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Bioactive ceramics have been used in bone tissue repair and regeneration. However, because of the complex in vivo osteogenesis process, long cycle, and difficulty of accurately tracking, the mechanism of interaction between materials and cells has yet to be fully understood, hindering its development. The ceramic microbridge microfluidic chip system may solve the problem and provide an in vitro method to simulate the microenvironment in vivo. Nevertheless, the complex microenvironment parameters of the chip system need to be studied in detail. Computer simulation bionics can provide clues for the setting of microenvironment parameters. This study used a computational bionic model to simulate the bone growth process in the presence of immune-related factors. The osteoblast differentiation of mesenchymal stem cells of calcium phosphate ceramics in a macrophage-dominated immune microenvironment was studied using a microfluidic chip system. The computational biomimetic model and microfluidic chip findings were basically consistent with the reported results of the animal experiments. These findings suggest that studying the osteogenic behavior of calcium phosphate ceramics using a microfluidic chip model is feasible. The method model provided in this study can be extended to other biomaterials, providing a viable path for their research and evaluation.

The synergistic piezoelectric and osteoconductive properties of barium titanate (BT) and hydroxyapatite (HA) could stir the development of a new generation of synthetic bone graft substitutes, with capability for rapid and safe osseointegration. The research focused on two concurrent approaches for coupling the BT and HA materials: (i) conventional sintering of BT-HA powder mixtures; and (ii) functionalization of pre-sintered BT with HA coatings using magnetron sputtering (MS). Irrespective of the BT/HA ratios ranging from 95/5 to 80/20 wt%, nanocrystalline or highly-crystallized nature of the powders, sub-micron- or micron-sized particle dimensions, and sintering temperature, it was observed that the BT-HA reactivity cannot be prevented above 800 °C. At higher temperatures in the range of 1000–1300 °C, HA undergoes decomposition and extensively reacts with BT, leading to the formation of several secondary phases such as CaTiO 3, Ba 2 Ca(PO 4) 2 , BaCa 6 (PO 4) 4 O, BaCa(PO 3) 4 , and β -Ca 2 P 2 O 7. As a consequence, the cytocompatibility assessed in fibroblast and osteoblast cell cultures, as well as the piezoelectric response, were significantly altered. Applying HA coatings by MS to the sintered BT ceramics successfully preserved their piezoelectric properties, while also providing an unaltered cytocompatible and osteogenic-prone surface. The HA coatings were fully crystallized at post-deposition annealing temperatures of 550 and 700 °C, achieving crystalline qualities comparable to HA powders sintered at 1100 and 1200 °C, respectively. No reactivity events between BT and HA were observed. Partial reactivity was only noticeable upon annealing at 1000 °C. Therefore, it is suggested that the HA coating of BT is effective in seamlessly coupling the piezoelectric and osteogenic properties of the two constituents without compromise. • BT-HA powder mixtures inevitably react at high-temperature to form secondary phases. • The HA osteogenic component can be lost at sintering temperatures above 1000 °C. • The secondary phases lead to a decay of the piezoelectric and biological responses. • HA-magnetron sputtered BT – a feasible solution to overcome inter-phases reactivity. • HA-coated BT yields uncompromised piezoelectric and in-vitro biologic performances. [ABSTRACT FROM AUTHOR]

In the biomedical field, the commonly used metal implant materials are prone to "stress shielding" because of their mechanical properties and elastic modulus are very different from human bone. The mechanical properties of metal materials are often difficult to maintain in corrosive media and release harmful ions. Nor can it reliably establish a sufficient combination with human bones, resulting in a service life that does not reach the desired goal. Researchers in this field propose to combine the superior mechanical properties of metals with bioactive materials, such as bioactive ceramics and the emerging ferrous glass, and achieve this through surface modification techniques. The laser cladding technique is of great interest for its low dilution rate, high bond strength and fine organisation. This review paper describes the development of common medical metal materials and the research progress of laser cladding surface modification technology. [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]

Bioactive ceramics, primarily consisting of bioactive glasses, glass–ceramics, calcium orthophosphate ceramics, calcium silicate ceramics and calcium carbonate ceramics, have received great attention in the past decades given their biocompatible nature and excellent bioactivity in stimulating cell proliferation, differentiation and tissue regeneration. Recent studies have tried to combine bioactive ceramics with bioactive ions, polymers, bioactive proteins and other chemicals to improve their mechanical and biological properties, thus rendering them more valid in tissue engineering scaffolds. This review presents the beneficial properties and potential applications of bioactive ceramic-based materials in dentistry, particularly in the repair and regeneration of dental hard tissue, pulp–dentin complex, periodontal tissue and bone tissue. Moreover, greater insights into the mechanisms of bioactive ceramics and the development of ceramic-based materials are provided. Article highlights Properties & characteristics of bioactive ceramics Properties and characteristics of bioactive glasses that are widely used in dental repair and regeneration. Properties and characteristics of glass-ceramics that are widely used in dental repair and regeneration. Properties and characteristics of calcium orthophosphate ceramics that are widely used in dental repair and regeneration. Properties and characteristics of calcium silicate ceramics that are widely used in dental repair and regeneration. Properties and characteristics of calcium carbonate ceramics that are widely used in dental repair and regeneration. Biomedical mechanisms & potential applications of bioactive ceramic-based materials in dental repair & regeneration Application and modification of bioactive ceramics for remineralization and regeneration of dental hard tissues. Application and modification of bioactive ceramics for pulp–dentin complex regeneration. Application and modification of bioactive ceramics for periodontal regeneration. Application and modification of bioactive ceramics for bone formation. Conclusion Due to the high bioactivity and biocompatibility, bioactive ceramics have been widely used in dental tissue repair. More recent attentions have focused on their modification to further enhance the bioactive behavior or further compositional changes that may introduce additional properties for dental hard tissue regeneration, pulp–dentin regeneration, periodontal regeneration and bone regeneration. Future perspective The bioactivity of ceramic-based materials is still to be further improved, such as nanosizing, surface modification, or combining or hybridizing with other bioactive substances to mimic the extracellular matrix environment as much as possible. These approaches may provide a key and effective direction to improve the application of bioactive ceramics in the field of oral tissue repair and regeneration. [ABSTRACT FROM AUTHOR]

