Bone healing with niobium-containing bioactive glass composition in rat femur model: A micro-CT study

Bioactive glasses for bone tissue engineering: a bibliometric study of the top 100-most cited papers

Using bioactive glasses (BGs) for bone reconstruction is a promising and expanding field of investigation in regenerative medicine. Therefore, the aim of this study was to assess the key features of the 100 most cited papers on BG in bone tissue engineering through bibliometric measures. A search was conducted in the Web of Science citation indexing database until October 2023. Three researchers performed study selection and data extraction. Data extraction included publication title and year, authors, number of citations and mean number of citations, institution, country and continent, study design, journal, keywords, and bioactive glasses. Citation counts were also collected in Google Scholar and Scopus databases. Graphical bibliometric networks were created using VOSviewer software. The number of citations of the 100 most cited articles ranged from 118 to 1836, with ten papers cited more than 400 times. Articles were mostly published between 2011 and 2012. Most papers, comprising 72 in vitro studies, originated from the United States (n = 22) and were published in Biomaterials (27%). Aldo Boccaccini was the most cited author (n = 17; 6332 citations). The most prolific institution was Imperial College London (n = 19; 7073 citations), followed by Missouri University (USA; n = 7; 2494 citations). "Bioactive glass" was the most frequent keyword, with 46 occurrences. Laboratory-based studies, primarily conducted in the United States, evaluating the physicochemical, osteogenic properties, and antibacterial activity of silica-based bioactive glasses such as 45S5 have been the most cited thus far.

Influence of zirconium dioxide (ZrO2) and magnetite (Fe3O4) additions on the structural, electrical, and biological properties of Bioglass® for metal implant coatings

Background

The growing need for durable implants, driven by aging populations and increased trauma cases, highlights challenges such as limited osseointegration and biofilm formation. 45S5 Bioglass® has shown promise due to its bioactivity, antimicrobial properties, and ability to enhance osseointegration through electrical polarization. This study investigates the effects of incorporating different concentrations of ZrO2 and Fe3O4 into 45S5 Bioglass® to enhance its electrical and biological properties.

Methods

Raman analysis was used to evaluate how these oxides influenced the amount of non-bridging oxygens (NBOs) and glass network connectivity. Electrical characterization was performed using impedance spectroscopy to measure conductivity and ion mobility. Antibacterial activity was assessed using the agar diffusion method, and bioactivity was evaluated through simulated body fluid (SBF) immersion tests.

Results

The results revealed that bioglasses containing ZrO2 exhibited higher NBO content compared to Fe3O4, leading to improved electrical and biological properties. ZrO2, particularly at 2 mol%, significantly enhanced conductivity, antibacterial activity, and bioactivity. In contrast, Fe3O4 reduced both antibacterial activity and bioactivity.

Conclusion

The findings demonstrate that ZrO2 addition improves the electrical and biological performance of 45S5 Bioglass®, making it a promising candidate for durable implants. Fe3O4, however, showed limited benefits.

Tailoring of bioactive glass and glass-ceramics properties for in vitro and in vivo response optimization: a review

Bioactive glasses are inorganic biocompatible materials that can find applications in many biomedical fields. The main application is bone and dental tissue engineering. However, some applications in contact with soft tissues are emerging. It is well known that both bulk (such as composition) and surface properties (such as morphology and wettability) of an implanted material influence the response of cells in contact with the implant. This review aims to elucidate and compare the main strategies that are employed to modulate cell behavior in contact with bioactive glasses. The first part of this review is focused on the doping of bioactive glasses with ions and drugs, which can be incorporated into the bioceramic to impart several therapeutic properties, such as osteogenic, proangiogenic, or/and antibacterial ones. The second part of this review is devoted to the chemical functionalization of bioactive glasses using drugs, extra-cellular matrix proteins, vitamins, and polyphenols. In the third and final part, the physical modifications of the surfaces of bioactive glasses are reviewed. Both top-down (removing materials from the surface, for example using laser treatment and etching strategies) and bottom-up (depositing materials on the surface, for example through the deposition of coatings) strategies are discussed.

