Magnesium-incorporated biocomposite scaffolds:A novel frontier in bone tissue engineering

Nonunion represents a crucial challenge in orthopedic medicine,demanding innovative solutions beyond the scope of traditional bone grafting methods.Among the various strategies available,magnesium(Mg)implants have been recognized for their biocompatibility and biodegradability.However,their susceptibility to rapid corrosion and degradation has garnered notable research interest in bone tissue engineering(BTE),particularly in the development of Mg-incorporated biocomposite scaffolds.These scaffolds gradually release Mg2+,which enhances immunomodulation,osteogenesis,and angiogenesis,thus facilitating effective bone regeneration.This review presents myriad fabrication techniques used to create Mg-incorporated biocomposite scaffolds,including electrospinning,three-dimensional printing,and sol-gel synthesis.Despite these advancements,the application of Mg-incorporated biocomposite scaffolds faces challenges such as controlling the degradation rate of Mg and ensuring mechanical stability.These limitations highlight the necessity for ongoing research aimed at refining fabrication techniques to better regulate the physicochemical and osteogenic properties of scaffolds.This review provides insights into the potential of Mg-incorporated biocomposite scaffolds for BTE and the challenges that need to be addressed for their successful translation into clinical applications.

Bone tissue engineering via nanostructured calcium phosphate biomaterials and stem cells

Tissue engineering is promising to meet the increasing need for bone regeneration. Nanostructured calcium phosphate （CAP） biomaterials/scaffolds are of special interest as they share chemical/crystallographic similarities to inorganic components of bone. Three applications of nano-CaP are discussed in this review： nanostructured calcium phosphate cement （CPC）; nano-CaP composites; and nano-CaP coatings. The interactions between stem cells and nano-CaP are highlighted, including cell attachment, orientation/ morphology, differentiation and in vivo bone regeneration. Several trends can be seen： （i） nano-CaP biomaterials support stem cell attachment/proliferation and induce osteogenic differentiation, in some cases even without osteogenic supplements; （ii） the influence of nano-CaP surface patterns on cell alignment is not prominent due to non-uniform distribution of nano-crystals; （iii） nano-CaP can achieve better bone regeneration than conventional CaP biomaterials; （iv） combining stem cells with nano-CaP accelerates bone regeneration, the effect of which can be further enhanced by growth factors; and （v） cell microencapsulation in nano-CaP scaffolds is promising for bone tissue engineering. These understandings would help researchers to further uncover the underlying mechanisms and interactions in nano-CaP stem cell constructs in vitro and in vivo, tailor nano-CaP composite construct design and stem cell type selection to enhance cell function and bone regeneration, and translate laboratory findings to clinical treatments.

Study on β-TCP Coated Porous Mg as a Bone Tissue Engineering Scaffold Material

Three-dimensional honeycomb-structured magnesium （Mg） scaffolds with interconnected pores of accurately controlled pore size and porosity were fabricated by laser perforation technique. Biodegradable and bioactiveβ- tricalcium phosphate （β-TCP） coatings were prepared on and the biodegradation mechanism was simply evaluated the porous Mg to further improve its biocompatibility, in vitro. It was found that the mechanical properties of this type of porous Mg significantly depended on its porosity. Elastic modulus and compressive strength similar to human bones could be obtained for the porous Mg with porosity of 42.6%-51%. It was observed that the human osteosarcoma cells （UMR106） were well adhered and proliferated on the surface of the β- TCP coated porous Mg, which indicates that theβ-TCP coated porous Mg is promising to be a bone tissue engineering scaffold material.

Exploring the interconnectivity of biomimetic hierarchical porous Mg scaffolds for bone tissue engineering:Effects of pore size distribution on mechanical properties,degradation behavior and cell migration ability

