Mechanical properties and in vitro cell compatibility of hydroxyapatite ceramics with graded pore structure

Autologous Tooth Granulometry and Specific Surface Area with Three Grinding Methods: An In Vitro Study

A postextraction socket becomes a clinical challenge due to the fact that a series of changes associated with bone remodelling and resorption of the socket that occur after extraction, which limits the aesthetic and functional prognosis of implant-supported rehabilitations. It has been studied that the use of the autologous tooth-derived graft (ATDG) has regenerative properties and could therefore be useful for solving this type of problem. There is no consensus in the scientific literature on a standardized protocol for the use of the autologous tooth. Therefore, the aim of the present study was to evaluate the most relevant parameters to achieve the best properties of ground ATDG using three methods, namely Gouge forceps, electric grinder, and manual, that made up the study group (SG) and compared with the control group (CG) consisting of Bio-Oss®. The sample obtained by the electric grinder had the highest value of specific surface area (2.4025 ± 0.0218 m2/g), while the particle size as average diameter (751.9 µm) was the lowest and most homogeneous of the three groups. Therefore, the electric grinder allowed for obtaining ATDG with more regenerative properties due to its specific surface-area value and particle size in accordance with the xenograft with the greatest bibliographical support (Bio-Oss®). The higher specific surface increases the reaction with the physiological media, producing faster biological mechanisms.

Sintered fluorapatite scaffolds as an autograft-like engineered bone graft

Hydroxyapatite (HA)-based materials are widely used as bone substitutes due to their inherent biocompatibility, osteoconductivity, and bio-absorption properties. However, HA scaffolds lack compressive strength when compared to autograft bone. It has been shown that the fluoridated form of HA, fluorapatite (FA), can be sintered to obtain this desired strength as well as slower degradation properties. Also, FA surfaces have been previously shown to promote stem cell differentiation toward an osteogenic lineage. Thus, it was hypothesized that FA, with and without stromal vascular fraction (SVF), would guide bone healing to an equal or better extent than the clinical gold standard. The regenerative potentials of these scaffolds were tested in 32 Lewis rats in a femoral condylar defect model with untreated (negative), isograft (positive), and commercial HA as controls. Animals were survived for 12 weeks post-implantation. A semi-quantitative micro-CT analysis was developed to quantify the percent new bone formation within the defects. Our model showed significantly higher (p < .05) new bone depositions in all apatite groups compared to the autograft group. Overall, the FA group had the most significant new bone deposition, while the differences between HA, FA, and FA + SVF were insignificant (p > .05). Histological observations supported the micro-CT findings and highlighted the presence of healthy bone tissues without interposing capsules or intense immune responses for FA groups. Most importantly, the regenerating bone tissue within the FA + SVF scaffolds resembled the architecture of the surrounding trabecular bone, showing intertrabecular spaces, while the FA group presented a denser cortical bone-like architecture. Also, a lower density of cells was observed near FA granules compared to HA surfaces, suggesting a reduced immune response. This first in vivo rat study supported the tested hypothesis, illustrating the utility of FA as a bone scaffold material.

Fabrication of graded porous structure of hydroxypropyl cellulose hydrogels via temperature-induced phase separation

A novel hydroxypropyl cellulose (gHPC) hydrogel with graded porosity has been fabricated, in which pore size, shape, and mechanical properties vary across the material. The graded porosity was achieved by cross-linking different parts of the hydrogel at temperatures below and above 42 °C, which was found to be the temperature of turbidity onset (lower critical solution temperature, LCST) for the HPC and divinylsulfone cross-linker mixture. Scanning electron microscopy imaging revealed a decreasing pore size along the cross-section of the HPC hydrogel from the top to the bottom layer. HPC hydrogels demonstrate graded mechanical properties whereby the top layer, Zone 1, cross-linked below LCST, can be compressed by about 50% before fracture, whereas the middle and bottom layers (Zone 2 and 3, respectively) cross-linked at 42 °C, can withstand 80% compression before failure. This work demonstrates a straightforward, yet novel, concept of exploiting a graded stimulus to incorporate a graded functionality into porous materials that can withstand mechanical stress and minor elastic deformations.

Prospective Clinical Study with New Materials for Tissue Regeneration: A Study in Humans

OBJECTIVE

 This study was performed to evaluate the clinical, radiographic, and histomorphometric outcomes of novel bone grafting materials and dental membranes and to compare the results with current data from the literature.

MATERIALS AND METHODS

 New synthetic bone substitutes, consisting of biphasic calcium phosphate in the ratio of 60% hydroxyapatite and 40% β-tricalcium phosphate, were applied in bony defects and covered by either a novel synthetic poly(lactic-co-glycolic) acid (PLGA) or porcine collagen membrane. A sample of 51 biomaterials was placed in a total of 20 patients during different surgical protocols. Implants were simultaneously inserted, and in the case of sinus floor elevations 6 months later. Pre- and postoperative cone-beam computed tomographies were taken. Bone biopsies were harvested from augmented sides and processed for histomorphometric evaluation.

STATISTICAL ANALYSIS

 Averages and ranges were calculated for the percentage of newly formed bone, residual biomaterial, and connective tissue. Data were submitted to analyze the radiological mean differences in length, width, and density. Paired t-tests were deployed for the analysis of differences within each group between the baseline (preoperative) and the final (postoperative) measurements.

RESULTS

 The mean bone gain in length and width were 0.96 ± 3.33 mm (+27.59%) and 1.22 ± 1.87 mm (+30.48%), respectively. The bone density was increased by a factor of 4, reaching an average of 387.47 ± 328.86 HU. Histomorphometric evaluations revealed new bone formation of 41.44 ± 5.37%, residual biomaterial of 24.91 ± 7.31%, and connective tissue of 33.64 ± 4.81%. The mean healing period was 8.32 ± 3.00 months.

