The material design of octacalcium phosphate bone substitute: increased dissolution and osteogenecity

E7 peptide modified poly(ε-caprolactone)/silk fibroin/octacalcium phosphate nanofiber membranes with "recruitment-osteoinduction" potentials for effective guided bone regeneration

Effective membranes that have the osteogneic potential and the ability to recruit osteoblast precursor cells challenged guided bone regeneration (GBR). Herein, we engineered multifunctional nanofiber membranes by using eletrospun poly(ε-caprolactone) (PCL) and silk fibroin (SF), incorporated with octacalcium phosphate (OCP) and BMSCs-affine peptide (E7) to form the PCL/SF/OCP/E7 (PSOE) nanofiber, wherein the E7 peptide enhances the enrichment of BMSCs, and OCP as osteogenesis promoter. The composite membranes enhance the recruitment and biomineralization processes essential for bone regeneration. Notably, the dual functionality of BMSC recruitment and osteoinduction provides a "recruitment-osteoinduction" strategy that significantly improves bone repair. In vitro analyses confirmed that the PSOE nanofibers have superior hydrophilicity and biocompatibility, and significantly upregulated the expression of osteogenic genes in mesenchymal stem cells, thereby facilitating osteogenic differentiation. In vivo studies using a rat tibial defect model revealed that PSOE nanofibers promoted bone repair within 8 weeks, as validated by micro-CT and histological evaluations. This study highlights the PSOE nanofiber's potential as a promising synthetic periosteum substitute for effective bone regeneration.

Effect of Octacalcium Phosphate on Osteogenic Differentiation of Induced Pluripotent Stem Cells in a 3D Hybrid Spheroid Culture

Octacalcium phosphate (OCP) has been shown to exhibit an osteogenic property and, therefore, has been utilized recently as a bone substitute, clinically. However, the stimulatory capacity for induced pluripotent stem (iPS) cells is not known. This study investigated whether OCP enhances osteoblastic differentiation of three-dimensionally cultured spheroids of iPS cells compared to hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP). Mouse iPS cells were mixed with smaller (less than 53 μm) or larger (300-500 μm) sizes of calcium phosphate (CaP) granules and cultured in a laboratory-developed oxygen-permeable culture chip under minimizing hypoxia for up to 21 days. Osteoblastic differentiation was estimated by the cellular alkaline phosphatase (ALP) activities. The degree of supersaturation (DS) with respect to CaP phases was determined from the media chemical compositions. Incubated CaP materials were characterized by Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD). The culture promoted well the formation of hybrid spheroids of CaP materials and iPS cells regardless of the type of materials and their granule sizes. The ALP activity of OCP was about 1.5 times higher than that of β-TCP and HA in smaller granule sizes. FTIR, XRD, and DS analyses showed that larger OCP granules tended to hydrolyze to HA slightly faster than smaller granules with time while HA and β-TCP materials tended to remain unchanged. In conclusion, the results suggest that OCP enhances the osteogenic differentiation of iPS cells more than HA and β-TCP through a mechanism of hydrolyzing to HA. This inherent material property of OCP is essential for enhancing the osteoblastic differentiation of iPS cells.

Enhanced osteogenic capacity of octacalcium phosphate involving adsorption of stromal-derived factor-1 in a standardized defect of a rat femur

