3D-printed Mg-incorporated PCL-based scaffolds: A promising approach for bone healing

Zein/ZnO-Modified 3D-Printed PCL/Sphene Scaffolds with Improved Bacterial Inhibition and Osteoblast Activity for Bone Regeneration Applications

3D printing offers a significant advantage in creating bioengineering scaffolds for patient-specific treatments of bony defects. In this study, a 3D-printed polycaprolactone (PCL)/sphene (SP, CaTiSiO5) scaffold coated with zein/ZnO was fabricated to provide a suitable environment for bone regeneration. SP nanoparticles were synthesized using a mechanochemical method and characterized by SEM-EDS, FTIR, and XRD. 0-30 wt % of prepared SP nanoparticles was used to fabricate 3D-printed PCL-based scaffolds. Incorporation of SP into PCL scaffolds (up to 20 wt %) significantly increased compressive strength (from 37.5 to 65.2 MPa) and modulus (from 0.33 to 0.63 MPa). In vitro bioactivity evaluation in simulated body fluid demonstrated the apatite formation ability of PCL/SP scaffolds, as confirmed by SEM-EDS analysis. Compared to PCL/SP, the zein/ZnO-modified scaffold showed increased surface hydrophilicity and significantly higher values of bactericidal potency against S. aureus and E. coli. Additionally, MTT assay, cell attachment, and alkaline phosphatase activity revealed that zein and ZnO coexistence on PCL/SP scaffolds resulted in significantly higher cell proliferation, improved cell adhesion, and enhanced osteogenic differentiation of MG-63 cells compared to unmodified samples. Overall, zein/ZnO-modified 3D-printed PCL/SP nanocomposite scaffolds with desirable physicochemical, mechanical, and biological characteristics can serve as superior platforms for bone regeneration applications.

Hydrogel-Based Scaffolds: Advancing Bone Regeneration Through Tissue Engineering

Bone tissue engineering has emerged as a promising approach to addressing the limitations of traditional bone grafts for repairing bone defects. This regenerative medicine strategy leverages biomaterials, growth factors, and cells to create a favorable environment for bone regeneration, mimicking the body's natural healing process. Among the various biomaterials explored, hydrogels (HGs), a class of three-dimensional, hydrophilic polymer networks, have gained significant attention as scaffolds for bone tissue engineering. Thus, this review aimed to investigate the potential of natural and synthetic HGs, and the molecules used for its functionalization, for enhanced bone tissue engineering applications. HGs offer several advantages such as scaffolds, including biocompatibility, biodegradability, tunable mechanical properties, and the ability to encapsulate and deliver bioactive molecules. These properties make them ideal candidates for supporting cell attachment, proliferation, and differentiation, ultimately guiding the formation of new bone tissue. The design and optimization of HG-based scaffolds involve adapting their composition, structure, and mechanical properties to meet the specific requirements of bone regeneration. Current research focuses on incorporating bioactive molecules, such as growth factors and cytokines, into HG scaffolds to further enhance their osteoinductive and osteoconductive properties. Additionally, strategies to improve the mechanical strength and degradation kinetics of HGs are being explored to ensure long-term stability and support for new bone formation. The development of advanced HG-based scaffolds holds great potential for revolutionizing bone tissue engineering and providing effective treatment options for patients with bone defects.

3D-Printed PCL/SrHA@DFO Bone Tissue Engineering Scaffold with Bone Regeneration and Vascularization Function

The application of a three-dimensional (3D)-printed biological functional scaffold in the repair of bone defects is a promising strategy. In this study, strontium-containing hydroxyapatite (SrHA) powder was synthesized by the hydrothermal method, and then poly(ε-caprolactone) (PCL)/HA and PCL/SrHA composite scaffolds were prepared by the high-temperature melt extrusion 3D printing technology. The basic physical and chemical properties, in vitro biological properties, osteogenesis, and angiogenesis abilities of the scaffold were studied. The results showed that HA and SrHA were uniformly embedded in the composite scaffold, and the scaffold exhibited a 3D interconnected porous structure and rough microsurface. The in vitro release curve showed that Sr2+ and Ca2+ were continuously released from the PCL/SrHA scaffold. In order to verify the performance of the composite scaffold in bone regeneration, the proliferation and osteogenic differentiation of mouse embryonic osteoblasts (MC3T3E1) grown on the scaffold were evaluated. The experimental results showed that the incorporation of SrHA significantly promoted cell proliferation. Compared with the PCL/HA scaffold, the PCL/SrHA scaffold could better promote cell osteogenic differentiation. Deferoxamine (DFO) was loaded on the surface of the PCL/SrHA scaffold. By studying the proliferation, angiogenesis, and expression of osteogenesis and angiogenesis-related genes of human umbilical vein endothelial cells (HUVECs) on PCL/SrHA@DFO scaffold, it was verified that DFO had the ability to promote angiogenesis. It could induce angiogenesis in vitro in combination with Sr2+. Therefore, we believe that the composite scaffold has potential application prospects in the field of bone tissue engineering.

Advances in the application and research of biomaterials in promoting bone repair and regeneration through immune modulation

With the ongoing development of osteoimmunology, increasing evidence indicates that the local immune microenvironment plays a critical role in various stages of bone formation. Consequently, modulating the immune inflammatory response triggered by biomaterials to foster a more favorable immune microenvironment for bone regeneration has emerged as a novel strategy in bone tissue engineering. This review first examines the roles of various immune cells in bone tissue injury and repair. Then, the contributions of different biomaterials, including metals, bioceramics, and polymers, in promoting osteogenesis through immune regulation, as well as their future development directions, are discussed. Finally, various design strategies, such as modifying the physicochemical properties of biomaterials and integrating bioactive substances, to optimize material design and create an immune environment conducive to bone formation, are explored. In summary, this review comprehensively covers strategies and approaches for promoting bone tissue regeneration through immune modulation. It offers a thorough understanding of current research trends in biomaterial-based immune regulation, serving as a theoretical reference for the further development and clinical application of biomaterials in bone tissue engineering.

Next-Generation Approaches for Biomedical Materials Evaluation: Microfluidics and Organ-on-a-Chip Technologies

Biological evaluation of biomedical materials faces constraints imposed by the limitations of traditional in vitro and animal experiments. Currently, miniaturized and biomimetic microfluidic technologies and organ-on-chip systems have garnered widespread attention in the field of drug development. However, their exploration in the context of biomedical material evaluation and medical device development remains relatively limited. In this review, a summary of existing biological evaluation methods, highlighting their respective advantages and drawbacks is provided. The application of microfluidic technologies in the evaluation of biomedical materials, emphasizing the potential of organ-on-chip systems as highly biomimetic in vitro models in material evaluation is then focused. Finally, the challenges and opportunities associated with utilizing organ-on-chip systems to evaluate biomedical materials in the field of material evaluation are discussed. In conclusion, the integration of advanced microfluidic technologies and organ-on-chip systems presents a potential paradigm shift in the biological assessment of biomedical materials, offering the prospective of more accurate and predictive in vitro models in the development of medical devices.

Synthesis methods of Mg-based scaffolds and their applications in tissue engineering: A review

Repair and regeneration of damaged tissues due to disease and accidents have become a severe challenge to tissue engineers and researchers. In recent years, biocompatible metal materials such as stainless steels, cobalt alloys, titanium alloys, tantalum alloys, nitinol, and Mg alloys have been studied for tissue engineering applications; as suitable candidates in orthopedic and dentistry implants. These materials and their alloys are used for load-bearing and physiological roles in biological applications. Due to the suitable conditions provided by a porous material, many studies have been performed on the porous implants, including Mg-based scaffolds. Mg alloy scaffolds are attractive due to some outstanding features and susceptibilities, such as providing a cell matrix for cell proliferation, migration, and regeneration, providing metabolic substances for bone tissue growth, biocompatibility, good biodegradability, elastic modulus comparable to the natural bone, etc. Accordingly, in the present study, a general classification of all the production methods of Mg-based scaffolds is provided. Strengths and weaknesses, the effect of the production approach on the final properties of scaffolds, including mechanical and biological capabilities, and the impact of alloying elements and process parameters have been reviewed, and discussed. Finally, the manufacturing methods have been compared and the upcoming challenges have been stated.

