Bony engineering using time-release porous scaffolds to provide sustained growth factor delivery

Microporous scaffolds designed to improve bony repair have had limited success; therefore, we sought to evaluate whether time-released porous scaffolds with or without recombinant bone morphogenetic protein 2 (rhBMP-2) could enhance stem cell osteoinduction. Custom-made 15/85 hydroxyapatite/β-tricalcium phosphate scaffolds were left empty (E) or filled with rhBMP-2 (E+), calcium sulfate (CS), or CS and rhBMP-2 (CS+). All scaffolds were placed in media and weighed daily. Conditioned supernatant was analyzed for rhBMP-2 and then used to feed human adipose-derived mesenchymal stem cells (ASCs). Adipose-derived mesenchymal stem cell ALP activity, OSTERIX expression, and bone nodule formation were determined. E scaffolds retained 97% (SD, 2%) of the initial weight, whereas CS scaffolds had a near-linear 30% (SD, 3%) decrease over 60 days. E+ scaffolds released 155 (SD, 5) ng of rhBMP-2 (77%) by day 2. In contrast, CS+ scaffolds released only 30 (SD, 2) ng (10%) by day 2, and the remaining rhBMP-2 was released over 20 days. Conditioned media from E+ scaffolds stimulated the highest ALP activity and OSTERIX expression in ACSs on day 2. However, after day 6, media from CS+ scaffolds stimulated the highest ALP activity and OSTERIX expression in ASCs. Adipose-derived mesenchymal stem cells exposed to day 8 CS+-conditioned media produced significantly more bone nodules (10.1 [SD, 1.7] nodules per high-power field) than all other scaffolds. Interestingly, day 8 conditioned media from CS scaffolds simulated significantly more bone nodules than either E or E+ scaffold (P < 0.05 for both). Time-released hydroxyapatite/β-tricalcium phosphate porosity provides sustained growth factor release, enhances ASC osteoinduction, and may result in better in vivo bone formation.     

京尼平交联改性可溶性蛋壳膜蛋白冻干支架的制备及检测

目的：评价京尼平交联改性前后可溶性蛋壳膜蛋白（soluble eggshell membrane protein,SEP）冻干组织工程支架的理化性能和生物相容性。方法：冷冻干燥法制备SEP的冻干支架,浸泡于京尼平溶液中交联改性。通过扫描电镜观察其表面形貌。测量其孔隙率、抗拉强度以及降解率,采用溶血实验、亚急性全身毒性实验和细胞毒性实验初步评价其生物相容性。结果：京尼平交联改性前后的SEP冻干支架孔径分别为（280±71）μm和（263±89）μm,孔隙率分别为（90.4±7.6）%和（87.9±9.7）%;交联改性显著提高了SEP冻干支架的拉伸强度和弹性模量,降低了支架的失重率（P〈0.01）;交联前后的材料均无溶血现象;亚急性短期全身毒性实验中组织切片均未见病理变化;细胞毒性检测均为0级。结论：京尼平交联改性在提高SEP冻干支架的力学强度和抗降解能力的同时,仍可保持支架材料良好的生物相容性。     

三维打印β-TCP颌骨修复支架的生物学评价

目的:探讨三维打印β-磷酸三钙(β-Tricalcium Phosphate, β-TCP)颌骨修复支架的生物学特性及体内成骨作用。方法:采用自动注浆技术制作β-TCP支架,将前成骨细胞(MC35T3-E1)接种在支架上,扫描电镜(SEM)观察材料结构与细胞黏附,CCK-8法检测细胞增殖,ALP法检测碱性磷酸酶活性。将2种支架复合重组人骨形成蛋白-2(recombinant human bone morphogenetic protein-2, rhBMP-2)后植入大鼠体内,发泡法制作的β-TCP支架为对照组,6周后取材行组织学观察。结果:三维打印支架具有规则多孔的立体结构,适合细胞黏附,且增殖及分化能力均高于对照组(P<0.05)。组织学显示复合rhBMP-2后三维打印支架新骨生成量高于发泡法制作的β-TCP支架(P<0.05)。结论:三维打印TCP支架生物相容性良好,复合rhBMP-2后可异位成骨。     

Development and characterization of a new chitosan-based scaffold associated with gelatin,microparticulate dentin and genipin for endodontic regeneration