This study investigated whether octacalcium phosphate (OCP) enhances bone regeneration through its synergistic effect with stromal-derived factor-1 (SDF-1). Recombinant SDF-1 (0.5-5.0 μg) was combined with OCP granules through lyophilization. OCP/SDF-1 granules were implanted into a rat femoral standardized defect for 2 and 4 weeks and subjected to histomorphometry, C-X-C motif chemokine receptor 4 (CXCR4) and osteocalcin immunohistomorphometry, and tartrate-resistant acid phosphatase (TRAP) staining. Calcium-deficient hydroxyapatite (CDHA) was used as a control for in vitro analyses. Mesenchymal stem cell (MSC) migration was estimated using a Transwell system with OCP/SDF-1. SDF-1 release from OCP/SDF-1 into the supernatant was determined without cells. SDF-1 adsorption in 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid buffer onto OCP, the chemical structure of OCP immersed in the medium using Fourier transform infrared spectroscopy, and the degree of supersaturation of the medium were determined. Bone regeneration and OCP degradation were enhanced the most by 1.0 μg of OCP/SDF-1 at 2 weeks after implantation by CT analysis and increasing CXCR4-positive, osteocalcin-positive, and TRAP-positive cells accumulation around the OCP. MSC migration increased until 48 h in the following order: SDF-1 only, CDHA/SDF-1, and OCP/SDF-1, with the greatest effect with 1.0 μg of SDF-1 than from OCP. CDHA promoted a greater release than OCP at 48 h. The physicochemical analyses indicated that SDF-1 interacted with OCP through Freundlich-type adsorption and that the adsorption controlled SDF-1 release from OCP during the hydrolysis into CDHA. Therefore, leveraging its molecular affinity for the OCP surface, OCP/SDF-1 facilitates MSC migration and enhances bone formation by ensuring the controlled, sustained release of SDF-1 from OCP.

Adsorption of Serum Fetuin onto Octacalcium Phosphate and Its Relation to Osteogenic Property

This study aimed to investigate how the chemical elements in relation to octacalcium phosphate (OCP) hydrolysis affect the osteoblastic differentiation in the presence of serum fetuin. The adsorption of fetuin onto OCP was examined in buffers having different degrees of supersaturation (DS) with respect to OCP and hydroxyapatite (HA) at pH 7.4 and 37 °C. The osteoblastic differentiation of mesenchymal stem cells (MSCs) was evaluated in cultures with OCP and 0 to 0.8 mg/mL of fetuin. The amount of fetuin adsorbed increased with increasing DS in the buffer. In the MSC culture, the coexistence of OCP and 0.2-0.4 mg/mL of fetuin close to serum level increased alkaline phosphatase activity; however, the activity was suppressed by 0.2-0.8 mg/mL of fetuin. Transmission electron microscopy revealed de novo crystal formation on OCP in supersaturated buffer and culture media with respect to OCP and HA at lower fetuin concentrations. Infrared spectroscopy and DS estimation indicate that the hydrolysis of OCP with de novo apatite formation was promoted in the culture media at 0.2-0.4 mg/mL of fetuin. These results suggest that OCP may promote osteoblastic differentiation if the suitable conditions are attained regarding the chemical elements and fetuin adsorption around OCP.

Bone Regeneration: Mini-Review and Appealing Perspectives

Bone is a natural mineral-organic nanocomposite protecting internal organs and allowing mobility. Through the ages, numerous strategies have been developed for repairing bone defects and fixing fractures. Several generations of bone repair biomaterials have been proposed, either based on metals, ceramics, glasses, or polymers, depending on the clinical need, the maturity of technologies, and knowledge of the natural constitution of the bone tissue to be repaired. The global trend in bone implant research is shifting toward osteointegrative, bioactive and possibly stimuli-responsive biomaterials and, where possible, resorbable implants that actively promote the regeneration of natural bone tissue. In this mini-review, the fundamentals of bone healing materials and clinical challenges are summarized and commented on with regard to progressing scientific discoveries. The main types of bone-healing materials are then reviewed, and their specific relevance to the field is reminded, with the citation of reference works. In the final part, we highlight the promise of hybrid organic-inorganic bioactive materials and the ongoing research activities toward the development of multifunctional or stimuli-responsive implants. This contribution is expected to serve as a commented introduction to the ever-progressing field of bone regeneration and highlight trends of future-oriented research.

Workshop on the Latest Advances in Biomedical Applications of Octacalcium Phosphate

The first workshop on the "latest advances in biomedical applications of octacalcium phosphate (OCP)" was organized as a satellite symposium to the Bioceramics33 conference in Solothurn, Switzerland, in October 2023. The event brought together leading researchers and industry representatives to present and discuss their latest groundbreaking research aimed at developing and commercializing advanced OCP-based biomaterials for bone regeneration. The topics presented by the six invited speakers ranged from a fundamental understanding of the OCP crystal chemistry to advanced processing and characterization methods, functionalization, biomineralization, and commercialization. With this summary report, we are laying the foundation for a continuation of a series of workshops on the subject of OCP biomaterials in order to promote the exchange between researchers and industry representatives and to drive forward the development and commercialization of new improved synthetic bone substitute materials.

