Physical stimulations and their osteogenesis-inducing mechanisms

The Effects of Electrical Stimulation on a 3D Osteoblast Cell Model

Electrical stimulation has been used with tissue engineering-based models to develop three-dimensional (3D), dynamic, research models that are more physiologically relevant than static two-dimensional (2D) cultures. For bone tissue, the effect of electrical stimulation has focused on promoting healing and regeneration of tissue to prevent bone loss. However, electrical stimulation can also potentially affect mature bone parenchymal cells such as osteoblasts to guide bone formation and the secretion of paracrine or endocrine factors. Due to a lack of physiologically relevant models, these phenomena have not been studied in detail. In vitro electrical stimulation models can be useful for gaining an understanding of bone physiology and its effects on paracrine tissues under different physiological and pathological conditions. Here, we use a 3D, dynamic, in vitro model of bone to study the effects of electrical stimulation conditions on protein and gene expression of SaOS-2 human osteosarcoma osteoblast-like cells. We show that different stimulation regimens, including different frequencies, exposure times, and stimulation patterns, can have different effects on the expression and secretion of the osteoblastic markers alkaline phosphatase and osteocalcin. These results reveal that electrical stimulation can potentially be used to guide osteoblast gene and protein expression.

NIR-stimulated rGO-HAMC hydrogel enhances fracture healing through regulating B-cell signaling

Bone fractures are frequently encountered in clinical practice and pose significant challenges, due to the high incidence of delayed healing or non-union. Reduced graphene oxide (rGO) stands out for its unique sensitivity to a wide range of light wavelengths, especially in the near-infrared (NIR) spectrum. In this study, we developed an approach to promote fracture healing using an rGO-HAMC hydrogel activated by NIR stimulation. In vitro experiments demonstrated that NIR-stimulated rGO hydrogel significantly enhanced osteogenesis in bone marrow stromal cells (BMSCs). In an in vivo mouse fracture model, the rGO hydrogel was applied to the fracture site, and NIR light was delivered transdermally, showing promising results in accelerating bone regeneration. These results demonstrate that NIR-stimulated rGO hydrogel significantly accelerates fracture healing, as evidenced by increased bone volume and trabecular thickness. Additionally, transcriptomic analysis revealed that pathways related to B-cell activation are implicated in the enhanced healing effects mediated by NIR-stimulated rGO hydrogel. These findings highlight the potential of the NIR-stimulated rGO hydrogel as an innovative strategy for bone regeneration, offering promising new avenues for the treatment and management of bone fractures.

3D-Printed Shape Memory and Piezoelectric Bifunctional Thermoplastic Polyurethane/Polyvinylidene Fluoride Porous Composite Scaffold for Bone Regeneration

Physical stimulations such as mechanical and electric stimulation can continuously work on bone defect locations to maintain and enhance cell activity, and it has become a hotspot for research in the field of bone repair. Herein, bifunctional porous composite scaffolds with shape memory and piezoelectric functions were fabricated using thermoplastic polyurethane (TPU) and poly(vinylidene fluoride) through triply periodic minimal surfaces design and selective laser sintering technology. Thereinto, the shape fixity ratio and recovery ratio of the composite scaffold reached 98.6% and 81.2%, respectively, showing excellent shape memory functions. More importantly, its piezoelectric coefficient (d33 = 2.47 pC/N) is close to the piezoelectric constant of bone tissue (d33 = 0.7-2.3 pC/N), and the voltage released during the compression process can reach 0.5 V. Furthermore, cyclic compression experiments showed that the strength of composite scaffold was up to 8.3 times compared with the TPU scaffold. Besides, the composite scaffold showed excellent cytocompatibility. In conclusion, the composite scaffold is expected to continuously generate mechanical and electric stimulation due to shape memory and piezoelectric function, respectively, which provide an effective strategy for bone repair.