ObjectiveAn ideal scaffold for endodontic regeneration should allow the predictableness of the new tissue organization and limit the negative impact of residual bacteria. Therefore, composition and functionalization of the scaffold play an important role in tissue bioengineering. The objective of this study was to assess the morphological, physicochemical, biological and antimicrobial properties of a new solid chitosan-based scaffold associated with gelatin, microparticulate dentin and genipin.MethodsScaffolds based on chitosan (Ch); chitosan associated with gelatin and genipin (ChGG); and chitosan associated with gelatin, microparticulate dentin and genipin (ChGDG) were prepared by using the freeze-drying method. The morphology of the scaffolds was analyzed by scanning electron microscopy (SEM). The physicochemical properties were assessed for biodegradation, swelling and total released proteins. The biological aspects of the scaffolds were assessed using human cells from the apical papilla (hCAPs). Cell morphology and adhesion to the scaffolds were evaluated by SEM, cytotoxicity and cell proliferation by MTT reduction-assay. Cell differentiation in scaffolds was assessed by using alizarin red assay. The antimicrobial effect of the scaffolds was evaluated by using the bacterial culture method, and bacterial adhesion to the scaffolds was observed by SEM.ResultsAll the scaffolds presented porous structures. The ChCDG had more protein release, adhesion, proliferation and differentiation of hCAPs, and bacteriostatic effect on Enterococcus faecalis than Ch and ChGG (p < 0.05).SignificanceThe chitosan associated with gelatin, microparticulate dentin and genipin has morphological, physicochemical, biological and antibacterial characteristics suitable for their potential use as scaffold in regenerative endodontics.     

Chitosan in association with osteogenic factors as a cell-homing platform for dentin regeneration: Analysis in a pulp-in-a-chip model

ObjectiveIn this paper we propose the association of β-glycerophosphate (βGP) and calcium-hydroxide with chitosan (CH) to formulate a porous bioactive scaffold suitable as a cell-homing platform for dentin regeneration.MethodsCalcium hydroxide and βGP solutions were incorporated into chitosan to modulate scaffold architecture and composition by a phase separation technique. Architecture, chemical composition, and degradability were evaluated, and biological characterizations were performed by the seeding of dental pulp cells (DPCs) onto scaffolds, or by cultivating them in contact with leachable components (extracts), to determine cytocompatibility and odontoblastic differentiation. Cell-free scaffolds were then positioned in intimate contact with a 3D culture of DPCs in a pulp-in-a-chip platform under simulated pulp pressure. Cell mobilization and odontoblastic marker expression were evaluated. Deposition of mineralized matrix was assessed in direct contact with dentin, in the absence of osteogenic factors.ResultsIncorporation of calcium hydroxide and βGP generated a stable porous chitosan scaffold containing Ca-P nanoglobule topography (CH-Ca-βGP), which favored cell viability, alkaline phosphatase activity, and mineralized matrix deposition by cells seeded onto the scaffold structure and at a distance. The pulp-in-a-chip assay denoted its chemotactic and bioactive potential, since dentin sialoprotein-positive DPCs from 3D culture adhered to CH-Ca-βGP more than to plain chitosan. The higher deposition of mineralized matrix onto the scaffold and surrounding dentin was also observed.SignificanceA CH-Ca-βGP scaffold creates a microenvironment capable of mobilizing DPC migration toward its structure, harnessing the odontogenic potential and culminating in the expression of a highly mineralizing phenotype, key factors for a cell-homing strategy.     

Ectopic bone formation after implantation of a slow release system of polylactid acid and rhBMP-2