Interconnectivity is the key characteristic of bone tissue engineering scaffold modulating cell migration,blood vessels invasion and transport of nutrient and waste.However,efforts and understanding of the interconnectivity of porous Mg is limited due to the diverse architectures of pore struts and pore size distribution of Mg scaffold systems.In this work,biomimetic hierarchical porous Mg scaffolds with tailored interconnectivity as well as pore size distribution were prepared by template replication of infiltration casting.Mg scaffold with better interconnectivity showed lower mechanical strength.Enlarging interconnected pores would enhance the interconnectivity of the whole scaffold and reduce the change of ion concentration,pH value and osmolality of the degradation microenvironment due to the lower specific surface area.Nevertheless,the degradation rates of five tested Mg scaffolds were no different because of the same geometry of strut unit.Direct cell culture and evaluation of cell density at both sides of four typical Mg scaffolds indicated that cell migration through hierarchical porous Mg scaffolds could be enhanced by not only bigger interconnected pore size but also larger main pore size.In summary,design of interconnectivity in terms of pore size distribution could regulate mechanical strength,microenvironment in cell culture condition and cell migration potential,and beyond that it shows great potential for personalized therapy which could facilitate the regeneration process.

Design and Preparation of Bone Tissue Engineering Scaffolds with Porous Controllable Structure

A novel method of designing and preparing bone tissue engineering scaffolds with controllable porous structure of both macro channels and micro pores was proposed. The CAD software UG NX3.0 was used to design the macro channels＇ shape, size and distribution. By integrating rapid prototyping and traditional porogen technique, the macro channels and micro pores were formed respectively. The size, shape and quantity of micro pores were controlled by porogen particulates. The sintered β-TCP porous scaffolds possessed connective macro channels of approximately 500 μm and micro pores of 200-400 μm. The porosity and connectivity of micro pores became higher with the increase of porogen ratio, while the mechanical properties weakened. The average porosity and compressive strength offl-TCP scaffolds prepared with porogen ratio of 60wt% were 78.12% and 0.2983 MPa, respectively. The cells＇ adhesion ratio of scaffolds was 67.43%. The ALP activity, OCN content and cells micro morphology indicated that cells grew and proliferated well on the scaffolds.

Design and Simulation of Flow Field for Bone Tissue Engineering Sca old Based on Triply Periodic Minimal Surface

A novel method was proposed to design the structure of a bone tissue engineering scafold based on triply periodic minimal surface.In this method,reverse engineering software was used to reconstruct the surface from point cloud data.This method overcomes the limitations of commercially available software packages that prevent them from generating models with complex surfaces used for bone tissue engineering scafolds.Additionally,the fluid feld of the scafolds was simulated through a numerical method based on fnite volume and the cell proliferation performance was evaluated via an in vitro experiment.The cell proliferation and the mass flow evaluated in a bioreactor further verifed the flow feld simulated using computational fluid dynamics.The result of this study illustrates that the pressure value drops rapidly from 0.103 Pa to 0.011 Pa in the y-axis direction and the mass flow is unevenly distributed in the outlets.The mass flow in the side outlets is observed to be approximately 24.3 times higher thanthe bottom.Importantly,although the mean value of wall shear stress is signifcantly more than 0.05 Pa,there is stil a large area with a suitable shear stress below 0.05 Pa where most cells can proliferate well.The result shows that th inlet velocity 0.0075 m/s is suitable for cell proliferation in the scafold.This study provides an insight into the design analysis,and in vitro experiment of a bone tissue engineering scafold.

Oxysterols as promising small molecules for bone tissue engineering: Systematic review