3D-printed polycaprolactone/collagen/alginate scaffold incorporating phlorotannin for bone tissue regeneration: Assessment of sub-chronic toxicity

The development of effective scaffolds for bone regeneration is crucial given the increasing demand for innovative solutions to address bone defects and enhance healing process. In this study, a polycaprolactone/fish collagen/alginate (P/FC/A) 3D scaffold incorporating phlorotannin was developed to promote bone tissue regeneration. While the efficacy of the P/FC/A scaffold has been demonstrated through in vitro and in vivo experiments, its sub-chronic toxicity in animal models remains understudied, raising concerns regarding its safety in clinical application. Therefore, this study assessed the sub-chronic toxicity of the P/FC/A scaffold over 12 week using a New Zealand White rabbit model. Our results indicate no significant adverse effects in the group exposed to the P/FC/A scaffold compared with the negative control group implanted with a high-density polyethylene scaffold. These findings underscore the non-toxicity and safety profile of the P/FC/A scaffold, further supporting its potential suitability for clinical use in bone regeneration.

Enhancing osteogenic differentiation of diabetic tendon stem/progenitor cells through hyperoxia: Unveiling ROS/HIF-1α signalling axis

Diabetic calcific tendinopathy is the leading cause of chronic pain, mobility restriction, and tendon rupture in patients with diabetes. Tendon stem/progenitor cells (TSPCs) have been implicated in the development of diabetic calcified tendinopathy, but the molecular mechanisms remain unclear. This study found that diabetic tendons have a hyperoxic environment, characterized by increased oxygen delivery channels and carriers. In hyperoxic environment, TSPCs showed enhanced osteogenic differentiation and increased levels of reactive oxygen species (ROS). Additionally, hypoxia-inducible factor-1a (HIF-1a), a protein involved in regulating cellular responses to hyperoxia, was decreased in TSPCs by the ubiquitin-proteasome system. By intervening with antioxidant N-acetyl-L-cysteine (NAC) and overexpressing HIF-1a, we discovered that blocking the ROS/HIF-1a signalling axis significantly inhibited the osteogenic differentiation ability of TSPCs. Animal experiments further confirmed that hyperoxic environment could cause calcification in the Achilles tendon tissue of rats, while NAC intervention prevented calcification. These findings demonstrate that hyperoxia in diabetic tendons promotes osteogenic differentiation of TSPCs through the ROS/HIF-1a signalling axis. This study provides a new theoretical basis and research target for preventing and treating diabetic calcified tendinopathy.

Development of lignin-based 3D-printable light responsive shape memory materials: Design of optically controlled devices

This study employs simple approaches involving melt blending and Fused Deposition Modeling (FDM) 3D printing to fabricate a light-responsive shape memory composite. And, this composite material is used for the design of optically controlled devices that mimics the blooming of flowers in the natural environment. The composite material utilizes poly(ε-caprolactone) (PCL) and thermoplastic polyurethane (TPU) as the matrix, with lignin (L) serving as a functional filler. The analysis indicates that, due to the excellent photothermal conversion efficiency of lignin, under constant illumination the shape memory materials heat up to 50 °C within 40 s, the shape recovery rate exceeds 95.06 %. Lignin ameliorated the rheological deficiencies of TPU, with the composite material viscosity decreasing from 103 to 101 at an angular frequency of 100 rad/s, enhancing its compatibility with FDM processes. This research offers greater economic efficiency compared to conventional light-responsive materials and a simpler production method.

In situ comparison of osteogenic effects of polymer-based scaffolds with different degradability by integrated scaffold model

Polymer-based scaffolds with different degradability have been investigated to screen the matrix whose degradation rate is more closely matched with the bone regeneration rate. However, these comparisons are inclined to be compromised by the animal individual differences. In this study, we constructed an integrated scaffold model comprising four parts with different degradability and bioactivity to achieve an in situ comparison of bone regeneration ability of different scaffolds. Slow-degradable polycaprolactone (PCL), fast-degradable poly (lactic-co-glycolic acid) (PLGA), and silica-coated PCL and PLGA scaffolds were assembled into a round sheet to form a hydroxyapatite (HA)-free integrated scaffold. HA-doped PCL, PLGA, and silica-coated PCL and PLGA scaffolds were assembled to create an HA-incorporated integrated scaffold. The in vivo experimental results demonstrated that the local acid microenvironment caused by the rapid degradation of PLGA interfered with the osteogenic process promoted by PCL-based scaffolds in defect areas implanted with HA-free integrated scaffolds. Since the incorporation of HA alleviated the acidic microenvironment to some extent, each scaffold in HA-incorporated scaffolds exhibited its expected bone regeneration capacity. Consequently, it is feasible to construct an integrated structure for comparing the osteogenic effects of various scaffolds in situ, when there is no mutual interference between the materials. The strategy presented in this study inspired the structure design of biomaterials to enable in situ comparison of bone regeneration capacity of scaffolds.

Structure-function integrated biodegradable Mg/polymer composites: Design, manufacturing, properties, and biomedical applications

Mg is a typical biodegradable metal widely used for biomedical applications due to its considerable mechanical properties and bioactivity. Biodegradable polymers have attracted great interest owing to their favorable processability and inclusiveness. However, it is challenging for the degradation rates of Mg or polymers to precisely match tissue repair processes, and the significant changes in local pH during degradation hinder tissue repair. The concept of combining Mg with polymers is proposed to overcome the shortcomings of materials, aiming to meet repair needs from various aspects such as mechanics and biology. Therefore, it is essential to systematically understand the behavior of biodegradable Mg/polymer composite (BMPC) from the design, manufacturing, mechanical properties, degradation, and biological effects. In this review, we elaborate on the design concepts and manufacturing strategies of high-strength BMPC, the "structure-function" relationship between the microstructures and mechanical properties of composites, the variation in the degradation rate due to endogenous and exogenous factors, and the establishment of advanced degradation research platform. Additionally, the interplay among composite components during degradation and the biological function of composites under non-responsive/stimuli-responsive platforms are also discussed. Finally, we hope that this review will benefit future clinical applications of "structure-function" integrated biomaterials.

3D printing of fish-scale derived hydroxyapatite/chitosan/PCL scaffold for bone tissue engineering

In the field of bone tissue repair, the treatment of bone defects has always posed a significant challenge. In recent years, the advancement of bone tissue engineering and regenerative medicine has sparked great interest in the development of innovative bone grafting materials. In this study, a novel hydroxyapatite (HA) material was successfully prepared and comprehensively characterized. Antimicrobial experiments and biological evaluations were conducted to determine its efficacy. Based on the aforementioned research findings, 3D printing technology was employed to fabricate HA/chitosan (CS)/ polycaprolactone (PCL) scaffolds. The composition of the scaffold materials was confirmed through X-ray diffractometer (XRD) and Fourier Transform Infrared Spectroscopy (FT-IR) tests, while the influence of different HA ratios on the scaffold surface morphology was observed. Additionally, antimicrobial experiments demonstrated the favorable antimicrobial activity of the scaffolds containing 30%HA + 5%CS + PCL. Furthermore, the water contact angle measurements confirmed the superhydrophilicity of the scaffolds. Finally, the excellent bioactivity and ability to promote tissue regeneration of the scaffolds were further confirmed by in vitro and in vivo experiments. This study provides new options for future repair and regeneration of bone tissue and clinical applications.