From the microspheres to scaffolds: advances in polymer microsphere scaffolds for bone regeneration applications

The treatment and repair of bone tissue damage and loss due to infection, tumours, and trauma are major challenges in clinical practice. Artificial bone scaffolds offer a safer, simpler, and more feasible alternative to bone transplantation, serving to fill bone defects and promote bone tissue regeneration. Ideally, these scaffolds should possess osteoconductive, osteoinductive, and osseointegrative properties. However, the current first-generation implants, represented by titanium alloys, have shown poor bone-implant integration performance and cannot meet the requirements for bone tissue repair. This has led to increased research on second and third generation artificial bone scaffolds, which focus on loading bioactive molecules and cells. Polymer microspheres, known for their high specific surface areas at the micro- and nanoscale, exhibit excellent cell and drug delivery behaviours. Additionally, with their unique rigid structure, microsphere scaffolds can be constructed using methods such as thermal sintering, injection, and microsphere encapsulation. These scaffolds not only ensure the excellent cell drug loading performance of microspheres but also exhibit spatial modulation behaviour, aiding in bone repair within a three-dimensional network structure. This article provides a summary and discussion of the use of polymer microsphere scaffolds for bone repair, focusing on the mechanisms of bone tissue repair and the current status of clinical bone grafts, aimed at advancing research in bone repair.

Iron oxide nanoparticle-stabilized Pickering emulsion-templated porous scaffolds loaded with polyunsaturated fatty acids (PUFAs) for bone tissue engineering

Dietary intake of ω-3-polyunsaturated fatty acids (PUFAs) can significantly improve the expression levels of alkaline phosphatase (ALP) and osteocalcin. However, PUFAs are hydrophobic and highly sensitive to temperature, oxygen concentration, pH, and ionic strength. Hence, it is challenging to use PUFAs as bioactive compounds for bone tissue engineering. Here, we encapsulated PUFAs in liposomes to improve their stability. The hydrodynamic size of the PUFA-loaded liposomes was found to be 121.3 ± 35 nm. GC-MS analysis showed that the encapsulation efficiency of the PUFAs was 19.9 ± 3.4%. These PUFA-loaded liposomes were loaded into porous scaffolds that were prepared by polymerizing glycidyl methacrylate and trimethylolpropane triacrylate monomers using the Pickering emulsion polymerization technique. Oleic acid-coated iron oxide nanoparticles were used as the stabilizing agent to prepare these acrylate-based scaffolds containing PUFA-loaded liposomes (P-Lipo-IO(GMA-TMPTA)). SEM micrographs confirmed the porous nature of the scaffolds and the presence of well-adhered liposomes. An in vitro cytotoxicity study conducted using MG63 cells confirmed that these scaffolds showed desirable cytocompatibility. Cell adhesion study showed a well-spread morphology, indicating firm adhesion of the cells. The alizarin red staining of P-Lipo-IO(GMA-TMPTA) scaffolds showed 3- and 2-fold higher calcium deposition compared to the control on days 7 and 14, respectively. ALP activity was also 2-fold higher than that of the control on day 14. RT-PCR analysis of cells exposed to P-Lipo-IO(GMA-TMPTA) scaffolds showed significantly higher expression of osteogenic markers compared to the control. An antibacterial study conducted on Staphylococcus aureus showed a higher percentage inhibition and reactive oxygen species generation in samples treated with P-Lipo-IO(GMA-TMPTA) scaffolds. These desirable biological properties indicate that the developed scaffolds are suitable for bone tissue engineering.

Remote actuation and on-demand activation of biomaterials pre-incorporated with physical cues for bone repair

The high incidence of bone defect-related diseases caused by trauma, infection, and tumor resection has greatly stimulated research in the field of bone regeneration. Generally, bone healing is a long and complicated process wherein manipulating the biological activity of interventional scaffolds to support long-term bone regeneration is significant for treating bone-related diseases. It has been reported that some physical cues can act as growth factor substitutes to promote osteogenesis through continuous activation of endogenous signaling pathways. This review focuses on the latest progress in bone repair by remote actuation and on-demand activation of biomaterials pre-incorporated with physical cues (heat, electricity, and magnetism). As an alternative method to treat bone defects, physical cues show many advantages, including effectiveness, noninvasiveness, and remote manipulation. First, we introduce the impact of different physical cues on bone repair and potential internal regulatory mechanisms. Subsequently, biomaterials that mediate various physical cues in bone repair and their respective characteristics are summarized. Additionally, challenges are discussed, aiming to provide new insights and suggestions for developing intelligent biomaterials to treat bone defects and promote clinical translation.

Mechanical impact on biomineralization: Enhancing the strength of composite materials

A recent study published in Nature Communications introduces a novel mechanically-mediated reaction involving ZnO nanoparticles that autonomously react, forming Zn/S mineral microrods within an organogel. These microrods selectively reinforce synthetic polymer composites, offering a unique approach to material strengthening. The method provides a distinctive pathway for mechanical mineralization in composite materials.

