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In connection with the increase in the number and severity of various types of bone tissue injuries received as a result of wounds during military operations in Ukraine, an important issue in orthopedics and traumatology is making informed decisions about the possibility of restoring the integrity and functions of bone tissue when using different types of composition, porosity and strength of apatite-biopolymer composites. The scientific direction of research is the development of principles and methods for making scientifically based decisions in the design and additive manufacturing of bone substitutes based on apatite-biopolymer composites with functional properties depending on the nature of the localization of the cavity bone defect and its size. A set of methods for analyzing images of bone tissue, taking into account its spatial structure, which are obtained by sensors of different physical nature, with the use of neural network models, development of methods of their design, optimization and training is proposed. The new knowledge obtained as a result of the project will become the necessary basis for making optimal decisions in practice for the introduction of the latest methods of treatment and prosthetics in trauma surgery, oncology, cranio-maxillofacial surgery, dentistry, taking into account the risks of biocompatibility of apatite-biopolymer composites. Software development of an intelligent decision support system will be used to design bone substitutes with controlled composition, structure, porosity and mechanical strength for the further selection of additive technology for its production from apatite-polymer composites, which will contribute to increasing the efficiency of treatment and prosthetics in orthopedics and traumatology. [ABSTRACT FROM AUTHOR]

Orthopedic implants have faced challenges in treating bone defects due to various factors, including inadequate osseointegration, oxidative stress, bacterial infection, immunological rejection, and poor individualized treatment. These challenges profoundly affect both the results of treatment and patients' daily lives. There is great promise for the layer-by-layer (LbL) assembly method in tissue engineering. The method primarily relies on electrostatic attraction and entails the consecutive deposition of electrolyte complexes with opposite charges onto a substrate, leading to the formation of homogeneous single layers that can be quickly deposited to produce nanolayer films. LbL has attracted considerable interest as a coating technology because of its ease of production, cost-effectiveness, and capability to apply diverse biomaterial coatings without compromising the primary bio-functional properties of the substrate materials. This review will look into the fundamentals and evolution of LbL in orthopedics, provide an analysis of the chemical strategy used to prepare bone implants with LbL and introduce the application of LbL bone implants in orthopedics over recent years. Among the many potential uses of LbL, such as the implementation of sustained-release and programmed drug delivery, which in turn promotes the osseointegration and the development of new blood vessels, as well as antibacterial, antioxidant, and other similar applications. In addition, we offer a thorough examination of cell behavior and biomaterial interaction to facilitate the advancement of next-generation LbL films for tissue engineering. [ABSTRACT FROM AUTHOR]

Abstract Orthopedic implants have faced challenges in treating bone defects due to various factors, including inadequate osseointegration, oxidative stress, bacterial infection, immunological rejection, and poor individualized treatment. These challenges profoundly affect both the results of treatment and patients' daily lives. There is great promise for the layer-by-layer (LbL) assembly method in tissue engineering. The method primarily relies on electrostatic attraction and entails the consecutive deposition of electrolyte complexes with opposite charges onto a substrate, leading to the formation of homogeneous single layers that can be quickly deposited to produce nanolayer films. LbL has attracted considerable interest as a coating technology because of its ease of production, cost-effectiveness, and capability to apply diverse biomaterial coatings without compromising the primary bio-functional properties of the substrate materials. This review will look into the fundamentals and evolution of LbL in orthopedics, provide an analysis of the chemical strategy used to prepare bone implants with LbL and introduce the application of LbL bone implants in orthopedics over recent years. Among the many potential uses of LbL, such as the implementation of sustained-release and programmed drug delivery, which in turn promotes the osseointegration and the development of new blood vessels, as well as antibacterial, antioxidant, and other similar applications. In addition, we offer a thorough examination of cell behavior and biomaterial interaction to facilitate the advancement of next-generation LbL films for tissue engineering.

Ying Yang,1– 3,* Bixia Zhou,1,2,* Min Li,4 Yishuai Sun,1,2 Xulei Jiang,1,2 Xinxin Zhou,1,2 Chengjun Hu,1,2 Dou Zhang,3 Hang Luo,3 Wuyuan Tan,1,2 Xinghua Yang,1,2 Shaorong Lei1,2 1Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University, Changsha, Hunan, People’s Republic of China; 3State Key Laboratory of Powder Metallurgy, Central South University, Changsha, Hunan, People’s Republic of China; 4Department of Oncology, Changsha Central Hospital, University of South China, Changsha, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shaorong Lei, Department of Plastic Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Tel +86 73189753014, Email leishaorong@csu.edu.cn Xinghua Yang, Department of Plastic Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Tel +86 73189753014, Email yxhua8805@sina.comPurpose: The treatment of craniofacial bone defects caused by trauma, tumors, and infectious and degenerative diseases is a significant issue in current clinical practice. Following the rapid development of bone tissue engineering (BTE) in the last decade, bioactive scaffolds coupled with multifunctional properties are in high demand with regard to effective therapy for bone defects. Herein, an innovative bone scaffold consisting of GO/Cu nanoderivatives and GelMA-based organic-inorganic hybrids was reported for repairing full-thickness calvarial bone defect.Methods: In this study, motivated by the versatile biological functions of nanomaterials and synthetic hydrogels, copper nanoparticle (CuNP)-decorated graphene oxide (GO) nanosheets (GO/Cu) were combined with methacrylated gelatin (GelMA)-based organic-inorganic hybrids to construct porous bone scaffolds that mimic the extracellular matrix (ECM) of bone tissues by photocrosslinking. The material characterizations, in vitro cytocompatibility, macrophage polarization and osteogenesis of the biohybrid hydrogel scaffolds were investigated, and two different animal models (BALB/c mice and SD rats) were established to further confirm the in vivo neovascularization, macrophage recruitment, biocompatibility, biosafety and bone regenerative potential.Results: We found that GO/Cu-functionalized GelMA/β-TCP hydrogel scaffolds exhibited evidently promoted osteogenic activities, M2 type macrophage polarization, increased secretion of anti-inflammatory factors and excellent cytocompatibility, with favorable surface characteristics and sustainable release of Cu2+. Additionally, improved neovascularization, macrophage recruitment and tissue integration were found in mice implanted with the bioactive hydrogels. More importantly, the observations of microCT reconstruction and histological analysis in a calvarial bone defect model in rats treated with GO/Cu-incorporated hydrogel scaffolds demonstrated significantly increased bone morphometric values and newly formed bone tissues, indicating accelerated bone healing.Conclusion: Taken together, this BTE-based bone repair strategy provides a promising and feasible method for constructing multifunctional GO/Cu nanocomposite-incorporated biohybrid hydrogel scaffolds with facilitated osteogenesis, angiogenesis and immunoregulation in one system, with the optimization of material properties and biosafety, it thereby demonstrates great application potential for correcting craniofacial bone defects in future clinical scenarios. Keywords: nanomaterials, hybrid hydrogel, bone scaffolds, craniofacial bone defects, bone regeneration

Abstract Bone defects pose significant challenges in healthcare, with over 2 million bone repair surgeries performed globally each year. As a burgeoning force in the field of bone tissue engineering, 3D printing offers novel solutions to traditional bone transplantation procedures. However, current 3D-printed bone scaffolds still face three critical challenges in material selection, printing methods, cellular self-organization and co-culture, significantly impeding their clinical application. In this comprehensive review, we delve into the performance criteria that ideal bone scaffolds should possess, with a particular focus on the three core challenges faced by 3D printing technology during clinical translation. We summarize the latest advancements in non-traditional materials and advanced printing techniques, emphasizing the importance of integrating organ-like technologies with bioprinting. This combined approach enables more precise simulation of natural tissue structure and function. Our aim in writing this review is to propose effective strategies to address these challenges and promote the clinical translation of 3D-printed scaffolds for bone defect treatment. Graphical abstract

