porous Fe-30Mn biodegradable scaffolds fabricated by SLM could be a reliable and practical alternative for repairing load-bearing bone defects.

Cancellous bone-like porous Fe@Zn scaffolds with core-shell-structured skeletons for biodegradable bone implants

Three-dimensional (3D) porous zinc (Zn) with a moderate degradation rate is a promising candidate for biodegradable bone scaffolds. However, fabrication of such scaffolds with adequate mechanical properties remains a challenge. Moreover, the composition, crystallography and microstructure of the in vivo degradation products formed at or near the implant-bone interface are still not precisely known. Here, we have fabricated porous Fe@Zn scaffolds with skeletons consisting of an inner core layer of Fe and an outer shell layer of Zn using template-assisted electrodeposition technique, and systematically evaluated their porous structure, mechanical properties, degradation mechanism, antibacterial ability and in vitro and in vivo biocompatibility. In situ site-specific focused ion beam micromilling and transmission electron microscopy were used to identify the in vivo degradation products at the nanometer scale. The 3D porous Fe@Zn scaffolds show similar structure and comparable mechanical properties to human cancellous bone. The degradation rates can be adjusted by varying the layer thickness of Zn and Fe. The antibacterial rates reach over 95% against S. aureus and almost 100% against E. coli. A threshold of released Zn ion concentration (~ 0.3 mM) was found to determine the in vitro biocompatibility. Intense new bone formation and ingrowth were observed despite with a slight inflammatory response. The in vivo degradation products were identified to be equiaxed nanocrystalline zinc oxide with dispersed zinc carbonate. This study not only demonstrates the feasibility of porous Fe@Zn for biodegradable bone implants, but also provides significant insight into the degradation mechanism of porous Zn in physiological environment.

Selective Voronoi tessellation as a method to design anisotropic and biomimetic implants

The geometry of a metallic scaffold is important for the success of bone implants, where the introduction of porosity can reduce stress shielding effects and allow for bone tissue integration. In this work, porous scaffolds were designed to closely mimic the natural structure of trabecular bone using selective Voronoi tessellation with preferential seeding. A workflow to generate these structures is introduced, where voided regions of seeds in the starting volume create preferential texture during polyhedral expansion, resulting in modified strut orientation in the implant. Anisotropy was digitally characterized by mean-intercept length and star volume distribution measurements to determine similarity to trabecular orientation. This work demonstrates that selective Voronoi tessellation is an effective method to generate biomimetic porous scaffolds with increased anisotropy and tunable strut architecture in three dimensions as a suitable alternative to patient-derived bone geometries.

Prospect of Metal Ceramic (Titanium-Wollastonite) Composite as Permanent Bone Implants: A Narrative Review

This literature review discusses the influence of titanium ceramic composites as a biomaterial towards the fabrication of implants for orthopedic applications. The concept of applying metal-ceramic composites enable many novel combinations in the design and fabrication of complex materials which enhances functionality to improve cell and tissue matrix interactions particularly in the formation of bone. Specific focus is placed on its plethora of materials selected from the metals and ceramic group and identifying the optimal combination that matches them. The prospect of wollastonite as the ceramic counterpart is also highlighted. In this review, we have highlighted the different fabrication methods for such metal-ceramic materials as well as the role that these hybrids play in an in vitro and in vivo environment. Its economic potential as a bone implant material is also discussed.

Osseointegration of 3D porous and solid Ti-6Al-4V implants - Narrow gap push-out testing and experimental setup considerations