Fabrication, characterization and evaluating properties of 3D printed PLA-Mn scaffolds

Polylactic acid (PLA) based scaffolds have attained considerable attention in recent years for being used as biodegradable implants in bone tissue engineering (BTE), owing to their suitable biocompatibility and processability. Nevertheless, the mechanical properties, bioactivity and biodegradation rate of PLA need to be improved for practical application. In this investigation, PLA-xMn composite filaments (x = 0, 1, 3, 5 and 7 wt%) were fabricated, characterized, and used for 3D printing of scaffolds by the fused deposition modeling process. The effect of Mn addition on the thermal, physical, mechanical, and structural properties, as well as the degradability and cell viability of 3D printed scaffolds were investigated in details. The obtained results indicate that the PLA-Mn composite filaments exhibit higher chain mobility and melt flow index values, with lower cold crystallization temperature and a higher degree of crystallinity. This higher flowability led to lower dimensional accuracy of 3D printed scaffolds, but resulted in higher interlayer adhesion. It was found that the mechanical properties of composite scaffolds were remarkably enhanced with the addition of Mn particles. The incorporation of Mn particles also caused higher surface roughness and hydrophilicity, a superior biodegradation rate of the scaffolds as well as better biocompatibility, indicating a promising candidate for (BTE) applications.

3D-printed Mg-incorporated PCL-based scaffolds improves rotator cuff tendon-bone healing through regulating macrophage polarization

Introduction: Rotator cuff tear (RCT) is a common shoulder injury impacting mobility and quality of life, while traditional surgeries often result in poor healing. Tissue engineering offers a promising solution, with poly (ε-caprolactone) (PCL) being favored due to its slow degradation, biocompatibility, and non-toxicity. However, PCL lacks sufficient compression resistance. Incorporating Mg, which promotes bone growth and has antibacterial effects, could enhance RCT repair. Methods: The Mg-incorporated PCL-based scaffolds were fabricated using a 3D printing technique. The scaffolds were incorporated with different percentages of Mg (0%, 5%, 10%, 15%, and 20%). The osteogenic activities and anti-inflammatory properties of the scaffolds were evaluated in vitro using human osteoblasts and macrophages. The tissue ingrowth and biocompatibility of the scaffolds were assessed in vivo using a rat model of RCT repair. The ability of the scaffolds to enhance macrophage polarization towards the M2 subtype and inhibit inflammation signaling activation was also investigated. Results: It was found that when incorporated with 10% Mg, PCL-based scaffolds exhibited the optimal bone repairing ability in vitro and in vivo. The in vitro experiments indicated that the successfully constructed 10 Mg/PCL scaffolds enhance osteogenic activities and anti-inflammatory properties. Besides, the in vivo studies demonstrated that 10 Mg/PCL scaffolds promoted tissue ingrowth and enhanced biocompatibility compared to the control PCL scaffolds. Furthermore, the 10 Mg/PCL scaffolds enhanced the macrophages' ability to polarize towards the M2 subtype and inhibited inflammation signaling activation. Discussion: These findings suggest that 3D-printed Mg-incorporated PCL scaffolds have the potential to improve RCT by enhancing osteogenesis, reducing inflammation, and promoting macrophage polarization. The incorporation of 10% Mg into PCL-based scaffolds provided the optimal combination of properties for RCT repair augmentation. This study highlights the potential of tissue engineering approaches in improving the outcomes of RCT repair and provides a foundation for future clinical applications.

Magnesium-oxide-enhanced bone regeneration: 3D-printing of gelatin-coated composite scaffolds with sustained Rosuvastatin release

Critical-size bone defects are one of the main challenges in bone tissue regeneration that determines the need to use angiogenic and osteogenic agents. Rosuvastatin (RSV) is a class of cholesterol-lowering drugs with osteogenic potential. Magnesium oxide (MgO) is an angiogenesis component affecting apatite formation. This study aims to evaluate 3D-printed Polycaprolactone/β-tricalcium phosphate/nano-hydroxyapatite/ MgO (PCL/β-TCP/nHA/MgO) scaffolds as a carrier for MgO and RSV in bone regeneration. For this purpose, PCL/β-TCP/nHA/MgO scaffolds were fabricated with a 3D-printing method and coated with gelatin and RSV. The biocompatibility and osteogenicity of scaffolds were examined with MTT, ALP, and Alizarin red staining. Finally, the scaffolds were implanted in a bone defect of rat's calvaria, and tissue regeneration was investigated after 3 months. Our results showed that the simultaneous presence of RSV and MgO improved biocompatibility, wettability, degradation rate, and ALP activity but decreased mechanical strength. PCL/β-TCP/nHA/MgO/gelatin-RSV scaffolds produced sustained release of MgO and RSV within 30 days. CT images showed that PCL/β-TCP/nHA/MgO/gelatin-RSV scaffolds filled approximately 86.83 + 4.9 % of the defects within 3 months and improved angiogenesis, woven bone, and osteogenic genes expression. These results indicate the potential of PCL/β-TCP/nHA/MgO/gelatin-RSV scaffolds as a promising tool for bone regeneration and clinical trials.

Porous Mg-Zn-Ca scaffolds for bone repair: a study on microstructure, mechanical properties and in vitro degradation behavior

Biodegradable porous Mg scaffolds are a promising approach to bone repair. In this work, 3D-spherical porous Mg-1.5Zn-0.2Ca (wt.%) scaffolds were prepared by vacuum infiltration casting technology, and MgF2 and fluorapatite coatings were designed to control the degradation behavior of Mg-based scaffolds. The results showed that the pores in Mg-based scaffolds were composed of the main spherical pores (450-600 μm) and interconnected pores (150-200 μm), and the porosity was up to 74.97%. Mg-based porous scaffolds exhibited sufficient mechanical properties with a compressive yield strength of about 4.04 MPa and elastic modulus of appropriately 0.23 GPa. Besides, both MgF2 coating and fluorapatite coating could effectively improve the corrosion resistance of porous Mg-based scaffolds. In conclusion, this research would provide data support and theoretical guidance for the application of biodegradable porous Mg-based scaffolds in bone tissue engineering.

Additively manufactured porous scaffolds by design for treatment of bone defects

There has been increasing attention to produce porous scaffolds that mimic human bone properties for enhancement of tissue ingrowth, regeneration, and integration. Additive manufacturing (AM) technologies, i.e., three dimensional (3D) printing, have played a substantial role in engineering porous scaffolds for clinical applications owing to their high level of design and fabrication flexibility. To this end, this review article attempts to provide a detailed overview on the main design considerations of porous scaffolds such as permeability, adhesion, vascularisation, and interfacial features and their interplay to affect bone regeneration and osseointegration. Physiology of bone regeneration was initially explained that was followed by analysing the impacts of porosity, pore size, permeability and surface chemistry of porous scaffolds on bone regeneration in defects. Importantly, major 3D printing methods employed for fabrication of porous bone substitutes were also discussed. Advancements of MA technologies have allowed for the production of bone scaffolds with complex geometries in polymers, composites and metals with well-tailored architectural, mechanical, and mass transport features. In this way, a particular attention was devoted to reviewing 3D printed scaffolds with triply periodic minimal surface (TPMS) geometries that mimic the hierarchical structure of human bones. In overall, this review enlighten a design pathway to produce patient-specific 3D-printed bone substitutions with high regeneration and osseointegration capacity for repairing large bone defects.

Magnesium Hydroxide as a Versatile Nanofiller for 3D-Printed PLA Bone Scaffolds

Polylactic acid (PLA) has attracted much attention in bone tissue engineering due to its good biocompatibility and processability, but it still faces problems such as a slow degradation rate, acidic degradation product, weak biomineralization ability, and poor cell response, which limits its wider application in developing bone scaffolds. In this study, Mg(OH)2 nanoparticles were employed as a versatile nanofiller for developing PLA/Mg(OH)2 composite bone scaffolds using fused deposition modeling (FDM) 3D printing technology, and its mechanical, degradation, and biological properties were evaluated. The mechanical tests revealed that a 5 wt% addition of Mg(OH)2 improved the tensile and compressive strengths of the PLA scaffold by 20.50% and 63.97%, respectively. The soaking experiment in phosphate buffered solution (PBS) revealed that the alkaline degradation products of Mg(OH)2 neutralized the acidic degradation products of PLA, thus accelerating the degradation of PLA. The weight loss rate of the PLA/20Mg(OH)2 scaffold (15.40%) was significantly higher than that of PLA (0.15%) on day 28. Meanwhile, the composite scaffolds showed long-term Mg2+ release for more than 28 days. The simulated body fluid (SBF) immersion experiment indicated that Mg(OH)2 promoted the deposition of apatite and improved the biomineralization of PLA scaffolds. The cell culture of bone marrow mesenchymal stem cells (BMSCs) indicated that adding 5 wt% Mg(OH)2 effectively improved cell responses, including adhesion, proliferation, and osteogenic differentiation, due to the release of Mg2+. This study suggests that Mg(OH)2 can simultaneously address various issues related to polymer scaffolds, including degradation, mechanical properties, and cell interaction, having promising applications in tissue engineering.