ABSTRACTThe co-precipitation method is used in the lab to create a sample of the ferromagnetic 45CaO-30P2O5-15SiO2-10Fe2O3 (mol%). In simulated body fluid (SBF), the ability of the ferromagnetic sample to regenerate bone was examined, and XRD and FTIR graphs demonstrate that bone formation has taken place. The Vibration Sample Magnetometer has confirmed that the sample’s ferromagnetic behavior was brought on by the presence of iron (VSM). When an external magnetic field is present, the resulting sample may be utilized to treat bone cancer due to its ferromagnetic nature (hyperthermia). The sample’s drug release is therefore tested both with and without the help of an external magnetic field, and the findings reveal that when the magnetic field is present, the sample displays good drug release. BET analysis also supports the capacity of drugs to load and release. The sample’s ability to distribute drugs is tested using the antibiotic gentamicin. The prolonged release of the medication in SBF solution is investigated using a first-order kinetic equation. Being a drug-loaded ferromagnetic sample with high magnetic attraction, makes it simple to target any nearby spot. With a cytotoxicity rate of more than 90%, the produced sample is seen to interact amicably with the MG-63 human cell line. According to antimicrobial research, samples also guard against both gram-positive and gram-negative germs in the implant region. By lowering the cell’s oxidative stress, the sample’s antioxidant activity aids in cell proliferation, which increases the implanted site’s recuperation.

Bone defects that occur with fragment fractures lead to an increase in the number of postoperative complications. Therefore, to restore the structure and function of the bone, there is a need for bone replacement, in particular doped calcium-phosphate ceramics. The purpose of the work is the biochemical assessment of acute-phase and endothelial reactions and immune complex formation during bone replacement with germanium-doped calcium-phosphate ceramics of bone fragment fractures in dogs. Dogs with fragment fractures of long tubular bones and plate osteosynthesis were included in the study. In the experimental group (n = 10), bone defects were replaced with germanium-doped calcium-phosphate ceramics (HА/β-TCP/l-Gе-700), in the control group (n = 10) – unalloyed (HА/β-TCP-700). Blood samples were taken after the injury and on the 3rd, 7th, 14th, 30th, and 60th days after osteosynthesis. Partial recovery of limb function in the experimental group was faster by 1.3 times (P < 0.001) and full by 1.2 times (P < 0.01) compared to the control. On the 60th day, in experimental animals, the defect was filled with a regenerate of high X-ray density without a periosteal reaction, while in the control animals, the bone regenerate did not have sufficient density with a significant periosteal reaction. In both groups, total protein and albumin content varied within the normal range. The activity of protein C on the 3rd day in the experimental group was 1.3 times higher (Р ˂ 0.001), and on the 7th day, it was twice as high (P ˂ 0.001) compared to the control group with normalization by the 14th day. The concentration of ceruloplasmin from the 7th day in the control animals was 1.1 times higher (Р ˂ 0.001) than in the experimental animals, with normalization in the latter by the 60th day. The level of small molecular circulating immune complexes (CIC) after the injury increased by 1.1 times (Р ˂ 0.001) and reached a peak in the control and experimental groups on the 14th day, with an increase in indicators by 2.1 and 1.4 times (Р ˂ 0.001), respectively, with normalization in the experimental group on the 60th day. The level of nitric oxide (NO) in the control group increased from the 7th to the 60th day, with a peak on the 30th day, and in the experimental group – from the 3rd to the 30th, with a peak on the seventh day. Osteoreplacement of fragment fractures of long tubular bones in dogs with calcium-phosphate ceramics doped with germanium is accompanied by a moderate level of the acute phase reaction and immune complex formation, an increase in the endothelial reaction and the anticoagulant potential of the blood, which contributes to a decrease in the intensity of the inflammatory-resorptive stage of reparative osteogenesis and an increase in its proliferative phase, which, respectively, accelerates the consolidation of fractures.

The co-precipitation method is used in the lab to create a sample of the ferromagnetic 45CaO-30P2O5-15SiO2-10Fe2O3 (mol%). In simulated body fluid (SBF), the ability of the ferromagnetic sample to regenerate bone was examined, and XRD and FTIR graphs demonstrate that bone formation has taken place. The Vibration Sample Magnetometer has confirmed that the sample's ferromagnetic behavior was brought on by the presence of iron (VSM). When an external magnetic field is present, the resulting sample may be utilized to treat bone cancer due to its ferromagnetic nature (hyperthermia). The sample's drug release is therefore tested both with and without the help of an external magnetic field, and the findings reveal that when the magnetic field is present, the sample displays good drug release. BET analysis also supports the capacity of drugs to load and release. The sample's ability to distribute drugs is tested using the antibiotic gentamicin. The prolonged release of the medication in SBF solution is investigated using a first-order kinetic equation. Being a drug-loaded ferromagnetic sample with high magnetic attraction, makes it simple to target any nearby spot. With a cytotoxicity rate of more than 90%, the produced sample is seen to interact amicably with the MG-63 human cell line. According to antimicrobial research, samples also guard against both gram-positive and gram-negative germs in the implant region. By lowering the cell's oxidative stress, the sample's antioxidant activity aids in cell proliferation, which increases the implanted site's recuperation. [ABSTRACT FROM AUTHOR]

The spine is the most common site of bone metastases. Many cancer patients will ultimately develop spinal metastatic disease with symptomatic epidural spinal cord compression. At present, the main treatment for cervical spine tumors is surgical resection combined with postoperative radiotherapy. Implant materials for cervical spine anterior column reconstruction need to meet amounts of different properties, such as biocompatibility, bioactivity and the ability to maintain long‐term mechanical strength. The selection of different materials determines the surgical efficacy and prognosis of patients to a certain extent. This article provides an overview of a variety of implant materials used for anterior column reconstruction after cervical spine tumor resection, introduces and analyzes their properties, advantages, disadvantages, derivatives, and applications in clinical practice, and looks forward to the future development of implant materials.

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.

