The role of new zinc incorporated monetite cements on osteogenic differentiation of human mesenchymal stem cells.

ß-Tricalcium phosphate particles were sintered in the presence of different amounts (0-0.72mol) of zinc oxide (ZnO) to prepare zinc doped ß-TCP (Znß-TCP) particles for further use in novel monetite (DCPA: CaHPO4) zinc incorporated bone cements with osteogenic differentiation potential towards human mesenchymal stem cells (hMSCs). XRD analysis of zinc incorporated cements prepared with ß-TCP reagent particles doped with different amount of ZnO (i.e. 0.03, 0.09 and 0.18mol ZnO) revealed the presence of unreacted Znß-TCP and monetite. Furthermore, it was shown that zinc ions preferentially occupied the ß-TCP crystal lattice rather than the monetite one. Release experiments indicated a burst release of ions from the different fabricated cements during the first 24h of immersion with zinc concentrations ranging between 85 and 100% of the total concentration released over a period of 21days. Cell proliferation significantly increased (P<0.05) on zinc incorporated monetite respect to control samples (Zinc-free cement) at 7 and 14days post seeding. The expression of Runx-2 was significantly up regulated (P<0.05) in the case of cells seeded on monetite prepared with ß-TCP doped with 0.03 moles of ZnO. On the other hand, the cell mineralization as well as the expression of osteogenic marker genes ALP and OSC decreased significantly (P<0.05) at 14days post cell seeding. In conclusion, these results suggest that the zinc ions released from the cements during the first 24h of culture played a critical role in regulating the osteogenic differentiation of hMSCs.

Osteoblast response to zirconia surfaces with different topographies.

Zirconia-3 mol% yttria ceramics were prepared with as-sintered, abraded, polished, and porous surfaces in order to explore the attachment, proliferation and differentiation of osteoblast-like cells. After modification, all surfaces were heated to 600°C to extinguish traces of organic contamination. All surfaces supported cell attachment, proliferation and differentiation but the surfaces with grain boundary grooves or abraded grooves provided conditions for enhanced initial cell attachment. Nevertheless, overall cell proliferation and total DNA were highest on the polished surface. Zirconia sintered at a lower temperature (1300°C vs. 1450°C) had open porosity and presented reduced proliferation as assessed by alamarBlue™ assay, possibly because the openness of the pores prevented cells developing a local microenvironment. All cells retained the typical polygonal morphology of osteoblast-like cells with variations attributable to the underlying surface notably alignment along the grooves of the abraded surface.

TRPA1 and TRPV4 activation in human odontoblasts stimulates ATP release.

The mechanism of pain in dentine hypersensitivity is poorly understood but proposed to result from the activation of dental sensory neurons in response to dentinal fluid movements. Odontoblasts have been suggested to contribute to thermal and mechanosensation in the tooth via expression of transient receptor potential (TRP) channels. However, a mechanism by which odontoblasts could modulate neuronal activity has not been demonstrated. In this study, we investigated functional TRP channel expression in human odontoblast-like cells and measured ATP release in response to TRP channel activation. Human immortalized dental pulp cells were driven toward an odontoblast phenotype by culture in conditioned media. Functional expression of TRP channels was determined with reverse transcription polymerase chain reaction and ratiometric calcium imaging with Fura-2. ATP release was measured using a luciferin-luciferase assay. Expression of mRNA for TRPA1, TRPV1, and TRPV4 but not TRPM8 was detected in odontoblasts by reverse transcription polymerase chain reaction. Expression of TRPV4 protein was detected by Western blotting and immunocytochemistry. The TRPA1 agonists allyl isothiocyanate and cinnamaldehyde and the TRPV4 agonist GSK1016790A caused a concentration-dependent increase in intracellular Ca(2+) concentration that was inhibited by the selective antagonists HC030031, AP18, and HC067047, respectively. In contrast, exposure to the TRPV1 agonist capsaicin or the TRPM8 agonist icilin had no effect on intracellular Ca(2+) concentration. Treatment with allyl isothiocyanate, cinnamaldehyde, or GSK1016790A caused an increase in ATP concentration in culture medium that was abolished by preincubation with TRP channel antagonists. These data demonstrate that activation of TRPA1 and TRPV4 channels in human odontoblast-like cells can stimulate ATP release. We were unable to confirm the presence of thermosensitive TRPV1 and TRPM8 that has previously been reported in odontoblasts.