BACKGROUND Bone tissue engineering is an area of continued interest within orthopaedic surgery,as it promises to create implantable bone substitute materials that obviate the need for autologous bone graft.Recently,oxysterols–oxygenated derivatives of cholesterol-have been proposed as a novel class of osteoinductive small molecules for bone tissue engineering.Here,we present the first systematic review of the in vivo evidence describing the potential therapeutic utility of oxysterols for bone tissue engineering.AIM To systematically review the available literature examining the effect of oxysterols on in vivo bone formation.METHODS We conducted a systematic review of the literature following PRISMA guidelines.Using the PubMed/MEDLINE,Embase,and Web of Science databases,we queried all publications in the English-language literature investigating the effect of oxysterols on in vivo bone formation.Articles were screened for eligibility using PICOS criteria and assessed for potential bias using an expanded version of the SYRCLE Risk of Bias assessment tool.All full-text articles examining the effect of oxysterols on in vivo bone formation were included.Extracted data included:Animal species,surgical/defect model,description of therapeutic and control treatments,and method for assessing bone growth.Primary outcome was fusion rate for spinal fusion models and percent bone regeneration for critical-sized defect models.Data were tabulated and described by both surgical/defect model and oxysterol employed.Additionally,data from all included studies were aggregated to posit the mechanism by which oxysterols may mediate in vivo bone formation.RESULTS Our search identified 267 unique articles,of which 27 underwent full-text review.Thirteen studies(all preclinical)met our inclusion/exclusion criteria.Of the 13 included studies,5 employed spinal fusion models,2 employed critical-sized alveolar defect models,and 6 employed critical-sized calvarial defect models.Based upon SYRCLE criteria,the included studies were found to possess an overall“unclear risk of bias”;54%of studies reported treatment randomization and 38%reported blinding at any level.Overall,seven unique oxysterols were evaluated:20(S)-hydroxycholesterol,22(R)-hydroxycholesterol,22(S)-hydroxycholesterol,Oxy4/Oxy34,Oxy18,Oxy21/Oxy133,and Oxy49.All had statistically significant in vivo osteoinductive properties,with Oxy4/Oxy34,Oxy21/Oxy133,and Oxy49 showing a dose-dependent effect in some cases.In the eight studies that directly compared oxysterols to rhBMP-2-treated animals,similar rates of bone growth occurred in the two groups.Biochemical investigation of these effects suggests that they may be primarily mediated by direct activation of Smoothened in the Hedgehog signaling pathway.CONCLUSION Present preclinical evidence suggests oxysterols significantly augment in vivo bone formation.However,clinical trials are necessary to determine which have the greatest therapeutic potential for orthopaedic surgery patients.

Three-dimensional printing of biomaterials for bonetissue engineering: a review

Processing biomaterials into porous scaffolds for bone tissueengineering is a critical and a key step in defining and controlling their physicochemical,mechanical,and biological properties.Biomaterials such as polymers are commonlyprocessed into porous scaffolds using conventional processing techniques,e.g.,saltleaching.However,these traditional techniques have shown unavoidable limitations andseveral shortcomings.For instance,tissue-engineered porous scaffolds with a complexthree-dimensional(3D)geometric architecture mimicking the complexity of theextracellular matrix of native tissues and with the ability to fit into irregular tissue defectscannot be produced using the conventional processing techniques.3D printing hasrecently emerged as an advanced processing technology that enables the processing ofbiomaterials into 3D porous scaffolds with highly complex architectures and tunableshapes to precisely fit into irregular and complex tissue defects.3D printing providescomputer-based layer-by-layer additive manufacturing processes of highly precise andcomplex 3D structures with well-defined porosity and controlled mechanical propertiesin a highly reproducible manner.Furthermore,3D printing technology provides anaccurate patient-specific tissue defect model and enables the fabrication of a patientspecifictissue-engineered porous scaffold with pre-customized properties.

Biomaterial–Related Cell Microenvironment in Tissue Engineering and Regenerative Medicine

An appropriate cell microenvironment is key to tissue engineering and regenerative medicine.Revealing the factors that influence the cell microenvironment is a fundamental research topic in the fields of cell biology,biomaterials,tissue engineering,and regenerative medicine.The cell microenvironment consists of not only its surrounding cells and soluble factors,but also its extracellular matrix(ECM)or nearby external biomaterials in tissue engineering and regeneration.This review focuses on six aspects of bioma-terial-related cell microenvironments:①chemical composition of materials,②material dimensions and architecture,③material-controlled cell geometry,④effects of material charges on cells,⑤matrix stiff-ness and biomechanical microenvironment,and⑥surface modification of materials.The present chal-lenges in tissue engineering are also mentioned,and eight perspectives are predicted.

Hybrid polymer biomaterials for bone tissue regeneration

Native tissues possess unparalleled physiochemical and biological functions, which can be attributed to their hybrid polymer composition and intrinsic bioactivity. However, there are also various concerns or limitations over the use of natural materials derived from animals or cadavers, including the potential immunogenicity, pathogen transmission, batch to batch consistence and mismatch in properties for various applications. Therefore, there is an increasing interest in developing degradable hybrid polymer biomaterials with controlled properties for highly efficient biomedical applications. There have been efforts to mimic the extracellular protein structure such as nanofibrous and composite scaffolds, to functionalize scaffold surface for improved cellular interaction, to incorporate controlled biomolecule release capacity to impart biological signaling, and to vary physical properties of scaffolds to regulate cellular behavior. In this review, we highlight the design and synthesis of degradable hybrid polymer biomaterials and focus on recent developments in osteoconductive, elastomeric, photoluminescent and electroactive hybrid polymers. The review further exemplifies their applications for bone tissue regeneration.