Using bone regeneration scaffolds to repair craniomaxillofacial bone defects is a promising strategy. However, most bone regeneration scaffolds still exist some issues such as a lack of barrier structure, inability to precisely match bone defects, and necessity to incorporate biological components to enhance efficacy. Herein, inspired by a periosteum‐bone complex, a class of multifunctional hierarchical porous poly(lactic‐co‐glycolic acid)/baicalein scaffolds is facilely prepared by the union of personalized negative mold technique and phase separation strategy and demonstrated to precisely fit intricate bone defect cavity. The dense up‐surface of the scaffold can prevent soft tissue cell penetration, while the loose bottom‐surface can promote protein adsorption, cell adhesion, and cell infiltration. The interior macropores of the scaffold and the loaded baicalein can synergistically promote cell differentiation, angiogenesis, and osteogenesis. These findings can open an appealing avenue for the development of personalized multifunctional hierarchical materials for bone repair. [ABSTRACT FROM AUTHOR]

Bone defects pose significant challenges in healthcare, with over 2 million bone repair surgeries performed globally each year. As a burgeoning force in the field of bone tissue engineering, 3D printing offers novel solutions to traditional bone transplantation procedures. However, current 3D-printed bone scaffolds still face three critical challenges in material selection, printing methods, cellular self-organization and co-culture, significantly impeding their clinical application. In this comprehensive review, we delve into the performance criteria that ideal bone scaffolds should possess, with a particular focus on the three core challenges faced by 3D printing technology during clinical translation. We summarize the latest advancements in non-traditional materials and advanced printing techniques, emphasizing the importance of integrating organ-like technologies with bioprinting. This combined approach enables more precise simulation of natural tissue structure and function. Our aim in writing this review is to propose effective strategies to address these challenges and promote the clinical translation of 3D-printed scaffolds for bone defect treatment. [ABSTRACT FROM AUTHOR]

In this work, a transient three-dimensional finite element model (FEM) of the laser micro spot welding (LMSW) process was established considering three heat source approaches: static heat source model (SHSM), dynamic heat source model (DHSM), and double dynamic heat source model (DDHSM). Each model was computed according to the aspect ratio of spot width to depth and the absorptance of the material. The numerical simulation computed the conduction-to-keyhole transition using an AISI 302 stainless steel alloy. Our results showed that the DDHSM results were based on the experiments reported in the literature. The conduction-to-keyhole transition for the SHSM and DHSM was observed to depend on the average laser power, having a constant keyhole aperture at 75 ms exposure time and 220 W average laser power. Additionally, the DDHSM configuration gave a conduction-to-keyhole transition with a similar constant aperture at 75 and 50 ms of exposure time for 200 and 220 W average laser power, respectively. The percentage errors for the DDHSM were 8%, 15%, 17%, and 20% for the penetration depth, top, middle, and bottom width, respectively. [ABSTRACT FROM AUTHOR]

Magnesium silicate ceramics are promising materials for bone tissue regeneration and can be prepared through 3D printing of magnesium oxide/silica (MgO/SiO2) cement pastes followed by calcination. Despite the growing interest in these formulations, additive manufacturing technology has only recently been explored for these cements, and the effects of admixtures and additives on such printing inks remain largely unexplored. In this study, we prepared various MgO/SiO2 cement formulations with differing amounts of sodium orthophosphate, a setting retarder, and cellulose ethers, used as rheo-modifiers. The samples' setting properties were investigated, and printing parameters were properly adjusted. The most promising formulations were then 3D printed and calcined to obtain forsterite bioceramics, which were further characterized using confocal Raman microscopy, scanning electron microscopy, atomic force microscopy, gas porosimetry, and compressive strength tests. Our results revealed that the cellulose derivatives influence the printability of the MgO/SiO2 formulations without affecting the hardening time, which can be adjusted by the addition of sodium phosphate. The use of fine-tuned formulations allowed for the preparation of 3D-printed forsterite bioceramics, potentially suitable for biological applications as cancellous bone scaffolds. [ABSTRACT FROM AUTHOR]

Bone has the capacity to regenerate itself for relatively small defects; however, this regenerative capacity is diminished in critical-size bone defects. The development of synthetic materials has risen as a distinct strategy to address this challenge. Effective synthetic materials to have emerged in recent years are bioceramic implants, which are biocompatible and highly bioactive. Yet nothing suitable for the repair of large bone defects has made the transition from laboratory to clinic. The clinical success of bioceramics has been shown to depend not only on the scaffold's intrinsic material properties but also on its internal porous geometry. This study aimed to systematically explore the implications of varying channel size, shape, and curvature in tissue scaffolds on in vivo bone regeneration outcomes. 3D printed bioceramic scaffolds with varying channel sizes (0.3 mm to 1.5 mm), shapes (circular vs rectangular), and curvatures (concave vs convex) were implanted in rabbit femoral defects for 8 weeks, followed by histological evaluation. We demonstrated that circular channel sizes of around 0.9 mm diameter significantly enhanced bone formation, compared to channel with diameters of 0.3 mm and 1.5 mm. Interestingly, varying channel shapes (rectangular vs circular) had no significant effect on the volume of newly formed bone. Furthermore, the present study systematically demonstrated the beneficial effect of concave surfaces on bone tissue growth in vivo , reinforcing previous in silico and in vitro findings. This study demonstrates that optimizing architectural configurations within ceramic scaffolds is crucial in enhancing bone regeneration outcomes. Despite the explosion of work on developing synthetic scaffolds to repair bone defects, the amount of new bone formed by scaffolds in vivo remains suboptimal. Recent studies have illuminated the pivotal role of scaffolds' internal architecture in osteogenesis. However, these investigations have mostly remained confined to in silico and in vitro experiments. Among the in vivo studies conducted, there has been a lack of systematic analysis of individual architectural features. Herein, we utilized bioceramic 3D printing to conduct a systematic exploration of the effects of channel size, shape, and curvature on bone formation in vivo. Our results demonstrate the significant influence of channel size and curvature on in vivo outcomes. These findings provide invaluable insights into the design of more effective bone scaffolds. [Display omitted] [ABSTRACT FROM AUTHOR]

Processing-structure-property relationships of 3D-printed multi-scale porous ceramics were investigated. Direct ink writing (DIW) of oil-templated colloidal pastes produced hierarchically porous beta-tricalcium phosphate (TCP) scaffolds. Print architecture and microporosity within filaments were varied, mimicking bone structure. The scaffolds exhibited 60–70 % porosity with interconnected macropores 300–700 μm and microporosity within the filaments at the 10 micron-scale. Varying surfactant and oil concentrations created two micro-pore morphologies – bubble-like pores (emulsion) and channel-like pores (capillary suspension). Emulsion scaffolds were stronger, stiffer and more reliable than capillary suspension scaffolds under both compression and bending. Reducing nozzle diameter and inter-filament distance improved strength and stiffness, at lower density. Immersed at physiological pH, the hierarchically porous TCP scaffolds' strength and modulus degraded at a moderate rate suitable for bone tissue engineering (BTE). Mechanical behavior can be controlled by manipulating process parameters which influence the material's structure. These properties were comparable with trabecular bone, promising for BTE.

Abstract Using bone regeneration scaffolds to repair craniomaxillofacial bone defects is a promising strategy. However, most bone regeneration scaffolds still exist some issues such as a lack of barrier structure, inability to precisely match bone defects, and necessity to incorporate biological components to enhance efficacy. Herein, inspired by a periosteum‐bone complex, a class of multifunctional hierarchical porous poly(lactic‐co‐glycolic acid)/baicalein scaffolds is facilely prepared by the union of personalized negative mold technique and phase separation strategy and demonstrated to precisely fit intricate bone defect cavity. The dense up‐surface of the scaffold can prevent soft tissue cell penetration, while the loose bottom‐surface can promote protein adsorption, cell adhesion, and cell infiltration. The interior macropores of the scaffold and the loaded baicalein can synergistically promote cell differentiation, angiogenesis, and osteogenesis. These findings can open an appealing avenue for the development of personalized multifunctional hierarchical materials for bone repair.