The spine is the most common site of bone metastases. Many cancer patients will ultimately develop spinal metastatic disease with symptomatic epidural spinal cord compression. At present, the main treatment for cervical spine tumors is surgical resection combined with postoperative radiotherapy. Implant materials for cervical spine anterior column reconstruction need to meet amounts of different properties, such as biocompatibility, bioactivity and the ability to maintain long‐term mechanical strength. The selection of different materials determines the surgical efficacy and prognosis of patients to a certain extent. This article provides an overview of a variety of implant materials used for anterior column reconstruction after cervical spine tumor resection, introduces and analyzes their properties, advantages, disadvantages, derivatives, and applications in clinical practice, and looks forward to the future development of implant materials. [ABSTRACT FROM AUTHOR]

Bone defects that occur with fragment fractures lead to an increase in the number of postoperative complications. Therefore, to restore the structure and function of the bone, there is a need for bone replacement, in particular doped calcium-phosphate ceramics. The purpose of the work is the biochemical assessment of acute-phase and endothelial reactions and immune complex formation during bone replacement with germanium-doped calciumphosphate ceramics of bone fragment fractures in dogs. Dogs with fragment fractures of long tubular bones and plate osteosynthesis were included in the study. In the experimental group (n = 10), bone defects were replaced with germanium-doped calcium-phosphate ceramics (HA/ß-TCP/l-Ge-700), in the control group (n = 10) - unalloyed (HA/ß-TCP-700). Blood samples were taken after the injury and on the 3rd, 7th, 14th, 30th, and 60th days after osteosynthesis. Partial recovery of limb function in the experimental group was faster by 1.3 times (P < 0.001) and full by 1.2 times (P < 0.01) compared to the control. On the 60th day, in experimental animals, the defect was filled with a regenerate of high X-ray density without a periosteal reaction, while in the control animals, the bone regenerate did not have sufficient density with a significant periosteal reaction. In both groups, total protein and albumin content varied within the normal range. The activity of protein C on the 3rd day in the experimental group was 1.3 times higher (P < 0.001), and on the 7th day, it was twice as high (P < 0.001) compared to the control group with normalization by the 14th day. The concentration of ceruloplasmin from the 7th day in the control animals was 1.1 times higher (P < 0.001) than in the experimental animals, with normalization in the latter by the 60th day. The level of small molecular circulating immune complexes (CIC) after the injury increased by 1.1 times (P < 0.001) and reached a peak in the control and experimental groups on the 14th day, with an increase in indicators by 2.1 and 1.4 times (P < 0.001), respectively, with normalization in the experimental group on the 60th day. The level of nitric oxide (NO) in the control group increased from the 7th to the 60th day, with a peak on the 30th day, and in the experimental group - from the 3rd to the 30th, with a peak on the seventh day. Osteoreplacement of fragment fractures of long tubular bones in dogs with calcium-phosphate ceramics doped with germanium is accompanied by a moderate level of the acute phase reaction and immune complex formation, an increase in the endothelial reaction and the anticoagulant potential of the blood, which contributes to a decrease in the intensity of the inflammatory-resorptive stage of reparative osteogenesis and an increase in its proliferative phase, which, respectively, accelerates the consolidation of fractures. [ABSTRACT FROM AUTHOR]

Introduction: Recently, efforts towards the development of patient-specific 3D printed scaffolds for bone tissue engineering from bioactive ceramics have continuously intensified. For reconstruction of segmental defects after subtotal mandibulectomy a suitable tissue engineered bioceramic bone graft needs to be endowed with homogenously distributed osteoblasts in order to mimic the advantageous features of vascularized autologous fibula grafts, which represent the standard of care, contain osteogenic cells and are transplanted with the respective blood vessel. Consequently, inducing vascularization early on is pivotal for bone tissue engineering. The current study explored an advanced bone tissue engineering approach combining an advanced 3D printing technique for bioactive resorbable ceramic scaffolds with a perfusion cell culture technique for pre-colonization with mesenchymal stem cells, and with an intrinsic angiogenesis technique for regenerating critical size, segmental discontinuity defects in vivo applying a rat model. To this end, the effect of differing Si-CAOP (silica containing calcium alkali orthophosphate) scaffold microarchitecture arising from 3D powder bed printing (RP) or the Schwarzwalder Somers (SSM) replica fabrication technique on vascularization and bone regeneration was analyzed in vivo. In 80 rats 6-mm segmental discontinuity defects were created in the left femur.Methods: Embryonic mesenchymal stem cells were cultured on RP and SSM scaffolds for 7d under perfusion to create Si-CAOP grafts with terminally differentiated osteoblasts and mineralizing bone matrix. These scaffolds were implanted into the segmental defects in combination with an arteriovenous bundle (AVB). Native scaffolds without cells or AVB served as controls. After 3 and 6 months, femurs were processed for angio-µCT or hard tissue histology, histomorphometric and immunohistochemical analysis of angiogenic and osteogenic marker expression.Results: At 3 and 6 months, defects reconstructed with RP scaffolds, cells and AVB displayed a statistically significant higher bone area fraction, blood vessel volume%, blood vessel surface/volume, blood vessel thickness, density and linear density than defects treated with the other scaffold configurations.Discussion: Taken together, this study demonstrated that the AVB technique is well suited for inducing adequate vascularization of the tissue engineered scaffold graft in segmental defects after 3 and 6 months, and that our tissue engineering approach employing 3D powder bed printed scaffolds facilitated segmental defect repair.

Bone defect disease causes damage to people's lives and property, and how to effectively promote bone regeneration is still a big clinical challenge. Most of the current repair methods focus on filling the defects, which has a poor effect on bone regeneration. Therefore, how to effectively promote bone regeneration while repairing the defects at the same time has become a challenge for clinicians and researchers. Strontium (Sr) is a trace element required by the human body, which mainly exists in human bones. Due to its unique dual properties of promoting the proliferation and differentiation of osteoblasts and inhibiting osteoclast activity, it has attracted extensive research on bone defect repair in recent years. With the deep development of research, the mechanisms of Sr in the process of bone regeneration in the human body have been clarified, and the effects of Sr on osteoblasts, osteoclasts, mesenchymal stem cells (MSCs), and the inflammatory microenvironment in the process of bone regeneration have been widely recognized. Based on the development of technology such as bioengineering, it is possible that Sr can be better loaded onto biomaterials. Even though the clinical application of Sr is currently limited and relevant clinical research still needs to be developed, Sr-composited bone tissue engineering biomaterials have achieved satisfactory results in vitro and in vivo studies. The Sr compound together with biomaterials to promote bone regeneration will be a development direction in the future. This review will present a brief overview of the relevant mechanisms of Sr in the process of bone regeneration and the related latest studies of Sr combined with biomaterials. The aim of this paper is to highlight the potential prospects of Sr functionalized in biomaterials. [ABSTRACT FROM AUTHOR]