Biomaterial Cues for Regulation of Osteoclast Differentiation and Function in Bone Regeneration

Tissue regeneration involves dynamic dialogue between and among different cells and their surrounding matrices. Bone regeneration is specifically governed by reciprocity between osteoblasts and osteoclasts within the bone microenvironment. Osteoclast-directed resorption and osteoblast-directed formation of bone are essential to bone remodeling, and the crosstalk between these cells is vital to curating a sequence of events that culminate in the creation of bone tissue. Among bone biomaterial strategies, many have investigated the use of different material cues to direct the development and activity of osteoblasts. However, less attention has been given to exploring features that similarly target osteoclast formation and activity, with even fewer strategies demonstrating or integrating biomaterial-directed modulation of osteoblast-osteoclast coupling. This review aims to describe various biomaterial cues demonstrated to influence osteoclastogenesis and osteoclast function, emphasizing those that enhance a material construct's ability to achieve bone healing and regeneration. Additionally discussed are approaches that influence the communication between osteoclasts and osteoblasts, particularly in a manner that takes advantage of their coupling. Deepening our understanding of how biomaterial cues may dictate osteoclast differentiation, function, and influence on the microenvironment may enable the realization of bone-replacement interventions with enhanced integrative and regenerative capacities.

Comparative Evaluation of Mathematical Model and In Vivo Study of Calcium Phosphate Bone Grafts

One of the key factors of the interaction 'osteoplastic material-organism' is the state of the implant surface. Taking into account the fact that the equilibrium in regeneration conditions is reached only after the reparative histogenesis process is completed, the implant surface is constantly modified. This work is devoted to the numerical description of the dynamic bilateral material-medium interaction under close to physiological conditions, as well as to the assessment of the comparability of the model with in vitro and in vivo experimental results. The semi-empirical model obtained on the basis of chemical kinetics allows us to describe numerically the processes occurring in the in vitro systems and extrapolates well to assess the behavior of dicalcium phosphate dihydrate (DCPD) material under conditions of ectopic (subcutaneous) implantation in Wistar rats. It is shown that an experiment conducted using a perfusion-diffusion bioreactor in a cell culture medium with the addition of fetal bovine serum (FBS) allows for achieving morphologically and chemically identical changes in the surface of the material in comparison with the real organism. This fact opens up wide possibilities for the creation of an analog of a 'laboratory-on-a-chip' and the transition from classical in vivo models to more controlled and mathematically based in vitro systems.

Chitosan as a Templating Agent of Calcium Phosphate Crystalline Phases in Biomimetic Mineralization: Theoretical and Experimental Studies

Highlighting the essential role of chitosan (CS), known for its biocompatibility, biodegradability, and ability to promote cell adhesion and proliferation, this study explores its utility in modulating the biomimetic mineralization of calcium phosphate (CaP). This approach holds promise for developing biomaterials suitable for bone regeneration. However, the interactions between the CS surface and in situ precipitated CaP still require further exploration. In the theoretical section, molecular dynamics (MD) simulations demonstrate that, at an appropriate pH level during the prenucleation stage, calcium ions (Ca2+) and hydrogen phosphate ions (HPO42-) form Posner-like clusters. Additionally, the interaction between these clusters and the CS molecule enhances system stability. Together, these phenomena facilitate the transition to subsequent heterogeneous nucleation on the surface of the organic matrix, which is a more controlled process than homogeneous nucleation in solution. Dynamic simulation results suggest that CS acts as a stabilizing matrix at pH 8.0 during biomimetic mineralization. In the experimental section, the effects of pH and the molecular weight of CS were investigated, with a focus on their impact on the crystal structure of the resulting material. X-ray diffraction and scanning electron microscopy analyses reveal that, under conditions of approximately pH 8.0 and a CS molecular weight of 20 000 g/mol, and controlled ion concentration, ultrasound radiation, and temperature, the dominant CaP phases in the material are carbonate-doped hydroxyapatite (CHA) and octacalcium phosphate (OCP). These findings suggest that CS, when adjusted for molecular weight and pH, facilitates the formation of CaP crystal phases that closely resemble the natural inorganic composition of bone, highlighting its protective and regulatory roles in the growth and maturation of crystals during mineralization. The theoretical predictions and experimental outcomes confirm the crucial role of CS as a templating agent, enabling the development of a biomimetic mineralization pathway. CS's ability to guide this process may prove valuable in the design of materials for bone tissue engineering, particularly in developing effective materials for bone tissue healing and regeneration.

