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Bioengineering
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New Sight of Implants and Bone Regeneration: Updates and Future...
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New Sight of Implants and Bone Regeneration: Updates and Future Directions

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Regenerative Engineering".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 14159

Special Issue Editors

Dr. Eugeniusz Sajewicz

E-Mail Website
Guest Editor
Department of Biomaterials and Medical Device Engineering, Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Bialystok, Poland
Interests: bone
Special Issues, Collections and Topics in MDPI journals
Dr. Piotr Prochor

E-Mail Website
Guest Editor
Department of Biomaterials and Medical Device Engineering, Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Bialystok, Poland
Interests: bone
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Currently, the clinical application of implants relates to two main areas: orthopedics and dentistry. For obvious reasons, there are differences between implants from these areas, but at the same time, there are some common issues. One of the most important is the osseointegration of implants, which affects their durability and functionality. Work is still underway on obtaining biomaterials and new design solutions, increasing the adaptation of implants and extending their durability In this aspect, achievements in the field of tissue engineering are important, including in terms of applications artificial products, such as scaffolds or part of organs, to improve treatment of severe mechanical damages or diseases by providing a functional structure that replaces affected tissue. Nowadays, a noticeable growth in interest in developing scaffolds can be noticed, which proves the need of conducting comprehensive research in order to enhance the functionality of these structures. That is why current studies are focusing on designing appropriate porosity, pore geometry, degradation time or overall scaffold architecture with adjusted manufacturing procedures. These studies are conducted with the use of analytical, numerical or experimental methods in which often researchers consider the use of bioreactors to provide an appropriate environment for studying cells behaviour in structures under development. Appropriately designed scaffold must meet all necessary requirements related to all mechanobiological factors, which makes the design process complicated.

The authors are encouraged to provide topic on (but not limited to):

  • dental implants,
  • orthopaedic implants,
  • implants in veterinary,
  • osseointegration,
  • biomaterials used for implant,
  • biotribology of implants,
  • bone regeneration,
  • scaffolds manufacturing procedures development,
  • functionality of materials designated for scaffolds,
  • analyses of the functionality of proposed scaffolds geometries,
  • cells behaviour under mechanobiological stimulation of scaffolds,
  • implanted active medical device.

Related topics will be also taken into consideration

Dr. Eugeniusz Sajewicz
Dr. Piotr Prochor
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • implant
  • scaffold
  • bioreactor
  • cells
  • biomedical materials

Published Papers (7 papers)

