Use of eggshell-derived nano-hydroxyapatite as novel bone graft substitute-A randomized controlled clinical study

In Vitro and In Vivo Bone Regeneration Assessment of Titanium-Doped Waste Eggshell-Derived Hydroxyapatite in the Animal Model

In this work, a titanium-doped hydroxyapatite (HAp) scaffold was produced from two different sources (natural eggshell and laboratory-grade reagents) to compare the efficacy of natural and synthetic resources of HAp materials on new bone regeneration. This comparative study also reports the effect of Ti doping on the physical, mechanical, and in vitro as well as in vivo biological properties of the HAp scaffold. Pellets were prepared in the conventional powder metallurgy route, compacted, and sintered at 900 °C, showing sufficient porosity for bony ingrowth. The physical-mechanical characterizations were performed by density, porosity evaluation, XRD, FTIR, SEM analysis, and hardness measurement. In vitro interactions were evaluated by bactericidal assay, hemolysis, MTT assay, and interaction with simulated body fluid. All categories of pellets showed absolute nonhemolytic and nontoxic character. Furthermore, significant apatite formation was observed on the Ti-doped HAp samples in the simulated body fluid immersion study. The developed porous pellets were implanted to assess the bone defect healing in the femoral condyle of healthy rabbits. A 2 month study after implantation showed no marked inflammatory reaction for any samples. Radiological analysis, histological analysis, SEM analysis, and oxytetracycline labeling studies depicted better invasion of mature osseous tissue in the pores of doped eggshell-derived HAp scaffolds as compared to the undoped HAp, and laboratory-made samples. Quantification using oxytetracycline labeling depicted 59.31 ± 1.89% new bone formation for Ti-doped eggshell HAp as compared to Ti-doped pure HAp (54.41 ± 1.93) and other undoped samples. Histological studies showed the presence of abundant osteoblastic and osteoclastic cells in Ti-doped eggshell HAp in contrast to other samples. Radiological and SEM data also showed similar results. The results indicated that Ti-doped biosourced HAp samples have good biocompatibility, new bone-forming ability, and could be used as a bone grafting material in orthopedic surgery.

Advanced materials and technologies for oral diseases

Oral disease, as a class of diseases with very high morbidity, brings great physical and mental damage to people worldwide. The increasing burden and strain on individuals and society make oral diseases an urgent global health problem. Since the treatment of almost all oral diseases relies on materials, the rapid development of advanced materials and technologies has also promoted innovations in the treatment methods and strategies of oral diseases. In this review, we systematically summarized the application strategies in advanced materials and technologies for oral diseases according to the etiology of the diseases and the comparison of new and old materials. Finally, the challenges and directions of future development for advanced materials and technologies in the treatment of oral diseases were refined. This review will guide the fundamental research and clinical translation of oral diseases for practitioners of oral medicine.

Role of Biomaterials Used for Periodontal Tissue Regeneration—A Concise Evidence-Based Review

Periodontal infections are noncommunicable chronic inflammatory diseases of multifactorial origin that can induce destruction of both soft and hard tissues of the periodontium. The standard remedial modalities for periodontal regeneration include nonsurgical followed by surgical therapy with the adjunctive use of various biomaterials to achieve restoration of the lost tissues. Lately, there has been substantial development in the field of biomaterial, which includes the sole or combined use of osseous grafts, barrier membranes, growth factors and autogenic substitutes to achieve tissue and bone regeneration. Of these, bone replacement grafts have been widely explored for their osteogenic potential with varied outcomes. Osseous grafts are derived from either human, bovine or synthetic sources. Though the biologic response from autogenic biomaterials may be better, the use of bone replacement synthetic substitutes could be practical for clinical practice. This comprehensive review focuses initially on bone graft replacement substitutes, namely ceramic-based (calcium phosphate derivatives, bioactive glass) and autologous platelet concentrates, which assist in alveolar bone regeneration. Further literature compilations emphasize the innovations of biomaterials used as bone substitutes, barrier membranes and complex scaffold fabrication techniques that can mimic the histologically vital tissues required for the regeneration of periodontal apparatus.