Polydioxanone Enhances Bone Regeneration After Resection and Reconstruction of Rat Femur with rhBMP2

The aim of this study was to assess the bone regeneration potential of a polydioxanone (PDO) scaffold together with recombinant human bone morphogenetic protein-2 (rhBMP-2) for the reconstruction of large bone defect. In total, 24 male rats (6 months old) were subjected to bilateral femoral stabilization using titanium plates to create a 2 mm gap, and reconstruction using rhBMP-2 (Infuse®; 3.25 μg). The bone defects were covered with PDO (PDO group), or with titanium mesh (Ti group). Animals were euthanized on days 14 and 60. Simultaneously, 16 rats received PDO and Ti in their dorsum for the purpose of biocompatibility analysis at 3, 5, 7, and 10 days postoperatively. X-ray densitometry showed a higher density in the PDO group on day 14. On day 60, coverage of the bone defect with PDO showed a larger quantity of newly formed bone than that found for the Ti group, a lower inflammatory infiltrate value, and a more significant number of blood vessels on day 14. By immunohistochemical assessment, runt-related transcription factor 2 (RUNX2) and osteocalcin (OCN) showed higher labeling on day 14 in the PDO group. On day 60, bone morphogenetic protein-2 (BMP-2) showed higher labeling in the PDO group, whereas Ti showed higher labeling for osteoprotegerin, nuclear factor kappa B ligand-activating receptor, RUNX2, and OCN. Furthermore, biocompatibility analysis showed a higher inflammatory response in the Ti group. The PDO scaffold enhanced bone regeneration when associated with rhBMP-2 in rat femur reconstruction. Impact statement Regeneration of segmental bone defects is a difficult task, and several techniques and materials have been used. Recent advances in the production of synthetic polymers, such as polydioxanone (PDO), produced by three-dimensional printing, have shown distinct characteristics that could improve tissue regeneration even in an important bone defect. The present preclinical study showed that PDO membranes used as scaffolds to carry recombinant human bone morphogenetic protein-2 (rhBMP-2) improved bone tissue regeneration by more than 8-fold when compared with titanium mesh, suggesting that PDO membranes could be a feasible and useful material for use in guided bone regeneration. (In English, viable is only used for living creatures capable of sustaining life.

Fabrication of bioactive glass/phosphorylated chitosan composite scaffold and its effects on MC3T3-E1 cells

This study aimed to synthesize bioactive glass (BG) and phosphorylated chitosan (PCS), and fabricate a BG/PCS composite scaffold. The physical properties (mechanical strength, swelling degree, and degradation rate) of the BG/PCS scaffold were tested. Thein vitromineralization properties of composite scaffolds in simulated body fluid were investigated. MC3T3-E1 cell responses with the BG/PCS scaffold were investigated using live/dead cell staining, actin staining, alkaline phosphatase (ALP) activity, and Alizarin red staining. Our results showed that the scaffold had an inner porous structure, good swelling properties, and good degradation rate. After immersion in SBF, the scaffolds demonstrated high properties in inducing mineralization. Leaching solutions of the composite scaffolds exhibited good cytocompatibility. MC3T3-E1 cells adhered, spread, and proliferated on the scaffold. The BG/PCS composite scaffold showed osteo-inductive activity by increasing ALP activity and calcium deposition. Our results indicated that the BG/PCS scaffold had potential applications as a bone-defect repair biomaterial.

A Review of the Application of Natural and Synthetic Scaffolds in Bone Regeneration

The management of bone defects is complicated by the presence of clinical conditions, such as critical-sized defects created by high-energy trauma, tumour resection, infection, and skeletal abnormalities, whereby the bone regeneration capacity is compromised. A bone scaffold is a three-dimensional structure matrix serving as a template to be implanted into the defects to promote vascularisation, growth factor recruitment, osteogenesis, osteoconduction, and mechanical support. This review aims to summarise the types and applications of natural and synthetic scaffolds currently adopted in bone tissue engineering. The merits and caveats of natural and synthetic scaffolds will be discussed. A naturally derived bone scaffold offers a microenvironment closer to in vivo conditions after decellularisation and demineralisation, exhibiting excellent bioactivity, biocompatibility, and osteogenic properties. Meanwhile, an artificially produced bone scaffold allows for scalability and consistency with minimal risk of disease transmission. The combination of different materials to form scaffolds, along with bone cell seeding, biochemical cue incorporation, and bioactive molecule functionalisation, can provide additional or improved scaffold properties, allowing for a faster bone repair rate in bone injuries. This is the direction for future research in the field of bone growth and repair.