Development of a multifunctional bioreactor to evaluate the promotion effects of cyclic stretching and electrical stimulation on muscle differentiation

A multifunctional bioreactor was fabricated in this study to investigate the facilitation efficiency of electrical and mechanical stimulations on myogenic differentiation. This bioreactor consisted of a highly stretchable conductive membrane prepared by depositing polypyrrole (PPy) on a flexible polydimethylsiloxane (PDMS) film. The tensile deformation of the PPy/PDMS membrane can be tuned by adjusting the channel depth. In addition, PPy/PDMS maintained its electrical conductivity under continuous cyclic stretching in the strain range of 6.5%-13% for 24 h. This device can be used to individually or simultaneously perform cyclic stretching and electrical stimulation. The results of single stimulation showed that either cyclic stretching or electrical stimulation upregulated myogenic gene expression and promoted myotube formation, where electrical stimulation improved better than cyclic stretching. However, only cyclic stretching can align C2C12 cells perpendicular to the stretching direction, and electrical stimulation did not affect cell morphology. Myosin heavy chain (MHC) immunostaining demonstrated that oriented cells under cyclic stretching resulted in parallel myotubes. The combination of these two stimuli exhibited synergetic effects on both myogenic gene regulation and myotube formation, and the incorporated electrical field did not affect the orientation effect of the cyclic stretching. These results suggested that these two treatments likely influenced cells through different pathways. Overall, the simultaneous application of cyclic stretching and electrical stimulation preserved both stimuli's advantages, so myo-differentiation can be highly improved to obtain abundant parallel myotubes, suggesting that our developed multifunctional bioreactor should benefit muscle tissue engineering applications.

Signalling pathways underlying pulsed electromagnetic fields in bone repair

Pulsed electromagnetic field (PEMF) stimulation is a prospective non-invasive and safe physical therapy strategy for accelerating bone repair. PEMFs can activate signalling pathways, modulate ion channels, and regulate the expression of bone-related genes to enhance osteoblast activity and promote the regeneration of neural and vascular tissues, thereby accelerating bone formation during bone repair. Although their mechanisms of action remain unclear, recent studies provide ample evidence of the effects of PEMF on bone repair. In this review, we present the progress of research exploring the effects of PEMF on bone repair and systematically elucidate the mechanisms involved in PEMF-induced bone repair. Additionally, the potential clinical significance of PEMF therapy in fracture healing is underscored. Thus, this review seeks to provide a sufficient theoretical basis for the application of PEMFs in bone repair.

Mild photothermal therapy assist in promoting bone repair: Related mechanism and materials

Achieving precision treatment in bone tissue engineering (BTE) remains a challenge. Photothermal therapy (PTT), as a form of precision therapy, has been extensively investigated for its safety and efficacy. It has demonstrated significant potential in the treatment of orthopedic diseases such as bone tumors, postoperative infections and osteoarthritis. However, the high temperatures associated with PTT can lead to certain limitations and drawbacks. In recent years, researchers have explored the use of biomaterials for mild photothermal therapy (MPT), which offers a promising approach for addressing these limitations. This review provides a comprehensive overview of the mechanisms underlying MPT and presents a compilation of photothermal agents and their utilization strategies for bone tissue repair. Additionally, the paper discusses the future prospects of MPT-assisted bone tissue regeneration, aiming to provide insights and recommendations for optimizing material design in this field.

Histomorphometric evaluation of 3D printed graphene oxide-enriched poly(ε-caprolactone) scaffolds for bone regeneration

Objective

Restoring large boney defects using bone grafts alone is an unpredictable procedure. Biodegradable polymeric scaffolds suffer rapid biodegradation and lack sufficient osteo-conductivity. The aim of this study was to histomorphometrically evaluate three-dimensional printed graphene oxide-enriched poly(ε-caprolactone) (PCL) scaffolds for bone regeneration in a rabbit defect model using two different concentrations of graphene oxide. Basic characteristic properties and mount of new bone regeneration formation were evaluated.

Methods

two concentrations of graphene oxide (1 and 3 wt%) were added to PCL scaffolds using hot blind technique while pure PCL scaffolds served as a control. Laboratory characterization included scanning electron microscopy (SEM), x-ray diffraction analysis (XRD), contact angle, internal porosity, in addition to density measurements. All scaffolds were subjected to biodegradation evaluation and cell cytotoxicity test. In vivo bone regeneration was evaluated in the tibia defect of a rabbit model by measuring the amount of new bone formation (n = 15, ά = 0.05).