Dual Mg-Reinforced PCL Membrane with a Janus Structure for Vascularized Bone Regeneration and Bacterial Elimination

Commercially available guided bone regeneration (GBR) membranes often exhibit limited mechanical properties or bioactivity, leading to poor performance in repairing bone defects. To surmount this limitation, we developed a Janus structural composite membrane (Mg-MgO/PCL) reinforced by dual Mg (Mg sheets and MgO NPs) by using a combined processing technique involving casting and electrospinning. Results showed that the addition of Mg sheets and MgO NPs enhanced the mechanical properties of the composite membrane for osteogenic space maintenance, specifically tensile strength (from 10.2 ± 1.2 to 50.3 ± 4.5 MPa) and compression force (from 0 to 0.94 ± 0.09 N mm-1), through Mg sheet reinforcement and improved crystallization. The dense cast side of the Janus structure membrane displayed better fibroblast barrier capacity than a single fiber structure; meanwhile, the PCL matrix protected the Mg sheet from severe corrosion due to predeformation. The porous microfibers side supported preosteoblast cell adhesion, enhanced osteogenesis, and angiogenesis in vitro, through the biomimetic extracellular matrix and sustainable Mg2+ release. Furthermore, the Mg-MgO/PCL membrane incorporating 2 wt % MgO NPs exhibited remarkable antimicrobial properties, inducing over 88.75% apoptosis in Staphylococcus aureus. An in vivo experiment using the rat skull defect model (Φ = 5 mm) confirmed that the Mg-MgO/PCL membrane significantly improved new bone formation postsurgery. Collectively, our investigation provides valuable insights into the design of multifunctional membranes for clinical oral GBR application.

The development of magnesium-based biomaterials in bone tissue engineering: A review

Bone regeneration is a vital clinical challenge in massive or complicated bone defects. Recently, bone tissue engineering has come to the fore to meet the demand for bone repair with various innovative materials. However, the reported materials usually cannot satisfy the requirements, such as ideal mechanical and osteogenic properties, as well as biocompatibility at the same time. Mg-based biomaterials have considerable potential in bone tissue engineering owing to their excellent mechanical strength and biosafety. Moreover, the biocompatibility and osteogenic activity of Mg-based biomaterials have been the research focuses in recent years. The main limitation faced in the applications of Mg-based biomaterials is rapid degradation, which can produce excessive Mg2+ and hydrogen, affecting the healing of the bone defect. In order to overcome the limitations, researchers have explored several ways to improve the properties of Mg-based biomaterials, including alloying, surface modification with coatings, and synthesizing other composite materials to control the degradation rate upon implantation. This article reviewed the osteogenic mechanism and requirement for appropriate degradation rate and focused on current progress in the biomedical use of Mg-based biomaterials to inspire more clinical applications of Mg in bone regeneration in the future.

Raising the Bar: Progress in 3D-Printed Hybrid Bone Scaffolds for Clinical Applications: A Review

Damage to bones resulting from trauma and tumors poses a significant challenge to human health. Consequently, current research in bone damage healing centers on developing three-dimensional (3D) scaffolding materials that facilitate and enhance the regeneration of fractured bone tissues. In this context, the careful selection of materials and preparation processes is essential for creating demanding scaffolds for bone tissue engineering. This is done to optimize the regeneration of fractured bones. This study comprehensively analyses the latest scientific advancements and difficulties in developing scaffolds for bone tissue creation. Initially, we clarified the composition and process by which bone tissue repairs itself. The review summarizes the primary uses of materials, both inorganic and organic, in scaffolds for bone tissue engineering. In addition, we present a comprehensive study of the most recent advancements in the mainstream techniques used to prepare scaffolds for bone tissue engineering. We also examine the distinct advantages of each method in great detail. This article thoroughly examines potential paths and obstacles in bone tissue engineering scaffolds for clinical applications.

Bioabsorbable Composites Based on Polymeric Matrix (PLA and PCL) Reinforced with Magnesium (Mg) for Use in Bone Regeneration Therapy: Physicochemical Properties and Biological Evaluation

Improvements in Tissue Engineering and Regenerative Medicine (TERM)-type technologies have allowed the development of specific materials that, together with a better understanding of bone tissue structure, have provided new pathways to obtain biomaterials for bone tissue regeneration. In this manuscript, bioabsorbable materials are presented as emerging materials in tissue engineering therapies related to bone lesions because of their ability to degrade in physiological environments while the regeneration process is completed. This comprehensive review aims to explore the studies, published since its inception (2010s) to the present, on bioabsorbable composite materials based on PLA and PCL polymeric matrix reinforced with Mg, which is also bioabsorbable and has recognized osteoinductive capacity. The research collected in the literature reveals studies based on different manufacturing and dispersion processes of the reinforcement as well as the physicochemical analysis and corresponding biological evaluation to know the osteoinductive capacity of the proposed PLA/Mg and PCL/Mg composites. In short, this review shows the potential of these composite materials and serves as a guide for those interested in bioabsorbable materials applied in bone tissue engineering.

Probing the Effects of Antimicrobial-Lysozyme Derivatization on Enzymatic Degradation of Poly(ε-caprolactone) Film and Fiber

Surface derivatization is essential for incorporating unique functionalities into biodegradable polymers. Nonetheless, its precise effects on enzymatic biodegradation still lack comprehensive understanding. In this study, a facile solution-based method is employed to surface derivatize poly(ε-caprolactone) films and electrospun fibers with lysozyme, aiming to impart antimicrobial properties and examine the impact on enzymatic degradation. The derivatized films and fibers have shown high antibacterial efficacy against Escherichia coli and Staphylococcus aureus. Through gravimetric analysis, it is observed that the degradation rate experiences a slight decrease upon lysozyme derivatization. However, this reduction is effectively countered by the inclusion of Tween-20, as affirmed by isothermal titration calorimetry. Comparing films and fibers, the latter undergoes degradation at a more accelerated pace, coupled with a rapid decline in molecular weight. This study provides valuable insights into the factors influencing the degradation of surface-derivatized biopolymers through electrospinning, offering a simple strategy to mitigate biomaterial-associated infections.

Actionable insights into hazard mitigation of typical 3D printing waste via pyrolysis

3D printing waste (3DPW) contains hazardous substances, such as photosensitizers and pigments, and may cause environmental pollution when improperly disposed of. Pyrolysis treatment can reduce hazards and turn waste into useful resources. This study coupled thermogravimetric (TG), TG-Fourier transform infrared spectroscopy-gas chromatography/mass spectrometry, and rapid pyrolysis gas chromatography/mass spectrometry analysis to evaluate the pyrolytic reaction mechanisms, products, and possible decomposition pathways of the three typical 3DPW of photosensitive resin waste (PRW), polyamide waste (PAW), and polycaprolactone waste (PCLW). The main degradation stages of the typical 3DPW occurred at 320-580 °C. The most appropriate reaction mechanisms of PRW, PAW and PCLW were D1, A1.2 and A1.5, respectively. The main pyrolysis processes were the decomposition of the complex organic polymers of PRW, the breaking of the NH-CH2 bond and dehydration of -CO-NH- of PAW, and the breaking and reorganization of the molecular chains of PCLW, mainly resulting in toluene (C7H8), undecylenitrile (C11H21N), tetrahydrofuran (C4H8O), respectively. Unlike the slow pyrolysis, the rapid pyrolysis produced volatiles consisting mainly of phenol, 4,4'-(1-methylethylidene)bis- (C15H16O2) for PRW; 1,10-dicyanodecane (C12H20N2) for PAW; and ɛ-caprolactone (C6H10O2) for PCLW. These pyrolysis products hold great potential for applications. The findings of the study offer actionable insights into the hazard reduction and resource recovery of 3D printing waste.