Calcium phosphate bio-ceramics are osteo-conductive, but it remains a challenge to promote the induction of bone augmentation and capillary formation. The surface micro/nano-topography of materials can be recognized by cells and then the cell fate are mediated. Traditional regulation methods of carving surface structures on bio-ceramics employ mineral reagents and organic additives, which might introduce impurity phases and affect the biological results. In a previous study, a facile and novel method was utilized with ultrapure water as the unique reagent for hydrothermal treatment, and a uniform hydroxyapatite (HAp) surface layer was constructed on composite ceramics (β-TCP/CaSiO3) in situ. Further combined with 3D printing technology, biomimetic hierarchical structure scaffolds were fabricated with interconnected porous composite ceramic scaffolds as the architecture and micro/nano-rod hybrid HAp as the surface layer. The obtained HAp surface layer favoured cell adhesion, alleviated the cytotoxicity of precursor scaffolds, and upregulated the cellular differentiation of mBMSCs and gene expression of HUVECs in vitro. In vivo studies showed that capillary formation, bone augmentation and new bone matrix formation were upregulated after the HAp surface layer was obtained, and the results confirmed that the fabricated biomimetic hierarchical structure scaffold could be an effective candidate for bone regeneration.

This study aimed to evaluate the in vivo initial microbial adhesion of oral microorganisms on the biomaterial Biodentine compared to MTA and AH Plus. Cylindrical samples of the materials were prepared, and dentin slabs served as a control. An individual intraoral lower jaw splint served as a carrier for the samples and was worn by six volunteers. The specimens were worn for 120 min. Adherent bacteria were quantified by determining the colony-forming units (CFUs), while the visualization and quantification of total adherent microorganisms were facilitated by using DAPI and live/dead staining combined with fluorescence microscopy. Bovine dentin had a significantly higher number of aerobic CFUs compared to Biodentine (p = 0.017) and MTA (p = 0.013). The lowest amounts of DAPI-stained adherent microorganisms were quantified for Biodentine (15% ± 9%) and the control (18% ± 9%), while MTA showed the highest counts of initially adherent microorganisms (38% ± 10%). Significant differences were found for MTA and Biodentine (p = 0.004) as well as for MTA and the control (p = 0.021) and for AH Plus and the control (p = 0.025). Biodentine inhibited microbial adherence, thereby yielding an antimicrobial effectivity similar to that of MTA. [ABSTRACT FROM AUTHOR]

Various artificial bone graft substitutes based on ceramics have been developed over the last 20 years. Among them, calcium-silicate-based ceramics, which are osteoconductive and can attach directly to biological organs, have received great attention for bone tissue engineering applications. However, the degradation rate of calcium-silicate and bone formation is often out of balance, resulting in stress shielding (osteopenia). A new strategy to improve the drawbacks of these ceramics is incorporating trace elements such as Zn, Mg, and Zr into their lattice structures, enhancing their physical and biological properties. Recently, baghdadite (Ca3ZrSi2O9) ceramic, one of the most appealing calcium-silicate-based ceramics, has demonstrated high bioactivity, biocompatibility, biodegradability, and cell interaction. Because of its physical, mechanical, and biological properties and ability to be shaped using various fabrication techniques, baghdadite has found high potential in various biomedical applications such as coatings, fillers, cement, scaffolds, and drug delivery systems. Undoubtedly, there is a high potential for this newly developed ceramic to contribute significantly to therapies to provide a tremendous clinical outcome. This review paper aims to summarize and discuss the most relevant studies performed on baghdadite-based ceramics and composites by focusing on their behavior in vivo and in vitro.

This study aimed to evaluate the in vivo initial microbial adhesion of oral microorganisms on the biomaterial Biodentine compared to MTA and AH Plus. Cylindrical samples of the materials were prepared, and dentin slabs served as a control. An individual intraoral lower jaw splint served as a carrier for the samples and was worn by six volunteers. The specimens were worn for 120 min. Adherent bacteria were quantified by determining the colony-forming units (CFUs), while the visualization and quantification of total adherent microorganisms were facilitated by using DAPI and live/dead staining combined with fluorescence microscopy. Bovine dentin had a significantly higher number of aerobic CFUs compared to Biodentine (p = 0.017) and MTA (p = 0.013). The lowest amounts of DAPI-stained adherent microorganisms were quantified for Biodentine (15% ± 9%) and the control (18% ± 9%), while MTA showed the highest counts of initially adherent microorganisms (38% ± 10%). Significant differences were found for MTA and Biodentine (p = 0.004) as well as for MTA and the control (p = 0.021) and for AH Plus and the control (p = 0.025). Biodentine inhibited microbial adherence, thereby yielding an antimicrobial effectivity similar to that of MTA.

Poly(methyl methacrylate) (PMMA)‐based bone cements (BCs) can be defined as a family of materials that consist of powder and liquid phases which after mixing form a plastic paste that can self‐set once implanted in the human body. PMMA‐based BCs are easily molded and adapted to complex bone cavities or used in orthodontic applications to restore dental damage. The main advantages of the use of cement are the excellent primary fixation between bone and implant and, therefore, the faster recovery of the patient. Despite the initial success rate of implant fixation with BCs, they have some disadvantages such as local tissue damage due to exothermic polymerization reactions, mechanical mismatch between native bone and cement, lack of bone regeneration and bioactivity and poor mechanical properties which may cause the failure of the BCs. BCs are still considered as a top option for bone repair. Due to the disadvantages highlighted, research has focused on alternative materials used with PMMA‐based BCs. This review aims to critically review the BCs and emerging materials used in combination with PMMA‐based BCs. These materials include titania, apatite–wollastonite (A‐W), glass ceramic (GC) and hydroxyapatite (HA). The review discusses the properties of these materials and their pathway to clinical study. Among the various kinds of reinforcement, HA has been extensively used. So, in this review, we compare the effects of HA as reinforcement in PMMA‐based BCs. Upcoming study of PMMA‐based BCs should concentrate on trialing combinations of these reinforcing agents as this might improve beneficial characteristics. © 2020 Society of Industrial Chemistry [ABSTRACT FROM AUTHOR]

Stem cells are the central element of regenerative medicine (RM). However, in many clinical applications, the use of scaffolds fabricated with biomaterials is required. In this sense, mesoporous bioactive glasses (MBGs) are going to play an important role in bone regeneration because of their striking textural properties, quick bioactive response, and biocompatibility. As other bioactive glasses, MBGs are mainly formed by silicon, calcium, and phosphorus oxides whose ions play an important role in cell proliferation as well as in homeostasis and bone remodeling process. A common improvement of bioactive glasses for RM is by adding small amounts of oxides of elements that confer them additional biological capacities, including osteogenic, angiogenic, antibacterial, anti-inflammatory, hemostatic, or anticancer properties. Moreover, MBGs are versatile in terms of the different ways in which they can be processed, such as scaffolds, fibers, coatings, or nanoparticles. MBGs are unique because their textural properties are so high that they still exhibit outstanding bioactive responses even after adding extra inorganic ions or being processed as scaffolds or nanoparticles. Moreover, they can be further improved by loading with biomolecules, drugs, and stem cells. This article reviews the state of the art and future perspectives of MBGs in the field of RM of hard tissues.