Results

SEM images showed slight reduction in pore size and increase in filament width of scaffolds with increasing GO contents. However, the printed scaffolds matched well with the dimensions of the original design. XRD patterns revealed characteristic peaks identifying microstructure of scaffolds. Addition of GO increased crystallinity of the scaffolds. The contact angle and porosity readings indicated reduction in measurements with increased content of GO indicating improved wetting properties while the density followed an opposing pattern. Higher biodegradability values were associated with higher GO content resulting in acceleration of observed biodegradation. The results of cytotoxicity test showed reduction in cell viability with higher GO content. Bone regeneration was significantly enhanced for 1 wt% GO scaffolds compared to other groups as was evident by higher bone density observed in x-ray images and higher amount of new bone formation observed at different time intervals.

Significance

Graphene oxide improved the physical and biological properties of PCL scaffolds and significantly enhanced new bone regeneration.

Significance of mechanical loading in bone fracture healing, bone regeneration, and vascularization

In 1892, J.L. Wolff proposed that bone could respond to mechanical and biophysical stimuli as a dynamic organ. This theory presents a unique opportunity for investigations on bone and its potential to aid in tissue repair. Routine activities such as exercise or machinery application can exert mechanical loads on bone. Previous research has demonstrated that mechanical loading can affect the differentiation and development of mesenchymal tissue. However, the extent to which mechanical stimulation can help repair or generate bone tissue and the related mechanisms remain unclear. Four key cell types in bone tissue, including osteoblasts, osteoclasts, bone lining cells, and osteocytes, play critical roles in responding to mechanical stimuli, while other cell lineages such as myocytes, platelets, fibroblasts, endothelial cells, and chondrocytes also exhibit mechanosensitivity. Mechanical loading can regulate the biological functions of bone tissue through the mechanosensor of bone cells intraosseously, making it a potential target for fracture healing and bone regeneration. This review aims to clarify these issues and explain bone remodeling, structure dynamics, and mechano-transduction processes in response to mechanical loading. Loading of different magnitudes, frequencies, and types, such as dynamic versus static loads, are analyzed to determine the effects of mechanical stimulation on bone tissue structure and cellular function. Finally, the importance of vascularization in nutrient supply for bone healing and regeneration was further discussed.

Biomaterial-assisted tumor therapy: A brief review of hydroxyapatite nanoparticles and its composites used in bone tumors therapy

Malignant bone tumors can inflict significant damage to affected bones, leaving patients to contend with issues like residual tumor cells, bone defects, and bacterial infections post-surgery. However, hydroxyapatite nanoparticles (nHAp), the principal inorganic constituent of natural bone, possess numerous advantages such as high biocompatibility, bone conduction ability, and a large surface area. Moreover, nHAp's nanoscale particle size enables it to impede the growth of various tumor cells via diverse pathways. This article presents a comprehensive review of relevant literature spanning the past 2 decades concerning nHAp and bone tumors. The primary goal is to explore the mechanisms responsible for nHAp's ability to hinder tumor initiation and progression, as well as to investigate the potential of integrating other drugs and components for bone tumor diagnosis and treatment. Lastly, the article discusses future prospects for the development of hydroxyapatite materials as a promising modality for tumor therapy.

The interplay of collagen/bioactive glass nanoparticle coatings and electrical stimulation regimes distinctly enhanced osteogenic differentiation of human mesenchymal stem cells