Waste-derived biomaterials as building blocks in the biomedical field

Recent developments in the biomedical arena have led to the fabrication of innovative biomaterials by utilizing bioactive molecules obtained from biological wastes released from fruit and beverage processing industries, and fish, meat, and poultry industries. These biological wastes that end up in water bodies as well as in landfills are an affluent source of animal- and plant-derived proteins, bio ceramics and polysaccharides such as collagens, gelatins, chitins, chitosans, eggshell membrane proteins, hydroxyapatites, celluloses, and pectins. These bioactive molecules have been intricately designed into scaffolds and dressing materials by utilizing advanced technologies for drug delivery, tissue engineering, and wound healing relevance. These biomaterials are environment-friendly, biodegradable, and biocompatible, and show excellent tissue regeneration attributes. Additionally, being cost-effective they can reduce the burden on the healthcare system as well as provide a sustainable solution to waste management. In this review, the current trends in the utilization of plant and animal waste-derived biomaterials in various biomedical fields are considered along with a separate section on their applications as xenografts.

Avian Egg: A Multifaceted Biomaterial for Tissue Engineering

Most components in avian eggs, offering a natural and environmentally friendly source of raw materials, hold great potential in tissue engineering. An avian egg consists of several beneficial elements: the protective eggshell, the eggshell membrane, the egg white (albumen), and the egg yolk (vitellus). The eggshell is mostly composed of calcium carbonate and has intrinsic biological properties that stimulate bone repair. It is a suitable precursor for the synthesis of hydroxyapatite and calcium phosphate, which are particularly relevant for bone tissue engineering. The eggshell membrane is a thin protein-based layer with a fibrous structure and is constituted of several valuable biopolymers, such as collagen and hyaluronic acid, that are also found in the human extracellular matrix. As a result, the eggshell membrane has found several applications in skin tissue repair and regeneration. The egg white is a protein-rich material that is under investigation for the design of functional protein-based hydrogel scaffolds. The egg yolk, mostly composed of lipids but also diverse essential nutrients (e.g., proteins, minerals, vitamins), has potential applications in wound healing and bone tissue engineering. This review summarizes the advantages and status of each egg component in tissue engineering and regenerative medicine, but also covers their current limitations and future perspectives.

Potential Use of Eggshell as Bone Graft Compared with Bovine for Bone Defect: A Systematic Review Study

Background : The use of Bone Graft in the management of Bone Defect is a challenge in the world of orthopedics. Recently, eggshell containing hydroxyapatite has become a new hope in the use of an economical and efficient bone graft in the treatment of bone defects. The aim of this systematic review was to explore the available literature on the clinical performance of eggshells as bone grafts in guided bone regeneration. Method : Two databases (PubMed and Cochrane) were searched from January 2010 to September 2020. Clinical trials using eggshells as bone grafts were included in the review. Animal and in vivo studies were excluded from the review. Results : A total of 202 studies were taken, then screened and 15 studies finally included. Clinical and radiological evaluations show complete recovery after the procedure. Comparison with synthetic hydroxyapatite shows similar healing characteristics. Conclusion : Eggshell compared to bovine showed no difference in bone healing. Within the limitations of the included studies, eggshells can be used safely and efficiently in integrated bone regeneration procedures. Keywords: Bone tissue regeneration; eggshell; bovine; bone defect; bone graft  

Functionalized Porous Hydroxyapatite Scaffolds for Tissue Engineering Applications: A Focused Review

Biomaterials have been widely used in tissue engineering applications at an increasing rate in recent years. The increased clinical demand for safe scaffolds, as well as the diversity and availability of biomaterials, has sparked rapid interest in fabricating diverse scaffolds to make significant progress in tissue engineering. Hydroxyapatite (HAP) has drawn substantial attention in recent years owing to its excellent physical, chemical, and biological properties and facile adaptable surface functionalization with other innumerable essential materials. This focused review spotlights a brief introduction on HAP, scope, a historical outline, basic structural features/properties, various synthetic strategies, and their scientific applications concentrating on functionalized HAP in the diverse area of tissue engineering fields such as bone, skin, periodontal, bone tissue fixation, cartilage, blood vessel, liver, tendon/ligament, and corneal are emphasized. Besides clinical translation aspects, the future challenges and prospects of HAP based biomaterials involved in tissue engineering are also discussed. Furthermore, it is expected that researchers may find this review expedient in gaining an overall understanding of the latest advancement of HAP based biomaterials.