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Research

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12 pages, 9496 KiB  
Article
Breakage of Tapered Junctions of Modular Stems in Revision Total Hip Arthroplasty—High Incidence in a Consecutive Series of a Single Institution
by Oliver E. Bischel, Arnold J. Suda, Paul M. Böhm, Therese Bormann, Sebastian Jäger and Jörn B. Seeger
Bioengineering 2023, 10(3), 341; https://doi.org/10.3390/bioengineering10030341 - 08 Mar 2023
Cited by 2 | Viewed by 1077
Abstract
Background: Modularity in revision THA (RTHA) has become accepted during the last three decades. Nevertheless, specific risks of modularity of current revision devices such as breakage of taper junctions occur during follow-up. Data reporting failure rates are predominantly given by the manufacturers but [...] Read more.
Background: Modularity in revision THA (RTHA) has become accepted during the last three decades. Nevertheless, specific risks of modularity of current revision devices such as breakage of taper junctions occur during follow-up. Data reporting failure rates are predominantly given by the manufacturers but independent data acquisition is missing so far. Questions/Purposes: 1. What time-related risk of breakage of taper junction between neck and body of an established modular revision device can be expected in a consecutive single institutional series and a mid-term follow-up? 2. Are there specific factors influencing breakage in this cohort? Materials and Methods: A retrospective analysis was performed of a consecutive series of 89 cases after femoral revision using a tapered modular revision stem. Mean follow-up period was 7.1 (range: 3.0–13.7) years. Breakage of stem as failure criteria of the implant was investigated with a Kaplan–Meier analysis. Results: Breakage of taper junctions occurred in four patients during follow-up showing a time-depending implant survival of 94.2 (95% CI: 88.6–100%) after 13.7 years. Implant survival of stems with lateralized necks of 87.4 (95% CI: 75.6–100%) after 13.7 years was significantly lower compared to the standard offset variant with 100% after 13.5 years (log rank test p = 0.0283). Chi square test also revealed a significantly higher risk of breakage of lateralized necks compared to standard offset pieces (p = 0.0141). Three of four patients were obese with a mean BMI of 37.9 kg/m2. Grade of obesity (grade 1 or higher) had significant influence on risk of breakage. Survival of the implant was significantly lower in obese patients with at least grade 1 obesity compared to patients with a BMI < 30 kg/m2 (82.9 (95% CI: 64.9–100%) after 11.6 years vs. 98.4 (95% CI: 95.3–100%) after 13.7 years; log-rank p = 0.0327). Conclusions: Cumulative risk for failure of taper junctions was high in this consecutive single institutional cohort and may further increase during follow-up. As independent data acquisition in registries is missing, failure rate may be higher than reported data of the manufacturers. The use of lateralized offset necks in obese patients of at least grade 1 obesity showed a significantly higher risk of breakage. The use of monobloc revision devices may be an option, but randomized control trials are currently missing to establish standardized treatment protocols considering individual risks for both monobloc and/or modular implants. Full article
(This article belongs to the Special Issue New Sight of Implants and Bone Regeneration: Updates and Future Directions)
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15 pages, 15846 KiB  
Article
Hybrid Distractor for Continuous Mandibular Distraction Osteogenesis
by Shahrokh Hatefi, Javad Alizargar, Yimesker Yihun, Milad Etemadi Sh, Nan-Chen Hsieh and Khaled Abou-El-Hossein
Bioengineering 2022, 9(12), 732; https://doi.org/10.3390/bioengineering9120732 - 28 Nov 2022
Cited by 1 | Viewed by 1753
Abstract
Distraction osteogenesis (DO) is a reconstruction method for repairing bone deficiencies in the oral and maxillofacial area. Manual DO techniques have shown the functionality of the DO method for bone tissue reconstruction. The DO method can improve treatment conditions, as well as the [...] Read more.
Distraction osteogenesis (DO) is a reconstruction method for repairing bone deficiencies in the oral and maxillofacial area. Manual DO techniques have shown the functionality of the DO method for bone tissue reconstruction. The DO method can improve treatment conditions, as well as the quality of the reconstructed bone, compared with conventional techniques. Recently, continuous DO devices have been proposed to enable an automatic DO process while using a continuous force for moving the bone segment (BS). Animal studies and clinical trials have shown the successful application of continuous distractors in terms of improving DO factors, including rate and rhythm. The continuous DO technique can shorten the treatment time and enhance the quality of the regenerated tissue. However, the developed continuous distractors are yet to be used in human applications. In this study, by combining motor-driven and hydraulic techniques, a hybrid distractor is proposed. The hybrid distractor is capable of generating a continuous distraction force while controlling the position of the BS in a linear vector, with a high positioning accuracy. Results of modelling and experimental study revealed that the proposed hybrid distractor met all required factors for enabling a continuous DO procedure in humans. The proposed distractor is capable of eliminating the drawbacks of exiting techniques in terms of generating and transferring a controlled distraction force to the BS. The wireless control, as well as the small size of the device, makes this device a suitable solution for use in the reconstruction of bone defects in the maxillofacial area in humans. Full article
(This article belongs to the Special Issue New Sight of Implants and Bone Regeneration: Updates and Future Directions)
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10 pages, 1621 KiB  
Article
Graft Diameter Should Reflect the Size of the Native Anterior Cruciate Ligament (ACL) to Improve the Outcome of ACL Reconstruction: A Finite Element Analysis
by Huizhi Wang, Mingzhu Tao, Qinyi Shi, Kaixin He and Cheng-Kung Cheng
Bioengineering 2022, 9(10), 507; https://doi.org/10.3390/bioengineering9100507 - 27 Sep 2022
Cited by 4 | Viewed by 3165
Abstract
The size of the anterior cruciate ligament (ACL) often varies between individuals, but such variation is not typically considered during ACL reconstruction (ACLR). This study aimed to explore how the size of the ACL affects the selection of a suitable graft diameter. A [...] Read more.
The size of the anterior cruciate ligament (ACL) often varies between individuals, but such variation is not typically considered during ACL reconstruction (ACLR). This study aimed to explore how the size of the ACL affects the selection of a suitable graft diameter. A finite element model of a human knee was implanted with intact ACLs of different dimensions (0.95, 1 and 1.05 times the size of the original ACL) and with grafts of different diameters, to simulate ACLR (diameter 7.5–12 mm in 0.5 mm increments). The knee models were flexed to 30° and loaded with an anterior tibial load of 103 N, internal tibial moment of 7.5 Nm, and valgus tibial moment of 6.9 Nm. Knee kinematics (anterior tibial translation (ATT), internal tibial rotation (ITR) and valgus tibial rotation (VTR)) and ligament forces were recorded and compared among the different groups. The results showed that, compared with the intact knee, a graft diameter of 7.5 mm was found to increase the ATT and VTR, but reduce the graft force. Increasing the graft diameter reduced knee laxity and increased the graft force. A 10% increase in the size of the ACL corresponded to a 3 mm larger graft diameter required to restore knee stability and graft force after ACLR. It was concluded that the graft diameter should be selected according to the dimensions of the native ACL, for better restoration of knee functionality. This study may help to improve the clinical treatment of ACL ruptures. Full article
(This article belongs to the Special Issue New Sight of Implants and Bone Regeneration: Updates and Future Directions)
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10 pages, 1617 KiB  
Article
Cell Viability Assay and Surface Morphology Analysis of Carbonated Hydroxyapatite/Honeycomb/Titanium Alloy Coatings for Bone Implant Applications
by Mona Sari, Chotimah, Ika Dewi Ana and Yusril Yusuf
Bioengineering 2022, 9(7), 325; https://doi.org/10.3390/bioengineering9070325 - 18 Jul 2022
Cited by 4 | Viewed by 1864
Abstract
In this work, carbonated hydroxyapatite/titanium alloy (CHA/Ti) and carbonated hydroxyapatite/honeycomb/titanium alloy (CHA/HCB/Ti) plates were coated using the electrophoretic deposition dip coating (EP2D) method. Analysis of cell viability and surface morphology of CHA/Ti and CHA/HCB/Ti coatings were carried out using the MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) [...] Read more.
In this work, carbonated hydroxyapatite/titanium alloy (CHA/Ti) and carbonated hydroxyapatite/honeycomb/titanium alloy (CHA/HCB/Ti) plates were coated using the electrophoretic deposition dip coating (EP2D) method. Analysis of cell viability and surface morphology of CHA/Ti and CHA/HCB/Ti coatings were carried out using the MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and scanning electron microscopy (SEM), respectively. In a previous study, the thickness and average compressive strength values for the CHA/Ti and CHA/HCB/Ti plates were about 63–89 μm and 54–75 MPa, respectively. The result for thickness and compressive strength in this research followed the thickness and compressive strength parameters for coating in bone implants. In this work, the cell viability for incubation times during 24 h and 48 h of CHA/Ti plates is demonstrably superior to that of CHA/HCB/Ti plates, respectively, where the cell viability for CHA/Ti plates increased to ((67 ± 2)%) after incubation for 48 h. According to the one-way analysis of variance (ANOVA), the p-value was <0.05, indicating a significant difference in the average cell viability value across the three groups. Furthermore, the surface of CHA/Ti is not changed after the coating process. These results will yield many positive biomedical applications, especially in bone implants. Overall, CHA/Ti and CHA/HCB/Ti plates can be considered candidates for biomedical applications based on an analysis of surface morphology and cell viability. Full article
(This article belongs to the Special Issue New Sight of Implants and Bone Regeneration: Updates and Future Directions)
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Review