CONCLUSIONS

 Data from this study confirmed the suitability of the tested materials in dental surgery. The biomaterials may be recommended for various clinical procedures. A satisfactory level of increase of new bone was reported in augmented sides. No significant differences were observed between the tested membranes. PLGA membranes might be superior to collagen membranes for their easier handling.

Improved Mechanical Amplification of Monolithic PZT and PZT Composite via Optimized Honeycomb Macrostructures

Honeycomb-based, modular composites with a relative density of 0.3948 and a slenderness ratio L_ges/t of 6.48 were fabricated on PZT building blocks connected with a PZT-filled phenyl silicone resin. The macro- and micro-structure, phase composition, and the interface between the two materials were analyzed by SEM and image analysis techniques. The mechanical in-plane strain response was determined with uniaxial compression tests and the transversal piezoelectric strain response was determined by applying an electric field. These deformations were analyzed by a 2D digital image correlation analysis to calculate the mechanical strain amplification of monolithic and composite PZT lattice structures. Compared to bulk PZT, the piezoelectric strain amplification in the Y-direction |a_y^piezo| was higher by a factor of 69 for the composite and by a factor of 12 for the monolithic cellular PZT lattice, when it was assumed that the ratio of the deformation of the bulk material to bulk material was 1. The mechanical amplification of the composite lattices increased up to 73 and that of the cellular PZT lattices decreased to 12. Special focus was given to the fracture behavior and the interface of the PZT/PZT-filled phenyl silicone resin interface.

Comparison of Two Bovine Commercial Xenografts in the Regeneration of Critical Cranial Defects

Autologous bone is the gold standard in regeneration processes. However, there is an endless search for alternative materials in bone regeneration. Xenografts can act as bone substitutes given the difficulty of obtaining bone tissue from patients and before the limitations in the availability of homologous tissue donors. Bone neoformation was studied in critical-size defects created in the parietal bone of 40 adult male Wistar rats, implanted with xenografts composed of particulate bovine hydroxyapatite (HA) and with blocks of bovine hydroxyapatite (HA) and Collagen, which introduces crystallinity to the materials. The Fourier-transform infrared spectroscopy (FTIR) analysis demonstrated the carbonate and phosphate groups of the hydroxyapatite and the amide groups of the collagen structure, while the thermal transitions for HA and HA/collagen composites established mainly dehydration endothermal processes, which increased (from 79 °C to 83 °C) for F2 due to the collagen presence. The xenograft’s X-ray powder diffraction (XRD) analysis also revealed the bovine HA crystalline structure, with a prominent peak centered at 32°. We observed macroporosity and mesoporosity in the xenografts from the morphology studies with heterogeneous distribution. The two xenografts induced neoformation in defects of critical size. Histological, histochemical, and scanning electron microscopy (SEM) analyses were performed 30, 60, and 90 days after implantation. The empty defects showed signs of neoformation lower than 30% in the three periods, while the defects implanted with the material showed partial regeneration. InterOss Collagen material temporarily induced osteon formation during the healing process. The results presented here are promising for bone regeneration, demonstrating a beneficial impact in the biomedical field.

Biocompatibility Assessment of Two Commercial Bone Xenografts by In Vitro and In Vivo Methods

Bone substitutes based on xenografts have been used for a long time in bone regeneration thanks to their inductive capacity for bone tissue regeneration. Some bone-based scaffolds have been modified by adding collagen and other proteins to improve their regenerative capacity and prevent migration and aggregation, especially particles. However, rejection of this graft has been reported due to protein residues caused by poor material preparation. We compared the in vitro and in vivo biological response of two commercial xenografts (InterOss^®, F1 and InterOss^® Collagen, F2) and a commercial porcine collagen membrane (InterCollagen^® Guide, F3) as a rapid degradation control. Fourier Transform Infrared Spectroscopy (FT-IR) analysis evidenced the presence of hydroxyl, orthophosphate, and carbonate groups of the xenografts and amide groups of collagen. Thermogravimetric analysis (TGA) of the xenografts demonstrated their thermal stability and the presence of a few amounts of organic material. The study by differential scanning calorimetry showed the presence of endothermic peaks typical of the dehydration of the xenografts (F1 and F2) and for the collagen membrane (F3), the beginning of structural three-dimensional protein changes. Subsequently, in vitro biocompatibility tests were carried out for the materials with Artemia salina and MTT cell viability with HeLa cells, demonstrating the high biocompatibility of the materials. Finally, in vivo biocompatibility was studied by implanting xenografts in biomodels (Wistar rats) at different periods (30, 60, and 90 days). The F1 xenograft (InterOss) remained remarkably stable throughout the experiment (90 days). F2 (InterOss Collagen) presented a separation of its apatite and collagen components at 60 days and advanced resorption at 90 days of implantation. Finally, the collagen membrane (F3) presented faster resorption since, at 90 days, only some tiny fragments of the material were evident. All the in vivo and in vitro test results demonstrated the biocompatibility of the xenografts, demonstrating the potential of these materials for tissue engineering.