Three-dimensional porous scaffolds are substitutes for traditional bone grafts in bone tissue engineering (BTE) applications to restore and treat bone injuries and defects. The use of computational modelling is gaining momentum to predict the parameters involved in tissue healing and cell seeding procedures in perfusion bioreactors to reach the final goal of optimal bone tissue growth. Computational modelling based on finite element method (FEM) and computational fluid dynamics (CFD) are two standard methodologies utilised to investigate the equivalent mechanical properties of tissue scaffolds, as well as the flow characteristics inside the scaffolds, respectively. The success of a computational modelling simulation hinges on the selection of a relevant mathematical model with proper initial and boundary conditions. This review paper aims to provide insights to researchers regarding the selection of appropriate finite element (FE) models for different materials and CFD models for different flow regimes inside perfusion bioreactors. Thus, these FEM/CFD computational models may help to create efficient designs of scaffolds by predicting their structural properties and their haemodynamic responses prior to in vitro and in vivo tissue engineering (TE) applications. [ABSTRACT FROM AUTHOR]

The application of 3D printing to calcium phosphates has opened unprecedented possibilities for the fabrication of personalized bone grafts. However, their biocompatibility and bioactivity are counterbalanced by their high brittleness. In this work we aim at overcoming this problem by developing a self-hardening ink containing reactive ceramic particles in a polycaprolactone solution instead of the traditional approach that use hydrogels as binders. The presence of polycaprolactone preserved the printability of the ink and was compatible with the hydrolysis-based hardening process, despite the absence of water in the ink and its hydrophobicity. The microstructure evolved from a continuous polymeric phase with loose ceramic particles to a continuous network of hydroxyapatite nanocrystals intertwined with the polymer, in a configuration radically different from the polymer/ceramic composites obtained by fused deposition modelling. This resulted in the evolution from a ductile behavior, dominated by the polymer, to a stiffer behavior as the ceramic phase reacted. The polycaprolactone binder provides two highly relevant benefits compared to hydrogel-based inks. First, the handleability and elasticity of the as-printed scaffolds, together with the proven possibility of eliminating the solvent, opens the door to implanting the scaffolds freshly printed once lyophilized, while in a ductile state, and the hardening process to take place inside the body, as in the case of calcium phosphate cements. Second, even with a hydroxyapatite content of more than 92 wt.%, the flexural strength and toughness of the scaffolds after hardening are twice and five times those of the all-ceramic scaffolds obtained with the hydrogel-based inks, respectively. Overcoming the brittleness of ceramic scaffolds would extend the applicability of synthetic bone grafts to high load-bearing situations. In this work we developed a 3D printing ink by replacing the conventional hydrogel binder with a water-free polycaprolactone solution. The presence of polycaprolactone not only enhanced significantly the strength and toughness of the scaffolds while keeping the proportion of bioactive ceramic phase larger than 90 wt.%, but it also conferred flexibility and manipulability to the as-printed scaffolds. Since they are able to harden upon contact with water under physiological conditions, this opens up the possibility of implanting them immediately after printing, while they are still in a ductile state, with clear advantages for fixation and press-fit in the bone defect. [Display omitted] [ABSTRACT FROM AUTHOR]

Repair of large bone defects remains challenge for orthopedic clinical treatment. Porous titanium alloys have been widely fabricated by the additive manufacturing, which possess the elastic modulus close to that of human cortical bone, good osteoconductivity and osteointegration. However, insufficient bone regeneration and vascularization inside the porous titanium scaffolds severely limit their capability for repair of large-size bone defects. Therefore, it is crucially important to improve the osteogenic function and vascularization of the titanium scaffolds. Herein, methacrylated gelatin (GelMA) were incorporated with the porous Ti-24Nb-4Zr-8Sn (Ti2448) scaffolds prepared by the electron beam melting (EBM) method (Ti2448-GelMA). Besides, the deferoxamine (DFO) as an angiogenic agent was doped into the Ti2448-GelMA scaffold (Ti2448-GelMA/DFO), in order to promote vascularization. The results indicate that GelMA can fully infiltrate into the pores of Ti2448 scaffolds with porous cross-linked network (average pore size: 120.2 ± 25.1 μm). Ti2448-GelMA scaffolds facilitated the differentiation of MC3T3-E1 cells by promoting the ALP expression and mineralization, with the amount of calcium contents ∼2.5 times at day 14, compared with the Ti2448 scaffolds. Impressively, the number of vascular meshes for the Ti2448-GelMA/DFO group (∼7.2/mm2) was significantly higher than the control group (∼5.3/mm2) after cultivation for 9 h, demonstrating the excellent angiogenesis ability. The Ti2448-GelMA/DFO scaffolds also exhibited sustained release of DFO, with a cumulative release of 82.3% after 28 days. Therefore, Ti2448-GelMA/DFO scaffolds likely provide a new strategy to improve the osteogenesis and angiogenesis for repair of large bone defects.

The present study investigated the influence of pore size of strut-based Diamond and surface-based Gyroid structures for their suitability as medical implants. Samples were made additively from laser powder bed fusion process with a relative density of 0.3 and pore sizes ranging from 300 to 1300 μm. They were subsequently examined for their manufacturability and mechanical properties. In addition, non-Newtonian computational fluid dynamics and discrete phase models were conducted to assess pressure drop and cell seeding efficiency. The results showed that both Diamond and Gyroid had higher as-built densities with smaller pore sizes. However, Gyroid demonstrated better manufacturability as its relative density was closer to the as-designed one. In addition, based on mechanical testing, the elastic modulus was largely unaffected by pore size, but post-yielding behaviors differed, especially in Diamond. High mechanical sensitivity in Diamond could be explained partly by Finite Element simulations, which revealed stress localization in Diamond and more uniform stress distribution in Gyroid. Furthermore, we defined the product of the normalized specific surface, normalized pressure drop, and cell seeding efficiency as the indicator of an optimal pore size, in which this factor identified an optimal pore size of approximately 500 μm for both Diamond and Gyroid. Besides, based on such criterion, Gyroid exhibited greater applicability as bone scaffolds. In summary, this study provides comprehensive assessment of the effect of pore size and demonstrates the efficient estimation of an in-silico framework for evaluating lattice structures as medical implants, which could be applied to other lattice architectures.

A large amount of research in orthopedic and maxillofacial domains is dedicated to the development of bioactive 3D scaffolds. This includes the search for highly resorbable compounds, capable of triggering cell activity and favoring bone regeneration. Considering the phosphocalcic nature of bone mineral, these aims can be achieved by the choice of amorphous calcium phosphates (ACPs). Because of their metastable property, these compounds are however to-date seldom used in bulk form. In this work, we used a non-conventional "cold sintering" approach based on ultrafast low-pressure RT compaction to successfully consolidate ACP pellets while preserving their amorphous nature (XRD). Complementary spectroscopic analyses (FTIR, Raman, solid-state NMR) and thermal analyses showed that the starting powder underwent slight physicochemical modifications, with a partial loss of water and local change in the HPO42- ion environment. The creation of an open porous structure, which is especially adapted for non-load bearing bone defects, was also observed. Moreover, the pellets obtained exhibited sufficient mechanical resistance allowing for manipulation, surgical placement and eventual cutting/reshaping in the operation room. Three-dimensional porous scaffolds of cold-sintered reactive ACP, fabricated through this low-energy, ultrafast consolidation process, show promise toward the development of highly bioactive and tailorable biomaterials for bone regeneration, also permitting combinations with various thermosensitive drugs. [ABSTRACT FROM AUTHOR]

Osseous disease accounts for over half of chronic pathologies, but there is a limited supply of autografts, the gold standard; hence, there is a demand for new synthetic biomaterials. Herein, we present the use of a promising, new dairy-derived biomaterial: whey protein isolate (WPI) in the form of hydrogels, modified with the addition of different concentrations of the biotechnologically produced protein-like polymeric substance poly-γ-glutamic acid (γ-PGA) as a potential scaffold for tissue regeneration. Raman spectroscopic analysis demonstrated the successful creation of WPI-γ-PGA hydrogels. A cytotoxicity assessment using preosteoblastic cells demonstrated that the hydrogels were noncytotoxic and supported cell proliferation from day 3 to 14. All γ-PGA-containing scaffold compositions strongly promoted cell attachment and the formation of dense interconnected cell layers. Cell viability was significantly increased on γ-PGA-containing scaffolds on day 14 compared to WPI control scaffolds. Significantly, the cells showed markers of osteogenic differentiation; they synthesised increasing amounts of collagen over time, and cells showed significantly enhanced alkaline phosphatase activity at day 7 and higher levels of calcium for matrix mineralization at days 14 and 21 on the γ-PGA-containing scaffolds. These results demonstrated the potential of WPI-γ-PGA hydrogels as scaffolds for bone regeneration. [ABSTRACT FROM AUTHOR]

