A Critical Review on the Design, Manufacturing and Assessment of the Bone Scaffold for Large Bone Defects

Overview of biodegradable materials for bone repair and osteosarcoma treatment: From bulk to scaffolds

Osteosarcoma, the most common type of malignant bone tumor that affects growing bones in teenagers and children, has become a significant challenge for medical science. The combination of chemotherapy and surgery has been the standard treatment strategy for decades. However, concerns about tumor recurrence and the toxic effects of the drugs continue to drive materials scientists to develop multifunctional scaffolds that can simultaneously support bone regeneration and prevent tumor recurrence. Emergent multifunctional scaffolds have the potential to foster essential and dynamic cellular communication, which can directly target, signal, stimulate, and enhance the body's natural bone repair response. This review emphasizes the mechanisms involved and highlights various technologies and manufacturing processes that align with the capability of these scaffolds to effectively promote bone repair, especially in the presence of osteosarcoma. Additionally, the review summarizes the current state of knowledge regarding scaffolds based on magnesium (Mg), zinc (Zn), and iron (Fe), as well as the antitumor properties of their corrosion products. The review also discusses the therapeutic potential of Mg-, Zn-, and Fe-based materials in inhibiting osteosarcoma cell proliferation. The article elaborates on the main research challenges and prospects of biodegradable materials for bone repair and osteosarcoma treatment.

Calcination-based direct extraction of hydroxyapatite from bovine bone waste

The main chemical components of waste cow bones are apatite minerals, especially those containing calcium and phosphorus. This study investigated whether this bone could produce extracted hydroxyapatite through calcining at 900° C for different holding times (1-6 h). An average mass loss of 45% occurred in this experiment during the preparation of bone powders, which involved crushing and further calcining at this temperature. The quantitative XRD analysis showed that 99.97 wt.% hydroxyapatite and over 0.3 wt.% calcite were present in the raw and as-calcined bone powders, with trace amounts of CaFe3O5 (calcium ferrite) phases appearing in the calcined product. Depending on the holding calcining times, SEM images of the calcined bovine powders revealed aggregate sizes ranging from 0.5-3 µm and crystallite (grain) sizes ranging from 70 to 340 nm in all calcium-phosphate powder products. Following EDX analysis of all sample surfaces, possible calcium-deficient hydroxyapatite instead of hydroxyapatite formed, as evidenced by the calcined product's Ca/P ratio exceeding 1.67. Additionally, calcining cow bones for 5-6 h at 900° C yielded a high-purity nano-crystalline hydroxyapatite powder precursor in biomedical applications.

A review of computational optimization of bone scaffold architecture: methods, challenges, and perspectives

The design and optimization of bone scaffolds are critical for the success of bone tissue engineering (BTE) applications. This review paper provides a comprehensive analysis of computational optimization methods for bone scaffold architecture, focusing on the balance between mechanical stability, biological compatibility, and manufacturability. Finite element method (FEM), computational fluid dynamics (CFD), and various optimization algorithms are discussed for their roles in simulating and refining scaffold designs. The integration of multiobjective optimization and topology optimization has been highlighted for developing scaffolds that meet the multifaceted requirements of BTE. Challenges such as the need for consideration of manufacturing constraints and the incorporation of degradation and bone regeneration models into the optimization process have been identified. The review underscores the potential of advanced computational tools and additive manufacturing techniques in evolving the field of BTE, aiming to improve patient outcomes in bone tissue regeneration. The reliability of current optimization methods is examined, with suggestions for incorporating non-deterministic approaches andin vivovalidations to enhance the practical application of optimized scaffolds. The review concludes with a call for further research into artificial intelligence-based methods to advance scaffold design and optimization.

Two decades of continuous progresses and breakthroughs in the field of bioactive ceramics and glasses driven by CICECO-hub scientists

Over the past two decades, the CICECO-hub scientists have devoted substantial efforts to advancing bioactive inorganic materials based on calcium phosphates and alkali-free bioactive glasses. A key focus has been the deliberate incorporation of therapeutic ions like Mg, Sr, Zn, Mn, or Ga to enhance osteointegration and vascularization, confer antioxidant properties, and impart antimicrobial effects, marking significant contributions to the field of biomaterials and bone tissue engineering. Such an approach is expected to circumvent the uncertainties posed by methods relying on growth factors, such as bone morphogenetic proteins, parathyroid hormone, and platelet-rich plasma, along with their associated high costs and potential adverse side effects. This comprehensive overview of CICECO-hub's significant contributions to the forefront inorganic biomaterials across all research aspects and dimensionalities (powders, granules, thin films, bulk materials, and porous structures), follows a unified approach rooted in a cohesive conceptual framework, including synthesis, characterization, and testing protocols. Tangible outcomes [injectable cements, durable implant coatings, and bone graft substitutes (scaffolds) featuring customized porous architectures for implant fixation, osteointegration, accelerated bone regeneration in critical-sized bone defects] were achieved. The manuscript showcases specific biofunctional examples of successful biomedical applications and effective translations to the market of bone grafts for advanced therapies.