Objectives: The present study was conducted to test the hypothesis that preshaped polylactic acid (PLA) implants loaded with recombinant human bone morphogenic protein 2 (rhBMP-2) can induce bone formation in a rat ectopic model.
Materials and methods: Two groups of porous cylindrical poly- dl -lactic acid implants of 8-mm diameter were produced by gas foaming with CO₂, incorporating 48 and 96 μg rhBMP-2, respectively, into each implant. Blank PLA implants were used as controls. The release of BMPs and the induction of alkaline phosphatase were assessed in vitro . Osteoinduction in vivo was tested by insertion of 15 implants from each group into the gluteal muscles of Wistar rats. Five implants from each group were retrieved after 6, 13 and 26 weeks and assessed using flat panel volume detector computed tomography and light microscopy.
Results: Both groups of implants showed increased release of rhBMP-2 during the first 24–48 h, with a slightly higher amount being released from the implants with 48 μg. Release during subsequent intervals was <100 ng/72 h in the low-concentration group and >100 ng in the group with 96 μg rhBMP-2. Implants with 95 μg rhBMP-2 exhibited bone formation in vivo on the outside of the implants across the observation period of 26 weeks with invasion of bone into the pores, whereas implants with 48 μg rhBMP-2 failed to induce the formation of bone tissue. No bone formation was found in the control implants.
Conclusions: The results suggest that release rates of rhBMP-2 for ectopic bone induction have to be >100 ng/72 h to maintain the osteoinductive activity of the tested porous PLA implants. This slow release system may have impact on alveolar bone augmentation procedures when used as individually preformed osteoinductive implants.     

Formation of a mandibular condyle in vitro by tissue engineering.

PURPOSE: Mandibular reconstructive procedures often produce significant donor site morbidity. Recently, the use of minimally invasive techniques has been reported for mandibular reconstruction with decreased morbidity at the primary operative site. To date, these techniques have not addressed the graft donor site. We hypothesize that tissue-engineering techniques may be used to fabricate bone and thereby eliminate donor site morbidity. METHODS: Porcine mesenchymal stem cells (pMSCs) were isolated from the bone marrow of 3 Yucatan minipigs and grown in standard culture flasks. When they became near-confluent, cells were detached and replated with the addition of osteogenic supplements. A model of a porcine mandibular condyle was made and used to fabricate porous polymer scaffolds from biodegradable poly DL-lactic-co-glycolic acid (PLGA). Differentiated osteoblasts were transferred to the PLGA scaffold and cultured for 6 weeks in a rotational oxygen-permeable bioreactor system. The cultured constructs, consisting of scaffold and cells, were evaluated by gross, radiologic, and histologic examinations. RESULTS: The engineered constructs were white and hard and had a shape that closely resembled that of the model condyle. Plain radiographs demonstrated that the radiodensity of the construct was between that of the normal condyle and that of control scaffolds. Histologically, bone was observed on the entire surface of the PLGA scaffolds with an average thickness of 0.03 mm. Bone was not observed in the control scaffolds. CONCLUSION: In this pilot study, autologous tissue-engineered bone constructs were successfully made by combining biodegradable polymers and pMSCs.     

丝素蛋白/纳米羟磷灰石支架的实验研究

目的设计和构建三维丝素蛋白/羟磷灰石骨组织工程支架材料。方法联合运用丝素蛋白非编织方法和仿生矿化技术,制备并表征三维多孔丝素蛋白/纳米羟磷灰石的有机/无机组织工程支架。结果仿生矿化在非编织支架上形成的针状羟磷灰石晶体,直径20～60 nm,长100～300 nm。复合支架孔隙度为70%～78%,孔径为（163.4±42.6）μm。结论采用非编织丝素蛋白和仿生矿化的方法可制备孔隙度和孔径可控的组织工程支架。     

Enhanced bone augmentation by controlled release of recombinant human bone morphogenetic protein-2 from bioabsorbable membranes

BACKGROUND: The present study was undertaken to determine the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded biodegradable membranes on bone augmentation in a rabbit calvarial model. METHODS: Five microg of rhBMP-2 was loaded into a stiff hemispherical dome membrane made of poly(L-lactide) and tricalcium phosphate (PLLA/TCP). The release kinetics of rhBMP-2 from the membrane were determined in vitro using a human BMP-2 immunoassay. Twelve rhBMP-2-loaded dome membranes (test group) and 12 control dome membranes (control group) were placed on the partial-thickness calvarial defects of 24 rabbits. The animals were sacrificed at 4 and 8 weeks, and undecalcified ground sections were prepared. Newly formed bone area and height were measured histomorphometrically and calculated by percentage ratio to the total submembranous space area and height below the dome. RESULTS: In vitro release results demonstrated that rhBMP-2 was released consistently over a 4-week period following a high initial burst release on the first day. At both 4 and 8 weeks, histomorphometric analysis revealed that the test group showed significantly higher newly formed bone heights and areas than the control group (P < 0.01). In the control group, new bone height was 36.3% of the dome height and the new bone area reached 8.2% of the submembranous space area at 8 weeks, while the test group reached 87.3% and 35.4%, respectively. CONCLUSION: These results suggest that the use of rhBMP-2-loaded PLLA/TCP membranes can result in additional bone augmentation, which is due to the osteoinductive properties of rhBMP-2 released from the membrane during healing.     