Bio-Physical Properties of Acetylated Chitosan/Poly(ɛ-Caprolactone) Composites for Three-Dimensional Printing Material Applications

For three-dimensional (3D) printing material applications in tissue engineering, acetylated chitosan (AC)/poly(ɛ-caprolactone) (PCL) composites were prepared by the melt mixing method using the acetylation of chitosan with PCL. The physiochemical properties of the AC/PCL composites were examined by measuring the water contact angles, dispersity of AC on the cross-section using scanning electron microscopy, and temperature stability. In addition, mechanical properties such as tensile strength and bending stress recovery were measured to determine the elasticity of the composite films. The fibroblast cell line NIH-3T3 was used to test the relative cell affinities based on the AC content and cell viability on AC/PCL at various temperatures. There was no difference between the melting points and tensile strengths of the AC/PCL composites and pure PCL. Overall, the AC/PCL composites showed high initial cell adhesion after 4 h of cell culture and increased cell proliferation compared to those of PCL composites used as a control. Based on these tests, an AC of 10.7 wt% was determined to be the optimal composition for the AC/PCL composite. Thus, these composites can be used in various 3D printing material applications in tissue engineering.

Shape Memory Polyester Scaffold Promotes Bone Defect Repair through Enhanced Osteogenic Ability and Mechanical Stability

Bone tissue engineering involving scaffolds is recognized as the ideal approach for bone defect repair. However, scaffold materials exhibit several limitations, such as low bioactivity, less osseointegration, and poor processability, for developing bone tissue engineering. Herein, a bioactive and shape memory bone scaffold was fabricated using the biodegradable polyester copolymer's four-dimensional fused deposition modeling. The poly(ε-caprolactone) segment with a transition temperature near body temperature was selected as the molecular switch to realize the shape memory effect. Another copolymer segment, i.e., poly(propylene fumarate), was introduced for post-cross-linking and improving the regulation effect of the resulting bioadaptable scaffold on osteogenesis. To mimic the porous structures and mechanical properties of the native spongy bone, the pore size of the printed scaffold was set as ∼300 μm, and a comparable compression modulus was achieved after photo-cross-linking. Compared with the pristine poly(ε-caprolactone), the scaffold made from fumarate-functionalized copolymer considerably enhanced the adhesion and osteogenic differentiation of MC3T3-E1 cells in vitro. In vivo experiments indicated that the bioactive shape memory scaffold could quickly adapt to the defect geometry during implantation via shape change, and bone regeneration at the defect site was remarkably promoted, providing a promising strategy to treat bone defects in the clinic, substantial bone defects with irregular geometry.

Antimicrobial and Biodegradable 3D Printed Scaffolds for Orthopedic Infections

In bone tissue engineering, the performance of scaffolds underpins the success of the healing of bone. Microbial infection is the most challenging issue for orthopedists. The application of scaffolds for healing bone defects is prone to microbial infection. To address this challenge, scaffolds with a desirable shape and significant mechanical, physical, and biological characteristics are crucial. 3D printing of antibacterial scaffolds with suitable mechanical strength and excellent biocompatibility is an appealing strategy to surmount issues of microbial infection. The spectacular progress in developing antimicrobial scaffolds, along with beneficial mechanical and biological properties, has sparked further research for possible clinical applications. Herein, the significance of antibacterial scaffolds designed by 3D, 4D, and 5D printing technologies for bone tissue engineering is critically investigated. Materials such as antibiotics, polymers, peptides, graphene, metals/ceramics/glass, and antibacterial coatings are used to impart the antimicrobial features for the 3D scaffolds. Polymeric or metallic biodegradable and antibacterial 3D-printed scaffolds in orthopedics disclose exceptional mechanical and degradation behavior, biocompatibility, osteogenesis, and long-term antibacterial efficiency. The commercialization aspect of antibacterial 3D-printed scaffolds and technical challenges are also discussed briefly. Finally, the discussion on the unmet demands and prevailing challenges for ideal scaffold materials for fighting against bone infections is included along with a highlight of emerging strategies in this field.

Fabrication of highly ordered willemite/PCL bone scaffolds by 3D printing: Nanostructure effects on compressive strength and in vitro behavior

In this study, first willemite (Zn₂SiO₄) micro and nano-powders were synthesized by the sol-gel method. X-ray diffraction (XRD), transmission electron microscopy (TEM), and dynamic light scattering (DLS) were applied to characterize the crystalline phases and particle size of powders. Then polycaprolactone (PCL) polymer scaffolds containing 20 wt% willemite were successfully fabricated by the DIW 3D printing (direct ink writing) method. The effects of willemite particle size on compressive strength, elastic modulus, degradation rate, and bioactivity of the composite scaffolds were investigated. The results showed that nanoparticle willemite/PCL (NW/PCL) scaffolds had 33.1% and 58.1% higher compressive strength and the elastic modulus of NW/PCL were 1.14 and 2.45 times better compared to micron size willemite/PCL (MW/PCL) and pure PCL scaffolds, respectively. Scanning electron microscopy (SEM) images and Energy-dispersive X-ray spectroscopy map (EDS map) results indicated that willemite nanoparticles, unlike microparticles, were smoothly embedded in the scaffold struts. In vitro tests also revealed an improvement in bone-like apatite formation ability and an increase in the degradation rate up to 2.17% by decreasing the willemite particle size to 50 nm. In addition, NW/PCL rendered significant enhancement in cell viability and cell attachment during the culture of MG-63 human osteosarcoma cell line. Nanostructure had also a positive effect on ALP activity and biomineralization in vitro.

Recent advances on 3D-printed PCL-based composite scaffolds for bone tissue engineering

Population ageing and various diseases have increased the demand for bone grafts in recent decades. Bone tissue engineering (BTE) using a three-dimensional (3D) scaffold helps to create a suitable microenvironment for cell proliferation and regeneration of damaged tissues or organs. The 3D printing technique is a beneficial tool in BTE scaffold fabrication with appropriate features such as spatial control of microarchitecture and scaffold composition, high efficiency, and high precision. Various biomaterials could be used in BTE applications. PCL, as a thermoplastic and linear aliphatic polyester, is one of the most widely used polymers in bone scaffold fabrication. High biocompatibility, low cost, easy processing, non-carcinogenicity, low immunogenicity, and a slow degradation rate make this semi-crystalline polymer suitable for use in load-bearing bones. Combining PCL with other biomaterials, drugs, growth factors, and cells has improved its properties and helped heal bone lesions. The integration of PCL composites with the new 3D printing method has made it a promising approach for the effective treatment of bone injuries. The purpose of this review is give a comprehensive overview of the role of printed PCL composite scaffolds in bone repair and the path ahead to enter the clinic. This study will investigate the types of 3D printing methods for making PCL composites and the optimal compounds for making PCL composites to accelerate bone healing.

Current Strategies for Engineered Vascular Grafts and Vascularized Tissue Engineering

Blood vessels not only transport oxygen and nutrients to each organ, but also play an important role in the regulation of tissue regeneration. Impaired or occluded vessels can result in ischemia, tissue necrosis, or even life-threatening events. Bioengineered vascular grafts have become a promising alternative treatment for damaged or occlusive vessels. Large-scale tubular grafts, which can match arteries, arterioles, and venules, as well as meso- and microscale vasculature to alleviate ischemia or prevascularized engineered tissues, have been developed. In this review, materials and techniques for engineering tubular scaffolds and vasculature at all levels are discussed. Examples of vascularized tissue engineering in bone, peripheral nerves, and the heart are also provided. Finally, the current challenges are discussed and the perspectives on future developments in biofunctional engineered vessels are delineated.