Increasing research has incorporated bioactive glass nanoparticles (BGN) and electric field (EF) stimulation for bone tissue engineering and regeneration applications. However, their interplay and the effects of different EF stimulation regimes on osteogenic differentiation of human mesenchymal stem cells (hMSC) are less investigated. In this study, we introduced EF with negligible magnetic field strength through a well-characterized transformer-like coupling (TLC) system, and applied EF disrupted (4/4) or consecutive (12/12) regime on type I collagen (Col) coatings with/without BGN over 28 days. Additionally, dexamethasone was excluded to enable an accurate interpretation of BGN and EF in supporting osteogenic differentiation. Here, we demonstrated the influences of BGN and EF on collagen topography and maintaining coating stability. Coupled with the release profile of Si ions from the BGN, cell proliferation and calcium deposition were enhanced in the Col-BGN samples after 28 days. Further, osteogenic differentiation was initiated as early as d 7, and each EF regime was shown to activate distinct pathways. The disrupted (4/4) regime was associated with the BMP/Smad4 pathways that up-regulate Runx2/OCN gene expression on d 7, with a lesser effect on ALP activity. In contrast, the canonical Wnt/β-Catenin signaling pathway activated through mechanotransduction cues is associated with the consecutive (12/12) regime, with significantly elevated ALP activity and Sp7 gene expression reported on d 7. In summary, our results illustrated the synergistic effects of BGN and EF in different stimulation regimes on osteogenic differentiation that can be further exploited to enhance current bone tissue engineering and regeneration approaches. STATEMENT OF SIGNIFICANCE: The unique release mechanisms of silica from bioactive glass nanoparticles (BGN) were coupled with pulsatile electric field (EF) stimulation to support hMSC osteogenic differentiation, in the absence of dexamethasone. Furthermore, the interplay with consecutive (12/12) and disrupted (4/4) stimulation regimes was investigated. The reported physical, mechanical and topographical effects of BGN and EF on the collagen coating, hMSC and the distinct progression of osteogenic differentiation (canonical Wnt/β-Catenin and BMP/Smad) triggered by respective stimulation regime were not explicitly reported previously. These results provide the fundamentals for further exploitations on BGN composites with metal ions and rotation of EF regimes to enhance osteogenic differentiation. The goal is sustaining continual osteogenic differentiation and achieving a more physiologically-relevant state and bone constructs in vitro.

Bifunctional scaffolds for tumor therapy and bone regeneration: Synergistic effect and interplay between therapeutic agents and scaffold materials

Bone tumor patients often face the problems with cancer cell residues and bone defects after the operation. Therefore, researchers have developed many bifunctional scaffolds with both tumor treatment and bone repair functions. Therapeutic agents are usually combined with bioactive scaffolds to achieve the "bifunctional". However, the synergistic effect of bifunctional scaffolds on tumor therapy and bone repair, as well as the interplay between therapeutic agents and scaffold materials in bifunctional scaffolds, have not been emphasized and discussed. This review proposes a promising design scheme for bifunctional scaffolds: the synergistic effect and interplay between the therapeutic agents and scaffold materials. This review summarizes the latest research progress in bifunctional scaffolds for therapeutic applications and regeneration. In particular, it summarizes the role of tumor therapeutic agents in bone regeneration and the role of scaffold materials in tumor treatment. Finally, a perspective on the future development of bifunctional scaffolds for tumor therapy and bone regeneration is discussed.

A review of current challenges and prospects of magnesium and its alloy for bone implant applications

Medical application materials must meet multiple requirements, and the designed implant must mimic the bone structure in shape and support the formation of bone tissue (osteogenesis). Magnesium (Mg) alloys, as a "smart" biodegradable material and as "the green engineering material in the twenty-first century", have become an outstanding bone implant material due to their natural degradability, smart biocompatibility, and desirable mechanical properties. Magnesium is recognised as the next generation of orthopaedic appliances and bioresorbable scaffolds. At the same time, improving the mechanical properties and corrosion resistance of magnesium alloys is an urgent challenge to promote the application of magnesium alloys. Nevertheless, the excessively quick deterioration rate generally results in premature mechanical integrity disintegration and local hydrogen build-up, resulting in restricted clinical bone restoration applicability. The condition of Mg bone implants is thoroughly examined in this study. The relevant approaches to boost the corrosion resistance, including purification, alloying treatment, surface coating, and Mg-based metal matrix composite, are comprehensively revealed. These characteristics are reviewed to assess the progress of contemporary Mg-based biocomposites and alloys for biomedical applications. The fabricating techniques for Mg bone implants also are thoroughly investigated. Notably, laser-based additive manufacturing fabricates customised forms and complicated porous structures based on its distinctive additive manufacturing conception. Because of its high laser energy density and strong controllability, it is capable of fast heating and cooling, allowing it to modify the microstructure and performance. This review paper aims to provide more insight on the present challenges and continued research on Mg bone implants, highlighting some of the most important characteristics, challenges, and strategies for improving Mg bone implants.