Template Electrochemical Synthesis of Hydroxyapatite on a Titania–Silver Composite Surface for Potential Use in Implantology

Modern materials science, both in terms of functional and structural materials, is actively developing towards the creation of structures with a given ordering. A wide range of methods involves ordering the structure according to a template shape. Template synthesis is one of the mots wide-spread approaches. Most often, the template synthesis method is implemented under conditions of limiting the growth of the phase due to the geometry of the template. In the present work, a template electrochemical method is considered for calcium hydroxyapatite (HAp) coating synthesis, based on the replication of the planar template texture during deposition. In this case, the template is an array of silver microparticles immobilized on an electrically conductive substrate, separated by an insulator layer. The developed approach is similar to the mask metallization widely used in planar technology. In this work, the possibility of the template pulsed electrodeposition of ceramics rather than metal is shown using HAp as an example. This approach is interesting for materials science, in particular, for obtaining micro-ordered hydroxyapatite structures—a crystallochemical analogue of the inorganic bone tissue component—on the surface of bone implants, which can be implemented to improve their biomedical characteristics. As a result of our study, we experimentally determined the conditions for obtaining the composite coating TiO2/Ag/Ca10(PO4)6(OH)2 with controlled phase structure, topology and localization of components on the surface, which was confirmed by Scanning Electron Microscopy, Energy Dispersive Spectroscopy, and X-ray Diffraction (SEM, EDS and XRD). The absence of cytotoxicity for the osteoblast-like cells of the developed coating was revealed by cytological tests.

Injection Molding of 3-3 Hydroxyapatite Composites

The manufacturing of ideal implants requires fabrication processes enabling an adjustment of the shape, porosity and pore sizes to the patient-specific defect. To meet these criteria novel porous hydroxyapatite (HAp) implants were manufactured by combining ceramic injection molding (CIM) with sacrificial templating. Varied amounts (Φ = 0–40 Vol%) of spherical pore formers with a size of 20 µm were added to a HAp-feedstock to generate well-defined porosities of 11.2–45.2 Vol% after thermal debinding and sintering. At pore former contents Φ ≥ 30 Vol% interconnected pore networks were formed. The investigated Young’s modulus and flexural strength decreased with increasing pore former content from 97.3 to 29.1 GPa and 69.0 to 13.0 MPa, agreeing well with a fitted power-law approach. Additionally, interpenetrating HAp/polymer composites were manufactured by infiltrating and afterwards curing of an urethane dimethacrylate-based (UDMA) monomer solution into the porous HAp ceramic preforms. The obtained stiffness (32–46 GPa) and Vickers hardness (1.2–2.1 GPa) of the HAp/UDMA composites were comparable to natural dentin, enamel and other polymer infiltrated ceramic network (PICN) materials. The combination of CIM and sacrificial templating facilitates a near-net shape manufacturing of complex shaped bone and dental implants, whose properties can be directly tailored by the amount, shape and size of the pore formers.

Synthesis and Characterization of Natural Nano-hydroxyapatite Derived from Turkey Femur-Bone Waste

Hydroxyapatite (HAp) is a bioactive and vital material which has found many applications in the biomedical and clinical fields. This bio-ceramic powder can be synthesized via different bio-waste materials. In this study, the production of natural nanohydroxyapatite was produced through calcination of untreated turkey femur-bone waste powder at 850 °C followed by ball milling the powder. The obtained powder was characterized using X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analysis. The morphology, size, and elemental composition of obtained turkey hydroxyapatite (THA) particles were investigated by scanning electron microcopy (SEM), transmission electron microcopy (TEM), and energy dispersive spectroscopy (EDS) analysis, in which the average particle size of ball milled THA was found to be about 85 nm with a Ca/P ratio of 1.63. The powder was then cold pressed and later sintered at 850, 950, 1050, and 1150 °C to evaluate its mechanical properties in terms of compressive strength and hardness. The results revealed that the strength and hardness of the samples increased by increasing the sintering temperature up to 1150 °C. Finally, the maximum values of hardness and compressive strength of the sintered THA were obtained at 1150 °C (37.44 MPa and 3.2 GPa, respectively).

Particulated, Extracted Human Teeth Characterization by SEM⁻EDX Evaluation as a Biomaterial for Socket Preservation: An in vitro Study

The aim of the study was to evaluate the chemical composition of crushed, extracted human teeth and the quantity of biomaterial that can be obtained from this process. A total of 100 human teeth, extracted due to trauma, decay, or periodontal disease, were analyzed. After extraction, all the teeth were classified, measured, and weighed on a microscale. The human teeth were crushed immediately using the Smart Dentin Grinder machine (KometaBio Inc., Cresskill, NJ, USA), a device specially designed for this procedure. The human tooth particles obtained were of 300⁻1200 microns, obtained by sieving through a special sorting filter, which divided the material into two compartments. The crushed teeth were weighed on a microscale, and scanning electron microscopy (SEM) evaluation was performed. After processing, 0.25 gr of human teeth produced 1.0 cc of biomaterial. Significant differences in tooth weight were found between the first and second upper molars compared with the lower molars. The chemical composition of the particulate was clearly similar to natural bone. Scanning electron microscopy⁻energy dispersive X-ray (SEM⁻EDX) analysis of the tooth particles obtained mean results of Ca% 23.42 0.34 and P% 9.51 0.11. Pore size distribution curves expressed the interparticle pore range as one small peak at 0.0053 µm. This result is in accordance with helium gas pycnometer findings; the augmented porosity corresponded to interparticle spaces and only 2.533% corresponded to intraparticle porosity. Autogenous tooth particulate biomaterial made from human extracted teeth may be considered a potential material for bone regeneration due to its chemical composition and the quantity obtained. After grinding the teeth, the resulting material increases in quantity by up to three times its original volume, such that two extracted mandibular lateral incisors teeth will provide a sufficient amount of material to fill four empty mandibular alveoli. The tooth particles present intra and extra pores up to 44.48% after pycnometer evaluation in order to increase the blood supply and support slow resorption of the grafted material, which supports healing and replacement resorption to achieve lamellar bone. After SEM⁻EDX evaluation, it appears that calcium and phosphates are still present within the collagen components even after the particle cleaning procedures that are conducted before use.