Niobium-containing bioactive glasses modulate alkaline phosphatase activity during bone repair

This study aimed to evaluate the pre-clinical behavior of niobium-containing bioactive glasses (BAGNb) by their ability to promote bone repair and regulate alkaline phosphatase (ALP) levels in an animal model. BAGNbs were produced as powders and as scaffolds and surgically implanted in the femur of male rats (Wistar lineage n = 10). Glasses without Nb (BAG) were produced and implanted as well. The Autogenous Bone (AB) was used as a control. After 15, 30, and 60 days of surgical implantation, blood serum samples were collected to quantify ALP activity, and femurs were removed to assess bone repair. Bone samples were histologically processed and stained with H&E to quantify the % new bone into defects. No postoperative complications were identified. Early-stage repair (15 days) resulted in increased ALP activity for all groups, with increased values ​​for powdered BAGNb. The maturation of the new bone led to a reduction in serum ALP levels. Histological sections showed the formation of immature bone tissue and vascularization with the progression of bone deposition to mature and functional tissue over time. BAG powder showed less new bone formation in 15 days, while the analysis at 30 and 60 days showed no difference between groups (p > .05). Niobium-containing bioactive glasses safely and successfully induced bone repair in vivo. The modulation of ALP activity may be a pathway to describe the ability of niobium-containing materials to contribute to new bone formation.

A bioactive glass functional hydrogel enhances bone augmentation via synergistic angiogenesis, self-swelling and osteogenesis

Bone augmentation materials usually cannot provide enough new bone for dental implants due to the material degradation and mucosal pressure. The use of hydrogels with self-swelling properties may provide a higher bone augmentation, although swelling is generally considered to be a disadvantage in tissue engineering. Herein, a double-crosslinked gelatin-hyaluronic acid hydrogels (GH) with self-swelling properties were utilized. Meanwhile, niobium doped bioactive glasses (NbBG) was dispersed in the hydrogel network to prepare the GH-NbBG hydrogel. The composite hydrogel exhibited excellent biocompatibility and the addition of NbBG significantly improved the mechanical properties of the hydrogel. In vivo results found that GH-NbBG synergistically promoted angiogenesis and increased bone augmentation by self-swelling at the early stage of implantation. In addition, at the late stage after implantation, GH-NbBG significantly promoted new bone formation by activating RUNX2/Bglap signaling pathway. Therefore, this study reverses the self-swelling disadvantage of hydrogels into advantage and provides novel ideas for the application of hydrogels in bone augmentation.

Bioactive glasses incorporating less-common ions to improve biological and physical properties

