3D-Printed Piezoelectric Scaffolds with Shape Memory Polymer for Bone Regeneration

Exogenous electron generation techniques for biomedical applications: Bridging fundamentals and clinical practice

Endogenous bioelectrical signals are quite crucial in biological development, governing processes such as regeneration and disease progression. Exogenous stimulation, which mimics endogenous bioelectrical signals, has demonstrated significant potential to modulate complex biological processes. Consequently, increasing scientific efforts have focused on developing methods to generate exogenous electrons for biological applications, primarily relying on piezoelectric, acoustoelectric, optoelectronic, magnetoelectric, and thermoelectric principles. Given the expanding body of literature on this topic, a systematic and comprehensive review is essential to foster a deeper understanding and facilitate clinical applications of these techniques. This review synthesizes and compares these methods for generating exogenous electrical signals, their underlying principles (e.g., semiconductor deformation, photoexcitation, vibration and relaxation, and charge separation), biological mechanisms, potential clinical applications, and device designs, highlighting their advantages and limitations. By offering a comprehensive perspective on the critical role of exogenous electrons in biological systems, elucidating the principles of various electron-generation techniques, and exploring possible pathways for developing medical devices utilizing exogenous electrons, this review aims to advance the field and support therapeutic innovation.

4D Printing: A Comprehensive Review of Technologies, Materials, Stimuli, Design, and Emerging Applications

4D printing is a groundbreaking technology that seamlessly integrates additive manufacturing with smart materials, enabling the creation of multiscale objects capable of changing shapes and/or functions in a controlled and programmed manner in response to applied energy inputs. Printing technologies, mathematical modeling, responsive materials, stimuli, and structural design constitute the blueprint of 4D printing, all of which have seen rapid advancement in the past decade. These advancements have opened up numerous possibilities for dynamic and adaptive structures, finding potential use in healthcare, textiles, construction, aerospace, robotics, photonics, and electronics. However, current 4D printing primarily focuses on proof-of-concept demonstrations. Further development is necessary to expand the range of accessible materials and address fabrication complexities for widespread adoption. In this paper, we aim to deliver a comprehensive review of the state-of-the-art in 4D printing, probing into shape programming, exploring key aspects of resulting constructs including printing technologies, materials, structural design, morphing mechanisms, and stimuli-responsiveness, and elaborating on prominent applications across various fields. Finally, we discuss perspectives on limitations, challenges, and future developments in the realm of 4D printing. While the potential of this technology is undoubtedly vast, continued research and innovation are essential to unlocking its full capabilities and maximizing its real-world impact.

Programming a UV-Triggered In Situ Cospinning Fiber with Site-Specific and Anisotropic Deformation Behavior toward Light-Driven Soft Actuators

Fabric and textile actuators capable of displaying light-controlled morphing behaviors are of essential significance in nature and wearable devices. Despite several studies on this system, the precise regulation for performing combined programmable site-specific and light-controlled deformation remains a challenging issue. In this work, a dual-layer-based fabric actuator is fabricated via UV-triggered in situ electrospinning of polycaprolactone/polyethylene glycol (denoted as PCL/PEG) matrix coated with polydopamine (PDA) nanospheres. The method affords the resultant fiber actuator capable of exhibiting stretchable characteristic in cold-drawing environment while maintaining relatively decent morphing properties. Additionally, upon site-specific irradiation with laser spot, the surface resonance absorption of the coated PDA allows for the formation of temperature gradient in the fiber's strained state, enabling the fabric actuators with programmable on-demand out-of-plane bending deformations due to anisotropic chain relaxation and the release of embedded internal stress. Uniquely, by designing macroscopic bilayer structures with orientated molecular chain segments and vector sum of shape recovery forces, the fabric actuator exhibited bending and chiral twisting deformations as determined by the orientation angles between the upper and lower layer. The results presented in this study clearly provide insight on fabricating light-driven programmable fabric actuators.