Evaluating and Modeling the Mechanical Properties of the Prepared PLGA/nano-BCP Composite Scaffolds for Bone Tissue Engineering

In this paper, preparation of nano-biphasic calcium phosphate （nBCP）, mechanical behavior and load-bearing of poly （lactide-co-glycolide） （PLGA） and PLGA/nBCP are presented. The nBCP with composition of 63/37 （w/w） HA/-TCP （hydroxyapatite/fl-tricalcium phosphate） was produced by heating of bovine bone at 700℃. Composite scaffolds were made by using PLGA matrix and 10-50 wt% nBCP powders as reinforcement material. All scaffolds were prepared by thermally induced solid-liquid phase separation （TIPS） at -60~C under 4 Pa （0.04 mbar） vacuum. The results of elastic modulus testing were adjusted with Ishai-Cohen and Narkis models for rigid polymeric matrix and compared to each other. PLGA/nBCP scaffolds with 30 wt% nBCP showed the highest value of yield strength among the scaffolds. In addition, it was found that by increasing the nBCP in scaffolds to 50 wt%, the modulus of elasticity was highly enhanced. However, the optimum value of yield strength was obtained at 30 wt% nBCP, and the agglomeration of reinforcing particles at higher percentages caused a reduction in yield strength. It is clear that the elastic modulus of matrix has the significant role in elastic modulus of scaffolds, as also the size of the filler particles in the matrix.

Recent advances in two-dimensional nanomaterials for bone tissue engineering

Over the last decades,bone tissue engineering has increasingly become a research focus in the field of biomedical engineering,in which biomaterials play an important role because they can provide both biomechanical support and osteogenic microenvironment in the process of bone regeneration.Among these biomaterials,two-dimensional(2D)nanomaterials have recently attracted considerable interest owing to their fantastic physicochemical and biological properties including great biocompatibility,excellent osteogenic capability,large specific surface area,and outstanding drug loading capacity.In this review,we summarize the state-of-the-art advances in 2D nanomaterials for bone tissue engineering.Firstly,we introduce the most explored biomaterials used in bone tissue engineering and their advantages.We then highlight the advances of cutting-edge 2D nanomaterials such as graphene and its derivatives,layered double hydroxides,black phosphorus,transition metal dichalcogenides,montmorillonite,hexagonal boron nitride,graphite phase carbon nitride,and transition metal carbonitrides(MXenes)used in bone tissue engineering.Finally,the current challenges and future prospects of 2D nanomaterials for bone tissue regeneration in process of clinical translation are discussed.

Biomaterial scaffolds in maxillofacial bone tissue engineering:A review of recent advances

Maxillofacial bone defects caused by congenital malformations,trauma,tumors,and inflammation can severely affect functions and aesthetics of maxillofacial region.Despite certain successful clinical applications of biomaterial scaffolds,ideal bone regeneration remains a challenge in maxillofacial region due to its irregular shape,complex structure,and unique biological functions.Scaffolds that address multiple needs of maxillofacial bone regeneration are under development to optimize bone regeneration capacity,costs,operational convenience.etc.In this review,we first highlight the special considerations of bone regeneration in maxillofacial region and provide an overview of the biomaterial scaffolds for maxillofacial bone regeneration under clinical examination and their efficacy,which provide basis and directions for future scaffold design.Latest advances of these scaffolds are then discussed,as well as future perspectives and challenges.Deepening our understanding of these scaffolds will help foster better innovations to improve the outcome of maxillofacial bone tissue engineering.