Design and Production of Continuously Gradient Macro/Microporous Calcium Phosphate (CaP) Scaffolds Using Ceramic/Camphene-Based 3D Extrusion

This study proposes a new type of calcium phosphate (CaP) scaffolds with a continuously gradient macro/microporous structure using the ceramic/camphene-based 3D extrusion process. Green filaments with a continuously gradient core/shell structure were successfully produced by extruding a bilayered feedrod comprised of a CaP/camphene mixture lower part and a pure camphene upper part. The extruded filaments were then deposited in a controlled manner to construct triangular prisms, followed by the assembly process for the production of CaP scaffolds with a gradient core/shell structure. In addition, a gradient microporous structure was created by heat-treating the green body at 43 °C to induce the overgrowth of camphene dendrites in the CaP/camphene walls. The produced CaP scaffold showed a highly macroporous structure within its inner core, where the size of macrochannels increased gradually with an increase in the distance from the outer shell, while relatively larger micropores were created in the outer shell.

Solid Freeform Techniques Application in Bone Tissue Engineering for Scaffold Fabrication

Solid freeform techniques are revolutionising technology with great potential to fabricate highly organized biodegradable scaffolds for damaged tissues and organs. Scaffolds fabricated via Solid freeform (SFF) techniques have more pronounced effect in bone tissue engineering. SFF techniques produce various types of scaffolds from different biomaterials with specific pore size, geometries, orientation, interconnectivity and anatomical shapes. Scaffolds needs to be designed from such biomaterials which can attach directly to natural tissues and mimic its properties, so ideally mechanical properties of scaffolds should be same as that of regenerating tissues for best results. The scaffolds designed without optimized mechanical properties would lead to the reduced nutrition diffusion within tissue engineered constructs (TECs) causing tissue necrosis. These scaffolds are mainly processed from ceramics and polymers like calcium phosphate, polydioxane, €-polycaprolactone, polylactic and polyglycolic acids etc. While, hydrogel scaffolds provide bridge for encapsulated cells and tissues to integrate with natural ECM. Likewise, 2D images from radiography were not sufficient for the prediction of the brain structure, cranial nerves, vessel and architecture of base of the skull and bones, which became possible using the 3D prototyping technologies. Any misrepresentation can lead to fatal outcomes. Biomodelling from these techniques for spinal surgery and preoperative planning are making its way toward successful treatment of several spinal deformities and spinal tumor. In this review we explored laser based and printing SFF techniques following its methodologies, principles and most recent areas of application with its achievements and possible challenges faced during its applications.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

Porous biphasic calcium phosphate ceramics coated with nano-hydroxyapatite and seeded with mesenchymal stem cells for reconstruction of radius segmental defects in rabbits

The osteoconduction of porous biphasic calcium phosphate (BCP) ceramics has been widely reported. In a previous study, we demonstrated that applying a nano-hydroxyapatite (nHA) coating enhances the osteoinductive potential of BCP ceramics, making these scaffolds more suitable for bone tissue engineering applications. The aim of the present study was to determine the effects of reconstructing radius defects in rabbits using nHA-coated BCP ceramics seeded with mesenchymal stem cells (MSCs) and to compare the bone regeneration induced by different scaffolds. Radius defects were created in 20 New Zealand rabbits, which were divided into four groups by treatment: porous BCP ceramics (Group A), nHA-coated porous BCP ceramics (Group B), porous BCP ceramics seeded with rabbit MSCs (Group C), and nHA-coated porous BCP ceramics seeded with rabbit MSCs (Group D). After in vitro incubation, the cell/scaffold complexes were implanted into the defects. Twelve weeks after implantation, the specimens were examined macroscopically and histologically. Both the nHA coating and seeding with MSCs enhanced the formation of new bone tissue in the BCP ceramics, though the osteoinductive potential of the scaffolds with MSCs was greater than that of the nHA-coated scaffolds. Notably, the combination of nHA coating and MSCs significantly improved the bone regeneration capability of the BCP ceramics. Thus, MSCs seeded into porous BCP ceramics coated with nHA may be an effective bone substitute to reconstruct bone defects in the clinic.

Effect of Ceramic Scaffold Architectural Parameters on Biological Response

Numerous studies have focused on the optimization of ceramic architectures to fulfill a variety of scaffold functional requirements and improve biological response. Conventional fabrication techniques, however, do not allow for the production of geometrically controlled, reproducible structures and often fail to allow the independent variation of individual geometric parameters. Current developments in additive manufacturing technologies suggest that 3D printing will allow a more controlled and systematic exploration of scaffold architectures. This more direct translation of design into structure requires a pipeline for design-driven optimization. A theoretical framework for systematic design and evaluation of architectural parameters on biological response is presented. Four levels of architecture are considered, namely (1) surface topography, (2) pore size and geometry, (3) porous networks, and (4) macroscopic pore arrangement, including the potential for spatially varied architectures. Studies exploring the effect of various parameters within these levels are reviewed. This framework will hopefully allow uncovering of new relationships between architecture and biological response in a more systematic way as well as inform future refinement of fabrication techniques to fulfill architectural necessities with a consideration of biological implications.