Physicochemical characterization of segmented polyurethanes prepared with glutamine or ascorbic acid as chain extenders and their hydroxyapatite composites.

The development of elastomeric, bioresorbable, and biocompatible segmented polyurethanes (SPUs) for use in tissue-engineering applications has attracted considerable interest in recent years because of the existing need for mechanically tunable scaffolds for regeneration of different tissues. In this study segmented polyurethanes were synthesized from poly(ε-caprolactone)diol, 4,4'-methylene bis(cyclohexyl isocyanate) (HMDI) using osteogenic compounds such as ascorbic acid (AA) and l-glutamine (GL) as chain extenders, which are known to play a role in osteoblast proliferation and collagen synthesis. Fourier transform infrared spectroscopy (FTIR) revealed the formation of urethane linkages at 3373, 1729, and 1522 cm-1 (N-H stretching, C[double bond, length as m-dash]O stretching and N-H bending + C-N stretching vibrations, respectively) while urea formation was confirmed by the appearance of a peak at 1632 cm-1. Differential scanning calorimetry, dynamic mechanical analysis, X-ray diffraction and mechanical testing of the polyurethanes showed that these polyurethanes were semi-crystalline polymers (Tg = -25 °C; Tm = 51.4-53.8 °C; 2θ = 21.3° and 23.4°) exhibiting elastomeric behavior (ε > 1000%) only for those prepared by HA incorporation during prepolymer formation. Dense and porous composite matrices of the segmented polyurethanes were prepared by the addition of hydroxyapatite (HA) via either mechanical mixing or in situ polymerization and supercritical fluid processing, respectively. The addition of HA by physical mixing decreased the crystallinity (from 38% to 31%) of the composites prepared with ascorbic acid as the chain extender. Both Tg of the composites and the strain were also lowered to -38 or 36 °C and 27-39% for ascorbic acid and glutamine containing polyurethanes respectively. Composites prepared with ascorbic acid as the chain extender yielded higher Young's modulus and tensile strength than composites prepared with glutamine when HA was incorporated during prepolymer formation. Composites obtained by incorporation of HA by physical mixing revealed a poor dispersion in comparison to composites obtained via HA inclusion during prepolymer formation. In contrast, good dispersion of HA and porosity were achieved at 60 °C, 400 bar and holding times between 0.5 h and 2 h with a downtime between 15 min and 60 min in the CO2 reactor. Biocompatibility studies showed that SPUs containing ascorbic acid allowed the increase of alveolar osteoblast proliferation; hence, they are potentially suitable for bone tissue regeneration.

A novel method of forming micro- and macroporous monetite cements.

Second to autologous bone grafts are the calcium phosphate cements (CPCs) used as synthetic bone substitutes due to their chemical similarity to the mineral component of bone. Their ability to conform to complex bone defects and excellent osteoconductivity also render them excellent scaffolds for bone tissue engineering, although they do have their own limitations. Calcium phosphates can be divided into two main categories, namely apatite and brushite. Apatites exhibit low solubility, whereas, calcium phosphates that set to form brushite, are metastable, which degrade rapidly, but do subsequently form hydroxyapatite that retards the rate. In contrast dicalcium phosphate anhydrous (monetite) has a higher solubility than octacalcium phosphate and does not transform to an apatite; thus, it is able to continue to degrade with time. Herein, a new method was used via the addition of sodium chloride to ß-tricalcium phosphate and monocalcium phosphate monohydrate to form micro- and macroporous monetite (DCPA). The X-ray diffraction and FTIR spectra confirmed the formation of monetite in the presence of both, 6.2 M NaCl solution or 60% of solid sodium chloride. The maximum compressive strength (σc = 12.3 ± 1.8 MPa) and the Young's modulus (E = 1.0 ± 0.1 GPa) of the monetite cements obtained were comparable to the upper limits of the values reported for cancellous bone and also higher than that reported by other routes used to form monetite. The porous cements analysed by microCT revealed an interconnected porosity with the preliminary in vitro biological evaluation indicating favourable osteoblast cell attachment and growth.