3D-printed Mg-1Ca/polycaprolactone composite scaffolds with promoted bone regeneration

In bone tissue engineering,polycaprolactone(PCL)is a promising material with good biocompatibility,but its poor degradation rate,mechanical strength,and osteogenic properties limit its application.In this study,we developed an Mg-1Ca/polycaprolactone(Mg-1Ca/PCL)composite scaffolds to overcome these limitations.We used a melt blending method to prepare Mg-1Ca/PCL composites with Mg-1Ca alloy powder mass ratios of 5,10,and 20 wt%.Porous scaffolds with controlled macro-and microstructure were printed using the fused deposition modeling method.We explored the mechanical strength,biocompatibility,osteogenesis performance,and molecular mechanism of the Mg-1Ca/PCL composites.The 5 and 10 wt%Mg-1Ca/PCL composites were found to have good biocompatibility.Moreover,they promoted the mechanical strength,proliferation,adhesion,and osteogenic differentiation of human bone marrow stem cells(hBMSCs)of pure PCL.In vitro degradation experiments revealed that the composite material stably released Mg_(2)+ions for a long period;it formed an apatite layer on the surface of the scaffold that facilitated cell adhesion and growth.Microcomputed tomography and histological analysis showed that both 5 and 10 wt%Mg-1Ca/PCL composite scaffolds promoted bone regeneration bone defects.Our results indicated that the Wnt/β-catenin pathway was involved in the osteogenic effect.Therefore,Mg-1Ca/PCL composite scaffolds are expected to be a promising bone regeneration material for clinical application.Statement of significance:Bone tissue engineering scaffolds have promising applications in the regeneration of critical-sized bone defects.However,there remain many limitations in the materials and manufacturing methods used to fabricate scaffolds.This study shows that the developed Ma-1Ca/PCL composites provides scaffolds with suitable degradation rates and enhanced boneformation capabilities.Furthermore,the fused deposition modeling method allows precise control of the macroscopic morphology and microscopic porosity of the scaffold.The obtained porous scaffolds can significantly promote the regeneration of bone defects.

Recent advances in biomaterials for 3D scaffolds: A review

Considering the advantages and disadvantages of biomaterials used for the production of 3D scaffolds for tissue engineering,new strategies for designing advanced functional biomimetic structures have been reviewed.We offer a comprehensive summary of recent trends in development of single-(metal,ceramics and polymers),composite-type and cell-laden scaffolds that in addition to mechanical support,promote simultaneous tissue growth,and deliver different molecules(growth factors,cytokines,bioactive ions,genes,drugs,antibiotics,etc.)or cells with therapeutic or facilitating regeneration effect.The paper briefly focuses on divers 3D bioprinting constructs and the challenges they face.Based on their application in hard and soft tissue engineering,in vitro and in vivo effects triggered by the structural and biological functionalized biomaterials are underlined.The authors discuss the future outlook for the development of bioactive scaffolds that could pave the way for their successful imposing in clinical therapy.

含铜介孔生物活性玻璃的体外成血管及成骨性能

背景:介孔生物活性玻璃因优异的生物相容性、骨诱导活性在骨修复方面具有巨大的应用潜力,将治疗性离子融入介孔生物活性玻璃颗粒中可赋予材料更加理想的生物学特性。目的:合成含铜介孔生物活性玻璃,探讨其体外促血管形成及成骨分化性能。方法:采用微乳液辅助溶胶-凝胶法合成介孔生物活性玻璃与含铜介孔生物活性玻璃,通过扫描电镜、透射电镜、能谱分析和X射线衍射等手段表征材料的形貌、结构和成分及离子缓释性能。将介孔生物活性玻璃浸提液、含铜介孔生物活性玻璃浸提液分别与小鼠成纤维细胞L929共培养,通过活死染色、CCK-8实验评价材料的生物相容性。将两种材料浸提液分别与人脐静脉内皮细胞共培养,通过Transwell实验、划痕实验和CD31免疫荧光染色评价材料的促血管形成性能。将两种材料浸提液分别与小鼠骨髓间充质干细胞共培养,通过碱性磷酸酶染色(未加入成骨诱导液)、茜素红染色(加入成骨诱导液)评估材料的促成骨性能。结果与结论:①表征结果显示,介孔生物活性玻璃和含铜介孔生物活性玻璃均呈现紧密排列的颗粒状形貌,内部介孔结构相似,含铜介孔生物活性玻璃可持续释放铜离子;②活死染色与CCK-8实验结果显示,相较于介孔生物活性玻璃,含铜介孔生物活性玻璃可促进L929细胞的增殖,具有良好的生物相容性;③Transwell实验、划痕实验和CD31免疫荧光染色结果显示,相较于介孔生物活性玻璃,含铜介孔生物活性玻璃可促进人脐静脉内皮细胞的迁移与CD31蛋白表达,促进血管形成;④碱性磷酸酶染色与茜素红染色结果显示,含铜介孔生物活性玻璃的促成骨性能强于介孔生物活性玻璃。结果表明:含铜介孔生物活性玻璃具有优异的生物相容性和促血管形成及骨再生潜力。