Calcium silicate-coated porous chitosan scaffold as a cell-free tissue engineering system for direct pulp capping

ObjectivesThis study aimed to develop and characterize different formulations of porous chitosan scaffolds (SCH) associated with calcium silicate (CaSi) and evaluate their chemotactic and bioactive potential on human dental pulp cells (hDPCs).MethodsDifferent concentrations of CaSi suspensions (0.5%, 1.0%, and 2.0%, w/v) were incorporated (1:5; v/v) /or not, into 2% chitosan solution, giving rise to the following groups: SCH (control); SCH+ 0.5CaSi; SCH+ 1.0CaSi; SCH+ 2.0 CaSi. The resulting solutions were submitted to thermally induced phase separation followed by freeze-drying procedures to obtain porous scaffolds. The topography, pH, and calcium release kinetics of the scaffolds were assessed. Next, the study evaluated the influence of these scaffolds on cell migration (MG), viability (VB), proliferation (PL), adhesion and spreading (A&S), and on total protein synthesis (TP), alkaline phosphatase (ALP) activity, mineralized matrix deposition (MMD), and gene expression (GE) of odontogenic differentiation markers (ALP, DSPP, and DMP-1). The data were analyzed with ANOVA complemented with the Tukey post-hoc test (α = 5%).ResultsIncorporation of the CaSi suspension into the chitosan scaffold formulation increased pore diameter when compared with control. Increased amounts of CaSi in the CH scaffold resulted in higher pH values and Ca release. In Groups SCH+ 1.0CaSi and SCH+ 2.0CaSi, increased VB, PF, A&S, GE of DSPP/DMP-1 and MMD values were shown. However, Group SCH+ 2.0CaSi was the only formulation capable of enhancing MG and showed the highest increase in TP, MMD, and GE of DMP-1 and DSPP values.SignificanceSCH+ 2.0CaSi formulation had the highest chemotactic and bioactive potential on hDPCs and may be considered a potential biomaterial for pulp-dentin complex regeneration.     

以胶原缓释rhBMP-2复合BMSCs及珊瑚构建组织工程骨异位成骨的实验研究

目的：观察以胶原缓释rhBMP-2复合BMSCs及珊瑚构建的组织工程骨异位成骨的能力。方法：构建3种复合支架材料：1)rhBMP-2／珊瑚；2)胶原rhBMP-2／珊瑚；3)BMSCs／胶原rhBMP-2／珊瑚。分别植入裸鼠皮下，8周后观察成骨情况，并作比较。结果：第3组材料异位成骨的能力最强，第2组次之，第1组较弱。结论：动物实验中胶原是rhBMP-2适宜的缓释载体，BMSCs对促进材料异位成骨有重要意义。     

数字化载葡萄糖酸氯己定PLA/nHA复合支架的制备及性能分析

目的:探讨负载葡萄糖酸氯己定壳聚糖纳米球(CSn-CG)3D打印多孔聚乳酸/纳米羟基磷灰石(PLA/nHA)支架的理化性能、细胞相容性及抗菌活性。方法:借助离子交联法,完成CSn(空白壳聚糖纳米球)与CSn-CG的制备,借助透射电镜(TEM)对纳米球形态进行观察。利用数字化设计3D打印技术,以PLA和nHA为原料,制备PLA/nHA支架。以浸泡法搭载CSn、CSn-CG,实验分为PLA/nHA组、PLA/nHA/CSn组、PLA/nHA/CSn-CG组3组。针对各组支架,通过扫描电镜(SEM)、X射线光电子能谱仪(XPS)、傅立叶红外光谱仪(FTIR)、X射线衍射(XRD)进行表征分析。体外释放实验评估支架的缓释性能,CCK-8法评估支架的生物相容性,琼脂扩散法检测支架的抗菌效果。采用SPSS25.0软件包对所得数据进行统计学分析。结果:CSn-CG为大小均匀的纳米球。SEM下发现,各组支架均为三维网状结构,孔径规则。体外释放结果表明,CG能够自支架内低速缓慢释放,用时30 d。CCK-8结果显示,PLA/nHA/CSn-CG组可促进小鼠前体成骨细胞(MC3T3-E1)增殖。体外抑菌实...     

