Nanocomposite bone scaffolds based on biodegradable polymers and hydroxyapatite

Gradient versus End-Capped Degradable Polymer Sequence Variations Result in Stiff to Elastic Photochemically 3D-Printed Substrates

Additive manufacturing affords the construction of complex scaffolds for tissue engineering, yet the limitation in material choice remains a barrier to clinical translation. Herein, a series of poly(propylene fumarate-co-propylene succinate) were synthesized using both one-pot and sequential ring-opening copolymerization reactions. Continuous liquid interface production-based photochemical 3D printing utilizing thiol-ene chemistry was used to fabricate precise structures with improved build time over the traditional poly(propylene fumarate)/diethyl fumarate 3D printing processes. Significantly, the materials do not exhibit a yield point under tension and Young's modulus of the 3D printed products can be tuned by more than 2 orders of magnitude (0.6-110 MPa) using polymer composition and the degree of polymerization. Printed constructs degrade fully under hydrolytic conditions and degradation rates can be tailored using polymer composition, polymer sequence, and resin formulation.

3D-printed hydroxyapatite microspheres reinforced PLGA scaffolds for bone regeneration

Bone tissue engineering scaffolds with similar composition, structure, and mechanical properties to natural bone are conducive to bone regeneration. The objective of this study was to prepare hydroxyapatite/poly (lactic-co-glycolic acid) (HA/PLGA) three-dimensional porous scaffolds with HA content close to natural bone and strong mechanical strength to promote osteogenesis. To achieve this, we modified HA microspheres with polyvinyl alcohol to create an inorganic filler to endow the HA/PLGA printing ink with higher HA content and excellent printing fluidity for 3D printing. We successfully printed a series of HA/PLGA scaffolds with different HA contents. The highest HA content reached 60 wt%, which is close to the mineral percentage in natural bone. The composition, structure, mechanical properties, and in vitro degradability of the fabricated scaffolds were systematically characterized. The cytocompatibility and osteogenic activity of the fabricated HA/PLGA scaffolds were evaluated by in vitro cell culture and rabbit femoral defect repair experiments in vivo. The results indicated that the HA/PLGA composite scaffold with 45 wt% HA had the highest compressive strength of more than 40 MPa, which was six times higher than that of the pure PLGA scaffold. The incorporation of HA microspheres into the PLGA matrix significantly improved the cell adhesion, proliferation, and osteogenic differentiation of bone marrow stem cells (BMSCs) cultured on the surface of the scaffolds. Animal experiments showed that the HA/PLGA composite with 45 wt% HA exhibited the best structure maintenance and osteogenic performance in vivo. The prepared HA/PLGA composite 3D scaffold with HA microsphere reinforcement has considerable application potential in the field of large bone defect repair.

Synthesis and characterization of a photo-cross-linked bioactive polycaprolactone-based osteoconductive biocomposite

In this study, a light cross-linkable biocomposite scaffold based on a photo-cross-linkable poly (propylene fumarate) (PPF)-co-polycaprolactone (PCL) tri-block copolymer was synthesized and characterized. The developed biodegradable scaffold was further modified with β-tricalcium phosphate (β-TCP) bioceramic for bone tissue engineering applications. The developed biocomposite was characterized using H nuclear magnetic resonance and Fourier transform infrared spectroscopy. Moreover, the bioceramic particle size distribution and morphology were evaluated using Brunauer-Emmett-Teller method, X-ray diffraction, and scanning electron microscopy. The mechanical properties and biodegradation of the scaffolds were also evaluated. Cytotoxicity and mineralization assays were performed to analyze the biocompatibility and bioactivity capacity of the developed biocomposite. The characterization data confirmed the development of a biodegradable and photo-cross-linkable PCL-based biocomposite reinforced with β-TCP bioceramic. In vitro analyses demonstrated the biocompatibility and mineralization potential of the synthesized bioceramic. Altogether, the results of the present study suggest that the photo-cross-linkable PCL-PPF-PCL tri-block copolymer reinforced with β-TCP is a promising biocomposite for bone tissue engineering applications. According to the results, this newly synthesized material has a proper chemical composition for further clinically-relevant studies in tissue engineering.