3D printed shape-memory piezoelectric scaffolds with in-situ self-power properties for bone defect repair

Electrical stimulation has been shown to regulate early immunity and late-stage osteogenesis in bone repair. However, achieving in-situ electrical stimulation in the form of self-power in vivo during the initial postoperative stages when the patients have limited mobility remains challenging. In this study, we developed a 3D-printed in-situ self-powered composite scaffold composed of shape memory polyurethane elastomers (SMPU) and polyvinylidene fluoride (PVDF) piezoelectric nanofibers. The composite scaffold demonstrates excellent shape memory performance, allowing for minimally invasive implantation. During the shape memory process, the composite scaffold can provide mechanical force stimulation to PVDF nanofibers to generate charge. Therefore, self-power was achieved through the integration of the shape memory process and piezoelectric effects, and it can be used for in-situ electrical stimulation during the initial postoperative period. Additionally, the composite scaffold can output voltage under continuous mechanical force stimulation, indicating that the patients can apply sustained mechanical force stimulation to the composite scaffold to output voltage through rehabilitation exercises when the patients regain mobility. Both cell experiments and animal studies confirmed that this composite scaffold can effectively regulate the immune microenvironment and enhance osteogenesis. This study successfully achieves in-situ electrical stimulation in the form of self-power by integrating the shape memory process and piezoelectric effects, which is expected to be an effective repair strategy for bone tissue engineering.

Biological effects, properties and tissue engineering applications of polyhydroxyalkanoates: A review

Polyhydroxyalkanoates (PHAs) are a group of polymers with a variety of monomers, which are extracted from microorganisms and plants. Due to its good biocompatibility, biodegradability, tunable mechanical property and piezoelectricity, PHAs have been widely used in biomedical fields, such as bone, cartilage, nerve, vascular and skin tissue engineering. This review focuses on the in vivo synthesis, metabolism and biological functions of PHA, and the applications of PHAs in the field of tissue engineering and commercial were also summarized and discussed. Moreover, this review hints the future perspective and research direction of PHA-based materials in the challenging field of tissue engineering. We hope that this review will catalyze the continued advancement and broadening of PHAs' applications in biomedicine.

Periosteum-bone inspired hierarchical scaffold with endogenous piezoelectricity for neuro-vascularized bone regeneration

The development of scaffolds for repairing critical-sized bone defects heavily relies on establishing a neuro-vascularized network for proper penetration of nerves and blood vessels. Despite significant advancements in using artificial bone-like scaffolds infused with various agents, challenges remain. Natural bone tissue consists of a porous bone matrix surrounded by a neuro-vascularized periosteum, with unique piezoelectric properties essential for bone growth. Drawing inspiration from this assembly, we developed a periosteum-bone-mimicking bilayer scaffold with piezoelectric properties for regeneration of critical-sized bone defects. The periosteum-like layer of this scaffold features a double network hydrogel composed of chelated alginate, gelatin methacrylate, and sintered whitlockite nanoparticles, emulating the viscoelastic and piezoelectric properties of the natural periosteum. The bone-like layer is composed of a porous structure of chitosan and bioactive hydroxyapatite created through a biomineralization process. Unlike conventional bone-like scaffolds, this bioinspired bilayer scaffold significantly enhances osteogenesis, angiogenesis, and neurogenesis combined with low-intensity pulsed ultrasound-assisted piezoelectric stimulation. Such a scheme enhances neuro-vascularized bone regeneration in vivo. The results suggest that the bilayer scaffold could serve as an effective self-powered electrical stimulator to expedite bone regeneration under dynamic physical stimulation.

Piezoelectric hydrogels for accelerating healing of diverse wound types

The skin, as the body's largest organ, plays a crucial role in protecting against mechanical forces and infections, maintaining fluid balance, and regulating body temperature. Therefore, skin wounds can significantly threaten human health and cause a heavy economic burden on society. Recently, bioelectric fields and electrical stimulation (ES) have been recognized as a promising pathway for modulating tissue engineering and regeneration of wounded skin. However, conventional hydrogel dressing lacks electrical generation capabilities and usually requires external stimuli to initiate the cell regeneration process, and the role of ES in different stages of healing is not fully understood. Therefore, to endow hydrogel-based wound dressings with piezoelectric properties, which can accelerate wound healing and potentially suppress infection via introducing ES, piezoelectric hydrogels (PHs) have emerged recently, combining the advantages of both piezoelectric nanomaterials and hydrogels beneficial for wound healing. Given the scarcity of systematic literature on the application of PHs in wound healing, this paper systematically discusses the principles of the piezoelectric effects, the design and fabrication of PHs, their piezoelectric properties, the way PHs trigger ES and the mechanisms by which they promote wound healing. Additionally, it summarizes the recent applications of PHs in various types of wounds, including traumatic wounds, pressure injuries, diabetic wounds, and infected wounds. Finally, the paper proposes future directions and challenges for the development of PH wound dressings for wound healing.