Calcium Orthophosphate-Containing Biocomposites and Hybrid Biomaterials for Biomedical Applications

The state-of-the-art on calcium orthophosphate (CaPO4)-containing biocomposites and hybrid biomaterials suitable for biomedical applications is presented. Since these types of biomaterials offer many significant and exciting possibilities for hard tissue regeneration, this subject belongs to a rapidly expanding area of biomedical research. Through the successful combinations of the desired properties of matrix materials with those of fillers (in such systems, CaPO4 might play either role), innovative bone graft biomaterials can be designed. Various types of CaPO4-based biocomposites and hybrid biomaterials those are either already in use or being investigated for biomedical applications are extensively discussed. Many different formulations in terms of the material constituents, fabrication technologies, structural and bioactive properties, as well as both in vitro and in vivo characteristics have been already proposed. Among the others, the nano-structurally controlled biocomposites, those containing nanodimensional compounds, biomimetically fabricated formulations with collagen, chitin and/or gelatin, as well as various functionally graded structures seem to be the most promising candidates for clinical applications. The specific advantages of using CaPO4-based biocomposites and hybrid biomaterials in the selected applications are highlighted. As the way from a laboratory to a hospital is a long one and the prospective biomedical candidates have to meet many different necessities, the critical issues and scientific challenges that require further research and development are also examined.

In situ generation of tunable porosity gradients in hydrogel-based scaffolds for microfluidic cell culture

Compared with preformed anisotropic matrices, an anisotropic matrix that allows users to alter its properties and structure in situ after synthesis offers the important advantage of being able to mimic dynamic in vivo microenvironments, such as in tissues undergoing morphogenesis or in wounds undergoing tissue repair. In this study, porous gradients are generated in situ in a hydrogel comprising enzymatically crosslinked gelatin hydroxyphenylpropionic acid (GTN-HPA) conjugate and carboxylmethyl cellulose tyramine (CMC-TYR) conjugate. The GTN-HPA component acts as the backbone of the hydrogel, while CMC-TYR acts as a biocompatible sacrificial polymer. The hydrogel is then used to immobilize HT1080 human fibrosarcoma cells in a microfluidic chamber. After diffusion of a biocompatible cellulase enzyme through the hydrogel in a spatially controlled manner, selective digestion of the CMC component of the hydrogel by the cellulase gives rise to a porosity gradient in situ instead of requiring its formation during hydrogel synthesis as with other methods. The influence of this in situ tunable porosity gradient on the chemotactic response of cancer cells is subsequently studied both in the absence and presence of chemoattractant. This platform illustrates the potential of hydrogel-based microfluidics to mimic the 3D in vivo microenvironment for tissue engineering and diagnostic applications.

Bone augmentation using a synthetic hydroxyapatite/silica oxide-based and a xenogenic hydroxyapatite-based bone substitute materials with and without recombinant human bone morphogenetic protein-2

AIM

To test whether or not bone regeneration using deproteinized bovine bone mineral (DBBM) is comparable to hydroxyapatite/silica oxide (HA/SiO) and to test the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) as an adjunct to DBBM for localized bone regeneration.

MATERIALS AND METHODS

In each of the 10 rabbits, 4 titanium cylinders were placed on the external cortical plates of their calvaria. Four treatment modalities were randomly allocated: (i) empty, (ii) HA/SiO, (iii) DBBM, and (iv) DBBM plus rhBMP-2 (DBBM/BMP). The animals were sacrificed at week 8. Descriptive histology and histomorphometric assessment using a superimposed test grid of points and cycloids were performed.

RESULTS

The mean number of points of the test grid coinciding with bone within the cylinder reached 124 ± 35 bone points for empty controls, 92 ± 40 bone points for DBBM, 98 ± 44 bone points for synthetic HA/SiO, and 146 ± 34 bone points DBBM/BMP. The P-value for DBBM with and without BMP reached a borderline statistical significance of 0.051. However, the area of bone regeneration within the cylinders peaked for DBBM/BMP and was statistically significantly higher compared with empty cylinders (P < 0.05). The bone-to-bone substitute contact ranged between 32.9% ± 21.7 for DBBM, 39.6 ± 18.4% for HA/SiO, and 57.8% ± 10.2 for DBBM/BMP. The differences between DBBM/BMP and controls (DBBM, HA/SiO) were statistically significant (P < 0.05).

CONCLUSIONS

DBBM and HA/SiO rendered comparable amounts of bone regeneration. The addition of rhBMP-2 to DBBM resulted in more favorable outcomes with respect to the area of bone regeneration and to bone-to-implant contact, thereby indicating the potential of this growth factor to enhance bone regeneration within this animal model.

Calcium Orthophosphate-Based Bioceramics

Various types of grafts have been traditionally used to restore damaged bones. In the late 1960s, a strong interest was raised in studying ceramics as potential bone grafts due to their biomechanical properties. A bit later, such synthetic biomaterials were called bioceramics. In principle, bioceramics can be prepared from diverse materials but this review is limited to calcium orthophosphate-based formulations only, which possess the specific advantages due to the chemical similarity to mammalian bones and teeth. During the past 40 years, there have been a number of important achievements in this field. Namely, after the initial development of bioceramics that was just tolerated in the physiological environment, an emphasis was shifted towards the formulations able to form direct chemical bonds with the adjacent bones. Afterwards, by the structural and compositional controls, it became possible to choose whether the calcium orthophosphate-based implants remain biologically stable once incorporated into the skeletal structure or whether they were resorbed over time. At the turn of the millennium, a new concept of regenerative bioceramics was developed and such formulations became an integrated part of the tissue engineering approach. Now calcium orthophosphate scaffolds are designed to induce bone formation and vascularization. These scaffolds are often porous and harbor different biomolecules and/or cells. Therefore, current biomedical applications of calcium orthophosphate bioceramics include bone augmentations, artificial bone grafts, maxillofacial reconstruction, spinal fusion, periodontal disease repairs and bone fillers after tumor surgery. Perspective future applications comprise drug delivery and tissue engineering purposes because calcium orthophosphates appear to be promising carriers of growth factors, bioactive peptides and various types of cells.