Today, hydroxyapatite (HA)-based composite scaffolds are widely studied, but there is a lack of a doping method that can simultaneously improve the mechanical strength, degradation rate, and bioactivity of HA scaffolds. In this paper, the amorphous magnesium silicate (MS) with a low melting point is selected as the doping phase of HA. The hydroxyapatite/magnesium silicate composite was fabricated using photocuring technology. In addition, at high temperatures, ionic substitution can occur between the magnesium silicate glass phase and the HA lattice. Therefore, a new phase with a pinning effect can be obtained at the grain boundary and the magnesium silicate can further improve the biocompatibility of HA scaffolds. In the sintering process, the magnesium silicate was melted to a liquid state, and then the sintering temperature of the scaffold was reduced for grain refinement. The morphological analysis shows that MS doping is an important factor for grain refinement, which has been reduced from 12 μm to 6 μm. Furthermore, the formation of new diopside and whitlockite phases with a pinning effect has been observed at the grain boundaries. Specifically, the compressive stress of the composite scaffold is increased by 59.15% compared to the pure HA scaffold. However, the soaking and cell experimental findings show that the composite scaffold has a better degradation rate, cell activity, and bone induction. Finally, this study found that a composite scaffold with improved mechanical strength, degradation performance, and biocompatibility can be obtained with the addition of magnesium silicate as the doping phase of HA with 30 wt% of. [ABSTRACT FROM AUTHOR]

Biomimetic metallic biomaterials prepared for bone scaffolds have drawn more and more attention in recent years. However, the topological design of scaffolds is critical to cater to multi-physical requirements for efficient cell seeding and bone regeneration, yet remains a big scientific challenge owing to the coupling of mechanical and mass-transport properties in conventional scaffolds that lead to poor control towards favorable modulus and permeability combinations. Herein, inspired by the microstructure of natural sea urchin spines, biomimetic scaffolds constructed by pentamode metamaterials (PMs) with hierarchical structural tunability were additively manufactured via selective laser melting. The mechanical and mass-transport properties of scaffolds could be simultaneously tuned by the graded porosity (B/T ratio) and the tapering level (D/d ratio). Compared with traditional metallic biomaterials, our biomimetic PM scaffolds possess graded pore distribution, suitable strength, and significant improvements to cell seeding efficiency, permeability, and impact-tolerant capacity, and they also promote in vivo osteogenesis, indicating promising application for cell proliferation and bone regeneration using a structural innovation.

Magnesium silicate ceramics are promising materials for bone tissue regeneration and can be prepared through 3D printing of magnesium oxide/silica (MgO/SiO2) cement pastes followed by calcination. Despite the growing interest in these formulations, additive manufacturing technology has only recently been explored for these cements, and the effects of admixtures and additives on such printing inks remain largely unexplored. In this study, we prepared various MgO/SiO2 cement formulations with differing amounts of sodium orthophosphate, a setting retarder, and cellulose ethers, used as rheo-modifiers. The samples’ setting properties were investigated, and printing parameters were properly adjusted. The most promising formulations were then 3D printed and calcined to obtain forsterite bioceramics, which were further characterized using confocal Raman microscopy, scanning electron microscopy, atomic force microscopy, gas porosimetry, and compressive strength tests. Our results revealed that the cellulose derivatives influence the printability of the MgO/SiO2 formulations without affecting the hardening time, which can be adjusted by the addition of sodium phosphate. The use of fine-tuned formulations allowed for the preparation of 3D-printed forsterite bioceramics, potentially suitable for biological applications as cancellous bone scaffolds.

Modern orthopaedic implants use lattice structures that act as 3D scaffolds to enhance bone growth into and around implants. Stochastic scaffolds are of particular interest as they mimic the architecture of trabecular bone and can combine isotropic properties and adjustable structure. The existing research mainly concentrates on controlling the mechanical and biological performance of periodic lattices by adjusting pore size and shape. Still, less is known on how we can control the performance of stochastic lattices through their design parameters: nodal connectivity, strut density and strut thickness. To elucidate this, four lattice structures were evaluated with varied strut densities and connectivity, hence different local geometry and mechanical properties: low apparent modulus, high apparent modulus, and two with near-identical modulus. Pre-osteoblast murine cells were seeded on scaffolds and cultured in vitro for 28 days. Cell adhesion, proliferation and differentiation were evaluated. Additionally, the expression levels of key osteogenic biomarkers were used to assess the effect of each design parameter on the quality of newly formed tissue. The main finding was that increasing connectivity increased the rate of osteoblast maturation, tissue formation and mineralisation. In detail, doubling the connectivity, over fixed strut density, increased collagen type-I by 140%, increased osteopontin by 130% and osteocalcin by 110%. This was attributed to the increased number of acute angles formed by the numerous connected struts, which facilitated the organization of cells and accelerated the cell cycle. Overall, increasing connectivity and adjusting strut density is a novel technique to design stochastic structures which combine a broad range of biomimetic properties and rapid ossification.

Bone repair is a major challenge in regenerative medicine, e.g. for large defects. There is a need for bioactive, highly percolating bone substitutes favoring bone ingrowth and tissue healing. Here, a modern 3D printing approach (VAT photopolymerization) was exploited to fabricate hydroxyapatite (HA) scaffolds with a Gyroid-"Triply periodic minimal surface" (TPMS) porous structure (65% porosity, 90.5% HA densification) inspired from trabecular bone. Percolation and absorption capacities were analyzed in gaseous and liquid conditions. Mechanical properties relevant to guided bone regeneration in non-load bearing sites, as for maxillofacial contour reconstruction, were evidenced from 3-point bending tests and macrospherical indentation. Scaffolds were implanted in a clinically-relevant large animal model (sheep femur), over 6 months, enabling thorough analyses at short (4 weeks) and long (26 weeks) time points. In vivo performances were systematically compared to the bovine bone-derived Bio-OssⓇ standard. The local tissue response was examined thoroughly by semi-quantitative histopathology. Results demonstrated the absence of toxicity. Bone healing was assessed by bone dynamics analysis through epifluorescence using various fluorochromes and quantitative histomorphometry. Performant bone regeneration was evidenced with similar overall performances to the control, although the Gyroid biomaterial slightly outperformed Bio-OssⓇ at early healing time in terms of osteointegration and appositional mineralization. This work is considered a pilot study on the in vivo evaluation of TPMS-based 3D porous scaffolds in a large animal model, for an extended period of time, and in comparison to a clinical standard. Our results confirm the relevance of such scaffolds for bone regeneration in view of clinical practice. Bone repair, e.g. for large bone defects or patients with defective vascularization is still a major challenge. Highly percolating TPMS porous structures have recently emerged, but no in vivo data were reported on a large animal model of clinical relevance and comparing to an international standard. Here, we fabricated TPMS scaffolds of HA, determined their chemical, percolation and mechanical features, and ran an in-depth pilot study in the sheep with a systematic comparison to the Bio-OssⓇ reference. Our results clearly show the high bone-forming capability of such scaffolds, with outcomes even better than Bio-OssⓇ at short implantation time. This preclinical work provides quantitative data validating the relevance of such TMPS porous scaffolds for bone regeneration in view of clinical evaluation. [Display omitted] [ABSTRACT FROM AUTHOR]

