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De Pace R, Molinari S, Mazzoni E, Perale G. Bone Regeneration: A Review of Current Treatment Strategies. J Clin Med 2025; 14:1838. [PMID: 40142646 PMCID: PMC11943102 DOI: 10.3390/jcm14061838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2025] [Revised: 03/02/2025] [Accepted: 03/05/2025] [Indexed: 03/28/2025] Open
Abstract
Bone regeneration has emerged as a critical research and clinical advancement field, fueled by the growing demand for effective treatments in orthopedics and oncology. Over the past two decades, significant progress in biomaterials and surgical techniques has led to the development of novel solutions for treating bone defects, surpassing the use of traditional autologous grafts. This review aims to assess the latest approaches in bone regeneration, including autologous, allogenic, and xenogenic grafts, naturally derived biomaterials, and innovative synthetic substitutes such as bioceramics, bioactive glasses, metals, polymers, composite materials, and other specialized applications. A comprehensive literature search was conducted on PubMed, focusing on studies published between 2019 and 2024, including meta-analyses, reviews, and systematic reviews. The review evaluated a range of bone regeneration strategies, examining the clinical outcomes, materials used, surgical techniques, and the effectiveness of various approaches in treating bone defects. The search identified numerous studies, with the inclusion criteria focused on those exploring innovative bone regeneration strategies. These studies provided valuable insights into the clinical and biological outcomes of different biomaterials and graft types. Results indicated that while advancements in synthetic and naturally derived biomaterials show promising potential, challenges remain in optimizing therapeutic strategies across diverse patient populations and clinical settings. The findings emphasize the need for an integrated approach that combines scientific research, clinical practice, and technological innovation to improve bone regeneration therapies. Further research is required to establish standardized protocols and determine the optimal application of various materials and techniques to enhance patient outcomes and the quality of care.
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Affiliation(s)
- Raffaella De Pace
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Silvia Molinari
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland
| | - Elisa Mazzoni
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Giuseppe Perale
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland
- Faculty of Biomedical Sciences, University of Southern Switzerland (USI), Via G. Buffi 13, 6900 Lugano, Switzerland
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria
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Kumar P, Shamim, Muztaba M, Ali T, Bala J, Sidhu HS, Bhatia A. Fused Deposition Modeling 3D-Printed Scaffolds for Bone Tissue Engineering Applications: A Review. Ann Biomed Eng 2024; 52:1184-1194. [PMID: 38418691 DOI: 10.1007/s10439-024-03479-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
The emergence of bone tissue engineering as a trend in regenerative medicine is forcing scientists to create highly functional materials and scaffold construction techniques. Bone tissue engineering uses 3D bio-printed scaffolds that allow and stimulate the attachment and proliferation of osteoinductive cells on their surfaces. Bone grafting is necessary to expedite the patient's condition because the natural healing process of bones is slow. Fused deposition modeling (FDM) is therefore suggested as a technique for the production process due to its simplicity, ability to create intricate components and movable forms, and low running costs. 3D-printed scaffolds can repair bone defects in vivo and in vitro. For 3D printing, various materials including metals, polymers, and ceramics are often employed but polymeric biofilaments are promising candidates for replacing non-biodegradable materials due to their adaptability and environment friendliness. This review paper majorly focuses on the fused deposition modeling approach for the fabrication of 3D scaffolds. In addition, it also provides information on biofilaments used in FDM 3D printing, applications, and commercial aspects of scaffolds in bone tissue engineering.
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Affiliation(s)
- Pawan Kumar
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, 151001, India.
| | - Shamim
- IIMT College of Medical Sciences, IIMT University, Ganga Nagar, Meerut, Uttar Pradesh, 250001, India
| | - Mohammad Muztaba
- Department of Pharmacology, Praduman Singh Sikshan Prasikshan Sansthan Pharmacy College, Phutahiya Sansarpur, Basti, Uttar Pradesh, 272001, India
| | - Tarmeen Ali
- Department of Pharmacy, Swami Vivekanand Subharti University, Subhartipuram, Meerut, Uttar Pradesh, 250005, India
| | - Jyoti Bala
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, 151001, India
| | - Haramritpal Singh Sidhu
- Department of Mechanical Engineering, Giani Zail Singh Campus College of Engineering & Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, 151001, India
| | - Amit Bhatia
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, 151001, India
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Jiao X, Wu F, Yue X, Yang J, Zhang Y, Qiu J, Ke X, Sun X, Zhao L, Xu C, Li Y, Yang X, Yang G, Gou Z, Zhang L. New insight into biodegradable macropore filler on tuning mechanical properties and bone tissue ingrowth in sparingly dissolvable bioceramic scaffolds. Mater Today Bio 2024; 24:100936. [PMID: 38234459 PMCID: PMC10792586 DOI: 10.1016/j.mtbio.2023.100936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/19/2024] Open
Abstract
Structural parameters of the implants such as shape, size, and porosity of the pores have been extensively investigated to promote bone tissue repair, however, it is unknown how the pore interconnectivity affects the bone growth behaviors in the scaffolds. Herein we systematically evaluated the effect of biodegradable bioceramics as a secondary phase filler in the macroporous networks on the mechanical and osteogenic behaviors in sparingly dissolvable bioceramic scaffolds. The pure hardystonite (HT) scaffolds with ∼550 & 800 μm in pore sizes were prepared by digital light processing, and then the Sr-doped calcium silicate (SrCSi) bioceramic slurry without and with 30 % organic porogens were intruded into the HT scaffolds with 800 μm pore size and sintered at 1150 °C. It indicated that the organic porogens could endow spherical micropores in the SrCSi filler, and the invasion of the SrCSi component could not only significantly enhance the compressive strength and modulus of the HT-based scaffolds, but also induce osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). The pure HT scaffolds showed extremely slow bio-dissolution in Tris buffer after immersion for 8 weeks (∼1 % mass decay); in contrast, the SrCSi filler would readily dissolve into the aqueous medium and produced a steady mass decay (>6 % mass loss). In vivo experiments in rabbit femoral bone defect models showed that the pure HT scaffolds showed bone tissue ingrowth but the bone growth was impeded in the SrCSi-intruded scaffolds within 4 weeks; however, the group with higher porosity of SrCSi filler showed appreciable osteogenesis after 8 weeks of implantation and the whole scaffold was uniformly covered by new bone tissues after 16 weeks. These findings provide some new insights that the pore interconnectivity is not inevitable to impede bone ingrowth with the prolongation of implantation time, and such a highly biodegradable and bioactive filler intrusion strategy may be beneficial for optimizing the performances of scaffolds in bone regenerative medicine applications.
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Affiliation(s)
- Xiaoyi Jiao
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Fanghui Wu
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Xusong Yue
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Jun Yang
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Yan Zhang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou, 310058, China
| | - Jiandi Qiu
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Xiurong Ke
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Xiaoliang Sun
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Liben Zhao
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Chuchu Xu
- Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Yifan Li
- Department of Orthopaedics, The First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou, 310003, China
| | - Xianyan Yang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou, 310058, China
| | - Guojing Yang
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou, 310058, China
| | - Lei Zhang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
- Department of Orthopaedics, The Third Hospital Affiliated to Wenzhou Medical University & Rui'an People's Hospital, Rui'an, 325200, China
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