Porosity in titanium alloy materials improves the bony integration and mechanical properties of implants. In certain areas of application such as vertebral spacers or trabecular bone replacement (e.g. wedge augmentation in prosthetics), surface structures are desirable that promote bone integration and have biomechanical properties that are resistant to intraosseous load transfers and at the same time resemble the stiffness of bone to possible reduce the risk of stress shielding. In the present study, we investigated the biomechanical push-out behavior of an open-porous Ti-6Al-4V material that was produced in a space-holder and sintering method creating a 3-D through-pores trabecular design that corresponds with the inhomogeneity and size relationships of trabecular bone. The short-term and mid-term effects of the material properties on osseointegration in a biomechanical push-out study were compared to those of to a conventional solid Ti-6Al-4V material. In order to raise the measurement accuracy we implemented a strict study protocol. Pairs of cylindrical implants with a porosity of 49% and an average pore diameter of 400 μm and equal sized solid, corundum blasted devices as reference were bilaterally implanted press fit in the lateral femoral condyles of 14 rabbits. After sacrifice at 4 and 12 weeks, a push-out test was performed while the test set-up was designed to ensure conformity of implant axes and direction of applied force. Maximum holding force, Young's modulus, and mode of failure were recorded. Results of maximum push-out force (F-max) revealed a significant material effect (p < 0.05) in favor of porous implants after 4 weeks of osseohealing (6.39 vs. 3.36 N/mm²) as well as after 12 weeks of osseoremodeling (7.58 vs. 4.99 N/mm²). Evaluation of the failure mode resulted in three different types of displacement characteristics, which revealed a different mechanism of osseous anchoring between the two types of implants and substantiate the F-max and Young's modulus results. Conclusively, the porous implant offers surface properties that significantly improve its osseous stability compared to solid material under experimental conditions. In addition, we have optimized our study protocol for biomechanical push-out tests to produce precise and comparable results.

Effect of Pore Size on the Physicochemical Properties and Osteogenesis of Ti6Al4V Porous Scaffolds with Bionic Structure

Ti6Al4V is widely used in implants in the fields of orthopedics and dentistry due to its high compressive strength and good biocompatibility. Nevertheless, Ti6Al4V has a certain degree of biological inertness and the elastic modulus of Ti6Al4V is much higher than the cortex and trabecular bone. In this study, we designed and printed a new type of pore size Ti6Al4V with like-trabecular structure scaffold (the pore size is 800/900/1000 μm, named P8/P9/P10, respectively) with electron beam melting (EBM). Its elastic modulus, compressive strength, and other physical and chemical properties, as well as cell adhesion, proliferation, and differentiation ability and in vitro biological properties were studied. The physical and chemical performance test results showed that as the pore size increased, the surface wettability increased and the elastic modulus decreased. As the pore size increased, F-actin and alkaline phosphatase (ALP) increased significantly, and osteogenesis-related genes including BMP2, OCN, RUNX2, and ALP were upregulated significantly. The reason may be that the components on the Ti6Al4V pore size may have an influence on intracellular signal conversion and then change the mode of cell proliferation and diffusion. In summary, the like-trabecular porous structure can effectively reduce the elastic modulus of metal materials, thereby avoiding stress concentration and promoting the adhesion and proliferation of osteoblasts. Porous materials with larger pores are more conducive to the proliferation and differentiation of osteoblasts. The irregular porous Ti6Al4V scaffold prepared by the EBM technology has good mechanical properties and the potential to promote adhesion, proliferation, and differentiation of osteoblasts, and has the possibility of application in the field of implantation.

Topography: A Biophysical Approach to Direct the Fate of Mesenchymal Stem Cells in Tissue Engineering Applications

Tissue engineering is a promising strategy to treat tissue and organ loss or damage caused by injury or disease. During the past two decades, mesenchymal stem cells (MSCs) have attracted a tremendous amount of interest in tissue engineering due to their multipotency and self-renewal ability. MSCs are also the most multipotent stem cells in the human adult body. However, the application of MSCs in tissue engineering is relatively limited because it is difficult to guide their differentiation toward a specific cell lineage by using traditional biochemical factors. Besides biochemical factors, the differentiation of MSCs also influenced by biophysical cues. To this end, much effort has been devoted to directing the cell lineage decisions of MSCs through adjusting the biophysical properties of biomaterials. The surface topography of the biomaterial-based scaffold can modulate the proliferation and differentiation of MSCs. Presently, the development of micro- and nano-fabrication techniques has made it possible to control the surface topography of the scaffold precisely. In this review, we highlight and discuss how the main topographical features (i.e., roughness, patterns, and porosity) are an efficient approach to control the fate of MSCs and the application of topography in tissue engineering.

Microstructure and Porosity Evolution of the Ti-35Zr Biomedical Alloy Produced by Elemental Powder Metallurgy

In the present study, the structure and porosity of binary Ti-35Zr (wt.%) alloy were investigated, allowing to consider powder metallurgy as a production method for new metallic materials for potential medical applications. The porous Ti-Zr alloys were obtained by milling, cold isostatic pressing and sintering. The pressure during cold isostatic pressing was a changing parameter and was respectively 250, 500, 750 and 1000 MPa. The X-ray diffraction study revealed only the α phase, which corresponds to the Ti-Zr phase diagram. The microstructure of the Ti-35Zr was observed by optical microscopy and scanning electron microscopy. These observations revealed that the volume fraction of the pores decreased from over 20% to about 7% with increasing pressure during the cold isostatic pressing. The microhardness measurements showed changes from 137 HV0.5 to 225 HV0.5.