Whey protein isolate (WPI) hydrogels are attractive biomaterials for application in bone repair and regeneration. However, their main limitation is low mechanical strength. Therefore, to improve these properties, the incorporation of ceramic phases into hydrogel matrices is currently being performed. In this study, novel whey protein isolate/calcium silicate (WPI/CaSiO3) hydrogel biomaterials were prepared with varying concentrations of a ceramic phase (CaSiO3). The aim of this study was to investigate the effect of the introduction of CaSiO3 to a WPI hydrogel matrix on its physicochemical, mechanical, and biological properties. Our Fourier Transform Infrared Spectroscopy results showed that CaSiO3 was successfully incorporated into the WPI hydrogel matrix to create composite biomaterials. Swelling tests indicated that the addition of 5% (w/v) CaSiO3 caused greater swelling compared to biomaterials without CaSiO3 and ultimate compressive strength and strain at break. Cell culture experiments demonstrated that WPI hydrogel biomaterials enriched with CaSiO3 demonstrated superior cytocompatibility in vitro compared to the control hydrogel biomaterials without CaSiO3. Thus, this study revealed that the addition of CaSiO3 to WPI-based hydrogel biomaterials renders them more promising for bone tissue engineering applications. [ABSTRACT FROM AUTHOR]

Critical-size bone defects of complex geometries are challenging to repair, making current approaches less satisfactory. Although calcium silicate (CaS) scaffolds prepared using 3D printing can be promising, these scaffolds are commonly treated with harsh conditions to reinforce their strength, significantly affecting the activity of biomolecules in the scaffolds. In this study, we developed a novel CaS biomaterial ink that did not require harsh post-treatments. It is shown that the printability was significantly improved using polyethylene glycol (PEG) and pluronic F-127 (PF), and the scaffolds showed excellent shape fidelity after printing. Moreover, the scaffolds demonstrated compatible mechanical strength with trabecular bone (∼7.07 MPa vs. 0.6 ∼ 16.8 MPa), and adding teriparatide (TP) in scaffolds could further improve the scaffold's potential for bone tissue engineering. [Display omitted] [ABSTRACT FROM AUTHOR]

Bioactive glasses (BGs) are especially useful materials in soft and bone tissue engineering and even in dentistry. They can be the solution to many medical problems, and they have a huge role in the healing processes of bone fractures. Interestingly, they can also promote skin regeneration and wound healing. Bioactive glasses are able to attach to the bone tissues and form an apatite layer which further initiates the biomineralization process. The formed intermediate apatite layer makes a connection between the hard tissue and the bioactive glass material which results in faster healing without any complications or side effects. This review paper summarizes the most recent advancement in the preparation of diverse types of BGs, such as silicate-, borate- and phosphate-based bioactive glasses. We discuss their physical, chemical, and mechanical properties detailing how they affect their biological performances. In order to get a deeper insight into the state-of-the-art in this area, we also consider their medical applications, such as bone regeneration, wound care, and dental/bone implant coatings. [ABSTRACT FROM AUTHOR]

Objective To evaluate the osteogenic effects of using a 3D-printed bredigite(BRT) bone scaffold on the Onlay graft in rats. Methods BRT scaffold material was fabricated by 3D printing technology as the experimental group, β-tricalcium phosphate(β-TCP) bone scaffolds were used as the control group. The scaffolds were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), mechanical test and in vitro degradation test. An animal model of Onlay graft in SD rats was established. According to the different grafts, the animal model was divided into autogenous bone transplantation group (Auto Group), β- TCP group and BRT group. At 12 weeks after the operation, the target line was obtained for gross observation, micro CT scanning and analysis, and HE staining histological analysis. Results BRT scaffolds have distinctive surface topographywith relatively uniformly sized pores in SEM imaging. A higher mechanical strength and degradation rate was obtained with BRT scaffolds（46.80 ± 3.44) MPa, compared to β-TCP scaffolds（11.29 ± 1.30) MPa (P

Given the pressing clinical need, the market for artificial bone scaffolds in orthopedics is growing at a rapid rate. In the past, ZrO 2 -based biomaterials intended for implantation were dense and 'bio-inert'. Material scientists have now shifted toward the design of deliberately porous and 'bioactive' ZrO 2 -based biomaterials that integrate with human cells and tissues. In this study, we designed and prepared porous and bioactive ZrO 2 –SiO 2 nanocrystalline ceramics. The phase composition, microstructure, pore formation mechanism, and ion release behaviors of the ceramics were explored. The ceramics showed a hierarchical porosity, consisting of connected macropores (∼100 μm or larger) and micropores (∼1 μm). The spherical macropores were formed by a pore-forming agent method, and the irregular micropores were formed because of incomplete densification. The bioactive dopants (Ca and Sr) acted as a destabilizer of tetragonal ZrO 2. Ca, Si, and Sr ions continuously released from the surface of the samples, providing good bioactivity for the ceramics. The porous and bioactive ceramics show great potential to be used as artificial bone scaffolds. [ABSTRACT FROM AUTHOR]

Population ageing and various diseases have increased the demand for bone grafts in recent decades. Bone tissue engineering (BTE) using a three-dimensional (3D) scaffold helps to create a suitable microenvironment for cell proliferation and regeneration of damaged tissues or organs. The 3D printing technique is a beneficial tool in BTE scaffold fabrication with appropriate features such as spatial control of microarchitecture and scaffold composition, high efficiency, and high precision. Various biomaterials could be used in BTE applications. PCL, as a thermoplastic and linear aliphatic polyester, is one of the most widely used polymers in bone scaffold fabrication. High biocompatibility, low cost, easy processing, non-carcinogenicity, low immunogenicity, and a slow degradation rate make this semi-crystalline polymer suitable for use in load-bearing bones. Combining PCL with other biomaterials, drugs, growth factors, and cells has improved its properties and helped heal bone lesions. The integration of PCL composites with the new 3D printing method has made it a promising approach for the effective treatment of bone injuries. The purpose of this review is give a comprehensive overview of the role of printed PCL composite scaffolds in bone repair and the path ahead to enter the clinic. This study will investigate the types of 3D printing methods for making PCL composites and the optimal compounds for making PCL composites to accelerate bone healing.

The application of additive manufacturing in the field of biomedical medical research is being widely explored, in the development of bone scaffolds with different architectures and desired properties. Robocasting, an extrusion-based additive manufacturing technique that can print a wide range of materials at a relatively lower cost has been adopted in this study. The 3D structure was realized by robocasting of hydroxyapatite (HA) incorporated with different loading percentages (0.5, 1, and 2 wt%) of multiwalled carbon nanotubes (MWCNTs). Carboxymethyl cellulose (CMC) is used as a binder for the development of ceramic slurries with desired viscoelastic properties. Microwave sintering of the developed scaffold structures in the argon (Ar) atmosphere was performed at different sintering temperatures, with a 5 min soaking time, and 3 LPM Ar flow rate. FESEM/EDS imaging and Raman spectroscopy analysis confirmed the retention of incorporated MWCNTs post-sintering. With an increase in sintering temperature, physical properties of the developed scaffold structures such as density and shrinkage were observed to increase whereas porosity was reduced. The better compressive strength was observed in samples sintered at 1100 °C. And a maximum compressive strength of 21.86 MPa was recorded for 0.5HAIF100 scaffold structures in comparison to other reported groups. The in vitro cell studies confirmed that the adopted percentages of MWCNTs were biocompatible and also capable of promoting osteogenic differentiation. The developed scaffolds also remained stable for about 28 days without undergoing degradation. [ABSTRACT FROM AUTHOR]

Bacterial infection associated with bone grafts is one of the major challenges that can lead to implant failure. Treatment of these infections is a costly endeavor; therefore, an ideal bone scaffold should merge both biocompatibility and antibacterial activity. Antibiotic-impregnated scaffolds may prevent bacterial colonization but exacerbate the global antibiotic resistance problem. Recent approaches combined scaffolds with metal ions that have antimicrobial properties. In our study, a unique strontium/zinc (Sr/Zn) co-doped nanohydroxyapatite (nHAp) and Poly (lactic-co-glycolic acid) -(PLGA) composite scaffold was fabricated using a chemical precipitation method with different ratios of Sr/Zn ions (1%, 2.5%, and 4%). The scaffolds' antibacterial activity against Staphylococcus aureus were evaluated by counting bacterial colony-forming unit (CFU) numbers after direct contact with the scaffolds. The results showed a dose-dependent reduction in CFU numbers as the Zn concentration increased, with 4% Zn showing the best antibacterial properties of all the Zn-containing scaffolds. PLGA incorporation in Sr/Zn-nHAp did not affect the Zn antibacterial activity and the 4% Sr/Zn-nHAp-PLGA scaffold showed a 99.7% bacterial growth inhibition. MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cell viability assay showed that Sr/Zn co-doping supported osteoblast cell proliferation with no apparent cytotoxicity and the highest doping percentage in the 4% Sr/Zn-nHAp-PLGA was found to be ideal for cell growth. In conclusion, these findings demonstrate the potential for a 4% Sr/Zn-nHAp-PLGA scaffold with enhanced antibacterial activity and cytocompatibility as a suitable candidate for bone regeneration. [ABSTRACT FROM AUTHOR]