From Tooth Adhesion to Bioadhesion: Development of Bioabsorbable Putty-like Artificial Bone with Adhesive to Bone Based on the New Material "Phosphorylated Pullulan"

Bioabsorbable materials have a wide range of applications, such as scaffolds for regenerative medicine and cell transplantation therapy and carriers for drug delivery systems. Therefore, although many researchers are conducting their research and development, few of them have been used in clinical practice. In addition, existing bioabsorbable materials cannot bind to the body's tissues. If bioabsorbable materials with an adhesive ability to biological tissues can be made, they can ensure the mixture remains fixed to the affected area when mixed with artificial bone or other materials. In addition, if the filling material in the bone defect is soft and uncured, resorption is rapid, which is advantageous for bone regeneration. In this paper, the development and process of a new bioabsorbable material "Phosphorylated pullulan" and its capability as a bone replacement material were demonstrated. Phosphorylated pullulan, which was developed based on the tooth adhesion theory, is the only bioabsorbable material able to adhere to bone and teeth. The phosphorylated pullulan and β-TCP mixture is a non-hardening putty. It is useful as a new resorbable bone replacement material with an adhesive ability for bone defects around implants.

Biodegradable Nanoflowers with Abaloparatide Spatiotemporal Management of Functional Alveolar Bone Regeneration

Post-extraction alveolar bone atrophy greatly hinders the subsequent orthodontic tooth movement (OTM) or implant placement. In this study, we synthesized biodegradable bifunctional bioactive calcium phosphorus nanoflowers (NFs) loaded with abaloparatide (ABL), namely ABL@NFs, to achieve spatiotemporal management for alveolar bone regeneration. The NFs exhibited a porous hierarchical structure, high drug encapsulation efficacy, and desirable biocompatibility. ABL was initially released to recruit stem cells, followed by sustained release of Ca2+ and PO43- for in situ interface mineralization, establishing an osteogenic "biomineralized environment". ABL@NFs successfully restored morphologically and functionally active alveolar bone without affecting OTM. In conclusion, the ABL@NFs demonstrated promising outcomes for bone regeneration under orthodontic condition, which might provide a desirable reference of man-made "bone powder" in the hard tissue regeneration field.

Comparative Analysis of Bone Regeneration According to Particle Type and Barrier Membrane for Octacalcium Phosphate Grafted into Rabbit Calvarial Defects

This animal study was aimed to evaluate the efficacy of new bone formation and volume maintenance according to the particle type and the collagen membrane function for grafted octacalcium phosphate (OCP) in rabbit calvarial defects. The synthetic bone substitutes were prepared in powder form with 90% OCP and granular form with 76% OCP, respectively. The calvarial defects were divided into four groups according to the particle type and the membrane application. All specimens were acquired 2 weeks (n = 5) and 8 weeks (n = 5) after surgery. According to the micro-CT results, the new bone volume increased at 2 weeks in the 76% OCP groups compared to the 90% OCP groups, and the bone volume ratio was significantly lower in the 90% OCP group after 2 weeks. The histomorphometric analysis results indicated that the new bone area and its ratio in all experimental groups were increased at 8 weeks except for the group with 90% OCP without a membrane. Furthermore, the residual bone graft area and its ratio in the 90% OCP groups were decreased at 8 weeks. In conclusion, all types of OCP could be applied as biocompatible bone graft materials regardless of its density and membrane application. Neither the OCP concentration nor the membrane application had a significant effect on new bone formation in the defect area, but the higher the OCP concentration, the less graft volume maintenance was needed.