ZnO Nanosheet-Coated TiZrPdSiNb Alloy as a Piezoelectric Hybrid Material for Self-Stimulating Orthopedic Implants

A Ti-based alloy (Ti₄₅Zr₁₅Pd₃₀Si₅Nb₅) with already proven excellent mechanical and biocompatibility features has been coated with piezoelectric zinc oxide (ZnO) to induce the electrical self-stimulation of cells. ZnO was grown onto the pristine alloy in two different morphologies: a flat dense film and an array of nanosheets. The effect of the combined material on osteoblasts (electrically stimulable cells) was analyzed in terms of proliferation, cell adhesion, expression of differentiation markers and induction of calcium transients. Although both ZnO structures were biocompatible and did not induce inflammatory response, only the array of ZnO nanosheets was able to induce calcium transients, which improved the proliferation of Saos-2 cells and enhanced the expression of some early differentiation expression genes. The usual motion of the cells imposes strain to the ZnO nanosheets, which, in turn, create local electric fields owing to their piezoelectric character. These electric fields cause the opening of calcium voltage gates and boost cell proliferation and early differentiation. Thus, the modification of the Ti₄₅Zr₁₅Pd₃₀Si₅Nb₅ surface with an array of ZnO nanosheets endows the alloy with smart characteristics, making it capable of electric self-stimulation.

Bone Healing in the Presence of a Biodegradable PBS-DLA Copolyester and Its Composite Containing Hydroxyapatite

The healing process of the fractured bone in a presence of poly(butylene succinate-butylene dilinoleate) (PBS-DLA) copolymer containing nanosized hydroxyapatite (HAP) particles has been investigated. The PBS-DLA material containing PBS hard segments and DLA soft segments (50:50 wt %) was used to prepare a polymer/ceramic composite with 30 wt % HAP. A new PBS-DLA copolymer showed a high elasticity of 500% and 15 MPa tensile strength. Addition of HAP improved tensile strength up to 25 MPa while high elasticity has been preserved going down only to 300% of elongation at break. A polymer nanocomposite was fabricated into small elastic polymer rods 15 mm long and 1 × 2 mm in cross section and used for tibia bone fixation in rats. Mallory trichrome staining indicated that new biodegradable copolymers and its composite containing HAP have triggered the most advanced bone healing of all tested materials, thus indicating their high potential for bone tissue engineering and repair.

Scaffolding polymeric biomaterials: Are naturally occurring biological macromolecules more appropriate for tissue engineering?

Nowadays, tissue and organ failures resulted from injury, aging accounts, diseases or other type of damages is one of the most important health problems with an increasing incidence worldwide. Current treatments have limitations including, low graft efficiency, shortage of donor organs, as well as immunological problems. In this context, tissue engineering (TE) was introduced as a novel and versatile approach for restoring tissue/organ function using living cells, scaffold and bioactive (macro-)molecules. Among these, scaffold as a three-dimensional (3D) support material, provide physical and chemical cues for seeding cells and has an essential role in cell missions. Among the wide verity of scaffolding materials, natural or synthetic biopolymers are the most commonly biomaterials mainly due to their unique physicochemical and biological features. In this context, naturally occurring biological macromolecules are particular of interest owing to their low immunogenicity, excellent biocompatibility and cytocompatibility, as well as antigenicity that qualified them as popular choices for scaffolding applications. In this review, we highlighted the potentials of natural and synthetic polymers as scaffolding materials. The properties, advantages, and disadvantages of both polymer types as well as the current status, challenges, and recent progresses regarding the application of them as scaffolding biomaterials are also discussed.

Strontium-substituted hydroxyapatite stimulates osteogenesis on poly(propylene fumarate) nanocomposite scaffolds

