Effects of Strontium-Doped ß-Tricalcium Scaffold on Longitudinal Nuclear Factor-Kappa Beta and Vascular Endothelial Growth Factor Receptor-2 Promoter Activities during Healing in a Murine Critical-Size Bone Defect Model.

It was hypothesized that strontium (Sr)-doped ß-tricalcium phosphate (TCP)-based scaffolds have a positive effect on the regeneration of large bone defects (LBD). Readouts in our mice models were nuclear factor-kappa beta (NF-κB) activity and vascular endothelial growth factor receptor-2 (VEGFR-2) promoter activity during the healing process. A 2-mm critical-size femoral fracture was performed in transgenic NF-κB- and VEGFR-2-luciferase reporter mice. The fracture was filled with a 3D-printed ß-TCP scaffold with or without Sr. A bioluminescence in-vivo imaging system was used to sequentially investigate NF-κB and VEGFR-2 expression for two months. After sacrifice, soft and osseous tissue formation in the fracture sites was histologically examined. NF-κB activity increased in the ß-TCP + Sr group in the latter stage (day 40-60). VEGFR-2 activity increased in the + Sr group from days 0-15 but decreased and showed significantly less activity than the ß-TCP and non-scaffold groups from days 40-60. The new bone formation and soft tissue formation in the + Sr group were significantly higher than in the ß-TCP group, whereas the percentage of osseous tissue formation in the ß-TCP group was significantly higher than in the ß-TCP + Sr group. We analyzed longitudinal VEGFR-2 promoter activity and NF-κB activity profiles, as respective agents of angiogenesis and inflammation, during LBD healing. The extended inflammation phase and eventually more rapid resorption of scaffold caused by the addition of strontium accelerates temporary bridging of the fracture gaps. This finding has the potential to inform an improved treatment strategy for patients who suffer from osteoporosis.

Synthesis of novel tricalcium phosphate-bioactive glass composite and functionalization with rhBMP-2.

A functionalization is required for calcium phosphate-based bone substitute materials to achieve an entire bone remodeling. In this study it was hypothesized that a tailored composite of tricalcium phosphate and a bioactive glass can be loaded sufficiently with rhBMP-2 for functionalization. A composite of 40 wt% tricalcium phosphate and 60 wt% bioactive glass resulted in two crystalline phases, wollastonite and rhenanite after sintering. SEM analysis of the composite's surface revealed a spongious bone-like morphology after treatment with different acids. RhBMP-2 was immobilized non-covalently by treating with chrome sulfuric acid (CSA) and 3-aminopropyltriethoxysilane (APS) and covalently by treating with CSA/APS, and additionally with 1,1'-carbonyldiimidazole. It was proved that samples containing non-covalently immobilized rhBMP-2 on the surface exhibit significant biological activity in contrast to the samples with covalently bound protein on the surface. We conclude that a tailored composite of tricalcium phosphate and bioactive glass can be loaded sufficiently with BMP-2.

Calcium phosphate/microgel composites for 3D powderbed printing of ceramic materials.

Composites of microgels and calcium phosphates are promising as drug delivery systems and basic components for bone substitute implants. In this study, we synthesized novel composite materials consisting of pure ß-tricalcium phosphate and stimuli-responsive poly(N-vinylcaprolactam-co-acetoacetoxyethyl methacrylate-co-vinylimidazole) microgels. The chemical composition, thermal properties and morphology for obtained composites were extensively characterized by Fourier transform infrared, X-ray photoelectron spectroscopy, IGAsorp moisture sorption analyzer, thermogravimetric analysis, granulometric analysis, ESEM, energy dispersive X-ray spectroscopy and TEM. Mechanical properties of the composites were evaluated by ball-on-three-balls test to determine the biaxial strength. Furthermore, initial 3D powderbed-based printing tests were conducted with spray-dried composites and diluted 2-propanol as a binder to evaluate a new binding concept for ß-tricalcium phosphate-based granulates. The printed ceramic bodies were characterized before and after a sintering step by ESEM. The hypothesis that the microgels act as polymer adhesive agents by efficient chemical interactions with the ß-tricalcium phosphate particles was confirmed. The obtained composites can be used for the development of new scaffolds.

Preparation of spherical calcium phosphate granulates suitable for the biofunctionalization of active brazed titanium alloy coatings.

Titanium-based alloys can be actively brazed onto bio-inert ceramics and potentially be used as biocompatible coatings. To further improve their bioactivity in vivo, introduction of calcium phosphate (CaP)-based granulates onto their surface layer is possible. For this, mechanically stable CaP-based granulates need to be able to withstand the demand of the brazing process. In this study, spherical granulates, made of a calcium phosphate composite composed primarily of ß-tricalcium phosphate and hydroxyapatite, a bioactive glass, and a mixture of the previous two, were manufactured by spray drying. The influence of organic additives (Dolapix CE64, trisodium citrate) and solids content (30-80 wt%) in the slurry on the physical characteristics of granulates was investigated. X-ray diffraction, Brunauer, Emmett, Teller specific surface area standard method, scanning electron microscopy, granulate size analysis, and single granule strength were performed. Our results showed that trisodium citrate permitted the production of granulates with regular morphology, high density, and increased failure stress values. The strong granules also withstood the brazing process. These results show that CaP bioactive agents can be generated and be integrated during the demanding metallurgical processes, allowing for one-step bioactivation of metal brazes.

Calcium phosphate based three-dimensional cold plotted bone scaffolds for critical size bone defects.

Bone substitutes, like calcium phosphate, are implemented more frequently in orthopaedic surgery to reconstruct critical size defects, since autograft often results in donor site morbidity and allograft can transmit diseases. A novel bone cement, based on ß-tricalcium phosphate, polyethylene glycol, and trisodium citrate, was developed to allow the rapid manufacturing of scaffolds, by extrusion freeform fabrication, at room temperature. The cement composition exhibits good resorption properties and serves as a basis for customised (e.g., drug or growth factor loaded) scaffolds for critical size bone defects. In vitro toxicity tests confirmed proliferation and differentiation of ATDC5 cells in scaffold-conditioned culture medium. Implantation of scaffolds in the iliac wing of sheep showed bone remodelling throughout the defects, outperforming the empty defects on both mineral volume and density present in the defect after 12 weeks. Both scaffolds outperformed the autograft filled defects on mineral density, while the mineral volume present in the scaffold treated defects was at least equal to the mineral volume present in the autograft treated defects. We conclude that the formulated bone cement composition is suitable for scaffold production at room temperature and that the established scaffold material can serve as a basis for future bone substitutes to enhance de novo bone formation in critical size defects.