Bone morphogenic protein-2 (BMP-2) loaded hybrid coating on porous hydroxyapatite scaffolds for bone tissue engineering

In this study, a silica xerogel-chitosan hybrid is utilized as a coating material to incorporate bone morphogenic protein-2 (BMP-2) on a porous hydroxyapatite (HA) scaffold for bone tissue engineering. BMP-2 is known as a therapeutic agent for improving bone regeneration and repair. Silica xerogel-chitosan hybrids have been used for the delivery of a growth factor as well as osteoconductive coatings. The biological properties of the hybrid coating incorporated with BMP-2 were evaluated in terms of the BMP-2 release behavior, osteoblastic cellular responses and in vivo performance. BMP-2 was continuously released from the hybrid coating layer on the porous HA scaffold for up to 6 weeks. The hybrid coating containing BMP-2 showed significantly enhanced osteoblastic cell responses in comparison with the hybrid coating and HA substrate. Consequently, new bone formation was significantly increased within the hybrid coating containing BMP-2. These results reveal that the hybrid coating containing BMP-2 has the potential to be used as a bone implant, whose osteogenic properties are promoted by the release of BMP-2 in a controlled manner for a prolonged period of time.

The Effect of Sintering Temperature on the Microstructural and Mechanical Characteristics of Hydroxyapatite Macroporous Scaffolds Prepared via Freeze-Casting

The most important characteristic of biomaterial as bone-repairing material, in addition to biocompatibility and appropriate porosity, is providing mechanical strength complying with injured tissue. In the present work, slurry with 15 vol% HA prepared from calcinated hydroxyapatite. The prepared slurry freeze casted unidirectionally with the cooling rate of 8°C/min from the ambient temperature. Then, green bodies freeze-dried for 72h following with sintering at different temperatures of 1250-1350°C with intervals of 25°C. The results showed that lamella space and porosity decreases with temperature while compressive strength and shrinkage goes up. Total porosity has a range of 75-83% while has a compressive strength of ~2-8 MPa. The sintered sample at 1350°C, with 75% porosity, which has a ~ 8 MPa compressive strength, chose to be the optimum. Also, some dendritic branch like structure and bridges can be seen on the internal walls of lamellae which can improve mechanical properties. These features may improve adhesion and growth of osseous cells.

Physicochemical characterization of six commercial hydroxyapatites for medical-dental applicatons as bone graft

The aim of this work was to characterize six hydroxyapatites in granular form for applications in medicine and dentistry as bone graft and to compare with manufacturers' specification. These samples were produced by four different manufacturers, and all of them are easily available in the Brazilian market. Physicochemical characterization was carried out by using electron microscopy (SEM), X-ray diffraction (XRD), infrared spectroscopy (FTIR) and surface area (BET) measurements. The results show that just one hydroxyapatite sample exhibited characterisitics in perfect agreement with the manufacturers' specifications. The studied parameters, namely crystallinity, surface area and composition may be used to estimate hydroxyapatite's biodegradability and as a criterion for quality control.

The effect of processing parameters and solid concentration on the mechanical and microstructural properties of freeze-casted macroporous hydroxyapatite scaffolds

The design and fabrication of macroporous hydroxyapatite scaffolds, which could overcome current bone tissue engineering limitations, have been considered in recent years. In the current study, controlled unidirectional freeze-casting at different cooling rates was investigated. In the first step, different slurries with initial hydroxyapatite concentrations of 7-37.5 vol.% were prepared. In the next step, different cooling rates from 2 to 14 °C/min were applied to synthesize the porous scaffold. Additionally, a sintering temperature of 1350 °C was chosen as an optimum temperature. Finally, the phase composition (by XRD), microstructure (by SEM), mechanical characteristics, and the porosity of sintered samples were assessed. The porosity of the sintered samples was in a range of 45-87% and the compressive strengths varied from 0.4 MPa to 60 MPa. The mechanical strength of the scaffolds increased as a function of initial concentration, cooling rate, and sintering temperature. With regards to mechanical strength and pore size, the samples with the initial concentration and the cooling rate of 15 vol.% and 5 °C/min, respectively, showed better results.

Preparation of PLGA scaffolds with graded pores by using a gelatin-microsphere template as porogen

Porous scaffolds with graded pores are crucial to osteochondral regeneration. In this study, a technique combining solution casting with gelatin-microsphere template leaching has been developed to produce poly(L-lactide-co-glycolide) (PLGA) scaffolds with graded pores. The traditional emulsification and solvent extraction method was improved by using the gradient ethanol/water solutions to extract water to prepare gelatin microspheres with a smooth surface without the use of any surfactant. Gelatin microspheres with different diameters were in sequence put into a custom-made cylindrical Teflon mold and bonded together to obtain gelatin-microsphere templates. By using the gelatin-microsphere templates as porogen, PLGA scaffolds with graded pore size across the cylindrical axis were prepared. The porosity of the scaffold was as high as 95%. The pore size effect on osteoblasts was studied. The results showed that the graded scaffolds possessed good biocompatibility for osteoblast growth. During the 14 days culture, the cell proliferation of all the three pore layers displayed the trend of increasing. The proliferation rate of the large pore layer was lower than the other two layers. However, the difference of alkaline phosphatase activity on the three pore layers was not statistically significant. We assumed that it was probably because of the hydrophobicity and the short culture time. It was demonstrated that gradient ethanol/water solutions provided a simple way to prepared gelatin microspheres. The graded scaffolds would provide potential application for osteochondral regeneration.