Structural Mechanical Properties of 3D Printing Biomimetic Bone Replacement Materials

One of the primary challenges in developing bone substitutes is to create scaffolds with mechanical properties that closely mimic those of regenerated tissue. Scaffolds that mimic the structure of natural cancellous bone are believed to have better environmental adaptability. In this study, we used the porosity and thickness of pig cancellous bone as biomimetic design parameters, and porosity and structural shape as differential indicators, to design a biomimetic bone beam scaffold. The mechanical properties of the designed bone beam model were tested using the finite element method (FEM). PCL/β-TCP porous scaffolds were prepared using the FDM method, and their mechanical properties were tested. The FEM simulation results were compared and validated, and the effects of porosity and pore shape on the mechanical properties were analyzed. The results of this study indicate that the PCL/β-TCP scaffold, prepared using FDM 3D printing technology for cancellous bone tissue engineering, has excellent integrity and stability. Predicting the structural stability using FEM is effective. The triangle pore structure has the most stability in both simulations and tests, followed by the rectangle and honeycomb shapes, and the diamond structure has the worst stability. Therefore, adjusting the porosity and pore shape can change the mechanical properties of the composite scaffold to meet the mechanical requirements of customized tissue engineering.

A review on polysaccharides mediated electrospun nanofibers for diabetic wound healing: Their current status with regulatory perspective

The current treatment strategies for diabetic wound care provide only moderate degree of effectiveness; hence new and improved therapeutic techniques are in great demand. Diabetic wound healing is a complex physiological process that involves synchronisation of various biological events such as haemostasis, inflammation, and remodelling. Nanomaterials like polymeric nanofibers (NFs) offer a promising approach for the treatment of diabetic wounds and have emerged as viable options for wound management. Electrospinning is a powerful and cost-effective method to fabricate versatile NFs with a wide array of raw materials for different biological applications. The electrospun NFs have unique advantages in the development of wound dressings due to their high specific surface area and porosity. The electrospun NFs possess a unique porous structure and biological function similar to the natural extracellular matrix (ECM), and are known to accelerate wound healing. Compared to traditional dressings, the electrospun NFs are more effective in healing wounds owing to their distinct characteristics, good surface functionalisation, better biocompatibility and biodegradability. This review provides a comprehensive overview of the electrospinning procedure and its operating principle, with special emphasis on the role of electrospun NFs in the treatment of diabetic wounds. This review discusses the present techniques applied in the fabrication of NF dressings, and highlights the future prospects of electrospun NFs in medicinal applications.

Effect of Pore Characteristics and Alkali Treatment on the Physicochemical and Biological Properties of a 3D-Printed Polycaprolactone Bone Scaffold

Polycaprolactone scaffolds were designed and 3D-printed with different pore shapes (cube and triangle) and sizes (500 and 700 μm) and modified with alkaline hydrolysis of different ratios (1, 3, and 5 M). In total, 16 designs were evaluated for their physical, mechanical, and biological properties. The present study mainly focused on the pore size, porosity, pore shapes, surface modification, biomineralization, mechanical properties, and biological characteristics that might influence bone ingrowth in 3D-printed biodegradable scaffolds. The results showed that the surface roughness in treated scaffolds increased compared to untreated polycaprolactone scaffolds (R _a = 2.3-10.5 nm and R _q = 17- 76 nm), but the structural integrity declined with an increase in the NaOH concentration especially in the scaffolds with small pores and a triangle shape. Overall, the treated polycaprolactone scaffolds particularly with the triangle shape and smaller pore size provided superior performance in mechanical strength similar to that of cancellous bone. Additionally, the in vitro study showed that cell viability increased in the polycaprolactone scaffolds with cubic pore shapes and small pore sizes, whereas mineralization was enhanced in the designs with larger pore sizes. Based on the results obtained, this study demonstrated that the 3D-printed modified polycaprolactone scaffolds exhibit a favorable mechanical property, biomineralization, and better biological properties; therefore, they can be applied in bone tissue engineering.

3D bioprinting of dECM/Gel/QCS/nHAp hybrid scaffolds laden with mesenchymal stem cell-derived exosomes to improve angiogenesis and osteogenesis

Craniofacial bone regeneration is a coupled process of angiogenesis and osteogenesis, which, associated with infection, still remains a challenge in bone defects after trauma or tumor resection. 3D tissue engineering scaffolds with multifunctional-therapeutic properties can offer many advantages for the angiogenesis and osteogenesis of infected bone defects. Hence, in the present study, a microchannel networks-enriched 3D hybrid scaffold composed of decellularized extracellular matrix (dECM), gelatin (Gel), quaterinized chitosan (QCS) and nano-hydroxyapatite (nHAp) (dGQH) was fabricated by an extrusion 3D bioprinting technology. And enlightened by the characteristics of natural bone microstructure and the demands of vascularized bone regeneration, the exosomes (Exos) isolated from human adipose derived stem cells as angiogenic and osteogenic factors were then co-loaded into the desired dGQH₂₀hybrid scaffold based on an electrostatic interaction. The results of the hybrid scaffolds performance characterization showed that these hybrid scaffolds exhibited an interconnected pore structure and appropriate degradability (>61% after 8 weeks of treatment), and the dGQH₂₀hybrid scaffold displayed the highest porosity (83.93 ± 7.38%) and mechanical properties (tensile modulus: 62.68 ± 10.29 MPa, compressive modulus: 16.22 ± 3.61 MPa) among the dGQH hybrid scaffolds. Moreover, the dGQH₂₀hybrid scaffold presented good antibacterial activities (against 94.90 ± 2.44% ofEscherichia coliand 95.41 ± 2.65% ofStaphylococcus aureus, respectively) as well as excellent hemocompatibility and biocompatibility. Furthermore, the results of applying the Exos to the dGQH₂₀hybrid scaffold showed that the Exo promoted the cell attachment and proliferation on the scaffold, and also showed a significant increase in osteogenesis and vascularity regeneration in the dGQH@Exo scaffoldsin vitroandin vivo. Overall, this novel dECM/Gel/QCS/nHAp hybrid scaffold laden with Exo has a considerable potential application in reservation of craniofacial bone defects.

Additive manufacturing of PLA-Mg composite scaffolds for hard tissue engineering applications

Polylactic acid (PLA) is considered as a great option to be employed as 3D porous scaffold in hard tissue engineering applications owing to its excellent biocompatibility and processability. However, relatively weak mechanical properties and inappropriate biodegradability limit its extensive usage. In order to overcome the mentioned challenges, micrometric magnesium particles were incorporated into the PLA matrix by the fused deposition modeling (FDM) technique. The effects of various Mg contents (i.e., 2, 4, 6, 8 and 10 wt%) on the structural, thermal, rheological, mechanical, wettability, degradability characteristics and cellular behavior of the 3D porous PLA-Mg composite scaffolds were examined. The developed PLA-Mg composites exhibit an interconnected porous structure with a mostly uniform distribution of Mg particles in the PLA matrix. It was found that incorporation of Mg particles into the PLA matrix enhances the mechanical, physical, chemical and biological characteristics of PLA. The cell studies demonstrate that the PLA-6Mg composite scaffold provides the best cellular response in terms of cell atachment and viability. The obtained results in this investigation greatly suggest that the 3D-printed PLA-Mg composite scaffold is a promising candidate for hard tissue engineering applications.

