Biomedical Applications of Injectable Inorganic Biomaterials

doi:10.15541/jim20250441

Abstract

Abstract:

The rapid advancement at the interface of medicine and engineering, as well as emerging biomedical research, has led to a new research area of injectable biomaterials. Owing to their advantages in minimally invasive surgery, injectable biomaterials have been extensively investigated for biomedical research fields such as tissue repair and regeneration, medical imaging, precision diagnosis and therapy, and other minimally invasive therapies. Furthermore, many injectable biomaterials have been successfully translated into medical devices and products. Among injectable biomaterials, inorganic materials possess distinctive materiobiological properties, rheological properties, and unique self-setting behaviors, making them highly promising for biomedical applications including minimally invasive orthopedics, cancer theranostics, and tissue substitution and repair. This review aims to introduce the basics of injectable inorganic materials and summarize their latest research advances and application progress. Firstly, the fundamental concepts and governing principles of injectability are introduced, along with a discussion of key regulatory factors (e.g., geometric properties of the particles, liquid-to-solid ratio of the system, liquid phase viscosity, and physicochemical reactions). Secondly, clinically oriented research and development progress in inorganic injectable biomaterials are summarized, covering areas such as hard tissue repair, medical imaging diagnosis, cancer therapy, dermatology, and plastic surgery. Advantages and limitations of these materials are also analyzed. Finally, the key challenges and future research directions for injectable inorganic biomaterials are discussed. This article is expected to provide valuable references for advancing application-oriented research and facilitating the clinical translation of injectable inorganic biomaterials, thereby promoting the technological innovation and development of related medical devices.

Key words: inorganic material, injectability, biomedicine, minimally invasive surgery, review

CLC Number:

R318

WANG Jinwen, YANG Zhen, ZHOU Huan, XIA Dan, YANG Lei. Biomedical Applications of Injectable Inorganic Biomaterials[J]. Journal of Inorganic Materials, 2026, 41(6): 751-763.

Figures/Tables 8

Fig. 1 Current injectable inorganic materials for clinical use and their typical components

Fig. 2 Effects of liquid-to-solid ratio and particle packing on the injectability of inorganic materials[35-39] (a) Effect of liquid-to-solid ratio on injectability[35]; (b) Packing state of particles of a single size[36]; (c) Packing state of particles of multiple sizes[36]; (d) Bimodal size distribution versus ϕmax[36]. Experimental maximum packing fraction data from Fiske et al.[38] and McGeary[39] for a bimodal size distribution (diameter ratio αp = D2/D1 = 20 (D1: diameter of small particles; D2: diameter of large particles; αp: diameter ratio of particles)) versus the small-to-large particle concentration ratio were compared with the predictions of the Ouchiyama & Tanaka[37] model

Fig. 3 Effect of liquid-phase viscosity on the injectability of inorganic materials and the rheological behavior of calcium phosphate bone cement during setting[44,46,49] (a) Injectability of calcium phosphate bone cement with different cellulose ether composites (A15, E4M, K4M, and K15M represent different grades of cellulose ether, with the viscosity relationship of A15 < E4M = K4M < K15M)[44]; (b) Injection force of solutions with varying viscosities in 27G and 29G-1 mL syringes[46]; (c) Schematic of calcium phosphate bone cement setting kinetics and linear viscoelastic properties over time[49]

Fig. 4 Applications of injectable inorganic materials in orthopedics and dentistry[55-57] (a-d) Filling of sheep vertebrae with different bone cements (CPC is calcium phosphate bone cement, CPS is a composite bone cement of CPC and starch, CPB is a composite bone cement of CPS and barium sulfate, and PMMA is polymethyl methacrylate bone cement)[55]; (e) Compressive strength of a complete vertebra and vertebrae filled with different bone cements[55]; (f) XMT axial view of the 12 weeks mandibular specimen (top) and corresponding buccal-lingual section histological images (down)[56]; (g) Percentage of bone area to tissue area (BA/TA) at different time points (left), and the percentage of bone substitute to tissue area (BS/TA) (right)[56]; (h) Recovery of the affected area in a pediatric patient after combined treatment with a rational skin flap repair and absorbable calcium sulfate load-bearing medication[57]