Advancements in Photothermal Therapy Using Near-Infrared Light for Bone Tumors

Bone tumors, particularly osteosarcoma, are prevalent among children and adolescents. This ailment has emerged as the second most frequent cause of cancer-related mortality in adolescents. Conventional treatment methods comprise extensive surgical resection, radiotherapy, and chemotherapy. Consequently, the management of bone tumors and bone regeneration poses significant clinical challenges. Photothermal tumor therapy has attracted considerable attention owing to its minimal invasiveness and high selectivity. However, key challenges have limited its widespread clinical use. Enhancing the tumor specificity of photosensitizers through targeting or localized activation holds potential for better outcomes with fewer adverse effects. Combinations with chemotherapies or immunotherapies also present avenues for improvement. In this review, we provide an overview of the most recent strategies aimed at overcoming the limitations of photothermal therapy (PTT), along with current research directions in the context of bone tumors, including (1) target strategies, (2) photothermal therapy combined with multiple therapies (immunotherapies, chemotherapies, and chemodynamic therapies, magnetic, and photodynamic therapies), and (3) bifunctional scaffolds for photothermal therapy and bone regeneration. We delve into the pros and cons of these combination methods and explore current research focal points. Lastly, we address the challenges and prospects of photothermal combination therapy.

Composite microgranular scaffolds with surface modifications for improved initial osteoblastic cell proliferation

Polyester-based granular scaffolds are a potent material for tissue engineering due to their porosity, controllable pore size, and potential to be molded into various shapes. Additionally, they can be produced as composite materials, e.g., mixed with osteoconductive β-tricalcium phosphate or hydroxyapatite. Such polymer-based composite materials often happen to be hydrophobic, which disrupts cell attachment and decreases cell growth on the scaffold, undermining its primary function. In this work, we propose the experimental comparison of three modification techniques for granular scaffolds to increase their hydrophilicity and cell attachment. Those techniques include atmospheric plasma treatment, polydopamine coating, and polynorepinephrine coating. Composite polymer/β-tricalcium phosphate granules have been produced in a solution-induced phase separation (SIPS) process using commercially available biomedical polymers: poly(lactic acid), poly(lactic-co-glycolic acid), and polycaprolactone. We used thermal assembly to prepare cylindrical scaffolds from composite microgranules. Atmospheric plasma treatment, polydopamine coating, and polynorepinephrine coating showed similar effects on polymer composites' hydrophilic and bioactive properties. All modifications significantly increased human osteosarcoma MG-63 cell adhesion and proliferation in vitro compared to cells cultured on unmodified materials. In the case of polycaprolactone/β-tricalcium phosphate scaffolds, modifications were the most necessary, as unmodified polycaprolactone-based material disrupted the cell attachment. Modified polylactide/β-tricalcium phosphate scaffold supported excellent cell growth and showed ultimate compressive strength exceeding this of human trabecular bone. This suggests that all investigated modification techniques can be used interchangeably for increasing wettability and cell attachment properties of various scaffolds for medical applications, especially those with high surface and volumetric porosity, like granular scaffolds.

Two Hawks with One Arrow: A Review on Bifunctional Scaffolds for Photothermal Therapy and Bone Regeneration

Despite the significant improvement in the survival rate of cancer patients, the total cure of bone cancer is still a knotty clinical challenge. Traditional surgical resectionof bone tumors is less than satisfactory, which inevitably results in bone defects and the inevitable residual tumor cells. For the purpose of realizing minimal invasiveness and local curative effects, photothermal therapy (PTT) under the irradiation of near-infrared light has made extensive progress in ablating tumors, and various photothermal therapeutic agents (PTAs) for the treatment of bone tumors have thus been reported in the past few years, has and have tended to focus on osteogenic bio-scaffolds modified with PTAs in order to break through the limitation that PTT lacks, osteogenic capacity. These so-called bifunctional scaffolds simultaneously ablate bone tumors and generate new tissues at the bone defects. This review summarizes the recent application progress of various bifunctional scaffolds and puts forward some practical constraints and future perspectives on bifunctional scaffolds for tumor therapy and bone regeneration: two hawks with one arrow.

On the Various Numerical Techniques for the Optimization of Bone Scaffold

As the application of bone scaffolds becomes more and more widespread, the requirements for the high performance of bone scaffolds are also increasing. The stiffness and porosity of porous structures can be adjusted as needed, making them good candidates for repairing damaged bone tissues. However, the development of porous bone structures is limited by traditional manufacturing methods. Today, the development of additive manufacturing technology has made it very convenient to manufacture bionic porous bone structures as needed. In the present paper, the current state-of-the-art optimization techniques for designing the scaffolds and the settings of different optimization methods are introduced. Additionally, various design methods for bone scaffolds are reviewed. Furthermore, the challenges in designing high performance bone scaffolds and the future developments of bone scaffolds are also presented.