Electrohydrodynamic deposition of nanotitanium doped hydroxyapatite coating for medical and dental applications.

Nano-sized titanium containing hydroxyaptite has been prepared, the particle size of nanoTiHA was shown to be 12-20 nm in width and 30-40 nm in length, smaller than that of nanoHA. X-ray diffraction analysis revealed the phase purity of nanoTiHA produced. Antimicrobical assays demonstrated that nanoTiHA has excellent growth inhibitory properties, and is able to inhibit the growth of all bacterial strains tested, both Gram-negative and Gram-positive species, including multi-antibiotic resistant EMRSA 15 and EMRSA 16 'superbugs'. Biocidal activity against all four Staphylococcus spp was also shown at the concentration tested. Nanostuctured TiHA coating was successfully deposited onto Ti surfaces using EHDA spraying under optimized processing conditions with the thickness of the coating being further controlled by the spraying time. All of the nanoTiHA coated Ti surfaces were able to support human osteoblast (HOB) cell attachment and growth. The coating thickness did not significantly influence the proliferation of HOB cells on nanoTiHA coatings, while the ability of nanoTiHA coating to support HOB cell differentiation was demonstrated from the alkaline phosphatase activity. Our study showed that nanoTiHA has excellent anti-bacterial properties and the thin nanoTiHA coating was also able to support the attachment, growth and differentiation of HOB cells. Therefore, nanoTiHA coating could pave the way for the development of the next generation of dental and orthopedic implants by offering anti-infection potential in addition to osteoconductivity.

The pathway to intelligent implants: osteoblast response to nano silicon-doped hydroxyapatite patterning.

Bioactive hydroxyapatite (HA) with addition of silicon (Si) in the crystal structure (silicon-doped hydroxyapatite (SiHA)) has become a highly attractive alternative to conventional HA in bone replacement owing to the significant improvement in the in vivo bioactivity and osteoconductivity. Nanometre-scaled SiHA (nanoSiHA), which closely resembles the size of bone mineral, has been synthesized in this study. Thus, the silicon addition provides an extra chemical cue to stimulate and enhance bone formation for new generation coatings, and the next stage in metallic implantation design is to further improve cellular adhesion and proliferation by control of cell alignment. Topography has been found to provide a powerful set of signals for cells and form contact guidance. Using the recently developed novel technique of template-assisted electrohydrodynamic atomization (TAEA), patterns of pillars and tracks of various dimensions of nanoSiHA were achieved. Modifying the parameters of TAEA, the resolution of pattern structures was controlled, enabling the topography of a substrate to be modified accordingly. Spray time, flow rate and distance between the needle and substrate were varied to improve the pattern formation of pillars and tracks. The 15 min deposition time provided the most consistent patterned topography with a distance of 50 mm and flow rate of 4 µl min(-1). A titanium substrate was patterned with pillars and tracks of varying widths, line lengths and distances under the optimized TAEA processing condition. A fast bone-like apatite formation rate was found on nanoSiHA after immersion in simulated body fluid, thus demonstrating its high in vitro bioactivity. Primary human osteoblast (HOB) cells responded to SiHA patterns by stretching of the filopodia between track and pillar, attaching to the apex of the pillar pattern and stretching between two. HOB cells responded to the track pattern by elongating along and between the track, and the length of HOB cells was proportional to the gaps between track patterns, but this relationship was not observed on the pillar patterns. The study has therefore provided an insight for future design of next generation implant surfaces to control and guide cellular responses, while TAEA patterning provides a controllable technique to provide topography to medical implants.

In vitro evaluation of samarium (III) oxide as a bone substituting material.

The biocompatibility of natural samarium (III) oxide, which has previously been used for treatment in bone-related diseases was determined as a first step in its evaluation as a bone implant material. Assessment for 28 days using osteoblast-like cells revealed no indications of cytotoxicity. The cells adhered and proliferated on the surface. Furthermore, the differentiation and mineralization were observed, indicating a normal biological response of the cells on the samarium (III) oxide surface. The in vitro, short term biocompatibility assessment of this oxide has indicated its biosafety with no damaging toxic effects on the cells and biofunctionality; with an appropriate cell response for a bone-contacting material. Hence, samarium (III) oxide deserves recognition in the field of biomaterials for its excellent in vitro performance and demonstrates that the class of potential bioceramics may be larger than previously thought. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010.