Bone-Regeneration Therapy Using Biodegradable Scaffolds: Calcium Phosphate Bioceramics and Biodegradable Polymers

Calcium phosphate-based synthetic bone is broadly used for the clinical treatment of bone defects caused by trauma and bone tumors. Synthetic bone is easy to use; however, its effects depend on the size and location of the bone defect. Many alternative treatment options are available, such as joint arthroplasty, autologous bone grafting, and allogeneic bone grafting. Although various biodegradable polymers are also being developed as synthetic bone material in scaffolds for regenerative medicine, the clinical application of commercial synthetic bone products with comparable performance to that of calcium phosphate bioceramics have yet to be realized. This review discusses the status quo of bone-regeneration therapy using artificial bone composed of calcium phosphate bioceramics such as β-tricalcium phosphate (βTCP), carbonate apatite, and hydroxyapatite (HA), in addition to the recent use of calcium phosphate bioceramics, biodegradable polymers, and their composites. New research has introduced potential materials such as octacalcium phosphate (OCP), biologically derived polymers, and synthetic biodegradable polymers. The performance of artificial bone is intricately related to conditions such as the intrinsic material, degradability, composite materials, manufacturing method, structure, and signaling molecules such as growth factors and cells. The development of new scaffold materials may offer more efficient bone regeneration.

Calcium Phosphate Biomaterials for 3D Bioprinting in Bone Tissue Engineering

Three-dimensional bioprinting is a promising technology for bone tissue engineering. However, most hydrogel bioinks lack the mechanical and post-printing fidelity properties suitable for such hard tissue regeneration. To overcome these weak properties, calcium phosphates can be employed in a bioink to compensate for the lack of certain characteristics. Further, the extracellular matrix of natural bone contains this mineral, resulting in its structural robustness. Thus, calcium phosphates are necessary components of bioink for bone tissue engineering. This review paper examines different recently explored calcium phosphates, as a component of potential bioinks, for the biological, mechanical and structural properties required of 3D bioprinted scaffolds, exploring their distinctive properties that render them favorable biomaterials for bone tissue engineering. The discussion encompasses recent applications and adaptations of 3D-printed scaffolds built with calcium phosphates, delving into the scientific reasons behind the prevalence of certain types of calcium phosphates over others. Additionally, this paper elucidates their interactions with polymer hydrogels for 3D bioprinting applications. Overall, the current status of calcium phosphate/hydrogel bioinks for 3D bioprinting in bone tissue engineering has been investigated.

Towards Polycaprolactone-Based Scaffolds for Alveolar Bone Tissue Engineering: A Biomimetic Approach in a 3D Printing Technique

The alveolar bone is a unique type of bone, and the goal of bone tissue engineering (BTE) is to develop methods to facilitate its regeneration. Currently, an emerging trend involves the fabrication of polycaprolactone (PCL)-based scaffolds using a three-dimensional (3D) printing technique to enhance an osteoconductive architecture. These scaffolds are further modified with hydroxyapatite (HA), type I collagen (CGI), or chitosan (CS) to impart high osteoinductive potential. In conjunction with cell therapy, these scaffolds may serve as an appealing alternative to bone autografts. This review discusses research gaps in the designing of 3D-printed PCL-based scaffolds from a biomimetic perspective. The article begins with a systematic analysis of biological mineralisation (biomineralisation) and ossification to optimise the scaffold's structural, mechanical, degradation, and surface properties. This scaffold-designing strategy lays the groundwork for developing a research pathway that spans fundamental principles such as molecular dynamics (MD) simulations and fabrication techniques. Ultimately, this paves the way for systematic in vitro and in vivo studies, leading to potential clinical applications.