Introduction. Many researchers are currently searching for new, safe, and effective methods of maxillofacial reconstruction in cancer patients.In this case, special attention should be paid to ceramic implants.Objective: to develop a personalized approach to the maxillofacial reconstruction using bioactive ceramic implants.Materials and methods. We performed virtual planning of the implants for the reconstruction of the maxillofacial region basing on the preoperative spiral computed tomography scans of the facial skeleton.Results. We have developed a new method of preoperative planning and creation of individualized implants made of bioactive ceramics for reconstructing the maxillofacial region. This method is demanded in reconstructive surgery and can be applied in routine clinical practice.Conclusion. Reconstructive surgeries with the implants made of bioactive ceramics allow achieving good functional and aesthetic results in patients with large postoperative defects in the maxillofacial region, thus, improving their quality of life.

Objective: To analyze the clinical and radiographic effectiveness of a calcium silicate-based bioactive ceramic iRoot BP Plus ® pulpotomy of immature permanent teeth with complicated crown fracture and to evaluate the factors influencing its long-term success rate., Methods: The digital medical records of patients under 13 years old who had undergone iRoot BP Plus ® pulpotomy in the Department of Oral Emergency or the First Clinical Division, Peking University School and Hospital of Stomatology from March 2017 to September 2022 due to complicated crown fracture of anterior teeth, and had taken at least one post-operation apical radiograph were reviewed. The clinical and radiographic information at the initial examination and follow-up period were obtained, including crown color, mobility, percussion, cold test (partial pulpotomy teeth), dental restoration, fistula, swelling or inflammation of the gingival tissue, the formation of apical foramen, pathologic radiolucency and calcification of pulp chamber or root canal obliteration. Data were tested by Fisher exact test and a multiple comparison., Results: In the study, 64 patients including 37 males (57.8%) and 27 females (42.2%) with a mean age of 9.1 years : ere finally enrolled. The total number of permanent teeth that received pulpotomy was 75, and the average follow-up time was 19.3 months. The success rate was 93.1% with the time interval between dental injury and treatment in 24 h, while the success rate dropped to 88.2% with the time intervals beyond 24 h. The time intervals did not significantly affect the pulp survival rate ( P =0.61) after pulpotomy (partial or coronal). The success rate 6 months after pulpotomy was 96. 0%, and one-year success rate was 94. 7%. A total of 23 cases were reviewed for more than 2 years after pulpotomy, and 6 cases failed. The mobility had no significant effect on the success rate ( P =0.28). Pulp chamber calcification and pulp canal obli-teration were not observed in all the post-operative radiographs., Conclusion: The one year clinical and radiographic success rates obtained in this study indicate that iRoot BP Plus ® is an appropriate pulp capping material option for pulpotomy treatment of complicated crown fracture in immature permanent teeth without displacement injuries. This technique has broad promotional value.

[Display omitted] • The innovative uses of bioactive ceramics in restorative dentistry is pointed out. • Theycan be combined with GIC and RMGIC cements for repairing teeth lesions. • They can be associated with laser therapy for treating dentin hypersensitivity. • Restorative dentistry can be progressively replaced by regenerative approaches in the future. Restorative dentistry comprises approaches to repair the tooth structure or manage conditions like dentin hypersensitivity, which all require biomaterials. Restorative clinical approaches are primarily based on bioactive materials, such as glass-ionomer cement (GIC) and resin-modified glass-ionomer cement (RMGIC). Although these cements show in vivo bioactivity, it is possible to increase their bioactive behavior, fastening and increasing the establishment of chemical bonds between the tooth and the cement, decreasing the risk of failure. Here, we reported how bioactive ceramics have been used to treat dentin hypersensitivity, either by being directly applied to the dentin, modifying GIC and RMGIC, or combined with other therapeutic approaches like laser therapy. Overall, bioactive ceramics have improved the bonding of composites to mineralized tooth structures, which is desired in restorative dentistry, and in some cases, they are likely to replace restorative with regenerative approaches. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Ideal artificial bone grafts aim for multiscale porosity, high mechanical strength and ensure rapid vascularization for bone ingrowth. In this work modular ceramic arteriovenous loops (AV-loops) with a hierarchical porosity approach were designed and manufactured to meet these criteria and to exceed the poor mechanical strength of monolithic scaffolds. Bioactive building blocks (β-TCP, HAp, BCP) with dimensions of 1.5–3.0 mm were prepared by injection molding and assembled to complex AV-loop scaffolds using a customized automated assembly technology (pick and place). The building blocks were bonded with a biocompatible adhesive. Single building blocks are characterized by a compressive strength of 112.4–134.5 MPa with a residual sintering porosity of 32.2–41.5%, matching the strength of cortical bone of 100–230 MPa. The compressive strength of the modular assemblies varied between 22.3 and 47.6 MPa primary depending on the building block arrangement. The achieved compressive strengths are superior to current monolithic AV-scaffolds and sufficient for the implantation as non-load-bearing AV-loop scaffolds in isolation chambers. The modular AV-loop scaffolds provide a hierarchical interconnected pore network (P = 58.8%) combining small macropores of 4.1–4.3 µm size for possible enhanced protein absorption and large gradient macropores of 200–1700 µm size for optimum vascularization and complete bone ingrowth. The modular building block approach allows to design patient individualized scaffolds with complex hierarchical pore networks. The pore volume, size and geometry as well as the biological response can effectively be tuned by changing the dimensions, shape and placing gap of the bioactive building blocks. Statement of Significance Gold standard of bone replacement in case of surgery or cancer is still own bone material usually taken from the hip/arm or leg in second surgery with poor mechanical properties and limited amount. To avoid a second surgery and provide mechanical strong scaffold structures for fast patient regeneration a novel modular building block approach is used. This allows complex scaffold geometry with a hierarchical interconnection porosity for blood vessel ingrowth. The pore volume, size and geometry as well as the biological response can effectively be tuned by changing the dimensions, shape and placing gap of the bioactive building blocks. [ABSTRACT FROM AUTHOR]