State-of-the-Art of Eggshell Waste in Materials Science: Recent Advances in Catalysis, Pharmaceutical Applications, and Mechanochemistry

Eggshell waste is among the most abundant waste materials coming from food processing technologies. Despite the unique properties that both its components (eggshell, ES, and eggshell membrane, ESM) possess, it is very often discarded without further use. This review article aims to summarize the recent reports utilizing eggshell waste for very diverse purposes, stressing the need to use a mechanochemical approach to broaden its applications. The most studied field with regards to the potential use of eggshell waste is catalysis. Upon proper treatment, it can be used for turning waste oils into biodiesel and moreover, the catalytic effect of eggshell-based material in organic synthesis is also very beneficial. In inorganic chemistry, the eggshell membrane is very often used as a templating agent for nanoparticles production. Such composites are suitable for application in photocatalysis. These bionanocomposites are also capable of heavy metal ions reduction and can be also used for the ozonation process. The eggshell and its membrane are applicable in electrochemistry as well. Due to the high protein content and the presence of functional groups on the surface, ESM can be easily converted to a high-performance electrode material. Finally, both ES and ESM are suitable for medical applications, as the former can be used as an inexpensive Ca2+ source for the development of medications, particles for drug delivery, organic matrix/mineral nanocomposites as potential tissue scaffolds, food supplements and the latter for the treatment of joint diseases, in reparative medicine and vascular graft producing. For the majority of the above-mentioned applications, the pretreatment of the eggshell waste is necessary. Among other options, the mechanochemical pretreatment has found an inevitable place. Since the publication of the last review paper devoted to the mechanochemical treatment of eggshell waste, a few new works have appeared, which are reviewed here to underline the sustainable character of the proposed methodology. The mechanochemical treatment of eggshell is capable of producing the nanoscale material which can be further used for bioceramics synthesis, dehalogenation processes, wastewater treatment, preparation of hydrophobic filters, lithium-ion batteries, dental materials, and in the building industry as cement.

Clinical applications of avian eggshell-derived hydroxyapatite

The search for bone reconstruction materials and methods is an ongoing challenge. The aim of this review is to systemically search the available literature concerning the clinical performance of eggshell as a substitute material in guided bone regeneration in oral surgery. Five databases (PubMed, Cochrane, Web of Science, Scopus, and Embase) were searched up to February 2020. Clinical trials that used eggshell as a bone substitute material were included in the review. Animal and in vivo studies were excluded from the review. ROBINS-I was used to evaluate the risk of bias. A total of 840 studies were retrieved, out of which 55 full-text articles were screened. Five studies were finally included: one study showed critical and four serious risk of bias. A total of 74 patients and 88 intervention sites were included in the five studies. Clinical and radiological evaluation showed complete healing during the follow-ups. Statistically significant radiological and clinical evidence of new bone formation was achieved for socket preservation, grafting after third molar extraction, and cystic/apicectomy grafting. One patient with complications was reported. Histological analysis and micro computed tomography confirmed that it promotes bone regeneration. A comparison with synthetic hydroxyapatite showed similar healing characteristics. Within the limitations of the included studies, the eggshell can be safely and efficiently used in guided bone regeneration procedures, but more research is needed to completely evaluate the full potential of this material.

The Bone Extracellular Matrix in Bone Formation and Regeneration

Bone regeneration repairs bone tissue lost due to trauma, fractures, and tumors, or absent due to congenital disorders. The extracellular matrix (ECM) is an intricate dynamic bio-environment with precisely regulated mechanical and biochemical properties. In bone, ECMs are involved in regulating cell adhesion, proliferation, and responses to growth factors, differentiation, and ultimately, the functional characteristics of the mature bone. Bone ECM can induce the production of new bone by osteoblast-lineage cells, such as MSCs, osteoblasts, and osteocytes and the absorption of bone by osteoclasts. With the rapid development of bone regenerative medicine, the osteoinductive, osteoconductive, and osteogenic potential of ECM-based scaffolds has attracted increasing attention. ECM-based scaffolds for bone tissue engineering can be divided into two types, that is, ECM-modified biomaterial scaffold and decellularized ECM scaffold. Tissue engineering strategies that utilize the functional ECM are superior at guiding the formation of specific tissues at the implantation site. In this review, we provide an overview of the function of various types of bone ECMs in bone tissue and their regulation roles in the behaviors of osteoblast-lineage cells and osteoclasts. We also summarize the application of bone ECM in bone repair and regeneration. A better understanding of the role of bone ECM in guiding cellular behavior and tissue function is essential for its future applications in bone repair and regenerative medicine.