Advanced Piezoelectric Materials, Devices, and Systems for Orthopedic Medicine

Harnessing the robust electromechanical couplings, piezoelectric materials not only enable efficient bio-energy harvesting, physiological sensing and actuating but also open enormous opportunities for therapeutic treatments through surface polarization directly interacting with electroactive cells, tissues, and organs. Known for its highly oriented and hierarchical structure, collagen in natural bones produces local electrical signals to stimulate osteoblasts and promote bone formation, inspiring the application of piezoelectric materials in orthopedic medicine. Recent studies showed that piezoelectricity can impact microenvironments by regulating molecular sensors including ion channels, cytoskeletal elements, cell adhesion proteins, and other signaling pathways. This review thus focuses on discussing the pioneering applications of piezoelectricity in the diagnosis and treatment of orthopedic diseases, aiming to offer valuable insights for advancing next-generation medical technologies. Beginning with an introduction to the principles of piezoelectricity and various piezoelectric materials, this review paper delves into the mechanisms through which piezoelectric materials accelerated osteogenesis. A comprehensive overview of piezoelectric materials, devices, and systems enhancing bone tissue repair, alleviating inflammation at infection sites, and monitoring bone health is then provided, respectively. Finally, the major challenges faced by applications of piezoelectricity in orthopedic conditions are thoroughly discussed, along with a critical outlook on future development trends.

Challenges and Innovations in Alveolar Bone Regeneration: A Narrative Review on Materials, Techniques, Clinical Outcomes, and Future Directions

This review explores the recent advancements and ongoing challenges in regenerating alveolar bone, which is essential for dental implants and periodontal health. It examines traditional techniques like guided bone regeneration and bone grafting, alongside newer methods such as stem cell therapy, gene therapy, and 3D bioprinting. Each approach is considered for its strengths in supporting bone growth and integration, especially in cases where complex bone defects make regeneration difficult. This review also looks at different biomaterials, from bioactive scaffolds to nanomaterials, assessing how well they encourage cell growth and healing. Personalized treatments, like customized 3D-printed scaffolds, show promise in enhancing bone formation and tissue compatibility. Additionally, signaling molecules, like bone morphogenetic proteins, play a crucial role in guiding the process of bone formation and remodeling. Despite these advances, challenges remain-particularly with severe bone loss and with refining biomaterials for more reliable, long-term outcomes. This review proposes combining advanced materials, regenerative technologies, and personalized approaches to achieve more effective and consistent outcomes in oral and maxillofacial surgery.

3D-Printed Shape Memory and Piezoelectric Bifunctional Thermoplastic Polyurethane/Polyvinylidene Fluoride Porous Composite Scaffold for Bone Regeneration

Physical stimulations such as mechanical and electric stimulation can continuously work on bone defect locations to maintain and enhance cell activity, and it has become a hotspot for research in the field of bone repair. Herein, bifunctional porous composite scaffolds with shape memory and piezoelectric functions were fabricated using thermoplastic polyurethane (TPU) and poly(vinylidene fluoride) through triply periodic minimal surfaces design and selective laser sintering technology. Thereinto, the shape fixity ratio and recovery ratio of the composite scaffold reached 98.6% and 81.2%, respectively, showing excellent shape memory functions. More importantly, its piezoelectric coefficient (d33 = 2.47 pC/N) is close to the piezoelectric constant of bone tissue (d33 = 0.7-2.3 pC/N), and the voltage released during the compression process can reach 0.5 V. Furthermore, cyclic compression experiments showed that the strength of composite scaffold was up to 8.3 times compared with the TPU scaffold. Besides, the composite scaffold showed excellent cytocompatibility. In conclusion, the composite scaffold is expected to continuously generate mechanical and electric stimulation due to shape memory and piezoelectric function, respectively, which provide an effective strategy for bone repair.

Advanced Materials for Energy Harvesting and Soft Robotics: Emerging Frontiers to Enhance Piezoelectric Performance and Functionality

Piezoelectric energy harvesting captures mechanical energy from a number of sources, such as vibrations, the movement of objects and bodies, impact events, and fluid flow to generate electric power. Such power can be employed to support wireless communication, electronic components, ocean monitoring, tissue engineering, and biomedical devices. A variety of self-powered piezoelectric sensors, transducers, and actuators have been produced for these applications, however approaches to enhance the piezoelectric properties of materials to increase device performance remain a challenging frontier of materials research. In this regard, the intrinsic polarization and properties of materials can be designed or deliberately engineered to enhance the piezo-generated power. This review provides insights into the mechanisms of piezoelectricity in advanced materials, including perovskites, active polymers, and natural biomaterials, with a focus on the chemical and physical strategies employed to enhance the piezo-response and facilitate their integration into complex electronic systems. Applications in energy harvesting and soft robotics are overviewed by highlighting the primary performance figures of merits, the actuation mechanisms, and relevant applications. Key breakthroughs and valuable strategies to further improve both materials and device performance are discussed, together with a critical assessment of the requirements of next-generation piezoelectric systems, and future scientific and technological solutions.