The cytotoxicity of monticellite based bioactive ceramic powder, which was synthesized from boron derivative waste has been determined by in vitro assays of MTT, NRU, and JC-1 staining. The toxicity of powder on different mammalian cell lines (3T3-L1, HUVEC, CRL-2120) was evaluated at the concentrations of 10, 100, 200, 400 and 800 µg/mL to justify its potential for biomedical applications. The obtained results showed that monticellite based bioactive ceramic powder possesses not only bioactive feature but also biocompatible characteristic at the concentration range of 10–200 µg/mL. Hence, monticellite based bioactive ceramics have high potential as a bone graft substitute for bone void filling and coating applications. [ABSTRACT FROM AUTHOR]

Monticellite bioactive ceramics have a high usage potential as bone graft substitutes due to their superior mechanical properties compared to hydroxyapatite and excellent bioactivity. Turkey has almost 72% of the global boron reserves and the fairly high amount of emerged boron derivative waste causes storage problems and environmental pollutions. The aim of this study was the solid state synthesis of monticellite based ceramic powders from boron derivative waste and the evaluation of bioactivity characteristic of produced powders. The monticellite based ceramic powders were synthesized at low temperature (800 °C). The powders were incubated in Simulated Body Fluid and their surfaces were examined using a scanning electron microscope. The surfaces of synthesized powders were bioactive and allowed formation of bone-like apatite layer within 15 days. Results of the study confirmed that cost-effective and eco-friendly monticellite based bioactive ceramic powders can be synthesized from boron derivative waste. [ABSTRACT FROM AUTHOR]

Biomaterials have a profound effect on tissue engineering and regenerative medicine, but few studies have reported the role of extracts from bioceramics in the regulation of stem cell pluripotency. The present study investigated the effects of bioceramics extracts, including silicate bredigite (Ca7MgSi4O16) and conventional β-tricalcium phosphate (β-TCP), on the pluripotency and the multilineage differentiation potential of human dental pulp cells (hDPCs). Basic fibroblast growth factor (bFGF), which is a known regulator of hDPCs pluripotency, was used as a reference. Bredigite extracts significantly promoted cell growth, proliferation, TERT expression and maintained hDPCs in a presenescent state. The extracts of bredigite significantly up-regulated the expression of pluripotency-related genes such as Stro1, Oct4 and Sox2, and further promoted the multilineage differentiation of hDPCs after odontogenic/adipogenic induction. The stimulation of bredigite extracts on hDPCs pluripotency was comparable to that of bFGF, whereas β-TCP extracts lacked these properties. Our results suggested for the first time that bredigite extracts enhance the pluripotency of dental-derived stem cells, paving the way for extended applications in regenerative medicine. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3465-3474, 2017. [ABSTRACT FROM AUTHOR]

The high brittleness and low strength of bioactive ceramics have severely restricted their application in bone repair despite the fact that they have been regarded as one of the most promising biomaterials. In the last few years, low-dimensional nanomaterials (LDNs), including carbon nanotubes, graphene and boron nitride nanotubes, have gained increasing attention owing to their favorable biocompatibility, large surface specific area and super mechanical properties. These qualities make LDNs potential nanofillers in reinforcing bioactive ceramics. In this review, the types, characteristics and applications of the commonly used LDNs in ceramic composites are summarized. In addition, the fabrication methods for LDNs/ceramic composites, such as hot pressing, spark plasma sintering and selective laser sintering, are systematically reviewed and compared. Emphases are placed on how to obtain the uniform dispersion of LDNs in a ceramic matrix and maintain the structural stability of LDNs during the high-temperature fabrication process of ceramics. The reinforcing mechanisms of LDNs in ceramic composites are then discussed in-depth. The in vitro and in vivo studies of LDNs/ceramic in bone repair are also summarized and discussed. Finally, new developments and potential applications of LDNs/ceramic composites are further discussed with reference to experimental and theoretical studies. Statement of Significance Despite bioactive ceramics having been regarded as promising biomaterials, their high brittleness and low strength severely restrict their application in bone scaffolds. In recent years, low-dimensional nanomaterials (LDNs), including carbon nanotubes, graphene and boron nitride nanotubes, have shown great potential in reinforcing bioactive ceramics owing to their unique structures and properties. However, so far it has been difficult to maintain the structural stability of LDNs during fabrication of LDNs/ceramic composites, due to the lengthy, high-temperature process involved. This review presents a comprehensive overview of the developments and applications of LDNs in bioactive ceramics. The newly-developed fabrication methods for LDNs/ceramic composites, the reinforcing mechanisms and the in vitro and in vivo performance of LDNs are also summarized and discussed in detail. [ABSTRACT FROM AUTHOR]

This study examines the effect of a hyaluronic acid (HyAc) containing tricalcium phosphate putty scaffold material (TCP-P) and of a particulate tricalcium phosphate (TCP-G) graft on bone formation, volume stability and osteogenic marker expression in biopsies sampled 6 months after bilateral sinus floor augmentation (SFA) in 7 patients applying a split-mouth design. 10% autogenous bone chips were added to the grafting material during surgery. The grain size of the TCP granules was 700 to 1400 μm for TCP-G and 125 to 250 μm and 500 to 700 μm (ratio 1:1) for TCP-P. Biopsies were processed for immunohistochemical analysis of resin-embedded sections. Sections were stained for collagen type I (Col I), alkaline phosphatase (ALP), osteocalcin (OC) and bone sialoprotein (BSP). Furthermore, the bone area and biomaterial area fraction were determined histomorphometrically. Cone-beam CT data recorded after SFA and 6 months later were used for calculating the graft volume at these two time points. TCP-P displayed more advantageous surgical handling properties and a significantly greater bone area fraction and smaller biomaterial area fraction. This was accompanied by significantly greater expression of Col I and BSP and in osteoblasts and osteoid and a less pronounced reduction in grafting volume with TCP-P. SFA using both types of materials resulted in formation of sufficient bone volume for facilitating stable dental implant placement with all dental implants having been in function without any complications for 6 years. Since TCP-P displayed superior surgical handling properties and greater bone formation than TCP-G, without the HyAc hydrogel matrix having any adverse effect on bone formation or graft volume stability, TCP-P can be regarded as excellent grafting material for SFA in a clinical setting. The greater bone formation observed with TCP-P may be related to the difference in grain size of the TCP granules and/or the addition of the HyAc. [ABSTRACT FROM AUTHOR]