成人牙髓干细胞与壳聚糖-磷酸三钙复合材料相容性试验研究

目的:研究成人牙髓干细胞与壳聚糖-磷酸三钙复合材料的生物相容性。方法:采用冷冻干燥法制备壳聚糖-磷酸三钙复合材料。酶消化法分离,培养人牙髓干细胞,并将达到一定数量级的牙髓干细胞与支架材料进行复合培养,通过扫描电镜观察细胞的生长情况。结果:扫描电镜可见复合材料具有良好的多孔网状结构,成人牙髓干细胞与材料表面紧密贴附,生长良好。结论:复合壳聚糖-磷酸三钙进行培养的成人牙髓干细胞生长良好,具有良好的生物相容性。表明壳聚糖-磷酸三钙完全符合生物支架材料的要求,是一个具有很好应用前景的牙髓组织工程支架材料。     

Towards resorbable 3D-printed scaffolds for craniofacial bone regeneration

This review will briefly examine the development of 3D-printed scaffolds for craniofacial bone regeneration. We will, in particular, highlight our work using Poly(L-lactic acid) (PLLA) and collagen-based bio-inks. This paper is a narrative review of the materials used for scaffold fabrication by 3D printing. We have also reviewed two types of scaffolds that we designed and fabricated. Poly(L-lactic acid) (PLLA) scaffolds were printed using fused deposition modelling technology. Collagen-based scaffolds were printed using a bioprinting technique. These scaffolds were tested for their physical properties and biocompatibility. Work in the emerging field of 3D-printed scaffolds for bone repair is briefly reviewed. Our work provides an example of PLLA scaffolds that were successfully 3D-printed with optimal porosity, pore size and fibre thickness. The compressive modulus was similar to, or better than, the trabecular bone of the mandible. PLLA scaffolds generated an electric potential upon cyclic/repeated loading. The crystallinity was reduced during the 3D printing. The hydrolytic degradation was relatively slow. Osteoblast-like cells did not attach to uncoated scaffolds but attached well and proliferated after coating the scaffold with fibrinogen. Collagen-based bio-ink scaffolds were also printed successfully. Osteoclast-like cells adhered, differentiated, and survived well on the scaffold. Efforts are underway to identify means to improve the structural stability of the collagen-based scaffolds, perhaps through mineralization by the polymer-induced liquid precursor process. 3D-printing technology is promising for constructing next-generation bone regeneration scaffolds. We describe our efforts to test PLLA and collagen scaffolds produced by 3D printing. The 3D-printed PLLA scaffolds showed promising properties akin to natural bone. Collagen scaffolds need further work to improve structural integrity. Ideally, such biological scaffolds will be mineralized to produce true bone biomimetics. These scaffolds warrant further investigation for bone regeneration.     

包载 rhBMP-2和 SDF-1的双层纳米微球的构建及体外释药研究

目的：构建搭载基质细胞衍生因子1（SDF-1）和人骨形态发生蛋白2（rhBMP-2）的双层纳米微球缓释系统,研究其体外释药特性。方法：用“乳化-溶剂挥发法”制备聚乳酸／壳聚糖（PLA ／CS）双层纳米微球,通过正交试验获得最佳制备参数;动态光散射法测定纳米微球的粒径,电镜观察纳米微球的形态;在乳化过程中将 rhBMP-2和 SDF-1依次加入纳米微球中,计算其包封率和载药量,透析袋扩散法检测其体外缓释效果。结果：制备的双层纳米微球外形圆整,表面光滑,平均粒径为（542．33±14．38）nm,微球之间无粘连。rhBMP-2包封率为（82．41±1．05）％,载药量为（24．67±0．43）ng／mg;SDF-1包封率为（75．58±0．84）％,载药量为（22．63±0．41）ng／mg。药物释放持续至少30 d,呈“双相释放”。第30天时累计释放的 rhBMP-2和 SDF-1分别为72．85％和91．01％。结论：成功制备了包裹 SDF-1和 rhBMP-2的双层载药微球,形态良好,包封率较高,体外缓释效果较好。     