贻贝启发接枝骨形态发生蛋白2成骨活性肽的介孔生物玻璃修复股骨髁缺损

背景:骨形态发生蛋白2在胚胎发育、骨骼形成和再生修复中具有重要作用,但高剂量应用与癌症发病密切相关。骨形态发生蛋白2成骨活性段L20能够有效减少癌症等不良反应,并可显著促进骨组织再生。目的:将骨形态发生蛋白2活性肽段以贻贝衍生肽模拟策略接枝在介孔生物玻璃表面,探究其对组织工程成骨性能的影响。方法:(1)采用模板法合成介孔生物玻璃纳米颗粒,采用一步法合成负载骨形态发生蛋白2成骨活性肽L20的介孔生物玻璃纳米颗粒,表征负载骨形态发生蛋白2成骨活性肽L20介孔活性玻璃纳米颗粒的形貌与体外缓释性能。(2)分离提取SD大鼠骨髓间充质干细胞,传2代后分别与PBS(空白组)、介孔生物玻璃纳米颗粒(对照组)、负载骨形态发生蛋白2成骨活性肽L20介孔生物玻璃纳米颗粒(实验组)共培养,采用细胞活死荧光染色和CCK-8法检测细胞毒性和细胞增殖,扫描电镜观察细胞黏附;成骨诱导分化后,进行碱性磷酸酶染色、茜素红S染色与成骨相关基因表达检测。(3)取15只SD大鼠,建立双侧股骨髁缺损模型,采用随机数字表法分为3组:空白组(n=5)不植入任何材料,对照组(n=5)植入介孔生物玻璃纳米颗粒,实验组(n=5)植入负载骨形态发生蛋白2成骨活性肽L20介孔生物玻璃纳米颗粒。术后8周,进行股骨Micro-CT扫描与组织形态观察。结果与结论:(1)扫描电镜下可见负载骨形态发生蛋白2成骨活性肽L20介孔生物玻璃纳米颗粒为球形、单分散颗粒,透射电镜下可见其具有多孔结构,平均粒径为(268.10±0.58) nm,体外可缓释L20。(2)负载骨形态发生蛋白2成骨活性肽L20介孔生物玻璃纳米颗粒无细胞毒性,并且可促进骨髓间充质干细胞的增殖与黏附;与空白组、对照组相比,实验组碱性磷酸酶活性与细胞外基质矿化能力均升高(P <0.05),碱性磷酸酶、Runx2、骨钙素mRNA表达升高(P <0.05)。(3)股骨Micro-CT扫描结果显示,与空白组、对照组相比,实验组新生骨量与骨密度均升高(P <0.05);苏木精-伊红与Masson染色结果显示,与空白组、对照组相比,实验组新骨生成与胶原纤维均增加。(4)结果表明,负载骨形态发生蛋白2活性肽L20介孔生物玻璃纳米颗粒具有良好的生物相容性及体内外促成骨性能,可促进SD大鼠股骨髁缺损的再生修复。

Bone tissue engineering scaffold materials: Fundamentals, advances, and challenges

Bone damage caused by trauma and tumors is a serious problem for human health, therefore, three-dimensional (3D) scaffolding materials that stimulate and promote the regeneration of broken bone tissues have become the focus of current research in the field of bone damage repair.To this regard, a preferential combination of materials and preparation techniques is considered crucial for the preparation of advanced bone tissue engineering scaffolds to better facilitate the regeneration of broken bone.In this review, current research advances and challenges in bone tissue engineering scaffolds are discussed and analyzed in detail.First, we elucidated the structure and self-healing mechanism of bone tissue.Subsequently, the main applications of different materials, including inorganic and organic materials, in bone tissue engineering scaffolds are summarized.Moreover, we overview the latest research progress of the mainstream preparation strategies of bone tissue engineering scaffolds, and provide an in-depth analysis of the different advantages of each method.Finally, promising future directions and challenges of bone tissue engineering scaffolds are systematically discussed.