Biocomposites and hybrid biomaterials based on calcium orthophosphates

The state-of-the-art of biocomposites and hybrid biomaterials based on calcium orthophosphates that are suitable for biomedical applications is presented in this review. Since these types of biomaterials offer many significant and exciting possibilities for hard tissue regeneration, this subject belongs to a rapidly expanding area of biomedical research. Through successful combinations of the desired properties of matrix materials with those of fillers (in such systems, calcium orthophosphates might play either role), innovative bone graft biomaterials can be designed. Various types of biocomposites and hybrid biomaterials based on calcium orthophosphates, either those already in use or being investigated for biomedical applications, are extensively discussed. Many different formulations, in terms of the material constituents, fabrication technologies, structural and bioactive properties as well as both in vitro and in vivo characteristics, have already been proposed. Among the others, the nanostructurally controlled biocomposites, those containing nanodimensional compounds, biomimetically fabricated formulations with collagen, chitin and/or gelatin as well as various functionally graded structures seem to be the most promising candidates for clinical applications. The specific advantages of using biocomposites and hybrid biomaterials based on calcium orthophosphates in the selected applications are highlighted. As the way from the laboratory to the hospital is a long one, and the prospective biomedical candidates have to meet many different necessities, this review also examines the critical issues and scientific challenges that require further research and development.

PHYSICOCHEMICAL CHARACTERIZATION OF LYOPHILIZED BOVINE BONE GRAFTS

To evaluate the physicochemical characteristics of lyophilized bovine grafts manufactured on a semi-industrial scale (Orthogen; Baumer S/A*) in accordance with a protocol previously developed by the authors.

METHODS

The lyophilized bovine bone grafts were characterized by means of scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffractometry (XRD), thermogravimetric (TG) analysis, differential exploratory scanning calorimetry (DSC) and Fourier-transform infrared (FT-IR) spectroscopy.

RESULTS

Ca was the main component (60%) found in the samples, followed by P (28%) and O (5%). The mean (sd) pore size was 316 μm (146.7), ranging from 91.2 to 497.8 μm, and 333.5 μm (304.8), ranging from 87.2 to 963.9 μm, at 50x and 150x magnification, respectively. The hydroxyapatite peaks were at 26°C and 32°C, and mass losses were observed between 250°C and 640°C, corresponding to organic material and water. Two temperature transitions (45.67°C and 91.89°C) showed denaturation of type 1 collagen and dehydration of hydroxyapatite.

CONCLUSION

The physicochemical assessment of lyophilized bovine bone grafts in accordance with the protocol developed at semi-industrial scale confirmed that this product presents excellent biocompatibility, with characteristics similar to natural bone.

Calcium orthophosphates as bioceramics: state of the art

In the late 1960s, much interest was raised in regard to biomedical applications of various ceramic materials. A little bit later, such materials were named bioceramics. This review is limited to bioceramics prepared from calcium orthophosphates only, which belong to the categories of bioactive and bioresorbable compounds. There have been a number of important advances in this field during the past 30-40 years. Namely, by structural and compositional control, it became possible to choose whether calcium orthophosphate bioceramics were biologically stable once incorporated within the skeletal structure or whether they were resorbed over time. At the turn of the millennium, a new concept of calcium orthophosphate bioceramics-which is able to promote regeneration of bones-was developed. Presently, calcium orthophosphate bioceramics are available in the form of particulates, blocks, cements, coatings, customized designs for specific applications and as injectable composites in a polymer carrier. Current biomedical applications include artificial replacements for hips, knees, teeth, tendons and ligaments, as well as repair for periodontal disease, maxillofacial reconstruction, augmentation and stabilization of the jawbone, spinal fusion and bone fillers after tumor surgery. Exploratory studies demonstrate potential applications of calcium orthophosphate bioceramics as scaffolds, drug delivery systems, as well as carriers of growth factors, bioactive peptides and/or various types of cells for tissue engineering purposes.

In vitro dissolution and mechanical behavior of c-axis preferentially oriented hydroxyapatite thin films fabricated by pulsed laser deposition

Owing to its resemblance to the major inorganic constituent of bone and tooth, hydroxyapatite is recognized as one of the most biocompatible materials and is widely used in systems for bone replacement and regeneration. In this study the pulsed laser deposition technique was chosen to produce hydroxyapatite with different crystallographic orientations in order to investigate some of the material properties, including its in vitro dissolution behavior, as well as mechanical properties. The crystallographic orientations of hydroxyapatite coatings can be carefully controlled, mainly by varying the energy density of the KrF excimer laser (248 nm) used for deposition. Nanoindentation results showed that highly c-axis oriented hydroxyapatite coatings have higher hardness and Young's modulus values compared with the values of randomly oriented coatings. After 24h immersion in simulated physiological solution the overall surface morphology of the highly oriented coatings was dramatically altered. The porosity was drastically increased and sub-micron pores were formed throughout the coatings, whereas the average size of the grains in the coatings was not significantly changed. The composition of the textured hydroxyapatite coatings remained essentially unchanged. Their c-axis texture, on the other hand, was rather enhanced with an increase in immersion time. The c-axis oriented hydroxyapatite surfaces are likely to promote preferentially oriented growth through a cyclic process of dissolution and reprecipitation, followed by homoepitaxial growth. The remarkable morphological and microstructural changes after dissolution suggest a capability of highly textured hydroxyapatite as a tissue engineering scaffold with an interconnecting porous network that may be beneficial for cellular activity.