Table 1 Examples of injectable inorganic materials for hard tissue repair in orthopedics and dentistry[63-74]

Product	Major component	Application
Self-setting calcium phosphate cement (Rebone)^[63]	Calcium phosphate	Non-load-bearing bone filling and root canal filling
HydroSet (Stryker)^[64]	Calcium phosphate	Cranial defect filling
Pro-Dense (Stryker)^[65]	Calcium phosphate, calcium sulfate	Bone defect filling and repair
AlloMatrix (Stryker)^[66]	Demineralized bone matrix, calcium sulfate	Bone defect filling and repair
DBX®Putty (DePuy Synthes)^[67]	Demineralized bone matrix	Bone defect filling and repair
Drillable bone void filler (DePuy Synthes)^[68]	Calcium phosphate	Bone defect filling and repair
FIBERGRAFT™ Bioactive glass (DePuy Synthes)^[69]	45S5 bioactive glass	Bone graft substitute
Calcium sulfate bone substitute (R&L Medical)^[70]	Calcium sulfate	Bone defect filling and repair
Inductigraft (Baxter)^[71]	Calcium phosphate, silicate	Bone graft substitute
Bone graft material-boneswift (Medgen Life Sciences)^[72]	Hydroxyapatite	Filling of orthopedic trauma and non-structural spinal defects
Vitapex (Morita)^[73]	Calcium hydroxide	Root canal filling
KP-Root SP (Kevin Peter)^[74]	Zirconia, silicate, calcium phosphate, calcium hydroxide	Root canal filling

Fig. 5 Applications of injectable inorganic materials in tumor therapy[81,83 -84] (a) Schematic of the preparation process and synergistic therapy for NGO-AuNPs-FA/MB and NGO-AuNPs-FA/5-Fu[81]; (b) Viability of HeLa cells with or without near-infrared (NIR) irradiation[81]; (c) Magnetic hyperthermia of tumors using Mg0.13-γFe2O3[83]; (d) Temperature-rise profiles under different treatments[83]; (e) Relative tumor volumes under different treatments[83]; (f) Embolization performance of the NeoCast embolic agent in porcine renal vasculature after 7 and 90 d[84]

Fig. 6 Applications of injectable inorganic materials in medical sensing and diagnostics[92-93] (a) Schematic illustration of the functions of the Alg-PBA/PVA/GOH hydrogel[92]; (b, c) Impedance spectra of Alg-PBA/PVA/GOH hydrogel after incubation with E. coli (b) and S. aureus (c) suspensions for different times[92]; (d, e) Alg-PBA/PVA/GOH hydrogel monitoring human finger bending (d) and index finger bending from 0° to 90° (e)[92]; (f) Surgical electromagnetic localization of intraluminal gastrointestinal neoplasms using MagLabel-IH[93]; (g) Electromagnetic guidance probe used to gradually approach the tumor site labeled with MagLabel-IH, and ultimately mark the intestinal segment containing the tumor during laparoscopic procedure in rabbits[93]

Fig. 7 Applications of injectable inorganic materials in skin repair and facial filling[98,102 -104,107] (a) Schematic diagram of the preparation process of EPPMO hydrogel[98]; (b) Before-and-after comparison using a calcium hydroxylapatite facial filler[102]; (c) Calcium hydroxylapatite microspheres[103]; (d, e) Type I collagen staining 9 months after treatment with calcium hydroxylapatite filler (d) and hyaluronic acid gel (e)[104]; (f) Intensity of type I collagen staining 9 months after treatment with calcium hydroxylapatite filler or hyaluronic acid gel[104]; (g) Facial artery embolization with ischemia of the nasal ala following injection of calcium hydroxylapatite filler in the nasolabial fold near the pyriform aperture[107]

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