Bone, a highly dynamic connective tissue, consist of a bioorganic phase comprising osteogenic cells and proteins which lies over an inorganic phase predominantly made of CaPO 4 (biological apatite). Injury to bone can be due to mechanical, metabolic or inflammatory agents also owing pathological conditions like fractures, osteomyelitis, osteolysis or cysts may arise in enameloid, chondroid, cementum, or chondroid bone which forms the intermediate tissues of the body. Bone tissue engineering (BTE) applies bioactive scaffolds, host cells and osteogenic signals for restoring damaged or diseased tissues. Various bioceramics used in BTE can be bioactive (like glass ceramics and hydroxyapatite bioactive glass), bioresorbable (like tricalcium phosphates) or bioinert (like zirconia and alumina). Limiting the size of these materials to nano-scale has resulted in a higher surface area to volume ratio thereby improving multi-functionality, solubility, surface catalytic activity, high heat and electrical conductivity. Nanoceramics have been found to induce osteoconduction, osteointegration, osteogenesis and osteoinduction. The present review aims at summarizing the interactions of nanoceramics and osteoblast/stem cells for promoting the proliferation and differentiation of the osteoblast cells by nanoceramics as superior bone substitutes in bone tissue engineering applications. [ABSTRACT FROM AUTHOR]

Cell migration is an essential bioactive ceramics property and critical for bone induction, clinical application, and mechanism research. Standardized cell migration detection methods have many limitations, including a lack of dynamic fluid circulation and the inability to simulate cell behavior in vivo. Microfluidic chip technology, which mimics the human microenvironment and provides controlled dynamic fluid cycling, has the potential to solve these questions and generate reliable models of cell migration in vitro. In this study, a microfluidic chip is reconstructed to integrate the bioactive ceramic into the microfluidic chip structure to constitute a ceramic microbridge microfluidic chip system. Migration differences in the chip system are measured. By combining conventional detection methods with new biotechnology to analyze the causes of cell migration differences, it is found that the concentration gradients of ions and proteins adsorbed on the microbridge materials are directly related to the occurrence of cell migration behavior, which is consistent with previous reports and demonstrates the effectiveness of the microfluidic chip model. This model provides in vivo environment simulation and controllability of input and output conditions superior to standardized cell migration detection methods. The microfluidic chip system provides a new approach to studying and evaluating bioactive ceramics., (© 2023 Wiley-VCH GmbH.)

Bioactive glasses (BAGs) are surface-active ceramic materials that can be used in bone regeneration due to their known osteoconductive and osteoinductive properties. This systematic review aimed to study the clinical and radiographic outcomes of using BAGs in periodontal regeneration. The selected studies were collected from PubMed and Web of Science databases, and included clinical studies investigating the use of BAGs on periodontal bone defect augmentation between January 2000 and February 2022. The identified studies were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 115 full-length peer-reviewed articles were identified. After excluding duplicate articles between the databases and applying the inclusion and exclusion criteria, 14 studies were selected. The Cochrane risk of bias tool for randomized trials was used to assess the selected studies. Five studies compared using BAGs with open flap debridement (OFD) without grafting materials. Two of the selected studies were performed to compare the use of BAGs with protein-rich fibrin, one of which also included an additional OFD group. Also, one study evaluated BAG with biphasic calcium phosphate and used a third OFD group. The remaining six studies compared BAG filler with hydroxyapatite, demineralized freeze-dried bone allograft, autogenous cortical bone graft, calcium sulfate β-hemihydrate, enamel matrix derivatives, and guided tissue regeneration. This systematic review showed that using BAG to treat periodontal bone defects has beneficial effects on periodontal tissue regeneration. OSF Registration No.: 10.17605/OSF.IO/Y8UCR.

Hydroxyapatite (HA)/β-tricalcium phosphate (β-TCP) composites attract attentions as bone implant materials. As one of the fabrication method of HA/β-TCP is mixing of HA and β-TCP powder in advance of sintering. This method enables to control the ratio of content of β-TCP easier. However, it is difficult to obtain dense composites. In this study, we focused on pulse electric current sintering (PECS) to obtain dense HA/β-TCP composites. The sinterability is evaluated with relative density and grain size measurements. Composition of sintered body was also characterized by X-ray diffraction. In comparison with pressureless sintering, PECS increased relative density of the composites without grain growth. In HA/β-TCP sintered by PECS, the phase transformation from β-TCP to α-TCP was promoted. This is due to higher thermal energy by spark discharge during PECS. On the other hand, sintering additives (MgO) inhibited phase transformation. It was suggested that sinterability of HA/β-TCP composites was improved by PECS. [ABSTRACT FROM PUBLISHER]

Recently new coating technologies have been developed based on the so-called Pulsed Laser Deposition (PLD) method, which consists in the laser ablation of a target material, and as a consequence of the matter-radiation interaction, the transport of ablated species from the target to the substrate is originated. PLD is quite versatile technique, and allows the incorporation of a reactive atmosphere and electric discharges in the process so that the properties of the coatings can be modified. In this work, these new technologies were applied in the processing of bioactive ceramic thin films of hydroxyapatite and bioactive glass. The influence of processing parameters, such as temperature, voltage applied of the radiofrequency discharge and reactive atmosphere, on the coating properties have been studied. It was found that in the case of hydroxyapatite coatings, the water vapour atmosphere coupled with the radiofrequency discharge enhances the deposition rate and cristallinity of the coatings. Nevertheless, the optimum properties for bioactive glass coatings were obtained in vacuum and absence of electrical discharge conditions.En la actualidad existen nuevas tecnologías de procesamiento de recubrimientos basados en la técnica denominada depósito por láser pulsado (PLD), la cual consiste en la ablación de un blanco mediante un haz láser y como consecuencia de la interacción radiación – materia se origina el transporte del material hasta el sustrato a recubrir. Esta técnica es muy versátil ya que permite la incorporación de atmósferas reactivas en el proceso y de descargas eléctricas en la pluma de ablación las cuales pueden inducir modificaciones en las propiedades de los recubrimientos. En este trabajo se aplican estas nuevas tecnologías a la obtención de capas cerámicas bioactivas de hidroxiapatita y de vidrio bioactivo. Se ha estudiado la influencia de parámetros de proceso como temperatura, diferencia de potencial de la descarga de radiofrecuencia aplicada y atmósfera reactiva, desde el punto de vista de la composición y estructura de los recubrimientos. En el caso de la hidroxiapatita, la presencia de una atmósfera de vapor de agua y de una descarga de radiofrecuencia favorece el ritmo de depósito y la cristalinidad de los recubrimientos. Sin embargo, los recubrimientos óptimos de vidrio bioactivo se obtienen en condiciones de vacío y ausencia de descargas eléctricas.