Effects of Mechanical Stress Stimulation on Function and Expression Mechanism of Osteoblasts

Osteoclasts and osteoblasts play a major role in bone tissue homeostasis. The homeostasis and integrity of bone tissue are maintained by ensuring a balance between osteoclastic and osteogenic activities. The remodeling of bone tissue is a continuous ongoing process. Osteoclasts mainly play a role in bone resorption, whereas osteoblasts are mainly involved in bone remodeling processes, such as bone cell formation, mineralization, and secretion. These cell types balance and restrict each other to maintain bone tissue metabolism. Bone tissue is very sensitive to mechanical stress stimulation. Unloading and loading of mechanical stress are closely related to the differentiation and formation of osteoclasts and bone resorption function as well as the differentiation and formation of osteoblasts and bone formation function. Consequently, mechanical stress exerts an important influence on the bone microenvironment and bone metabolism. This review focuses on the effects of different forms of mechanical stress stimulation (including gravity, continuously compressive pressure, tensile strain, and fluid shear stress) on osteoclast and osteoblast function and expression mechanism. This article highlights the involvement of osteoclasts and osteoblasts in activating different mechanical transduction pathways and reports changings in their differentiation, formation, and functional mechanism induced by the application of different types of mechanical stress to bone tissue. This review could provide new ideas for further microscopic studies of bone health, disease, and tissue damage reconstruction.

The Review of Bioeffects of Static Magnetic Fields on the Oral Tissue-Derived Cells and Its Application in Regenerative Medicine

Magnets have been widely used in dentistry for orthodontic tooth movement and denture retention. Nevertheless, criticisms have arisen regarding the biosafety of static magnetic field (SMF) effects on surrounding tissues. Various controversial pieces of evidence have been discussed regarding SMFs on cellular biophysics, but little consensus has been reached, especially in the field of dentistry. Thus, the present paper will first review the safe use of SMFs in the oral cavity and as an additive therapy to orthodontic tooth movement and periodontium regeneration. Then, studies regarding SMF-incorporated implants are reviewed to investigate the advantageous effects of SMFs on osseointegration and the underlying mechanisms. Finally, a review of current developments in dentistry surrounding the combination of magnetic nanoparticles (MNPs) and SMFs is made to clarify potential future clinical applications.

Magnetoelectric effect: principles and applications in biology and medicine- a review

Magnetoelectric (ME) effect experimentally discovered about 60 years ago remains one of the promising research fields with the main applications in microelectronics and sensors. However, its applications to biology and medicine are still in their infancy. For the diagnosis and treatment of diseases at the intracellular level, it is necessary to develop a maximally non-invasive way of local stimulation of individual neurons, navigation, and distribution of biomolecules in damaged cells with relatively high efficiency and adequate spatial and temporal resolution. Recently developed ME materials (composites), which combine elastically coupled piezoelectric (PE) and magnetostrictive (MS) phases, have been shown to yield very strong ME effects even at room temperature. This makes them a promising toolbox for solving many problems of modern medicine. The main ME materials, processing technologies, as well as most prospective biomedical applications will be overviewed, and modern trends in using ME materials for future therapies, wireless power transfer, and optogenetics will be considered.

Review of physical stimulation techniques for assisting distraction osteogenesis in maxillofacial reconstruction applications

Distraction Osteogenesis (DO) is an emerging limb lengthening method for the reconstruction of the hard tissue and the surrounding soft tissue, in different human body zones. DO plays an important role in treating bone defects in Maxillofacial Reconstruction Applications (MRA) due to reduced side effects and better formed bone tissue compared to conventional reconstruction methods i.e. autologous bone graft, and alloplast implantation. Recently, varying techniques have been evaluated to enhance the characteristics of the newly formed tissues and process parameters. Promising results have been shown in assisting DO treatments while benefiting bone formation mechanisms by using physical stimulation techniques, including photonic, electromagnetic, electrical, and mechanical stimulation technique. Using assisted DO techniques has provided superior results in the outcome of the DO procedure compared to a standard DO procedure. However, DO methods, as well as assisting technologies applied during the DO procedure, are still emerging. Studies and experiments on developed solutions related to this field have been limited to animal and clinical trials. In this review paper, recent advances in physical stimulation techniques and their effects on the outcome of the DO treatment in MRA are surveyed. By studying the effects of using assisting techniques during the DO treatment, enabling an ideal assisted DO technique in MRA can be possible. Although mentioned techniques have shown constructive effects during the DO procedure, there is still a need for more research and investigation to be done to fully understand the effects of assisting techniques and advanced technologies for use in an ultimate DO procedure in MRA.