Cell-free and cytokine-free self-assembling peptide hydrogel-polycaprolactone composite scaffolds for segmental bone defects

Segmental bone defects over the self-healing threshold are a major challenge for orthopedics. Despite the advancements in clinical practice, traditional tissue engineering methods are limited by the addition of heterogeneous cells and cytokines, leading to carcinoma or other adverse effects. Here, we present a cell-free and cytokine-free strategy using an ECM-mimetic self-assembling peptide hydrogel (SAPH)- polycaprolactone (PCL) composite scaffold. The hydrophilic SAPH endows the rigid PCL scaffold with excellent biocompatibility and preference for osteogenesis induction. The autologous cells around the bone defect site immediately grew, proliferated, and secreted ECM and cytokines after contacting the implanted SAPH-PCL composite scaffold, and the bone repair of rabbit ulnar segmental bone defect was achieved in just six months. Quantitative proteomic analysis reveals that the SAPH-PCL composite scaffold accelerates osteoblastogenesis, osteoclastogenesis, and angiogenesis with moderate immune responses and negligible effects on pathological fibrosis. These findings have important implications for the potential clinical applications of the SAPH-PCL composite scaffold in patients with segmental bone defects and identify the mechanisms of action for accelerated segmental bone defect repair.

Accelerated Degradation of Poly-ε-caprolactone Composite Scaffolds for Large Bone Defects

This research investigates the accelerated hydrolytic degradation process of both anatomically designed bone scaffolds with a pore size gradient and a rectangular shape (biomimetically designed scaffolds or bone bricks). The effect of material composition is investigated considering poly-ε-caprolactone (PCL) as the main scaffold material, reinforced with ceramics such as hydroxyapatite (HA), β-tricalcium phosphate (TCP) and bioglass at a concentration of 20 wt%. In the case of rectangular scaffolds, the effect of pore size (200 μm, 300 μm and 500 μm) is also investigated. The degradation process (accelerated degradation) was investigated during a period of 5 days in a sodium hydroxide (NaOH) medium. Degraded bone bricks and rectangular scaffolds were measured each day to evaluate the weight loss of the samples, which were also morphologically, thermally, chemically and mechanically assessed. The results show that the PCL/bioglass bone brick scaffolds exhibited faster degradation kinetics in comparison with the PCL, PCL/HA and PCL/TCP bone bricks. Furthermore, the degradation kinetics of rectangular scaffolds increased by increasing the pore size from 500 μm to 200 μm. The results also indicate that, for the same material composition, bone bricks degrade slower compared with rectangular scaffolds. The scanning electron microscopy (SEM) images show that the degradation process was faster on the external regions of the bone brick scaffolds (600 μm pore size) compared with the internal regions (200 μm pore size). The thermal gravimetric analysis (TGA) results show that the ceramic concentration remained constant throughout the degradation process, while differential scanning calorimetry (DSC) results show that all scaffolds exhibited a reduction in crystallinity (Xc), enthalpy (Δm) and melting temperature (Tm) throughout the degradation process, while the glass transition temperature (Tg) slightly increased. Finally, the compression results show that the mechanical properties decreased during the degradation process, with PCL/bioglass bone bricks and rectangular scaffolds presenting higher mechanical properties with the same design in comparison with the other materials.

A Review on Three-Dimensional Printed Silicate-Based Bioactive Glass/Biodegradable Medical Synthetic Polymer Composite Scaffolds

In recent years, tissue engineering scaffolds have turned into the preferred option for the clinical treatment of pathological and traumatic bone defects. In this field, silicate-based bioactive glasses (SBGs) and biodegradable medical synthetic polymers (BMSPs) have attracted a great deal of attention owing to their shared exceptional advantages, like excellent biocompatibility, good biodegradability, and outstanding osteogenesis. Three-dimensional (3D) printed SBG/BMSP scaffolds can not only replicate the mechanical properties and microstructure of natural bone but also degrade in situ after service and end up being replaced by regenerated bone tissue in vivo. This review first consolidates the research efforts in 3D printed SBG/BMSP scaffolds, and then focuses on their composite mechanism. This review may help to provide a fresh perspective for SBG/BMSP composite system in bone regeneration.

Additive Manufacturing of Polymer/Mg-Based Composites for Porous Tissue Scaffolds

Due to their commercial availability, superior processability, and biocompatibility, polymers are frequently used to build three-dimensional (3D) porous scaffolds. The main issues limiting the widespread clinical use of monophasic polymer scaffolds in the bone healing process are their inadequate mechanical strength and inappropriate biodegradation. Due to their mechanical strength and biocompatibility, metal-based scaffolds have been used for various bone regenerative applications. However, due to the mismatch in mechanical properties and nondegradability, they lack integration with the host tissues, resulting in the production of fiber tissue and the release of toxic ions, posing a risk to the durability of scaffolds. Due to their natural degradability in the body, Mg and its alloys increasingly attract attention for orthopedic and cardiovascular applications. Incorporating Mg micro-nano-scale particles into biodegradable polymers dramatically improves scaffolds and implants' strength, biocompatibility, and biodegradability. Polymer biodegradable implants also improve the quality of life, particularly for an aging society, by eliminating the secondary surgery often needed to remove permanent implants and significantly reducing healthcare costs. This paper reviews the suitability of various biodegradable polymer/Mg composites for bone tissue scaffolds and then summarizes the current status and challenges of polymer/magnesium composite scaffolds. In addition, this paper reviews the potential use of 3D printing, which has a unique design capability for developing complex structures with fewer material waste at a faster rate, and with a personalized and on-site fabrication possibility.

Fabrication and characterization of three-dimensional polycaprolactone/sodium alginate and egg whites and eggshells hybrid scaffold in bone tissue engineering

The aim of this study was to fabricate three-dimensional bone scaffolds using polycaprolactone and egg shell powder. The scaffolds were coated with sodium alginate/egg white. SEM was used to investigate egg shell particles on the surface of each string of scaffolds. The presence of calcium carbonate in the scaffold structure was confirmed by microstructural analyses employing XRD. Egg shell-related functional groups were discovered using FTIR investigations. Bone cells were used to conduct biocompatibility tests on scaffolds (MG-63). Finally, scaffolds with the highest proportion of egg whites and eggshells have the best cell survival rate. It may be concluded that the PCL/7% Esh/15% Ew scaffold is a good option for application in bone tissue engineering.

The 3D Printability and Mechanical Properties of Polyhydroxybutyrate (PHB) as Additives in Urethane Dimethacrylate (UDMA) Blends Polymer for Medical Application

The integration of additive manufacturing (3D printing) in the biomedical sector required material to portray a holistic characteristic in terms of printability, biocompatibility, degradability, and mechanical properties. This research aims to evaluate the 3D printability and mechanical properties of polyhydroxybutyrate (PHB) as additives in the urethane dimethacrylate (UDMA) based resin and its potential for medical applications. The printability of the PHB/UDMA resin blends was limited to 11 wt.% as it reached the maximum viscosity value at 2188 cP. Two-way analysis of variance (ANOVA) was also conducted to assess the significant effect of the varied PHB (wt.%) incorporation within UDMA resin, and the aging duration of 3D printed PHB/UDMA on mechanical properties in terms of tensile and impact properties. Meanwhile, the increasing crystallinity index (CI) of X-ray diffraction (XRD) in the 3D printed PHB/UDMA as the PHB loading increased, indicating that there is a strong correlation with the lower tensile and impact strength. FESEM images also proved that the agglomerations that occurred within the UDMA matrix had affected the mechanical performance of 3D printed PHB/UDMA. Nonetheless, the thermal stability of the 3D printed PHB/UDMA had only a slight deviation from the 3D printed UDMA since it had better thermal processability.

New dual-function in situ bone repair scaffolds promote osteogenesis and reduce infection

Background

The treatment of infectious bone defects is a difficult problem to be solved in the clinic. In situ bone defect repair scaffolds with anti-infection and osteogenic abilities can effectively deal with infectious bone defects. In this study, an in situ polycaprolactone (PCL) scaffold containing ampicillin (Amp) and Mg microspheres was prepared by 3D printing technology.