This study examines the effect of a hyaluronic acid (HyAc) containing tricalcium phosphate putty scaffold material (TCP-P) and of a particulate tricalcium phosphate (TCP-G) graft on bone formation, volume stability and osteogenic marker expression in biopsies sampled 6 months after bilateral sinus floor augmentation (SFA) in 7 patients applying a split-mouth design. 10% autogenous bone chips were added to the grafting material during surgery. The grain size of the TCP granules was 700 to 1400 µm for TCP-G and 125 to 250 µm and 500 to 700 µm (ratio 1:1) for TCP-P. Biopsies were processed for immunohistochemical analysis of resin-embedded sections. Sections were stained for collagen type I (Col I), alkaline phosphatase (ALP), osteocalcin (OC) and bone sialoprotein (BSP). Furthermore, the bone area and biomaterial area fraction were determined histomorphometrically. Cone-beam CT data recorded after SFA and 6 months later were used for calculating the graft volume at these two time points. TCP-P displayed more advantageous surgical handling properties and a significantly greater bone area fraction and smaller biomaterial area fraction. This was accompanied by significantly greater expression of Col I and BSP and in osteoblasts and osteoid and a less pronounced reduction in grafting volume with TCP-P. SFA using both types of materials resulted in formation of sufficient bone volume for facilitating stable dental implant placement with all dental implants having been in function without any complications for 6 years. Since TCP-P displayed superior surgical handling properties and greater bone formation than TCP-G, without the HyAc hydrogel matrix having any adverse effect on bone formation or graft volume stability, TCP-P can be regarded as excellent grafting material for SFA in a clinical setting. The greater bone formation observed with TCP-P may be related to the difference in grain size of the TCP granules and/or the addition of the HyAc.

The consolidation of highly porous nanostructured wollastonite powders was conducted via Spark Plasma Sintering (SPS) technique, and porous composite materials of high mechanical strength were obtained (Young׳s modulus over 60 MPa). Peculiarities of structural parameters variation of studied materials under SPS conditions within the temperature interval 800–1000 °С are described. The procedure of porous structure control of CaSiO 3 composites, allows obtaining of hierarchically porous silica framework from nano- to microsized pores through a poreforming agent (carbonaceous template), is suggested. Obtained silicate composites are classified as bioactive ceramic materials, which are prospective for application in medical practice. [ABSTRACT FROM AUTHOR]

Synthetic biopolymers are commonly used for the repair and regeneration of damaged tissues. Specifically targeting bone, the composite approach of utilizing inorganic components is considered promising in terms of improving mechanical and biological properties. We developed gelatin-apatite co-precipitates which mimic the native bone matrix composition within poly(lactide-co-caprolactone) (PLCL). Ionic reaction of calcium and phosphate with gelatin molecules enabled the co-precipitate formation of gelatin-apatite nanocrystals at varying ratios. The gelatin-apatite precipitates formed were carbonated apatite in nature, and were homogeneously distributed within the gelatin matrix. The incorporation of gelatin-apatite significantly improved the mechanical properties, including tensile strength, elastic modulus and elongation at break, and the improvement was more pronounced as the apatite content increased. Of note, the tensile strength increased to as high as 45 MPa (a four-fold increase vs. PLCL), the elastic modulus was increased up to 1500 MPa (a five-fold increase vs. PLCL), and the elongation rate was ∼240% (twice vs. PLCL). These results support the strengthening role of the gelatin-apatite precipitates within PLCL. The gelatin-apatite addition considerably enhanced the water affinity and the acellular mineral-forming ability in vitro in simulated body fluid; moreover, it stimulated cell proliferation and osteogenic differentiation. Taken together, the GAp-PLCL nanocomposite composition is considered to have excellent mechanical and biological properties, which hold great potential for use as bone regenerative matrices. [ABSTRACT FROM PUBLISHER]

The goal of periodontal tissue engineering is to regenerate alveolar bone, root cementum and periodontal ligament. To achieve this goal, bioactive scaffolds play an important role in inducing in vitro osteogenic/cementogenic gene expression of periodontal ligament cells (PDLCs) and in vivo bone/cementum formation. Diopside (DIOP: CaMgSi2O6) ceramics have shown excellent in vitro bioactivity for potential bone repair application. However, there is no study about DIOP porous scaffolds for periodontal tissue engineering. The aim of this study is to prepare DIOP scaffolds and investigate their in vitro and in vivo osteogenesis/cementogenesis for periodontal regeneration application. DIOP scaffolds with highly porous architecture were prepared and β-tricalcium phosphate (β-TCP) scaffolds were used for the control. The interaction of DIOP scaffolds with PDLCs was studied by investigating cell attachment, proliferation and ostegenic/cementogenic differentiation of PDLCs. DIOP scaffolds were implanted into the periodontal defects of beagle dogs to evaluate their in vivo osteogenesis/cementogenesis by hematoxylin and eosin (H&E), tartrate-resistant acid phosphatase staining, and immunohistochemistry (type I collagen: Col I; cementum attachment protein) analyses. The results have shown that DIOP scaffolds supported the attachment and proliferation of PDLCs. DIOP scaffolds significantly enhanced osteogenesis/cementogenesis-related gene expression (Col 1, Runx2, transforming growth factor beta 1, and bone morphogenetic protein 2) of PDLCs, compared to β-TCP scaffolds. The in vivo study showed that DIOP scaffolds induced new bone and cementum regeneration of periodontal tissue defects. The rate of new bone and cementum in DIOP scaffolds is comparable to that in conventional β-TCP scaffolds. Our results indicated that silicate-based DIOP ceramics could not only be used for bone tissue engineering, but also for periodontal tissue engineering due to their excellent in vitro and in vivo osteogeneis/cementogenesis. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 105-116, 2014. [ABSTRACT FROM AUTHOR]