Implant-guided vertical bone growth in the mini-pig

Objective: To attain and describe guided vertical bone regeneration around titanium (Ti) and titanium zirconium (Ti–Zr) dental implants utilizing non‐glycosylated recombinant human bone morphogenetic protein‐2 (ng/rhBMP‐2), biomaterial scaffolds and a scaffold retainer. Materials and methods: Thirty‐two modified Straumann TE implants were partially embedded in the mandibles of eight adult mini‐pigs. Pre‐shaped resorbable scaffolds were placed around the implant and shielded and stabilized with a newly developed Ti custom scaffold retainer (umbrella) or wide‐neck (WN) healing caps to stabilize the scaffold. Ng/rhBMP‐2 (50 μg) was applied to the supracrestal portion of the implant or incorporated within the scaffold. At 9 weeks, soft tissue healing was assessed. Vertical bone regeneration outcomes including bone height, bone‐to‐implant contact (BIC) and bone volume were assessed by micro‐computed tomography and histology. Results: Soft tissue healing at the test sites (+ng/rhBMP‐2/+scaffold) appeared to be substantially better than the control sites (?ng/rhBMP‐2/?scaffold). Bone height, BIC percentage and bone volume were all similar regardless of whether WN healing caps or umbrella scaffold stabilization was used for all biomaterial scaffolds tested. WN healing cap test sites showed greater new bone height and BIC as compared with aggregate data from the control sites (P=0.05). Comparison of aggregate data from the umbrella test sites showed greater BIC and new bone volume as compared with aggregate data from the control sites(P=0.05). Conclusion: Vertical bone regeneration was successfully attained utilizing ng/rhBMP‐2, biomaterial scaffolds and a scaffold retainer.     

新型骨组织工程支架复合BMP-2体内异位成骨的研究

目的 评价新型骨组织工程支架聚消旋乳酸与聚乳酸-聚乙二醇-聚乳酸共混物复合rhBMP-2作为组织因子载体的体内异位成骨的能力.方法 在12只成年新西兰兔背部两侧骶棘肌内各制作互不相通的2个肌袋.然后将复合rhBMP-2的材料植入一侧肌袋为实验组,未复合rhBMP-2的材料作为对照组植入另一侧肌袋.术后2、 4、 8周取材行大体标本观察、组织学观察,观察体内异位成骨情况.结果 植入体内8周,实验组见成熟骨组织形成,对照组无骨组织形成.结论 新型骨组织工程支架复合rhBMP-2后植入动物体内有较强的异位成骨能力,是BMP的良好载体.     

丝素蛋白/左旋聚乳酸支架材料与软骨细胞体外细胞相容性研究

目的:观察静电纺丝支架材料丝素蛋白/左旋聚乳酸(SF/PLLA)的体外细胞相容性,探索其作为软骨组织工程支架材料的可行性,为进一步的体内及动物实验奠定基础。方法:将兔膝关节软骨细胞与丝素蛋白/左旋聚乳酸(SF/PLLA)支架材料复合培养,在第3、7、14天分别作HE染色和阿利新蓝+核固红染色,扫描电镜检验细胞黏着情况,MTT试验检测细胞在支架上的增殖情况。结果:细胞在支架上可以获得良好的粘附,细胞增殖良好,无细胞表型的变化。结论:丝素蛋白/左旋聚乳酸(SF/PLLA)具有良好的细胞相容性,可作为软骨组织工程支架材料。     

3D打印多孔磷酸镁生物陶瓷支架的制备及其体外骨诱导能力的研究

目的:应用3D打印技术及致孔剂浸出法制备具有两种不同尺度孔隙的磷酸镁多孔支架,研究其物理化学性能及骨诱导能力.方法:通过间接打印法制备多孔磷酸镁(MgP)支架,利用NaCl(粒径25～50μm)作为致孔剂引入微孔,制备MgP-Na微孔支架;通过扫描电镜、压汞仪、通用材料试验机及X线衍射仪检测支架的物理及化学性能;应用C...