Bioactive glasses (BGs) have been a focus of research for over five decades for several biomedical applications. Although their use in bone substitution and bone tissue regeneration has gained important attention, recent developments have also seen the expansion of BG applications to the field of soft tissue engineering. Hard and soft tissue repair therapies can benefit from the biological activity of metallic ions released from BGs. These metallic ions are incorporated in the BG network not only for their biological therapeutic effects but also in many cases for influencing the structure and processability of the glass and to impart extra functional properties. The "classical" elements in silicate BG compositions are silicon (Si), phosphorous (P), calcium (Ca), sodium (Na), and potassium (K). In addition, other well-recognized biologically active ions have been incorporated in BGs to provide osteogenic, angiogenic, anti-inflammatory, and antibacterial effects such as zinc (Zn), magnesium (Mg), silver (Ag), strontium (Sr), gallium (Ga), fluorine (F), iron (Fe), cobalt (Co), boron (B), lithium (Li), titanium (Ti), and copper (Cu). More recently, rare earth and other elements considered less common or, some of them, even "exotic" for biomedical applications, have found room as doping elements in BGs to enhance their biological and physical properties. For example, barium (Ba), bismuth (Bi), chlorine (Cl), chromium (Cr), dysprosium (Dy), europium (Eu), gadolinium (Gd), ytterbium (Yb), thulium (Tm), germanium (Ge), gold (Au), holmium (Ho), iodine (I), lanthanum (La), manganese (Mn), molybdenum (Mo), nickel (Ni), niobium (Nb), nitrogen (N), palladium (Pd), rubidium (Rb), samarium (Sm), selenium (Se), tantalum (Ta), tellurium (Te), terbium (Tb), erbium (Er), tin (Sn), tungsten (W), vanadium (V), yttrium (Y) as well as zirconium (Zr) have been included in BGs. These ions have been found to be particularly interesting for enhancing the biological performance of doped BGs in novel compositions for tissue repair (both hard and soft tissue) and for providing, in some cases, extra functionalities to the BG, for example fluorescence, luminescence, radiation shielding, anti-inflammatory, and antibacterial properties. This review summarizes the influence of incorporating such less-common elements in BGs with focus on tissue engineering applications, usually exploiting the bioactivity of the BG in combination with other functional properties imparted by the presence of the added elements.

3D printing of poly(butylene adipate-co-terephthalate) (PBAT)/niobium containing bioactive glasses (BAGNb) scaffolds: Characterization of composites, in vitro bioactivity, and in vivo bone repair

This study aimed to produce poly(butylene adipate-co-terephthalate) (PBAT)/niobium containing bioactive glasses (BAGNb) composites scaffolds produced by fused deposition modeling (FDM) printing and evaluate their physicochemical and biological properties in vitro and in vivo. The composite filaments were produced by melt-extrusion with the addition of 10 wt% of BAGNb (PBAT/BAGNb). Filaments without BAGNb were produced as the control group (PBAT). The filaments were characterized and were used to produce 3D-printed scaffolds using FDM. The scaffolds' structure and surface properties were assessed. In vitro cell, proliferation, and cell mineralization analysis were performed. In vivo data was obtained in the rat femur model (n = 10), and the bone repair was assessed after 15, 30, and 60 postoperative days. The printed structures presented 69.81% porosity for the PBAT/BAGNb group and 74.54% for the PBAT group. Higher cell mineralization was observed for the PBAT/BAGNb group. The in vivo data showed that the PBAT/BAGNb presented new bone formation comparable to positive controls. The combination of PBAT and BAGNb in 3D-printed scaffolds may be an alternative to produce bioactive materials with controllable shapes and properties for bone regeneration treatments.

Comparison of osseointegration of Ti-Al6V4 and Ti-Al6Nb7 implants: An experimental study

Objective

In this study we aimed to investigate bone-implant connections (BICs) with Ti-Al₆V₄ and Ti-Al₆Nb₇ alloys. Two types of surface morphology, resorbable blast material (RBM) and sandblasted and acid-etched surfaces (SLA), were used for implants.

Materials and methods

Thirty female Sprague Dawley rats aged 0.5-1 year were used. The rats were randomly separated into three groups: 1) Ti-Al₆V₄ RBM surface (n = 10), 2), Ti-Al₆Nb₇ RBM surface (n = 10), and 3) Ti-Al₆Nb₇ SLA (n = 10) surface implants were surgically integrated in femoral bones. The average roughness (Ra) values for these implants were 1-2 Ra. The rats were sacrificed four weeks after the surgical procedure. For each section, the BIC ratio (%) was determined as a percentage of the total implant surface that was in direct contact with the bone.

Results

The BIC ratio was found to be higher in the Ti-Al₆Nb₇ RBM and Ti-Al₆Nb₇ SLA groups than in the Ti-Al₆V₄ RBM group (p < 0.05). There was no statistically significant difference in the BIC ratios between the Ti-Al₆Nb₇ RBM and Ti-Al₆Nb₇ SLA groups (p > 0.05).