Incorporation of hydroxyapatite (HA) into polymer networks is a promising strategy to enhance the mechanical properties and osteoinductivity of the composite scaffolds for bone tissue engineering. In this study, we designed a group of nanocomposite scaffolds based on cross-linkable poly(propylene fumarate) (PPF) and 30 wt % strontium-hydroxyapatite (Sr-HA) nanoparticles. Four different Sr contents [Sr:(Sr + Ca), molar ratio] in the Sr-HA particles were studied: 0% (HA), 5% (Sr5-HA), 10% (Sr10-HA), and 20% (Sr20-HA). Two-dimensional (2D) disks were prepared using a thermal crosslinking method. The structure and surface morphology of different Sr-HA and PPF/Sr-HA composites were characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), transmission electron microscopy (TEM), and atomic force microscopy (AFM). To detect cellular responses in vitro, MC3T3-E1 cells were seeded and cultured on the different PPF/Sr-HA composite disks. Cell morphology after 24 h and 5 days were imaged using Live/Dead live cell staining and SEM, respectively. Cell proliferation was quantified using an MTS assay at 1, 4, and 7 days. Osteogenic differentiation of the cells was examined by alkaline phosphatase (ALP) staining at 10 days and quantified using ALP activity and osteocalcin assays at 7, 14, and 21 days. The sizes of the HA, Sr5-HA, Sr10-HA, and Sr20-HA particles were mainly between 10 × 20 nm and 10 × 250 nm, and these nanoparticles were dispersed or clustered in the composite scaffolds. in vitro cell studies showed that the PPF/Sr10-HA scaffold was significantly better than the other three groups (PPF/HA, PPF/Sr5-HA, and PPF/Sr20-HA) in supporting MC3T3-E1 cell adhesion, proliferation, and differentiation. PPF/Sr10-HA may, therefore, serve as a promising scaffold material for bone tissue engineering. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 631-642, 2019.

In Vitro Osteogenesis Stimulation via Nano-Hydroxyapatite/Carbon Nanotube Thin Films on Biomedical Stainless Steel

We evaluated the electrophoretic deposition of nanohydroxyapatite/superhydrop hilic multiwalled carbon nanotube composites (nHAp/MWCNT) onto stainless steel biomedical alloys for applications in bone tissue engineering. First, nHAp/MWCNT composites were dispersed into 0.042 mol·L⁻¹ of Ca(NO₃)₂·4H₂O + 0.025 mol·L⁻¹ NH₄H₂PO₄ electrolytes (pH = 4.8) at two different concentrations. Next, a voltage of −2 V was applied using 316L stainless steel as a working electrode (0.27 cm²), a high-purity platinum coil wire was used as the auxiliary electrode, and an Ag/AgCl (3 M) electrode was used as the reference electrode. The nHAp/MWCNT composites were characterized by transmission electron microscopy. The deposited nHAp and nHAp/MWCNT films were characterized by profilometry, scanning electron microscopy, X-ray diffractometry and Raman spectroscopy. Human osteoblast cells were cultivated with the different materials and in vitro cytotoxicity was evaluated using lactate dehydrogenase (LDH) assay. The osteogenesis process was evaluated by mRNA levels of the three genes that are directly related to bone repair: Alkaline Phosphatase, Osteopontin and Osteocalcin. We showed that rough, crystalline apatite thin films containing phases of nHAp were successfully deposited onto 316L stainless steel alloys. Also, we noticed that nHAp/MWCNT thin films deposited onto 316L stainless steel alloys upregulated the expression of important genes related to bone mineralization and maturation. Our results strongly support the possibility of this new alternative to modify the surface of metallic biomedical alloys to promote bone tissue regeneration.

Four-Dimensional Printing Hierarchy Scaffolds with Highly Biocompatible Smart Polymers for Tissue Engineering Applications

The objective of this study was to four-dimensional (4D) print novel biomimetic gradient tissue scaffolds with highly biocompatible naturally derived smart polymers. The term "4D printing" refers to the inherent smart shape transformation of fabricated constructs when implanted minimally invasively for seamless and dynamic integration. For this purpose, a series of novel shape memory polymers with excellent biocompatibility and tunable shape changing effects were synthesized and cured in the presence of three-dimensional printed sacrificial molds, which were subsequently dissolved to create controllable and graded porosity within the scaffold. Surface morphology, thermal, mechanical, and biocompatible properties as well as shape memory effects of the synthesized smart polymers and resultant porous scaffolds were characterized. Fourier transform infrared spectroscopy and gel content analysis confirmed the formation of chemical crosslinking by reacting polycaprolactone triol and castor oil with multi-isocyanate groups. Differential scanning calorimetry revealed an adjustable glass transition temperature in a range from -8°C to 35°C. Uniaxial compression testing indicated that the obtained polymers, possessing a highly crosslinked interpenetrating polymeric networks, have similar compressive modulus to polycaprolactone. Shape memory tests revealed that the smart polymers display finely tunable recovery speed and exhibit greater than 92% shape fixing at -18°C or 0°C and full shape recovery at physiological temperature. Scanning electron microscopy analysis of fabricated scaffolds revealed a graded microporous structure, which mimics the nonuniform distribution of porosity found within natural tissues. With polycaprolactone serving as a control, human bone marrow-derived mesenchymal stem cell adhesion, proliferation, and differentiation greatly increased on our novel smart polymers. The current work will significantly advance the future design and development of novel and functional biomedical scaffolds with advanced 4D printing technology and highly biocompatible smart biomaterials.