Biomimetic Design for a Dual Concentric Porous Titanium Scaffold with Appropriate Compressive Strength and Cells Affinity

In repairing or replacing damaged bones, a dual concentric porous titanium scaffold (P-Tix-y) has emerged as a promising bio-mimic design. Herein, various P-Tix-y were made and sintered with relatively dense (x = 10, 20, or 30% porosity) and loose (y = 45, 55, or 65 porosity) structures. Firstly, NaCl was used as the pore-forming additive and followed by a hydrothermal removal method. The compressive strength of the as-formed P-Tix_y and surface morphology, nanomechanical property, and cells' affinity on the cross-sectioned surface of P-Tix_y (CP-Tix_y) were then characterized. The results demonstrate that the compressive strength of P-Ti10_45, P-Ti20_45, or P-Ti20_55 exhibits a relatively mild decline (e.g., in the range of 181 and 97 MPa, higher than the required value of 70 MPa) and suitable porosities for the intended structure. Nano-hardness on the solid surface of CP-Tix_y shows roughly consistent with that of CP-Ti (i.e., ~8.78 GPa), thus, the porous structure of CP-Tix_y remains mostly unaffected by the addition of NaCl and subsequent sintering process. Most of the surfaces of CP-Tix_y exhibit high fibroblast (L929) cell affinity with low cell mortality. Notably, in the hFOB 1.19 cell adhesion and proliferation test, CP-Ti20_55 and CP-Ti20_65 reveal high cell viability, most probably relating with the assembly of dual porosities with interconnected pores. Overall, the sample P-Ti20_55 provides a relatively load-bearable design with high cell affinity and is thus promising as a three-dimensional bio-scaffold.

Biological Responses of Ceramic Bone Spacers Produced by Green Processing of Additively Manufactured Thin Meshes

Bone spacers are exclusively used for replacing the tissue after trauma and/or diseases. Ceramic materials bring positive opportunities to enhance greater osteointegration and performance of implants, yet processing of porous geometries can be challenging. Additive Manufacturing (AM) opens opportunities to grade porosity levels in a part; however, its productivity may be low due to its batch processing approach. The paper studies the biological responses yielded by hydroxyapatite with β-TCP (tricalcium phosphate) ceramic porous bone spacers manufactured by robocasting 2-layer meshes that are rolled in green and sintered. The implants are assessed in vitro and in vivo for their compatibility. Human bone marrow mesenchymal stem cells attached, proliferated and differentiated on the bone spacers produced. Cells on the spacers presented alkaline phosphatase staining, confirming osteogenic differentiation. They also expressed bone-specific COL1A1, BGAP, BSP, and SPP1 genes. The fold change of these genes ranged between 8 to 16 folds compared to controls. When implanted into the subcutaneous tissue of rabbits, they triggered collagen fibre formation and mild fibroblastic proliferation. In conclusion, rolled AM-meshes bone spacers stimulated bone formation in vitro and were biocompatible in vivo. This technology may give the advantage to custom produce spacers at high production rates if industrially upscaled.

The Effect of Ti-6Al-4V Alloy Surface Structure on the Adhesion and Morphology of Unidirectional Freeze-Coated Gelatin

The modification of a metal implant surface with a biomimetic coating of bone-like anisotropic and graded porosity structures to improve its biological anchorage with the surrounding bone tissue at implanting, is still a high challenge. In this paper, we present an innovative way of a gelatin (GEL) dip-coating on Ti-6Al-4V substrates of different square-net surface textures by the unidirectional deep-freezing process at simultaneous cross-linking using carbodiimide chemistry. Different concentrations of GEL solution were used to study the changes in morphology, density, and mechanical properties of the coatings. In addition, the surface free energy and polarity of Ti-6Al-4V substrate surfaces and GEL solutions have been evaluated to assess the wetting properties at the substrate interfaces, and to describe the adhesion of GEL macromolecules with their surfaces, being supported by mechanical pull-out testing. The results indicate that the coating’s morphology depends primarily on the Ti-6Al-4V substrate’s surface texture and second, on the concentration of GEL, which further influences their adhesion properties, orientation, morphological arrangement, as well as compression strength. The substrate with a 300 × 300 μm2 texture resulted in a highly adhered GEL coating with ≥80% porosity, interconnected and well-aligned pores of 75–200 μm, required to stimulate the bone ingrowth, mechanically and histologically.