Conclusion

Ti-Al₆Nb₇ exhibited good biocompatibility with bone cells. Ti-Al₆Nb₇ alloy could be a candidate material for dental implant production.

Long-term exposure to low doses of aluminum affects mineral content and microarchitecture of rats alveolar bone

Aluminum (Al) is one of the most found elements in nature in many forms, and human exposure can be quite common. Therefore, it is important to investigate the effects of exposure to Al mainly at low doses and for a prolonged period, in order to simulate human exposure in the periodontium, an important structure for support and protection of the teeth. This investigation aimed to study the aluminum chloride (AlCl₃) toxicological effects in the mineral composition and micromorphology of the alveolar bone of rats. Two groups of eight male Wistar rats were used for the experiment. AlCl₃ group was exposed to AlCl₃ orally at a dose of 8.3 mg/kg/day for 60 days, while the control group received only distilled water. After that, the mandibles were collected and submitted to the following analyses: Fourier transform infrared spectroscopy, Raman spectroscopy, and X-ray microtomography analysis; blood was also collected for determination of Al circulating levels. Our data showed that AlCl₃ was capable of increasing Al circulating levels in blood. It was able to promote changes in the mineral content and triggers significant changes in the mineralized bone microstructure, such as number and thickness of trabeculae, being associated with alveolar bone-loss.

Hydrogel Composites with Different Dimensional Nanoparticles for Bone Regeneration

The treatment of large segmental bone defects and complex types of fractures caused by trauma, inflammation, or tumor resection is still a challenge in the field of orthopedics. Various natural or synthetic biological materials used in clinical applications cannot fully replicate the structure and performance of raw bone. This highlights how to endow materials with multiple functions and biological properties, which is a problem that needs to be solved in practical applications. Hydrogels with outstanding biocompatibility, for their casting into any shape, size, or form, are suitable for different forms of bone defects. Therefore, they have been used in regenerative medicine more widely. In this review, versatile hydrogels are compounded with nanoparticles of different dimensions, and many desirable features of these materials in bone regeneration are introduced, including drug delivery, cell factor vehicle, cell scaffolds, which have potential in bone regeneration applications. The combination of hydrogels and nanoparticles of different dimensions encourages better filling of bone defect areas and has higher adaptability. This is due to the minimally invasive properties of the material and ability to match irregular defects. These biological characteristics make composite hydrogels with different dimensional nanoparticles become one of the most attractive options for bone regeneration materials.

Bone Density around Titanium Dental Implants Coating Tested/Coated with Chitosan or Melatonin: An Evaluation via Microtomography in Jaws of Beagle Dogs

Peri-implant bone density plays an important role in the osseointegration of dental implants. The aim of the study was to evaluate via micro-CT, in Hounsfield units, the bone density around dental implants coated with chitosan and melatonin and to compare it with the bone density around implants with a conventional etched surface after 12 weeks of immediate post-extraction placement in the jaws of Beagle dogs. Six dogs were used, and 48 implants were randomly placed: three groups—melatonin, chitosan, and control. Seven 10 mm × 10 mm regions of interest were defined in each implant (2 in the crestal zone, 4 in the medial zone, and 1 in the apical zone). A total of 336 sites were studied with the AMIDE tool, using the Norton and Gamble classification to assess bone density. The effect on bone density of surface coating variables (chitosan, melatonin, and control) at the crestal, medial, and apical sites and the implant positions (P2, P3, P4, and M1) was analyzed at bivariate and multivariate levels (linear regression). Adjusted effects on bone density did not indicate statistical significance for surface coatings (p = 0.653) but did for different levels of ROIs (p < 0.001) and for positions of the implants (p = 0.032). Micro-CT, with appropriate software, proved to be a powerful tool for measuring osseointegration.