Extrusion-based 3D printing of poly(propylene fumarate) scaffolds with hydroxyapatite gradients

The primary focus of this work is to present the current challenges of printing scaffolds with concentration gradients of nanoparticles with an aim to improve the processing of these scaffolds. Furthermore, we address how print fidelity is related to material composition and emphasize the importance of considering this relationship when developing complex scaffolds for bone implants. The ability to create complex tissues is becoming increasingly relevant in the tissue engineering community. For bone tissue engineering applications, this work demonstrates the ability to use extrusion-based printing techniques to control the spatial deposition of hydroxyapatite (HA) nanoparticles in a 3D composite scaffold. In doing so, we combined the benefits of synthetic, degradable polymers, such as poly(propylene fumarate) (PPF), with osteoconductive HA nanoparticles that provide robust compressive mechanical properties. Furthermore, the final 3D printed scaffolds consisted of well-defined layers with interconnected pores, two critical features for a successful bone implant. To demonstrate a controlled gradient of HA, thermogravimetric analysis was carried out to quantify HA on a per-layer basis. Moreover, we non-destructively evaluated the tendency of HA particles to aggregate within PPF using micro-computed tomography (μCT). This work provides insight for proper fabrication and characterization of composite scaffolds containing particle gradients and has broad applicability for future efforts in fabricating complex scaffolds for tissue engineering applications.

Functional analysis of bioactivated and antiinfective PDLLA - coated surfaces

Common scaffold surfaces such as titanium can have side effects; for example, infections, cytotoxicity, impaired osseointegration, or low regeneration rates for bone tissue. These effects lead to poor implant integration or even implant loss. Therefore, bioactive implants are promising instruments in tissue regeneration. Osteoinductive elements-such as growth factors and anti-infectives-support wound healing and bone growth and thereby enable faster osseointegration, even in elderly patients. In this study, titanium surfaces were coated with a poly-(d,l-lactide) (PDLLA) layer containing different concentrations of copolymer-protected gene vectors (COPROGs) to locally provide bone morphogenetic protein-2 (BMP-2) or activated anti-infective agents, such as chlorhexidine gluconate, triclosan, and metronidazole, to prevent peri-implantitis. The coated titanium implants were then loaded with osteoblasts, NIH 3T3 fibroblasts, and human mesenchymal stem cells in 96-well plates. When shielded by COPROGs as a protective layer and resuspended in PDLLA, BMP-2-encoding pDNA at relatively low doses (5.63 µg/implant) induced the local expression of BMP-2. A linear dose dependence, which is common for recombinant growth factors, was not found, probably due to the retention property of the PDLLA surface. PDLLA, in general, successfully retains additional elements, such as osteoconductive growth factors (BMP-2) and anti-infective agents, which was demonstrated using metronidazole, and thus prevents the systemic application of excessive doses. These bioactive implant surfaces that provide the local release of therapeutic gene vectors or anti-infective agents allow the controlled stimulation of the implant and scaffold osseointegration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1672-1683, 2017.