Exploring the application of piezoelectric ceramics in bone regeneration

Piezoelectric ceramics are piezoelectric materials with polycrystalline structure and have been widely used in many fields such as medical imaging and sound sensors. As knowledge about this kind of material develops, researchers find piezoelectric ceramics possess favorable piezoelectricity, biocompatibility, mechanical properties, porous structure and antibacterial effect and endeavor to apply piezoelectric ceramics to the field of bone tissue engineering. However, clinically no piezoelectric ceramics have been exercised so far. Therefore, in this paper we present a comprehensive review of the research and development of various piezoelectric ceramics including barium titanate, potassium sodium niobate and zinc oxide ceramics and aims to explore the application of piezoelectric ceramics in bone regeneration by providing a detailed overview of the current knowledge and research of piezoelectric ceramics in bone tissue regeneration.

Application of Bioactive Materials for Osteogenic Function in Bone Tissue Engineering

Bone tissue defects present a major challenge in orthopedic surgery. Bone tissue engineering using multiple versatile bioactive materials is a potential strategy for bone-defect repair and regeneration. Due to their unique physicochemical and mechanical properties, biofunctional materials can enhance cellular adhesion, proliferation, and osteogenic differentiation, thereby supporting and stimulating the formation of new bone tissue. 3D bioprinting and physical stimuli-responsive strategies have been employed in various studies on bone regeneration for the fabrication of desired multifunctional biomaterials with integrated bone tissue repair and regeneration properties. In this review, biomaterials applied to bone tissue engineering, emerging 3D bioprinting techniques, and physical stimuli-responsive strategies for the rational manufacturing of novel biomaterials with bone therapeutic and regenerative functions are summarized. Furthermore, the impact of biomaterials on the osteogenic differentiation of stem cells and the potential pathways associated with biomaterial-induced osteogenesis are discussed.

Piezoelectric Biomaterials Inspired by Nature for Applications in Biomedicine and Nanotechnology

Bioelectricity provides electrostimulation to regulate cell/tissue behaviors and functions. In the human body, bioelectricity can be generated in electromechanically responsive tissues and organs, as well as biomolecular building blocks that exhibit piezoelectricity, with a phenomenon known as the piezoelectric effect. Inspired by natural bio-piezoelectric phenomenon, efforts have been devoted to exploiting high-performance synthetic piezoelectric biomaterials, including molecular materials, polymeric materials, ceramic materials, and composite materials. Notably, piezoelectric biomaterials polarize under mechanical strain and generate electrical potentials, which can be used to fabricate electronic devices. Herein, a review article is proposed to summarize the design and research progress of piezoelectric biomaterials and devices toward bionanotechnology. First, the functions of bioelectricity in regulating human electrophysiological activity from cellular to tissue level are introduced. Next, recent advances as well as structure-property relationship of various natural and synthetic piezoelectric biomaterials are provided in detail. In the following part, the applications of piezoelectric biomaterials in tissue engineering, drug delivery, biosensing, energy harvesting, and catalysis are systematically classified and discussed. Finally, the challenges and future prospects of piezoelectric biomaterials are presented. It is believed that this review will provide inspiration for the design and development of innovative piezoelectric biomaterials in the fields of biomedicine and nanotechnology.

Multimaterial 3D and 4D Bioprinting of Heterogenous Constructs for Tissue Engineering

Additive manufacturing (AM), which is based on the principle of layer-by-layer shaping and stacking of discrete materials, has shown significant benefits in the fabrication of complicated implants for tissue engineering (TE). However, many native tissues exhibit anisotropic heterogenous constructs with diverse components and functions. Consequently, the replication of complicated biomimetic constructs using conventional AM processes based on a single material is challenging. Multimaterial 3D and 4D bioprinting (with time as the fourth dimension) has emerged as a promising solution for constructing multifunctional implants with heterogenous constructs that can mimic the host microenvironment better than single-material alternatives. Notably, 4D-printed multimaterial implants with biomimetic heterogenous architectures can provide a time-dependent programmable dynamic microenvironment that can promote cell activity and tissue regeneration in response to external stimuli. This paper first presents the typical design strategies of biomimetic heterogenous constructs in TE applications. Subsequently, the latest processes in the multimaterial 3D and 4D bioprinting of heterogenous tissue constructs are discussed, along with their advantages and challenges. In particular, the potential of multimaterial 4D bioprinting of smart multifunctional tissue constructs is highlighted. Furthermore, this review provides insights into how multimaterial 3D and 4D bioprinting can facilitate the realization of next-generation TE applications.