TAZ promotes osteogenic differentiation of mesenchymal stem cells line C3H10T1/2, murine multi-lineage cells lines C2C12, and MEFs induced by BMP9

Bone morphogenetic protein 9 (BMP9), also named as growth differentiation factor 2 (GDF-2), is the strongest cytokine that promotes osteogenic differentiation in the BMP family, and has broad clinical application value. Nevertheless, the mechanism of BMP9 promotes osteogenic differentiation remain unclear. TAZ, a transcriptional co-activator, has great effects on cell proliferation, differentiation, and stem cell self-renewal. In this research, we investigated the effects of TAZ in BMP9-induced osteogenic differentiation of mesenchymal stem cell line C3H10T1/2 (MSCs) and murine multi-lineage cell lines C2C12 and MEFs (MMCs) and explored its possible mechanisms. This study has found that BMP9 induces the expression of TAZ and promotes its nuclear translocation. Meanwhile, our study found that Ad-TAZ and TM-25659, a TAZ agonist, can enhance the osteogenic differentiation of MSCs and MMCs induced by BMP9. Conversely, Ad-si-TAZ and verteporfin, an inhibitor of TAZ, have the contradictory effect. Likewise, the promotion of TAZ to the BMP9-induced ectopic bone formation in vivo was confirmed by the subcutaneous transplantation of MSCs in nude mice. Furthermore, we have detected that TAZ might increase the levels of the phosphorylation of Smad1/5/8, p38, ERK1/2, and JNK induced by BMP9. Additionally, we also found that TAZ increased the total protein level of β-catenin induced by BMP9. In summary, our results strongly indicated that TAZ will promote the osteogenic differentiation in MSCs and MMCs induced by BMP9 through multiple signal pathways.

Novel Approaches and Biomaterials for Bone Tissue Engineering: A Focus on Silk Fibroin

Bone tissue engineering (BTE) represents a multidisciplinary research field involving many aspects of biology, engineering, material science, clinical medicine and genetics to create biological substitutes to promote bone regeneration. The definition of the most appropriate biomaterials and structures for BTE is still a challenge for researchers, aiming at simultaneously combining different features such as tissue generation properties, biocompatibility, porosity and mechanical strength. In this scenario, among the biomaterials for BTE, silk fibroin represents a valuable option for the development of functional devices because of its unique biological properties and the multiple chances of processing. This review article aims at providing the reader with a general overview of the most recent progresses in bone tissue engineering in terms of approaches and materials with a special focus on silk fibroin and the related mechanisms involved in bone regeneration, and presenting interesting results obtained by different research groups, which assessed the great potential of this protein for bone tissue engineering.

Designing anisotropic porous bone scaffolds using a self-learning convolutional neural network model

The design of bionic bone scaffolds to mimic the behaviors of native bone tissue is crucial in clinical application, but such design is very challenging due to the complex behaviors of native bone tissues. In the present study, bionic bone scaffolds with the anisotropic mechanical properties similar to those of native bone tissues were successfully designed using a novel self-learning convolutional neural network (CNN) framework. The anisotropic mechanical property of bone was first calculated from the CT images of bone tissues. The CNN model constructed was trained and validated using the predictions from the heterogonous finite element (FE) models. The CNN model was then used to design the scaffold with the elasticity matrix matched to that of the replaced bone tissues. For the comparison, the bone scaffold was also designed using the conventional method. The results showed that the mechanical properties of scaffolds designed using the CNN model are closer to those of native bone tissues. In conclusion, the self-learning CNN framework can be used to design the anisotropic bone scaffolds and has a great potential in the clinical application.

Protein-inorganic hybrid porous scaffolds for bone tissue engineering

Porous scaffolds hold promise in the treatment of bone defects for bone tissue engineering due to their interconnected porous structure and suitable mechanical properties. Herein, LAPONITE® (LAP), which is able to promote osteogenic differentiation, was introduced into regenerated silk fibroin (RSF) porous scaffolds. Due to hydrogen bonding and electrostatic interactions between RSF and LAP, RSF/LAP 3D porous scaffolds were successfully prepared. The pore size, porosity, and mechanical properties of the RSF/LAP 3D porous scaffolds were modulated during the preparation process. Evaluation of the proliferation of bone marrow mesenchymal stem cells (BMSCs) on the RSF/LAP 3D porous scaffolds in vitro indicated that the addition of LAP improved the adhesion and proliferation of cells. Additionally, alkaline phosphatase activity and osteospecific gene expression analysis showed that the RSF/LAP 3D porous scaffolds enhanced the osteogenic differentiation of BMSCs compared to the pristine RSF porous scaffolds, especially with a higher LAP content. The subcutaneous implantation of the RSF/LAP 3D porous scaffolds in rats demonstrated good histocompatibility in vivo. Therefore, RSF/LAP 3D porous scaffolds with good biocompatibility and biodegradability have good application prospects in the field of bone tissue engineering.