One Ion to Rule Them All: Combined Antibacterial, Osteoinductive and Anticancer Properties of Selenite-Incorporated Hydroxyapatite

Although hydroxyapatite (HAp) has been doped with dozens of different ions, the quest for an ion imparting a combination of properties conducive to bone healing is still ongoing. Because of its protean potency and the similarity in size and shape to the phosphate tetrahedron, selenite ion presents a natural ionic substitute in HAp. The incorporation of selenite into synthetic HAp using two different methods - co-precipitation and ion-exchange sorption - was studied for its effect on crystal properties and on a triad of biological responses: antibacterial, anticancer and osteoinductive. Co-precipitation yielded HAp with higher selenite contents than sorption and the stoichiometry of HAp richest in selenite was represented as Ca_9.75(PO₄)_5.75(SeO₃)_0.25(OH)_1.75. Crystallinity of HAp decreased in direct proportion with the amount of selenite incorporated. Because of their lower selenite content, HAp powders prepared by ion-exchange exhibited a consistently higher crystallinity compared to the co-precipitated ones. Annealing partially recovered the crystallinity, yet the difference in crystallinity between powders prepared by co-precipitation and by ion-exchange remained, suggesting that the amorphization is mainly due to structural incorporation of selenite, not its effect on the crystal growth kinetics. The addition of selenite changed the morphology of HAp nanoparticles from acicular to rounded and affected the crystal lattice parameters in different ways depending on whether the powders were annealed or not. As for the annealed powders, the incorporation of selenite contracted the lattice in both a and c crystallographic directions. In the agar diffusion assay, the effectiveness of HAp was more dependent on the presence or absence of selenite in it than on its concentration and was highest against E. coli and S. aureus, moderately high against S. enteritidis and ineffective against P. aeruginosa. In liquid inoculation tests, on the other hand, the antibacterial activity of HAp was directly proportional to the amount of selenite contained in it. The viability of K7M2 osteosarcoma cells decreased in direct proportion with the amount of selenite in HAp and was significantly different from the untreated control and from pure HAp at contents equal to or higher than 1.9 wt.%. In contrast, no reduction was observed in the viability of primary fibroblasts treated with HAp incorporating different amounts of selenite ions, suggesting their potentially selective anticancer activity: lethal for the cancer cells and harmless for the healthy cells. Finally, mRNA expression of bone gamma-carboxyglutamate protein (BGLAP3) was higher in differentiated MC3T3-E1 osteoblastic cells treated with selenite-incorporated HAp particles than in cells treated with pure HAp. The osteoinductive effect was due to an overall higher metabolic activity of cells treated with the particles and not due to increased proliferation. In such a way, a triad of antibacterial, osteoinductive and anticancer activities was attributed to selenite-incorporated HAp.

Stem cells, growth factors and scaffolds in craniofacial regenerative medicine

Current reconstructive approaches to large craniofacial skeletal defects are often complicated and challenging. Critical-sized defects are unable to heal via natural regenerative processes and require surgical intervention, traditionally involving autologous bone (mainly in the form of nonvascularized grafts) or alloplasts. Autologous bone grafts remain the gold standard of care in spite of the associated risk of donor site morbidity. Tissue engineering approaches represent a promising alternative that would serve to facilitate bone regeneration even in large craniofacial skeletal defects. This strategy has been tested in a myriad of iterations by utilizing a variety of osteoconductive scaffold materials, osteoblastic stem cells, as well as osteoinductive growth factors and small molecules. One of the major challenges facing tissue engineers is creating a scaffold fulfilling the properties necessary for controlled bone regeneration. These properties include osteoconduction, osetoinduction, biocompatibility, biodegradability, vascularization, and progenitor cell retention. This review will provide an overview of how optimization of the aforementioned scaffold parameters facilitates bone regenerative capabilities as well as a discussion of common osteoconductive scaffold materials.

Photocrosslinkable and elastomeric hydrogels for bone regeneration

Nanocomposite biomaterials are extensively investigated for cell and tissue engineering applications due their unique physical, chemical and biological characteristics. Here, we investigated the mechanical, rheological, and degradation properties of photocrosslinkable and elastomeric nanocomposite hydrogels from nanohydroxyapatite (nHAp) and gelatin methacryloyl (GelMA). The addition of nHAp resulted in a significant increase in mechanical stiffness and physiological stability. Cells readily adhere and proliferate on the nanocomposite surfaces. Cyclic stretching of cells on the elastomeric nanocomposites revealed that nHAp elicited a stronger alignment response in the direction of strain. In vitro studies highlight enhanced bioactivity of nanocomposites as determined by alkaline phosphate (ALP) activity. Overall, the elastomeric and photocrosslinkable nanocomposite hydrogels can be used for minimally invasive therapy for bone regeneration.