Piezoelectric Hydrogels: Hybrid Material Design, Properties, and Biomedical Applications

Hydrogels show great potential in biomedical applications due to their inherent biocompatibility, high water content, and resemblance to the extracellular matrix. However, they lack self-powering capabilities and often necessitate external stimulation to initiate cell regenerative processes. In contrast, piezoelectric materials offer self-powering potential but tend to compromise flexibility. To address this, creating a novel hybrid biomaterial of piezoelectric hydrogels (PHs), which combines the advantageous properties of both materials, offers a systematic solution to the challenges faced by these materials when employed separately. Such innovative material system is expected to broaden the horizons of biomedical applications, such as piezocatalytic medicinal and health monitoring applications, showcasing its adaptability by endowing hydrogels with piezoelectric properties. Unique functionalities, like enabling self-powered capabilities and inducing electrical stimulation that mimics endogenous bioelectricity, can be achieved while retaining hydrogel matrix advantages. Given the limited reported literature on PHs, here recent strategies concerning material design and fabrication, essential properties, and distinctive applications are systematically discussed. The review is concluded by providing perspectives on the remaining challenges and the future outlook for PHs in the biomedical field. As PHs emerge as a rising star, a comprehensive exploration of their potential offers insights into the new hybrid biomaterials.

Mechanically robust and personalized silk fibroin-magnesium composite scaffolds with water-responsive shape-memory for irregular bone regeneration

The regeneration of critical-size bone defects, especially those with irregular shapes, remains a clinical challenge. Various biomaterials have been developed to enhance bone regeneration, but the limitations on the shape-adaptive capacity, the complexity of clinical operation, and the unsatisfied osteogenic bioactivity have greatly restricted their clinical application. In this work, we construct a mechanically robust, tailorable and water-responsive shape-memory silk fibroin/magnesium (SF/MgO) composite scaffold, which is able to quickly match irregular defects by simple trimming, thus leading to good interface integration. We demonstrate that the SF/MgO scaffold exhibits excellent mechanical stability and structure retention during the degradative process with the potential for supporting ability in defective areas. This scaffold further promotes the proliferation, adhesion and migration of osteoblasts and the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. With suitable MgO content, the scaffold exhibits good histocompatibility, low foreign-body reactions (FBRs), significant ectopic mineralisation and angiogenesis. Skull defect experiments on male rats demonstrate that the cell-free SF/MgO scaffold markedly enhances bone regeneration of cranial defects. Taken together, the mechanically robust, personalised and bioactive scaffold with water-responsive shape-memory may be a promising biomaterial for clinical-size and irregular bone defect regeneration.

Dual Circularly Polarized Luminescence (CPL) and Piezoelectric Responses in Self-Assembled Chiral Nanostructures Derived from a Dipeptide Based Piezorganogel

Next-generation medical and consumer electrical devices require soft, flexible materials. Piezoelectric materials, capable of converting mechanical stress into electrical energy, are of interest across various fields. Chiral nanostructures, with inherent chirality, have emerged as potential piezoelectric materials. Peptide-based materials, known for self-assembly and stimuli responsiveness, hold promise for the utilization of chiral nanostructures. When combined with luminescent chromophores, peptides can generate aggregation-induced chiroptical effects like Circularly Polarized Luminescence (CPL) and Circular Dichroism (CD). In this study, a chiral organogel, L,L-1 is synthesized, and its self-assembly, mechanical properties, and chiroptical features are examined. The organogel exhibits thermo-reversible and thixotropic behavior, forming fibrillar networks and 2D-sheets upon cooling. CD spectroscopy reveals aggregation-induced chirality on pyrene chromophore, resulting in CPL with glum values of 3.0 (± 0.2) × 10-3 and 3.1 (± 0.2) × 10-3 for L,L-1 and D,D-1, respectively. Notably, the 2D-sheets exhibit an enhanced piezoelectric response (d33 ≈76.0 pm V-1 ) compared to the fibrillar network (d33 ≈64.1 pm V-1 ). Introducing an electron-deficient molecule into the solution forms a Charge-transfer (CT) complex, modulating the piezoelectric response to d33 ≈52.44 pm V-1 . This study offers a promising approach to optoelectronics design, presenting a chiral system with both CPL and piezoelectric responses, opening new possibilities for innovative applications.