水凝胶:口腔颌面部组织缺损修复中的作用与问题

背景:水凝胶因优越的机械及生物性能在生物医学领域占据独特优势,已成为研究热点。目前水凝胶相关研究涉及组织工程和创口敷料等方面。目的:综述水凝胶的优势性能与在口腔颌面部缺损修复领域中的应用研究进展,探讨水凝胶目前在应用推广中的局限以及在此领域所面临的挑战,为未来研究方向提供新思路。方法:利用计算机检索Pub Med、中国知网、万方数据库发表的相关文献,检索词为“水凝胶,口腔颌面部缺损,机械性能,组织工程,创口敷料”“hydrogel,oral and maxillofacial defects,mechanical properties,guided tissue regeneration,wound dressing”。通过阅读文题和摘要进行初步筛选,排除与文章主题不相关的文献,根据纳入标准和排除标准,最终纳入108篇文献进行结果分析。结果与结论:(1)水凝胶具有良好的生物学活性、机械可控性及刺激响应等优势性能。(2)聚合物、金属和陶瓷联合制备的水凝胶复合物具有适当的机械性能、生物降解性以及可控的释放速率,契合颌面骨组织工程的需求。(3)纤维蛋白基水凝胶可填充穿过神经缺损区域的中空神经导管并促进轴突再生和生长从而恢复颌面神经功能。(4)控制纳米材料和水凝胶的相互作用可以改善肌纤维定向结构的形成以促进颌面肌组织再生。(5)多糖水凝胶,因具有控制药物递送和携带生物活性分子等作用,并且与其他材料联合应用可以产生与细胞外基质相匹配的最佳支架,因此逐渐成为修复不规则牙周缺损的首选。(6)磷酸钙或碳酸钙基水凝胶中填充不规则形状或精细的组织缺损并使牙体硬组织再矿化,自组装水凝胶制备简便且生物活性优良。(7)唾液腺来源的细胞外基质样凝胶有望参与许多唾液腺疾病的治疗。(8)水凝胶可作为伤口敷料结合生物黏合剂、脱细胞生物材料、抗微生物和抗氧化剂或干细胞等而被广泛用于治疗各种伤口。(9)纤维蛋白基水凝胶在口腔颌面部缺损修复中最具潜力,其具有优良的生物相容性、柔韧性和可塑性,可与细胞、细胞外基质蛋白和各种生长因子结合,能够促进间充质干细胞的成骨分化、轴突的再生与生长、血管生成、肌管分化、唾液腺组织再生和牙周组织再生,在口腔颌面部缺损组织的修复中具有广泛前景。然而其治疗效果取决于所携带物质的功能,复杂的制备工艺、安全性和长期疗效以及口腔颌面特殊的解剖结构是阻碍推广的难题,这也为未来的研究提供了方向。

Additively manufactured metallic biomaterials

Metal additive manufacturing(AM)has led to an evolution in the design and fabrication of hard tissue substitutes,enabling personalized implants to address each patient’s specific needs.In addition,internal pore architectures integrated within additively manufactured scaffolds,have provided an opportunity to further develop and engineer functional implants for better tissue integration,and long-term durability.In this review,the latest advances in different aspects of the design and manufacturing of additively manufactured metallic biomaterials are highlighted.After introducing metal AM processes,biocompatible metals adapted for integration with AM machines are presented.Then,we elaborate on the tools and approaches undertaken for the design of porous scaffold with engineered internal architecture including,topology optimization techniques,as well as unit cell patterns based on lattice networks,and triply periodic minimal surface.Here,the new possibilities brought by the functionally gradient porous structures to meet the conflicting scaffold design requirements are thoroughly discussed.Subsequently,the design constraints and physical characteristics of the additively manufactured constructs are reviewed in terms of input parameters such as design features and AM processing parameters.We assess the proposed applications of additively manufactured implants for regeneration of different tissue types and the efforts made towards their clinical translation.Finally,we conclude the review with the emerging directions and perspectives for further development of AM in the medical industry.