Results

Mg and Amp were evenly distributed in PCL scaffolds and could be released slowly to the surrounding defect sites with the degradation of scaffolds. In vitro experiments demonstrated that the PCL scaffold containing Mg and Amp (PCL@Mg/Amp) demonstrated good cell adhesion and proliferation. The osteogenic genes collagen I (COL-I) and Runx2 were upregulated in cells grown on the PCL@Mg/Amp scaffold. The PCL@Mg/Amp scaffold also demonstrated excellent antibacterial ability against E. coli and S. aureus. In vivo experiments showed that the PCL@Mg/Amp scaffold had the strongest ability to promote tibial defect repair in rats compared with the other groups of scaffolds.

Conclusions

This kind of dual-function in situ bone repair scaffold with anti-infection and osteogenic abilities has good application prospects in the field of treating infectious bone defects.

A Study on the Effect of Nanoscale MgO and Hydrogen Bonding in Nanofiber Mats for the Controlled Drug Release along with In Vitro Breast Cancer Cell Line and Antimicrobial Studies

Nanosized metal oxide-incorporated drug carriers have received significant attention due to their biocompatibility, mechanical strength, controlled drug release, and biodegradability. Herein, an attempt was made to fabricate polycaprolactone-based electrospun nanofiber mats involving the 5-fluorouracil (5Fu) drug, MgO nanoparticle, methyl cellulose, and polyethylene glycol. The chemical interactions, surface wettability, mechanical properties, structural and morphological changes, and thermal stability were studied by the respective analyses. The ionic interaction between 5Fu, MgO, and polymers were found to be responsible for the controlled drug release. Zero-order kinetic and model data also revealed that a controlled drug release pattern was observed in a period of 16 days. Furthermore, the nanofiber mats were subjected to cytotoxicity studies against MDA-MB-231 cancer cell line and the results showed higher cytotoxicity in a short time of 24 h and less toxicity to normal L929 fibroblast cell line. The apoptosis in cancer cell lines was also tested by AO/PI staining assay and confirmed by fluorescence microscopy. In addition, the growth inhibition of several bacterial and fungal strains was tested for the mats and the results exhibited good inhibition activity. Hence, the reported nanofiber drug carrier was found to be an efficient implant for the controlled release of anticancer drug along with other significant properties.

Optimizing Design Parameters of PLA 3D-Printed Scaffolds for Bone Defect Repair

Current materials used to fill bone defects (ceramics, cement) either lack strength or do not induce bone repair. The use of biodegradable polymers such as PLA may promote patient healing by stimulating the production of new bone in parallel with a controlled degradation of the scaffold. This project aims to determine the design parameters maximising scaffold mechanical performance in such materials. Starting from a base cylindrical model of 10 mm height and of outer and inner diameters of 10 and 4 mm, respectively, 27 scaffolds were designed. Three design parameters were investigated: pore distribution (crosswise, lengthwise, and eccentric), pore shape (triangular, circular, and square), and pore size (surface area of 0.25 mm2, 0.5625 mm2, and 1 mm2). Using the finite element approach, a compressive displacement (0.05 mm/s up to 15% strain) was simulated on the models and the resulting scaffold stiffnesses (N/mm2) were compared. The models presenting good mechanical behaviors were further printed along two orientations: 0° (cylinder sitting on its base) and 90° (cylinder laying on its side). A total of n = 5 specimens were printed with PLA for each of the retained models and experimentally tested using a mechanical testing machine with the same compression parameters. Rigidity and yield strength were evaluated from the experimental curves. Both numerically and experimentally, the highest rigidity was found in the model with circular pore shape, crosswise pore distribution, small pore size (surface area of 0.25 mm2), and a 90° printing orientation. Its average rigidity reached 961 ± 32 MPa from the mechanical testing and 797 MPa from the simulation, with a yield strength of 42 ± 1.5 MPa. The same model with a printing orientation of 0° resulted in an average rigidity of 515 ± 7 MPa with a yield strength of 32 ± 1.6 MPa. Printing orientation and pore size were found to be the most influential design parameters on rigidity. The developed design methodology should accelerate the identification of effective scaffolds for future in vitro and in vivo studies.

Preparation of 4D printed peripheral vascular stent and its degradation behavior under fluid shear stress after deployment

Shape memory stents are mild intervention devices for vascular diseases as compared to balloon-dilated ones; however, their degradation behavior under blood shear stress after deployment also deserves further attention. To understand the degradation behavior, we first prepared 4D printed poly(lactic acid) (PLA) stents via 3D printing technology and studied their failure behavior in a dynamic condition after self-expandable deployment. Mechanical property tests showed that the 4D printed stents had a compression force of 0.06-0.39 N mm^-1 and a recovery ratio of 85.3-93.4%, respectively, which was verified to be wall thickness dependent. The stents were then implanted in simulated blood vessels with minimal microstructural damage at 60 °C followed by 8-week degradation tests. The results showed the microstructure damage caused by deployment could accelerate the degradation of stents faster than fluid shear stress. Furthermore, we conducted microstructural analysis and numerical simulation on the stent by finite element analysis (FEA) to explain the relationship between stent injury, vascular injury, and stent deployment temperature. A physical model derived from micro-morphologies on the degradation mechanism of PLA was also proposed. These results may provide new insights for the examination of the degradation behavior of 4D printed stents and minimize medical risk.

A Review of 3D Printed Bone Implants

3D printing, that is, additive manufacturing, has solved many major problems in general manufacturing, such as three-dimensional tissue structure, microenvironment control difficulty, product production efficiency and repeatability, etc., improved the manufacturing speed and precision of personalized bone implants, and provided a lot of support for curing patients with bone injuries. The application of 3D printing technology in the medical field is gradually extensive, especially in orthopedics. The purpose of this review is to provide a report on the related achievements of bone implants based on 3D printing technology in recent years, including materials, molding methods, optimization of implant structure and performance, etc., in order to point out the existing shortcomings of 3D printing bone implants, promote the development of all aspects of bone implants, and make a prospect of 4D printing, hoping to provide some reference for the subsequent research of 3D printing bone implants.

Bone Healing Materials in the Treatment of Recalcitrant Nonunions and Bone Defects

The usual treatment for bone defects and recalcitrant nonunions is an autogenous bone graft. However, due to the limitations in obtaining autogenous bone grafts and the morbidity associated with their procurement, various bone healing materials have been developed in recent years. The three main treatment strategies for bone defects and recalcitrant nonunions are synthetic bone graft substitutes (BGS), BGS combined with bioactive molecules, and BGS and stem cells (cell-based constructs). Regarding BGS, numerous biomaterials have been developed to prepare bone tissue engineering scaffolds, including biometals (titanium, iron, magnesium, zinc), bioceramics (hydroxyapatite (HA)), tricalcium phosphate (TCP), biopolymers (collagen, polylactic acid (PLA), polycaprolactone (PCL)), and biocomposites (HA/MONs@miR-34a composite coating, Bioglass (BG)-based ABVF-BG (antibiotic-releasing bone void filling) putty). Bone tissue engineering scaffolds are temporary implants that promote tissue ingrowth and new bone regeneration. They have been developed to improve bone healing through appropriate designs in terms of geometric, mechanical, and biological performance. Concerning BGS combined with bioactive molecules, one of the most potent osteoinductive growth factors is bone morphogenetic proteins (BMPs). In recent years, several natural (collagen, fibrin, chitosan, hyaluronic acid, gelatin, and alginate) and synthetic polymers (polylactic acid, polyglycolic acid, polylactic-coglycolide, poly(e-caprolactone) (PCL), poly-p-dioxanone, and copolymers consisting of glycolide/trimethylene carbonate) have been investigated as potential support materials for bone tissue engineering. Regarding BGS and stem cells (cell-based constructs), the main strategies are bone marrow stromal cells, adipose-derived mesenchymal cells, periosteum-derived stem cells, and 3D bioprinting of hydrogels and cells or bioactive molecules. Currently, significant research is being performed on the biological treatment of recalcitrant nonunions and bone defects, although its use is still far from being generalized. Further research is needed to investigate the efficacy of biological treatments to solve recalcitrant nonunions and bone defects.