Osteoblasts in bone tissue engineering.

Osteoblasts are integral to the development, growth, function, repair and maintenance of bone. The osteoblast forms organic, non-mineralized bone matrix and is involved in complex interactions with a variety of factors, mediators and cell types. Degeneration, pathology, and trauma cause disruption and destruction of the normal skeletal environment and may lead to bone loss. There is a rise in active populations involved in trauma, elderly patients with fragility fractures and an overall increase in primary, revision and reconstructive bone and joint surgery. Despite the rapid evolution of implant technologies and bone grafting techniques, there is still a great demand for novel bone replacement strategies. Bone tissue engineering is the state of the art science with the potential to regenerate bone with natural form and function. This review presents the biology of osteoblasts and their current applications in bone tissue engineering biotechnologies and role in stem cell, bioactive factor, recombinant signalling molecule and gene therapy research.

In vitro biocompatibility of hydroxyapatite-reinforced polymeric composites manufactured by selective laser sintering.

The selective laser sintering (SLS) technique was used to manufacture hydroxyapatite-reinforced polyethylene and polyamide composites as potential customized maxillofacial implants. In vitro tests were carried out to assess cellular responses, in terms of cell attachment, morphology, proliferation, differentiation, and mineralized nodule formation, using primary human osteoblast cells. This study showed that the SLS composite processed was biocompatible, with no adverse effects observed on cell viability and metabolic activity, supporting a normal metabolism and growth pattern for osteoblasts. Positive von Kossa staining demonstrated the presence of bone-like mineral on the SLS materials. Higher hydroxyapatite content composites enhanced cell proliferation, increased alkaline phosphatase activity, and produced more osteocalcin. The present findings showed that SLS materials have good in vitro biocompatibility and hence demonstrated biologically the potential of SLS for medical applications.

Tissue engineered intervertebral disc repair in the pig using injectable polymers.

The intervertebral disc (IVD) has a central nucleus pulposus (NP) able to resist compressive loads and an outer annulus fibrosus which withstands tension and gives mechanical strength. The tissue engineering of a disc substitute represents a challenge from mechanical and biological (nutrition and transport) points of view. Two hyaluronan-derived polymeric substitute materials, HYAFF 120, an ester and HYADD 3, an amide were injected into the NP of the lumbar spine of female pigs (11.1 +/- 1.0 Kg) in which a nucleotomy had also been performed. Homologous bone marrow stem cells, obtained from the bone marrow three weeks before spinal surgery, were included in the HYADD 3 material (1x 10(6) cells/ml). Two lumbar discs were operated in each animal. Control discs received a nucleotomy only. The animals were killed after 6 weeks and the lumbar spines recovered for histopathological study. Nucleotomy resulted in loss of normal IVD structure with narrowing, fibrous tissue replacement and disruption of the bony end-plates (4/4). By contrast, both HYAFF 120 (4/4) and HYADD 3 (4/4) treatment prevented this change. The injected discs had a central NP-like region which had a close similarity to the normal biconvex structure and contained viable chondrocytes forming matrix like that of normal disc.

In vitro osteoblastic response to 30 vol% hydroxyapatite-polyethylene composite.

Hydroxyapatite-reinforced high-density polyethylene (HA-HDPE) composite, as a bone replacement material, has successfully been used clinically as middle ear prostheses and orbital floor implants. The aim of this study was to examine its in vitro biocompatibility in order to develop a further application, that is, as skull reconstruction implants. Human osteoblast cells isolated from femoral heads and crania were used to determine the biological response of the composites. HA-HDPE composites (30 vol %) with two grades of HA filler that had different surface morphologies were selected for this in vitro assessment. The results showed that HA-HDPE composite was bioactive and supported osteoblast attachment, proliferation, and differentiation. The composite with rough-surfaced HA filler demonstrated slightly better cellular response than the composite with smooth-surfaced HA filler. Although osteoblastic cells derived from skull showed an overall slower response compared with those from femoral heads, these in vitro results show that HA-HDPE composite potentially could be used as a skull implant.

Transformation of a prefabricated hydroxyapatite/osteogenic protein-1 implant into a vascularised pedicled bone flap in the human chest.