Electrostatic self-assembly of pFe3O4 nanoparticles on graphene oxide: A co-dispersed nanosystem reinforces PLLA scaffolds

Cell responses and mechanical properties are vital for scaffold in bone regeneration. Fe₃O₄ nanoparticles with excellent magnetism can provide magnetic stimulation for cell growth, while graphene oxide (GO) nanosheets are commonly used as reinforcement phases due to their high strength. However, Fe₃O₄ or GO is tended to agglomerate in matrix. In present study, a novel co-dispersed Fe₃O₄-GO nanosystem was constructed through electrostatic self-assembly of positively charged Fe₃O₄ (pFe₃O₄) on negatively charged GO nanosheets. In the nanosystem, pFe₃O₄ nanoparticles and GO nanosheets support each other, which effectively alleviates the π-π stacking between GO nanosheets and magnetic attraction between pFe₃O₄ nanoparticles. Subsequently, the nanosystem was incorporated into poly _L-lactic acid (PLLA) scaffolds fabricated using selective laser sintering. The results confirmed that the pFe₃O₄-GO nanosystem exhibited a synergistic enhancement effect on stimulating cell responses by integrating the capturing effect of GO and the magnetic simulation effect of pFe₃O₄. The activity, proliferation and differentiation of cells grown on scaffolds were significantly enhanced. Moreover, the nanosystem also exhibited a synergistic enhancement effect on mechanical properties of scaffolds, since the pFe₃O₄ loaded on GO improved the efficiency of stress transfer in matrix. The tensile stress and compressive strength of scaffolds were increased by 67.1% and 132%, respectively. In addition, the nanosystem improved the degradation capability and hydrophilicity of scaffolds.

Establishment of a Numerical Model to Design an Electro-Stimulating System for a Porcine Mandibular Critical Size Defect

Electrical stimulation is a promising therapeutic approach for the regeneration of large bone defects. Innovative electrically stimulating implants for critical size defects in the lower jaw are under development and need to be optimized in silico and tested in vivo prior to application. In this context, numerical modelling and simulation are useful tools in the design process. In this study, a numerical model of an electrically stimulated minipig mandible was established to find optimal stimulation parameters that allow for a maximum area of beneficially stimulated tissue. Finite-element simulations were performed to determine the stimulation impact of the proposed implant design and to optimize the electric field distribution resulting from sinusoidal low-frequency ( f = 20 Hz ) electric stimulation. Optimal stimulation parameters of the electrode length h el = 25 m m and the stimulation potential φ stim = 0.5 V were determined. These parameter sets shall be applied in future in vivo validation studies. Furthermore, our results suggest that changing tissue properties during the course of the healing process might make a feedback-controlled stimulation system necessary.

Three-Dimensional Hierarchical Nanofibrous Collagen Scaffold Fabricated Using Fibrillated Collagen and Pluronic F-127 for Regenerating Bone Tissue

It is well known that a nanoscale fibrous structure can provide a unique stage for encouraging reasonable cell activities including attachment and proliferation owing to its similar topological structure to the extracellular matrix. Hence, the structure has been widely applied in tissue regeneration. Type-I collagen has been typically used as a typical tissue regenerative material owing to its biocompatibility and abundance, although it has potential for antigenicity. In particular, collagen has been fabricated in two different forms, porous spongy and nanofibers. However, although the structures provided outstanding cellular activities, they exhibit disadvantages such as low cell migration capabilities in a spongy scaffold owing to the low degree of interconnected macropores and low processability in fabricating three-dimensional (3D) structures in an electrospun collagen scaffold. Hence, the fabrication of 3D nanofibrous collagen structures with interconnected macropores can be extremely challenging. In this work, we developed a 3D collagen scaffold consisting of multilayered nanofibrous struts fabricated using a 3D printing process and pluronic F-127 (PF-127), which is a thermoreversible polymer. After optimizing various processing conditions, we successfully achieved the 3D nanofibrous collagen mesh structure with fully interconnected macropores. A 3D-printed collagen scaffold that was fabricated using a low-temperature printing process was applied as a control. Through various analyses using physical properties (surface morphology, fibronectin absorption, mechanical properties, etc.) and cell activities using preosteoblasts (MC3T3-E1), we are convinced that the newly designed 3D nanofibrous collagen scaffold can be a new promising scaffold for bone tissue engineering.

Bioprinting science

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