During extrusion printing of pasty biomaterials, internal geometries are mainly adjusted by positioning of straightly deposited strands which does not allow realization of spatially adaptable density gradients in x -, y - and z -direction for anisotropic scaffolds or anatomically shaped constructs. Herein, an alternative concept for printing patterns based on sinusoidal curves was evaluated using a clinically approved calcium phosphate cement (CPC). Infill density in scaffolds was adjusted by varying wavelength and amplitude of a sinus curve. Both wavelength and amplitude factors were defined by multitudes of the applied nozzle diameter. For CPC as a biomaterial ink in bone application, porosity, mechanical stiffness and biological response by seeded immortalized human mesenchymal stem cells – adhesion and pore bridging behavior – were investigated. The internal structure of a xyz -gradient scaffold was proven via X-ray based micro computed tomography (µCT). Silicone was used as a model material to investigate the impact of printing velocity and strand distance on the shape fidelity of the sinus pattern for soft matter printing. The impact of different sinus patterns on mechanical properties was assessed. Density and mechanical properties of CPC scaffolds were successfully adjusted without an adverse effect on adhesion and cell number development. In a proof-of-concept experiment, a sinus-adjusted density gradient in an anatomically shaped construct (human vertebral body) defined via clinical computed tomography (CT) data was demonstrated. This fills a technological gap for extrusion-based printing of freely adjustable, continuously guidable infill density gradients in all spatial directions. 3D extrusion printing of biomaterials allows the generation of anatomically shaped, patient-specific implants or tissue engineering scaffolds. The density of such a structure is typically adjusted by the strand-to-strand distance of parallel, straight-meandered strands in each deposited layer. By printing in a sinusoidal pattern, design of density gradients is possible with a free, spatial resolution in x-, y- and z-direction. We demonstrated that porosity and mechanical properties can be freely adapted in this way without an adverse effect on cell adhesion. With the example of a CT dataset of a human spine, the anisotropic pattern of a vertebral body was resembled by this printing technique that can be translated to various patterns, materials and application. [Display omitted] [ABSTRACT FROM AUTHOR]

In this work, composite filaments in the form of sticks and 3D-printed scaffolds were investigated as a future component of an osteochondral implant. The first part of the work focused on the development of a filament modified with bioglass (BG) and Zn-doped BG obtained by injection molding. The main outcome was the manufacture of bioactive, strong, and flexible filament sticks of the required length, diameter, and properties. Then, sticks were used for scaffold production. We investigated the effect of bioglass addition on the samples mechanical and biological properties. The samples were analyzed by scanning electron microscopy, optical microscopy, infrared spectroscopy, and microtomography. The effect of bioglass addition on changes in the SBF mineralization process and cell morphology was evaluated. The presence of a spatial microstructure within the scaffolds affects their mechanical properties by reducing them. The tensile strength of the scaffolds compared to filaments was lower by 58–61%. In vitro mineralization experiments showed that apatite formed on scaffolds modified with BG after 7 days of immersion in SBF. Scaffold with Zn-doped BG showed a retarded apatite formation. Innovative 3D-printing filaments containing bioglasses have been successfully applied to print bioactive scaffolds with the surface suitable for cell attachment and proliferation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Mg is a material of choice for biodegradable implants. The main challenge for using Mg in temporary implants is to provide protective surfaces that mitigate its rapid degradation in biological fluids and also confer sufficient cytocompatibility and bacterial resistance to Mg-coated surfaces. Even though carbonate mineralization is the most important source of biominerals, such as the skeletons and shells of many marine organisms, there has been little success in the controlled growth of carbonate layers by synthetic processes. We present here the formation mechanism, antibacterial activity, and cell viability of magnesian calcite biomimetic coatings grown on biodegradable Mg via a green, one-step route. Cell compatibility assessment showed cell viability higher than 80% after 72 h using fibroblast cells (NCTC, clone L929) and higher than 60% after 72 h using human osteoblast-like cells (SaOS-2); the cells displayed a normal appearance and a density similar to the control sample. Antimicrobial potential evaluation against both Gram-positive (Staphylococcus aureus (ATCC 25923)) and Gram-negative (Pseudomonas aeruginosa (ATCC 27853)) strains demonstrated that the coated samples significantly inhibited bacterial adhesion and biofilm formation compared to the untreated control. Calcite coatings grown on biodegradable Mg by a single coating process showed the necessary properties of cell compatibility and bacterial resistance for application in surface-modified Mg biomaterials for temporary implants. [ABSTRACT FROM AUTHOR]

[Display omitted] • Development of interpenetrating phase composites (IPCs) scaffold with biomimetic multiscale pores. • Significant improvements in mechanical properties and stress conduction of IPCs compared to the pure scaffold. • Understanding the failure and strengthening mechanisms of IPCs by FEA. Multicomponent functional scaffolds hold great promise as implanted materials with compatible mechanical properties and biological functionalities. Interpenetrating phase composites (IPCs) with biomimetic multiscale porosity were fabricated in this study by additive manufacturing and foaming processes using polymethyl methacrylate (PMMA) and polyurethane foam (PUF), respectively. PMMA creates the macroscopic pores with triply periodic minimal surface (TPMS) structures, while PUF forms microscale porosity interpenetrating within the scaffolds, which has been confirmed by SEM and CT tests. Mechanical testing and finite element analysis (FEA) demonstrated significant enhancements in peak strength, toughness, and energy absorption of the IPCs compared to the scaffold alone, with increases of 134%, 73%, and 236%, respectively. The FEA provided insights into the failure and strengthening mechanisms of the interpenetrating porous structure. The continuous PUF component integrated within the IPCs effectively facilitated stress transfer, impeded crack propagation, and significantly prolonged the stress plateau of the scaffolds. Meanwhile, the PMMA primarily served as the main mechanical load-bearing component, transferring stress to the PUF during the deformation stage, resulting in a highly uniform stress distribution within the scaffolds. This uniform stress distribution creates an environment conducive to effective stress stimulation of the internally growing tissue. [ABSTRACT FROM AUTHOR]

A large amount of research in orthopedic and maxillofacial domains is dedicated to the development of bioactive 3D scaffolds. This includes the search for highly resorbable compounds, capable of triggering cell activity and favoring bone regeneration. Considering the phosphocalcic nature of bone mineral, these aims can be achieved by the choice of amorphous calcium phosphates (ACPs). Because of their metastable property, these compounds are however to-date seldom used in bulk form. In this work, we used a non-conventional “cold sintering” approach based on ultrafast low-pressure RT compaction to successfully consolidate ACP pellets while preserving their amorphous nature (XRD). Complementary spectroscopic analyses (FTIR, Raman, solid-state NMR) and thermal analyses showed that the starting powder underwent slight physicochemical modifications, with a partial loss of water and local change in the HPO42- ion environment. The creation of an open porous structure, which is especially adapted for non-load bearing bone defects, was also observed. Moreover, the pellets obtained exhibited sufficient mechanical resistance allowing for manipulation, surgical placement and eventual cutting/reshaping in the operation room. Three-dimensional porous scaffolds of cold-sintered reactive ACP, fabricated through this low-energy, ultrafast consolidation process, show promise toward the development of highly bioactive and tailorable biomaterials for bone regeneration, also permitting combinations with various thermosensitive drugs.