We describe the intramuscular transformation of a hydroxyapatite/osteogenic protein-1 (HA/OP-1) composite implant, into a vascularised pedicled bone flap useful for reconstruction of a hemi-mandible. Extraskeletal induction of a bone flap for transplantation was achieved without the addition of harvested bone, bone marrow, or stem cells. Five months after apparent clinical success, an MRSA infection of the graft led to its failure. The background to ectopically induced bone flaps is introduced, with our experience in a human case presented. The results from this emerging biotechnology are discussed in the light of limited human clinical experience.

The chemical constitution and biocompatibility of accelerated Portland cement for endodontic use.

AIM: To evaluate the biocompatibility of mineral trioxide aggregate and accelerated Portland cement and their eluants by assessing cell metabolic function and proliferation. METHODOLOGY: The chemical constitution of grey and white Portland cement, grey and white mineral trioxide aggregate (MTA) and accelerated Portland cement produced by excluding gypsum from the manufacturing process (Aalborg White) was determined using both energy dispersive analysis with X-ray and X-ray diffraction analysis. Biocompatibility of the materials was assessed using a direct test method where cell proliferation was measured quantitatively using Alamar Blue dye and an indirect test method where cells were grown on material elutions and cell proliferation was assessed using methyltetrazolium assay as recommended by the International standard guidelines, ISO 10993-Part 5 for in vitro testing. RESULTS: The chemical constitution of all the materials tested was similar. Indirect studies of the eluants showed an increase in cell activity after 24 h compared with the control in culture medium (P<0.05). Direct cell contact with the cements resulted in a fall in cell viability for all time points studied (P<0.001). CONCLUSIONS: Biocompatibility testing of the cement eluants showed the presence of no toxic leachables from the grey or white MTA, and that the addition of bismuth oxide to the accelerated Portland cement did not interfere with biocompatibility. The new accelerated Portland cement showed similar results. Cell growth was poor when seeded in direct contact with the test cements. However, the elution made up of calcium hydroxide produced during the hydration reaction was shown to induce cell proliferation.

Bioresorbable glass fibres facilitate peripheral nerve regeneration.

This is a proof of principle report showing that fibres of Bioglass 45S5 can form a biocompatible scaffold to guide regrowing peripheral axons in vivo. We demonstrate that cultured rat Schwann cells and fibroblasts grow on Bioglass fibres in vitro using SEM and immunohistochemistry, and provide qualitative and quantitative evidence of axonal regeneration through a Silastic conduit filled with Bioglass fibres in vivo (across a 0.5 cm interstump gap in the sciatic nerves of adult rats). Axonal regrowth at 4 weeks is indistinguishable from that which occurs across an autograft. Bioglass fibres are not only biocompatible and bioresorbable, which are absolute requirements of successful devices, but are also amenable to bioengineering, and therefore have the potential for use in the most challenging clinical cases, where there are long inter-stump gaps to be bridged.

Porous hydroxyapatite ceramics for tissue engineering.

We have determined the biocompatibility of high porosity (92%) sintered hydroxyapatite (HA) foams prepared using a novel ceramic foaming system. The ability of human osteoblast-like cells to grow within the HA foam was investigated in vitro using human osteosarcoma cells seeded directly on the ceramic surfaces to determine the bioactivity. Scanning electron microscopy showed evidence of attachment of numerous cells to the surface. Significant proliferation was observed and the pattern was comparable to that of the tissue culture control, Thermanox TM . There was an increase in cell proliferation and retention of phenotype for the period studied. This hydroxyapaptite foam which has the advantage of being easily fashioned by surgeons, shows potential as a bone substitute scaffold for tissue engineering and future development for clinical application.

An ultrastructural study of cellular response to variation in porosity in phase-pure hydroxyapatite.

Hydroxyapatite has been shown to be biocompatible and bioactive. Incorporation of porosity has been shown to enhance osteointegration; however, difficulty in controlling the extent and type of porosity has limited investigation into determining the role of both macro- and microporosity. The current investigation reports on the synthesis of four types of phase-pure hydroxyapatite with varying levels of porosity (HA1-HA4), and with defined levels of macro- and microporosities. Transmission electron microscopy was used to evaluate qualitatively the effect of these two parameters on cell-material interactions following a 30-day incubation period. Biological mineralization was observed within vesicles and the needle-like minerals were confirmed as hydroxyapatite using X-ray microanalysis. This demonstrated the suitability of primary human osteoblast-like cells as a tool to assess the extent of mineralization. Furthermore, internalization of hydroxyapatite particles was observed. Our findings show that the variation in macro- and microporosity does not affect the extent of cell-material interaction, with collagen synthesis evident in all samples.