Development of Hydroxyapatite Coatings for Orthopaedic Implants from Colloidal Solutions: Part 2-Detailed Characterisation of the Coatings and Their Growth Mechanism

This study is the second part of a two-part study whereby supersaturated solutions of calcium and phosphate ions generate well-defined hydroxyapatite coatings for orthopaedic implants. An 'ideal' process solution is selected from Part 1, and the detailed characterisation of films produced from this solution is undertaken here in Part 2. Analysis is presented on the hydroxyapatite produced, in both powder form and as a film upon titanium substrates representative of orthopaedic implants. From thermal analysis data, it is shown that there is bound and interstitial water present in the hydroxyapatite. Nuclear magnetic resonance data allow for the distinction between an amorphous and a crystalline component of the material. As hydroxyapatite coatings are generated, their growth mechanism is tracked across repeated process runs. A clear understanding of the growth mechanism is achieved though crystallinity and electron imaging data. Transmission electron imaging data support the proposed crystal growth and deposition mechanism. All of the data conclude that this process has a clear propensity to grow the hydroxyapatite phase of octacalcium phosphate. The investigation of the hydroxyapatite coating and its growth mechanism establish that a stable and reproducible process window has been identified. Precise control is achieved, leading to the successful formation of the desired hydroxyapatite films.

Exploring the Formation Kinetics of Octacalcium Phosphate from Alpha-Tricalcium Phosphate: Synthesis Scale-Up, Determination of Transient Phases, Their Morphology and Biocompatibility

Even with decades of research studies behind octacalcium phosphate (OCP), determination of OCP phase formation has proved to be a cumbersome challenge. Even though obtaining a large quantity of OCP is important for potential clinical uses, it still remains a hindrance to obtain high yields of pure OCP. Taking that into consideration, the purpose of this study was to scale-up OCP synthesis for the first time and to use a multi-technique approach to follow the phase transformation pathway at multiple time points. In the present study, OCP has been synthesized from α-tricalcium phosphate (α-TCP), and subsequently scaled-up tenfold and hundredfold (100 mg → 10 g). The hydrolysis mechanism has been followed and described by using XRD and FTIR spectroscopy, as well as Raman and SEM. Gradual transformation into the OCP phase transpired through dicalcium phosphate dihydrate (brushite, DCPD, up to ~36%) as an intermediary phase. Furthermore, the obtained transitional phases and final OCP phases (across all scale-up levels) were tested with human bone marrow-derived mesenchymal stem cells (hBMSCs), in order to see how different phase mixtures affect the cell viability, and also to corroborate the safety of the scaled-up product. Twelve out of seventeen specimens showed satisfactory percentages of cell viability and confirmed the prospective use of scaled-up OCP in further in vitro studies. The present study, therefore, provides the first scale-up process of OCP synthesis, an in depth understanding of the formation pathway, and investigation of the parameters able to contribute in the OCP phase formation.

Bone Apatite Nanocrystal: Crystalline Structure, Chemical Composition, and Architecture

The biological and mechanical functions of bone rely critically on the inorganic constituent, which can be termed as bone apatite nanocrystal. It features a hydroxylapatite-like crystalline structure, complex chemical compositions (e.g., carbonate-containing and calcium- and hydroxyl-deficient), and fine geometries and properties. The long research with vast literature across broad spectra of disciplines and fields from chemistry, crystallography, and mineralogy, to biology, medical sciences, materials sciences, mechanics, and engineering has produced a wealth of knowledge on the bone apatite nanocrystal. This has generated significant impacts on bioengineering and industrial engineering, e.g., in developing new biomaterials with superior osteo-inductivities and in inspiring novel strong and tough composites, respectively. Meanwhile, confusing and inconsistent understandings on the bone mineral constituent should be addressed to facilitate further multidisciplinary progress. In this review, we present a mineralogical account of the bone-related ideal apatite mineral and then a brief historical overview of bone mineral research. These pave the road to understanding the bone apatite nanocrystal via a material approach encompassing crystalline structure, diverse chemical formulae, and interesting architecture and properties, from which several intriguing research questions emerge for further explorations. Through providing the classical and latest findings with decent clearness and adequate breadth, this review endeavors to promote research advances in a variety of related science and engineering fields.