Osseous disease accounts for over half of chronic pathologies, but there is a limited supply of autografts, the gold standard; hence, there is a demand for new synthetic biomaterials. Herein, we present the use of a promising, new dairy-derived biomaterial: whey protein isolate (WPI) in the form of hydrogels, modified with the addition of different concentrations of the biotechnologically produced protein-like polymeric substance poly-γ-glutamic acid (γ-PGA) as a potential scaffold for tissue regeneration. Raman spectroscopic analysis demonstrated the successful creation of WPI-γ-PGA hydrogels. A cytotoxicity assessment using preosteoblastic cells demonstrated that the hydrogels were noncytotoxic and supported cell proliferation from day 3 to 14. All γ-PGA-containing scaffold compositions strongly promoted cell attachment and the formation of dense interconnected cell layers. Cell viability was significantly increased on γ-PGA-containing scaffolds on day 14 compared to WPI control scaffolds. Significantly, the cells showed markers of osteogenic differentiation; they synthesised increasing amounts of collagen over time, and cells showed significantly enhanced alkaline phosphatase activity at day 7 and higher levels of calcium for matrix mineralization at days 14 and 21 on the γ-PGA-containing scaffolds. These results demonstrated the potential of WPI-γ-PGA hydrogels as scaffolds for bone regeneration.

Bioceramics are the ideal artificial materials of the bone scaffolds to repair the bone defects next to the traditional metal materials. The combination of additive manufacturing and bioceramics provides the enormous possibilities to achieve the customized and personalized scaffolds with more complex structures for the personalized therapy. Nowadays, the bioceramics scaffolds prepared by the additive manufacturing show the great prospects, but meet the problems of poor mechanical strength and single biofunction. To improve the mechanical properties and expand the biological functions of the bioceramics scaffolds, the influence of the slurry/powder system, debinding and sintering process, composite materials, and structure design on the mechanical properties of the bioceramics scaffolds was concluded and analyzed in this paper. The progress of the multifunctional bioceramics scaffolds was summarized from two aspects of drug release and cancer treatment. The research status of bioceramics scaffolds by additive manufacturing in vivo was also introduced. Finally, the development of bioceramics scaffolds by additive manufacturing was prospected

Objectives: The use of a biomaterial scaffold can improve the healing process of bone defects. Using radiologic and ultrasonographic methods, this study aimed to evaluate the effects of zeolite/collagen nanocomposite and nanohydroxyapatite (nHA) bone scaffolds on the healing process of bone defect in rabbit femur. Materials and Methods: Twenty-eight mature male New Zealand white rabbits were classified into four equal groups (n=7 in each). In the first group, the defect was made, and the wound was closed with no treatment; in the second group, the nHA was implanted into the defect; in the third group, the nanocomposite of zeolite/collagen was implanted; and in the fourth group, the defect was filled using autograft. Radiologic (Sedecal Veterinary X-Ray System, Model No. A6544-2) and ultrasonographic (Mindray Z5 Veterinary Ultrasound Scanner) examinations were done on days 0, 15, 30, 45, and 60 postoperatively. Results: There were no healing effects on days 0 and 7 in any of the studied groups in the radiologic examination. The highest and lowest healing effects were related to treatment with zeolite/collagen nanocomposite and control group on day 60 after operation, respectively. There was no angiogenesis on day 0 in any group in the ultrasonographic examination. The highest and lowest levels of angiogenesis were related to rabbits treated with zeolite/collagen nanocomposite and the control group on day 30 after operation, respectively. Also, bone filling and angiogenesis in rabbits treated with zeolite/collagen nanocomposite were higher than other groups. Conclusions: Zeolite/collagen nanocomposite scaffolds bear a crucial capability in the reconstruction of bone defects and can be used in bone fractures. [ABSTRACT FROM AUTHOR]

Bone is a highly vascularized tissue and relies on the angiogenesis and response of cells in the immediate environmental niche at the defect site for regeneration. Hence, the ability to control angiogenesis and cellular responses during osteogenesis has important implications in tissue-engineered strategies. Self-assembling ionic-complementary peptides have received much interest as they mimic the natural extracellular matrix. Three-dimensional (3D)-printed biphasic calcium phosphate (BCP) scaffolds coated with self-assembling DAR 16-II peptide provide a support template with the ability to recruit and enhance the adhesion of cells. In vitro studies demonstrated prompt the adhesion of both human umbilical vein endothelial cells (HUVEC) and human mesenchymal stem cells (hMSC), favoring endothelial cell activation toward an angiogenic phenotype. The SEM-EDS and protein micro bicinchoninic acid (BCA) assays demonstrated the efficacy of the coating. Whole proteomic analysis of DAR 16-II-treated HUVECs demonstrated the upregulation of proteins involved in cell adhesion (HABP2), migration (AMOTL1), cytoskeletal re-arrangement (SHC1, TMOD2), immuno-modulation (AMBP, MIF), and morphogenesis (COL4A1). In vivo studies using DAR-16-II-coated scaffolds provided an architectural template, promoting cell colonization, osteogenesis, and angiogenesis. In conclusion, DAR 16-II acts as a proactive angiogenic factor when adsorbed onto BCP scaffolds and provides a simple and effective functionalization step to facilitate the translation of tailored 3D-printed BCP scaffolds for clinical applications. [ABSTRACT FROM AUTHOR]

The present work reports the synthesis and characterization of polycaprolactone fibers loaded with particulate calcium magnesium silicates, to form composite materials with bioresorbable and bioactive properties. The inorganic powders were achieved through a sol–gel method, starting from the compositions of diopside, akermanite, and merwinite, three mineral phases with suitable features for the field of hard tissue engineering. The fibrous composites were fabricated by electrospinning polymeric solutions with a content of 16% polycaprolactone and 5 or 10% inorganic powder. The physico-chemical evaluation from compositional and morphological points of view was followed by the biological assessment of powder bioactivity and scaffold biocompatibility. SEM investigation highlighted a significant reduction in fiber diameter, from around 3 μm to less than 100 nm after the loading stage, while EDX and FTIR spectra confirmed the existence of embedded mineral entities. The silicate phases were found be highly bioactive after 4 weeks of immersion in SBF, enriching the potential of the polymeric host that provides only biocompatibility and bioresorbability. Moreover, the cellular tests indicated a slight decrease in cell viability over the short-term, a compromise that can be accepted if the overall benefits of such multifunctional composites are considered. [ABSTRACT FROM AUTHOR]

Bioceramic scaffolds are being widely employed in bone tissue engineering applications for their ability to interact with host tissues without inducing any toxicity. Additionally, bioceramics possess good biocompatibility, osteointegration, osteoinduction, and biodegradation characteristics. Hydroxyapatite (HAP) is one such bioceramic known to exhibit closeness to natural bone in terms of chemical composition. The present reports additive manufacturing of HAP and Multiwalled carbon nanotubes (MWCNTs) reinforced HAP scaffold structures for bone tissue engineering applications using the Robocasting technique. Carboxymethyl Cellulose (CMC) was employed as the polymeric binder in this study to prepare the highly viscous HAP and CNT-HAP slurry ideal for robocasting of the scaffold structures. Different percentages of MWCNT (0.5, 1 and 2 wt%) incorporated into the developed CNT-HAP scaffold structures and were vacuum sintered at 1000 °C for 15 min. Vacuum sintering was found to effectively prevent oxidation of MWCNT which is subjected to decomposition at temperatures above 400 or 500 °C in Oxygen atmosphere as per literature. Further, the retention of MWCNTs in the developed CNT-HAP structures post sintering was confirmed using FESEM imaging. The mechanical characterizations revealed that 0.5CNT-HAP structures exhibited highest compression strength (3.36 ± 0.67 MPa) in comparison to 1CNT-HAP and 2CNT-HAP structures. Also, the in vitro biological characterizations demonstrated that the developed CNT-HAP scaffold structures were cytocompatible and remained stable for about 35 days at 37 °C. [ABSTRACT FROM AUTHOR]

Bioactive glasses (BGs) are especially useful materials in soft and bone tissue engineering and even in dentistry. They can be the solution to many medical problems, and they have a huge role in the healing processes of bone fractures. Interestingly, they can also promote skin regeneration and wound healing. Bioactive glasses are able to attach to the bone tissues and form an apatite layer which further initiates the biomineralization process. The formed intermediate apatite layer makes a connection between the hard tissue and the bioactive glass material which results in faster healing without any complications or side effects. This review paper summarizes the most recent advancement in the preparation of diverse types of BGs, such as silicate-, borate- and phosphate-based bioactive glasses. We discuss their physical, chemical, and mechanical properties detailing how they affect their biological performances. In order to get a deeper insight into the state-of-the-art in this area, we also consider their medical applications, such as bone regeneration, wound care, and dental/bone implant coatings.