Polybutylene-adipate-terephthalate and niobium-containing bioactive glasses composites: Development of barrier membranes with adjusted properties for guided bone regeneration

This study aimed to develop bioactive guided bone regeneration (GBR) membranes by manufacturing PBAT/BAGNb composites as casting films. Composites were produced by melt-extrusion, and BAGNb was added at 10 wt%, 20 wt%, and 30 wt% concentration. Pure PBAT membranes were used as a control (0wt%BAGNb). FTIR and thermogravimetric analysis characterized the composites. Barrier membranes were produced by solvent casting, and their mechanical and surface properties were assessed by tensile strength test and contact angle analysis, respectively. The ion release and cell behavior were evaluated by pH, cell proliferation, and mineralization. Composites were successfully produced, and the chemical structure showed no interference of BAGNb in the PBAT structure. The addition of BAGNb increased the stiffness of the membranes and reduced the contact angle, increasing the roughness in one side of the membrane. Sustained pH increment was observed for BAGNb-containing membranes with increased proliferation and mineralization as the concentration of BAGNb increases. The incorporation of up to 30 wt% of BAGNb into PBAT barrier membranes was able to maintain adequate chemical-mechanical properties leading to the production of materials with tailored surface properties and bioactivity. Finally, this biomaterial class showed outstanding potential and may contribute to bone formation in GBR procedures.

Blood Oxidative Stress Modulates Alveolar Bone Loss in Chronically Stressed Rats

We aimed to investigate the effects of chronic stress (CS) on experimental periodontitis (EP) in rats. For this, 28 Wistar rats were divided into four groups: control, ligature-induced experimental periodontitis (EP), chronic stress (CS; by physical restraint model) and CS+EP (association of chronic stress and ligature-induced periodontitis). The experimental period lasted 30 days, including exposure to CS every day and ligature was performed on the 15th experimental day. After 30 days, the animals were submitted to the behavioral test of the elevated plus maze (EPM). Next, rats were euthanized for blood and mandible collection in order to evaluate the oxidative biochemistry (by nitric oxide (NO), reduced-glutathione activity (GSH), and thiobarbituric acid reactive substance levels (TBARS)) and alveolar bone characterization (by morphometric, micro-CT, and immunohistochemistry), respectively. The behavioral parameters evaluated in EPM indicated higher anxiogenic activity in the CS and CS+EP, groups, which is a behavioral reflex of CS. The results showed that CS was able to change the blood oxidative biochemistry in CS and CS+EP groups, decrease GSH activity in the blood, and increase the NO and TBARS concentrations. Thus, CS induces oxidative blood imbalance, which can potentialize or generate morphological, structural, and metabolic damages to the alveolar bone.

Effects of an antler velvet-based natural compound on osteoporosis in a rodent model

Context Velvet antlers (VA) are claimed to have the effects on osteoporosis in traditional Chinese medicine. Aims So as to scientifically confirm this claim, a VA-based compound (VAC, the mixture of upper part of VA, deer blood, and calcined oyster shell powder in a ratio of 4:1:1) was produced and administered to osteoporotic model rats, with osteoporosis being induced by retinoic acid via gavage. Methods In total, 48 rats were used and divided into six groups (8/group). Concentrations of alkaline phosphatase and osteocalcin in the rat serum were measured, and bone ash weight, concentrations of calcium and phosphorus in rat femur were measured. Bone biomechanical test was performed using a computer-controlled three-point bending tester. Ratio of trabecular bone area to tissue area in a given view field of the femoral tissue section was histologically examined and calculated. Bone histomorphometry was measured using micro-CT. Key results No significant difference was found between the VAC-treated groups and the positive control (alendronate sodium) on the basis of the following tested parameters: (1) levels of alkaline phosphatase and osteocalcin in rat serum; (2) maximum load value (N) of femur and maximum compression force of lumbar vertebra; (3) concentrations of calcium and phosphorus in femur; (4) ratio of trabecular bone area to tissue area; and (5) bone histomorphometry. Conclusions Effects of VAC used in the present study on osteoporosis in the model rats were comparable to the alendronate sodium (western medicine for treating osteoporosis) on the basis of our selected parameters. Implications This compound has the potential to be developed as an effective traditional Chinese medicine for clinic use to treat osteoporosis.