Comparison of two pore sizes of LAE442 scaffolds and their effect on degradation and osseointegration behavior in the rabbit model

The magnesium alloy LAE442 emerged as a possible bioresorbable bone substitute over a decade ago. In the present study, using the investment casting process, scaffolds of the Magnesium (Mg) alloy LAE442 with two different and defined pore sizes, which had on average a diameter of 400 μm (p400) and 500 μm (p500), were investigated to evaluate degradation and osseointegration in comparison to a ß-TCP control group. Open-pored scaffolds were implanted in both greater trochanter of rabbits. Ten scaffolds per time group (6, 12, 24, and 36 weeks) and type were analyzed by clinical, radiographic and μ-CT examinations (2D and 3D). None of the scaffolds caused adverse reactions. LAE442 p400 and p500 developed moderate gas accumulation due to the Mg associated in vivo corrosion, which decreased from week 20 for both pore sizes. After 36 weeks, p400 and p500 showed volume decreases of 15.9 and 11.1%, respectively, with homogeneous degradation, whereas ß-TCP lost 74.6% of its initial volume. Compared to p400, osseointegration for p500 was significantly better at week 2 postsurgery due to more frequent bone-scaffold contacts, higher number of trabeculae and higher bone volume in the surrounding area. No further significant differences between the two pore sizes became apparent. However, p500 was close to the values of ß-TCP in terms of bone volume and trabecular number in the scaffold environment, suggesting better osseointegration for the larger pore size.

Degradation behavior, cytotoxicity, hemolysis, and antibacterial properties of electro-deposited Zn-Cu metal foams as potential biodegradable bone implants

Zinc (Zn) alloys have attracted much attention for biomedical applications due to their biodegradability, biocompatibility, and biological functionalities. Zn alloy foams have high potential to be used as regenerative medical implants by virtue of their porous structure, which allows new bone tissue ingrowth, their low elastic modulus approximating that of natural bone, and their biodegradation, which eliminates the need for follow-up surgery to remove the implants after bone tissue healing. In this context, a biodegradable Zn-Cu foam was fabricated by electrochemical deposition on a foamed Cu template and given a subsequent diffusion heat treatment. The microstructure, mechanical properties, degradation behavior, toxicity, hemolysis percentages, and antibacterial effects of the Zn-Cu foams were assessed for biomedical applications. The Zn-Cu foams exhibited a yield strength of ~12.1 MPa, a plateau strength of 16.8 MPa, and a strain over 50% under compression tests. The corrosion rate of the Zn-Cu foams measured by electrochemical polarization testing was 0.18 mm/y. The Zn-Cu foams showed good blood compatibility with a hemolysis percentage of less than 5%. Cytotoxicity assessment indicated that a 100% concentration of the Zn-Cu foam extract showed clear cytotoxicity against MC3T3-E1 osteoblast cells, but a 12.5% concentration of the extract showed > 90% cell viability. Moreover, the Zn-Cu foams showed good antibacterial effects. STATEMENT OF SIGNIFICANCE: This work reportsa biodegradable Zn-Cu foam with high mechanical strength and ductility, suitable degradation rate, good antibacterial capacity, and good hemolysis property and biocompatibility. The Zn-Cu foam exhibited a yield strength of ~12.1 MPa, a plateau strength of 16.8 MPa, and a strain over 50% under compression tests. The corrosion rate of the Zn-Cu foam measured by electrochemical polarization testing was 0.18 mm/y in Hanks' Solutions. The Zn-Cu foam showed good blood compatibility with a hemolysis percentage of less than 5%. Cytotoxicity assessment indicated that a 12.5% concentration of the foam extract showed > 90% cell viability. Moreover, the Zn-Cu foam showed good antibacterial effects against S. aureus.

Chemobrionic structures in tissue engineering: self-assembling calcium phosphate tubes as cellular scaffolds

A diverse range of complex patterns and mineralised hierarchical microstructures can be derived from chemobrionic systems. In this work, we explore chemobrionic calcium phosphate tubes as cellular scaffolds.