Functional Bioadaptability in Medical Bioceramics: Biological Mechanism and Application

doi:10.15541/jim20230244

Abstract

Abstract:

The question of what qualities excellent medical bioceramics must possess to ensure satisfactory prognosis for bone healing and reconstruction remains a topic of great interest in both clinical and biomaterial sciences. Our team has been dedicated to researching medical bioceramics since the 1990s, involving basic scientific research, applied translational research, and clinical trials. Consequently, we have amassed a wealth of research and implementation experience. In this article, we aim to explore the subject of “Functional Bioadaptability in Medical Bioceramics”, specifically focusing on calcium phosphate-based materials. We summarized how to effectively combine bioadaptability with design and manufacturing of medical bioceramics in the background of orthopedic clinical application, with the following aspects of structural adaptability, degradative adaptability, mechanical adaptability, and application adaptability. Hopefully, some suggestions put forward can ultimately provide valuable insights and recommendations for the design, production, supervision, and application of the upcoming medical bioceramics.

Key words: bioceramics, bioadaptability, material microstructure, biodegradation, osteo-regeneration, vascularization, perspective

CLC Number:

TQ174

ZHENG Jiaqian, LU Xiao, LU Yajie, WANG Yingjun, WANG Zhen, LU Jianxi. Functional Bioadaptability in Medical Bioceramics: Biological Mechanism and Application[J]. Journal of Inorganic Materials, 2024, 39(1): 1-16.

Figures/Tables 13

Fig. 1 Theory of “Cell-Material-Blood supply” interacting with trinity tissue regeneration[17]

Fig. 2 Effects of microstructure on cell recombination and proliferation[21,27] (a) Cell motility in bioceramic microstructure with three-dimensional flow dynamic culture system, perfusion bioreactor; (b) SEM images of the cross section of a scaffold seeded with sheep MSCs; (c) Histological section of the cell-TCP composite stained with May-Grünwald Giemsa (A-F)

Fig. 3 Different kinds of interconnective pore size β-TCP porous ceramics with the same macroporous size (300-400 μm) evaluated in vivo[31] (a-e) Interconnective pore size is 70, 100, 120, 150, and 200 μm, respectively; (f) The lumen of new blood vessels passing through the interconnection became narrower and larger after entering the hole, resembling a string-of-beads shape. Scale bars in all images are 100 μm

Fig. 4 Blood vessels growth curve guided by porous ceramic rod at different time[17]

Fig. 5 Effect of packing method on degradation[63] (a, d) Radiographs of cases with loose packing; (b, c) Radiographs of cases implanted with β-TCP granules by dense packing

Fig. 6 Mechanically enhanced bioceramics[72] (a) Structure of mechanically enhanced bioceramics; (b) Wedge- shaped implant for high tibial osteotomy (HTO); (c, d) Microstructures of the bioinspired β-TCP bioceramics showing the dense/porous interface (c), and macroporous structure (d)

Fig. 7 Clinical case of the bird’s nest-like frame structure implant

Fig. 8 Clinical case of long, hollow tubular frame structure implant

Fig. 9 Failure clinical case showing the implant broken due to stress concentration and insufficient support

Fig. 10 Bioceramics used in combination with chondrocytes to achieve better cartilage tissue repair[85] (a) Repaired with bioceramic-chondrocyte constructs implant, 2 w postsurgery; (b) Repaired with bioceramic-chondrocyte constructs implant, 24 w postsurgery; (c) Repaired with bioceramic without cells implant, 24 w postsurgery; (d) Defect without any implant (control), 24 w postsurgery

Fig. 11 Standard surgical procedure for ONFH treatment, performed with surgical ancillary instruments[44] (a) Insertion of the Kirschner wire under fluoroscopy; (b) Core decompression by drilling; (c) Necrosis debridement by minimal reamers; (d) Bioceramic granules packing; (e) Insertion of the porous bioceramic rods

Fig. 12 Van Gieson staining of “In Vivo Bioreactor” in rabbits showed the “Rebar Coagulated Bone” structure[102] Yellow arrow: Newly formed bone; White arrow: Connective. Scale bar: 50 μm (blue), 20 μm (green); Colorful figures are available on website

Fig. 13 Application of“In vivo Bioreactor” in operation[77] (a) Multi-material, structural, and technical bone defect repair solution; (b) Bioceramics granules being used; (c) Bioceramics microstructure; (d) Composite in operation

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