The number of bone fractures and cracks requiring surgical interventions increases every year; hence, there is a huge need to develop new potential bone scaffolds for bone regeneration. The goal of this study was to gain knowledge about the basic properties of novel curdlan/whey protein isolate/hydroxyapatite biomaterials in the context of their use in bone tissue engineering. The purpose of this research was also to determine whether the concentration of whey protein isolate in scaffolds has an influence on their properties. Thus, two biomaterials differing in the concentration of whey protein isolate (i.e., 25 wt.% and 35 wt.%; hereafter called Cur_WPI25_HAp and Cur_WPI35_HAp, respectively) were fabricated and subjected to evaluation of porosity, mechanical properties, swelling ability, protein release capacity, enzymatic biodegradability, bioactivity, and cytocompatibility towards osteoblasts in vitro. It was found that both biomaterials fulfilled a number of requirements for bone scaffolds, as they demonstrated limited swelling and the ability to undergo controllable enzymatic biodegradation, to form apatite layers on their surfaces and to support the viability, growth, proliferation, and differentiation of osteoblasts. On the other hand, the biomaterials were characterized by low open porosity, which may hinder the penetration of cells though their structure. Moreover, they had low mechanical properties compared to natural bone, which limits their use to filling of bone defects in non-load bearing implantation areas, e.g., in the craniofacial area, but then they will be additionally supported by application of mechanically strong materials such as titanium plates. Thus, this preliminary in vitro research indicates that biomaterials composed of curdlan, whey protein isolate, and hydroxyapatite seem promising for bone tissue engineering applications, but their porosity and mechanical properties should be improved. This will be the subject of our further work. [ABSTRACT FROM AUTHOR]

Additive manufacturing has been used to develop a variety of scaffold designs for clinical and industrial applications. Mechanical properties (i.e., compression, tension, bending, and torsion response) of these scaffolds are significantly important for load-bearing orthopaedic implants. In this study, we designed and additively manufactured porous metallic biomaterials based on two different types of triply periodic minimal surface structures (i.e., gyroid and diamond) that mimic the mechanical properties of bone, such as porosity, stiffness, and strength. Physical and mechanical properties, including compressive, tensile, bending, and torsional stiffness and strength of the developed scaffolds, were then characterised experimentally and numerically using finite element method. Sheet thickness was constant at 300 μm, and the unit cell size was varied to generate different pore sizes and porosities. Gyroid scaffolds had a pore size in the range of 600–1200 μm and a porosity in the range of 54–72%, respectively. Corresponding values for the diamond were 900–1500 μm and 56–70%. Both structure types were validated experimentally, and a wide range of mechanical properties (including stiffness and yield strength) were predicted using the finite element method. The stiffness and strength of both structures are comparable to that of cortical bone, hence reducing the risks of scaffold failure. The results demonstrate that the developed scaffolds mimic the physical and mechanical properties of cortical bone and can be suitable for bone replacement and orthopaedic implants. However, an optimal design should be chosen based on specific performance requirements. [ABSTRACT FROM AUTHOR]

Zirconia (ZrO 2) and calcium silicate (CS) are widely used in bone repair. Zirconia has excellent mechanical properties, while calcium silicate has exceptional biological activity. A porous ZrO 2 /CS composite ceramic scaffold was formed by digital light processing (DLP) technology in this study. The microstructure analysis demonstrated that CS was embedded between ZrO 2 particles. Mechanical tests showed that interconnected CS particles could improve mechanical properties, while discrete CS particles led to a decrease in that. Cell experiments showed that adding CS to ZrO 2 had a positive effect on cell proliferation and differentiation. In vitro degradation test showed that the weight loss of scaffolds in four weeks increased form −0.63%–1.42% with the increase of CS content. Moreover, the degradation of scaffold promoted the deposition of apatite, which was beneficial to the integration of the scaffold with living bone. In conclusion, the ZrO 2 /CS composite scaffold had better biocompatibility compared with the ZrO 2 scaffold, which showed a potential solution for 3D printing bone repair scaffolds. [ABSTRACT FROM AUTHOR]

The use of biocompatible and biodegradable porous scaffolds produced via additive manufacturing is one of the most common approaches in tissue engineering. The geometric design of tissue engineering scaffolds (e.g., pore size, pore shape, and pore distribution) has a significant impact on their biological behavior. Fluid flow dynamics are important for understanding blood flow through a porous structure, as they determine the transport of nutrients and oxygen to cells and the flushing of toxic waste. The aim of this study is to investigate the impact of the scaffold architecture, pore size and distribution on its biological performance using Computational Fluid Dynamics (CFD). Different blood flow velocities (BFV) induce wall shear stresses (WSS) on cells. WSS values above 30 mPa are detrimental to their growth. In this study, two scaffold designs were considered: rectangular scaffolds with uniform square pores (300, 350, and 450 µm), and anatomically designed circular scaffolds with a bone-like structure and pore size gradient (476–979 µm). The anatomically designed scaffolds provided the best fluid flow conditions, suggesting a 24.21% improvement in the biological performance compared to the rectangular scaffolds. The numerical observations are aligned with those of previously reported biological studies. [ABSTRACT FROM AUTHOR]

We designed and fabricated a simple setup for the controlled crumpling of nanopatterned, surface-porous flat metallic sheets for the fabrication of volume-porous biomaterials and showed that crumpling can be considered as an efficient alternative to origami-inspired folding. Before crumpling, laser cutting was used to introduce pores to the sheets. We then fabricated titanium (Ti) nanopatterns through reactive ion etching on the polished Ti sheets. Thereafter, nanopatterned porous Ti sheets were crumpled at two deformation velocities (i.e., 2 and 100 mm/min). The compression tests of the scaffolds indicated that the elastic modulus of the specimens vary in the range of 11.8–13.9 MPa. Micro-computed tomography scans and computational simulations of crumpled scaffolds were performed to study the morphological properties of the resulting meta-biomaterials. The porosity and pore size of the scaffolds remained within the range of those reported for trabecular bone. Finally, the in vitro cell preosteoblasts culture demonstrated the cytocompatibility of the nanopatterned scaffolds. Moreover, the aspect ratio of the cells residing on the nanopatterned surfaces was found to be significantly higher than those cultured on the control scaffolds, indicating that the nanopatterned surface may have a higher potential for inducing the osteogenic differentiation of the preosteoblasts.

The development of novel biomaterials for regenerative therapy relies on the ability to assess tissue development, quality, and similarity with native tissue types in in vivo experiments. Non-invasive imaging modalities such as X-ray computed tomography offer high spatial resolution but limited biochemical information while histology and biochemical assays are destructive. Raman spectroscopy is a non-invasive, label-free and non-destructive technique widely applied for biochemical characterization. Here we demonstrate the use of fibre-optic Raman spectroscopy for in vivo quantitative monitoring of tissue development in subcutaneous calcium phosphate scaffolds in mice over 16 weeks. Raman spectroscopy was able to quantify the time dependency of different tissue components related to the presence, absence, and quantity of mesenchymal stem cells. Scaffolds seeded with stem cells produced 3–5 times higher amount of collagen-rich extracellular matrix after 16 weeks implantation compared to scaffolds without. These however, showed a 2.5 times higher amount of lipid-rich tissue compared to implants with stem cells. Ex vivo micro-computed tomography and histology showed stem cell mediated collagen and bone development. Histological measures of collagen correlated well with Raman derived quantifications (correlation coefficient in vivo 0.74, ex vivo 0.93). In the absence of stem cells, the scaffolds were largely occupied by adipocytes. The technique developed here could potentially be adapted for a range of small animal experiments for assessing tissue engineering strategies at the biochemical level.