The fundamentals of tissue engineering: new scaffolds.

The ability to regenerate new bone for skeletal use is a major clinical need. In this study, two novel porous calcium phosphate materials pure HA and biphasic HA/beta-Tricalcium phosphate (HA/beta -TCP) were evaluated as potential scaffolds for cell-seeded bone substitutes using human osteoblast-like cells (HOS) and primary human mesenchymal stem cells (hMSCs). A high rate of proliferation was observed on both scaffolds. A greater increase in alkaline phosphatase (ALP- an indicator of osteoblast differentiation) was observed on HA/beta -TCP compared to HA. This observation indicates that HA/TCP may play a role in inducing osteoblastic differentiation. Although further evaluation is required both materials show potential as innovative synthetic substitutes for tissue engineered scaffolds.

Porosity variation in hydroxyapatite and osteoblast morphology: a scanning electron microscopy study.

The biocompatibility of hydroxyapatite has been demonstrated by previous studies, with enhancement of osteointegration through the use of porous hydroxyapatite (pHA). Emphasis has been focused on the use of coralline hydroxyapatite or the introduction of macroporosity into synthetic hydroxyapatite. The current study investigates the role of macro- and microporosities in synthetic phase-pure porous hydroxyapatite on the morphological aspects of human osteoblast-like cells using scanning electron microscopy. Cells were seeded on four different types of porous hydroxyapatite (HA1, HA2, HA3 and HA4) and examined following 1, 2, 14 and 30 days of incubation in vitro. The results indicated that the cells had an affinity to micropores through filopodia extensions, at initial stage of attachment. Cellular proliferation and colonization was evident on all materials with cells forming cellular bridges across the macropores at day 14 with cellular canopy formation covering entire macropores observed by day 30. This study demonstrates that while the introduction of microporosity has no evident effect on cellular morphology at later time points, it seems to play a role in initial cellular anchorage and attachment.

Titanium for osteointegration: Comparison between a novel biomimetic treatment and commercially exploited surfaces.

The objective of this preliminary in vitro biological study was to assess the effect of the surface physicochemical and topographical properties of a novel bioactive titanium (BSP) obtained by BioSpark treatment. A short-term study was per-formed to evaluate the bone cell response to BSP and compare it to two commercially available materials: no treated (TI) and chemically etched (ETC) titanium. Material characterization was carried out using scanning electron microscopy (SEM), energy dispersion spectroscopy (EDS), non-contact laser profilometry (LPM), and Thin Film X-ray Diffraction (TF-XRD). Surface analysis showed ETC to have the highest rough surface, followed by TI surface and then BSP being the smoothest material at micro level, but showing a sub micrometer porous structure covered with a ""net-like"" rough structure. The BSP surface was found to consist of a layer of amorphous calcium and phosphorus and crystalline titanium oxide, not detected in the other materials tested. Indirect biological cytotoxicity studies were performed to determine cell viability following incubation with the eluted extract of the materials. Results indicated no remarkable deterioration in cell viability. In particular, no detectable effect was observed on cellular viability as a result of the chemical interaction between the BSP bioactive surface and the surrounding culture medium. Direct cellular studies showed that the material surface resulted in good cell adhesion on BSP samples. This could be related to both the nano-roughness, and also the crystallinity of the superficial layer of titanium oxide coupled with bioactive Ca- and P-chemical enrichment. The cellular proliferation analysis demonstrated a remarkably higher activity for the cells cultured on BSP, with values significantly higher than the other test materials and the control for all time points. These findings are highly suggestive that the surface properties of the BioSpark treated titanium significantly increases cell proliferation rate. In conclusion, this study has demonstrated that the novel bioactive treatment shows potential as a method for improving osteointegration properties of titanium for orthopaedic and dental implants. (Journal of Applied Biomaterials & Biomechanics 2004; 2: 35-44).