Graded/Gradient Porous Biomaterials

Biomaterials include bioceramics, biometals, biopolymers and biocomposites and they play important roles in the replacement and regeneration of human tissues. However, dense bioceramics and dense biometals pose the problem of stress shielding due to their high Young’s moduli compared to those of bones. On the other hand, porous biomaterials exhibit the potential of bone ingrowth, which will depend on porous parameters such as pore size, pore interconnectivity, and porosity. Unfortunately, a highly porous biomaterial results in poor mechanical properties. To optimise the mechanical and the biological properties, porous biomaterials with graded/gradient porosity, pores size, and/or composition have been developed. Graded/gradient porous biomaterials have many advantages over graded/gradient dense biomaterials and uniform or homogenous porous biomaterials. The internal pore surfaces of graded/gradient porous biomaterials can be modified with organic, inorganic, or biological coatings and the internal pores themselves can also be filled with biocompatible and biodegradable materials or living cells. However, graded/gradient porous biomaterials are generally more difficult to fabricate than uniform or homogenous porous biomaterials. With the development of cost-effective processing techniques, graded/gradient porous biomaterials can find wide applications in bone defect filling, implant fixation, bone replacement, drug delivery, and tissue engineering.

Novel preparation of graded porous structures for medical engineering

The gradation of porosity in a biomaterial can be very useful for a variety of medical engineering applications such as filtration, bone replacement and implant development. However, the preparation of such structures is not a technologically trivial task and replication methods do not offer an easy solution. In this work, we elucidate the preparation of structures having a graded porosity by electrohydrodynamic spraying, using zirconia (ZrO2), which is widely used in biomedical and other applications. The processes are generic and can be achieved using other bioactive ceramics with similar particle characteristics. The pores on the sprayed surface, the innermost surface and lengthwise cross sections have been analysed in addition to the change in depth of penetration as a function of spraying time. Control of porosity, pore size and depth of penetration has been obtained by varying parameters such as the spraying time, sintering temperature and the sacrificial template. It has been possible to obtain structures with interconnected pore networks of pore size greater than 100microm as well as scattered pores smaller than 10microm in size.

Strategies and applications for incorporating physical and chemical signal gradients in tissue engineering

From embryonic development to wound repair, concentration gradients of bioactive signaling molecules guide tissue formation and regeneration. Moreover, gradients in cellular and extracellular architecture as well as in mechanical properties are readily apparent in native tissues. Perhaps tissue engineers can take a cue from nature in attempting to regenerate tissues by incorporating gradients into engineering design strategies. Indeed, gradient-based approaches are an emerging trend in tissue engineering, standing in contrast to traditional approaches of homogeneous delivery of cells and/or growth factors using isotropic scaffolds. Gradients in tissue engineering lie at the intersection of three major paradigms in the field-biomimetic, interfacial, and functional tissue engineering-by combining physical (via biomaterial design) and chemical (with growth/differentiation factors and cell adhesion molecules) signal delivery to achieve a continuous transition in both structure and function. This review consolidates several key methodologies to generate gradients, some of which have never been employed in a tissue engineering application, and discusses strategies for incorporating these methods into tissue engineering and implant design. A key finding of this review was that two-dimensional physicochemical gradient substrates, which serve as excellent high-throughput screening tools for optimizing desired biomaterial properties, can be enhanced in the future by transitioning from two dimensions to three dimensions, which would enable studies of cell-protein-biomaterial interactions in a more native tissue-like environment. In addition, biomimetic tissue regeneration via combined delivery of graded physical and chemical signals appears to be a promising strategy for the regeneration of heterogeneous tissues and tissue interfaces. In the future, in vivo applications will shed more light on the performance of gradient-based mechanical integrity and signal delivery strategies compared to traditional tissue engineering approaches.

Porous ceramic bone scaffolds for vascularized bone tissue regeneration

Hydroxyapatite scaffolds with a multi modal porosity designed for use in tissue engineering of vascularized bone graft substitutes were prepared by three dimensional printing. Depending on the ratio of coarse (mean particle size 50 microm) to fine powder (mean particle size 4 microm) in the powder granulate and the sintering temperature total porosity was varied from 30% to 64%. While macroscopic pore channels with a diameter of 1 mm were created by CAD design, porosity structure in the sintered solid phase was governed by the granulate structure of the printing powder. Scaffolds sintered at 1,250 degrees C were characterized by a bimodal pore structure with intragranular pores of 0.3-0.4 microm and intergranular pores of 20 microm whereas scaffolds sintered at 1,400 degrees C exhibit a monomodal porosity with a maximum of pore size distribution at 10-20 microm. For in-vivo testing, matrices were implanted subcutaneously in four male Lewis rats. Scaffolds with 50% porosity and an average pore size of approximately 18 microm were successfully transferred to rats and vascularized within 4 weeks.

Hierarchical pore structure of calcium phosphate scaffolds by a combination of gel-casting and multiple tape-casting methods

The objective of this work was to design hierarchical pore structure scaffolds with potential applications in bone tissue regeneration. For that purpose, a bioceramic material such as biphasic calcium phosphate, which consists of a mixture of hydroxyapatite and beta-tricalcium phosphate, was selected. Multilayer pieces (MLP) with hierarchical pore structure were developed employing a new technique that combines gel casting and adding porogens, using multiple tape-casting methods. Pieces with functionally graded porosity were fabricated using porogens with different sizes. The porogens used were Porlat K85 and Porlat K86 with diameters <150 microm and 150-300 microm, respectively. Two types of sintered tapes, with different porosity, no cracking and enough interconnection size were selected. MLP with hierarchical pore structure were designed by the multiple tape-casting method. Interconnected pores whose sizes increase from interior tapes (1.6-3.6 microm) towards exterior tapes (20-51.5 microm) and interpenetration between tapes were achieved. Delamination or cracking were not observed after heat treatment. The flexural strength of pieces was investigated by the three-point bending test. This new combination of methods offers the possibility of manufacturing scaffolds with interconnected pore sizes ranging from 1.6 to 51.5 microm.