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19 pages, 1204 KiB  
Review
Recent Advance of Strontium Functionalized in Biomaterials for Bone Regeneration
by Xin Liu, Huagui Huang, Jing Zhang, Tianze Sun, Wentao Zhang and Zhonghai Li
Bioengineering 2023, 10(4), 414; https://doi.org/10.3390/bioengineering10040414 - 26 Mar 2023
Cited by 7 | Viewed by 1765
Abstract
Bone defect disease causes damage to people’s lives and property, and how to effectively promote bone regeneration is still a big clinical challenge. Most of the current repair methods focus on filling the defects, which has a poor effect on bone regeneration. Therefore, [...] Read more.
Bone defect disease causes damage to people’s lives and property, and how to effectively promote bone regeneration is still a big clinical challenge. Most of the current repair methods focus on filling the defects, which has a poor effect on bone regeneration. Therefore, how to effectively promote bone regeneration while repairing the defects at the same time has become a challenge for clinicians and researchers. Strontium (Sr) is a trace element required by the human body, which mainly exists in human bones. Due to its unique dual properties of promoting the proliferation and differentiation of osteoblasts and inhibiting osteoclast activity, it has attracted extensive research on bone defect repair in recent years. With the deep development of research, the mechanisms of Sr in the process of bone regeneration in the human body have been clarified, and the effects of Sr on osteoblasts, osteoclasts, mesenchymal stem cells (MSCs), and the inflammatory microenvironment in the process of bone regeneration have been widely recognized. Based on the development of technology such as bioengineering, it is possible that Sr can be better loaded onto biomaterials. Even though the clinical application of Sr is currently limited and relevant clinical research still needs to be developed, Sr-composited bone tissue engineering biomaterials have achieved satisfactory results in vitro and in vivo studies. The Sr compound together with biomaterials to promote bone regeneration will be a development direction in the future. This review will present a brief overview of the relevant mechanisms of Sr in the process of bone regeneration and the related latest studies of Sr combined with biomaterials. The aim of this paper is to highlight the potential prospects of Sr functionalized in biomaterials. Full article
(This article belongs to the Special Issue New Sight of Implants and Bone Regeneration: Updates and Future Directions)
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Other

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15 pages, 3731 KiB  
Systematic Review
Surgical Classification for Preclinical Rat Femoral Bone Defect Model: Standardization Based on Systematic Review, Anatomical Analysis and Virtual Surgery
by Yu Sun, Heike Helmholz and Regine Willumeit-Römer
Bioengineering 2022, 9(9), 476; https://doi.org/10.3390/bioengineering9090476 - 15 Sep 2022
Cited by 3 | Viewed by 2358
Abstract
Though surgical techniques profoundly influence in vivo experiments, significant heterogeneity exists in current surgeries for inducing rat femoral bone defects. Such variations reduce the reproducibility and comparability of preclinical studies, and are detrimental to clinical translation. The purposes of this study were: (1) [...] Read more.
Though surgical techniques profoundly influence in vivo experiments, significant heterogeneity exists in current surgeries for inducing rat femoral bone defects. Such variations reduce the reproducibility and comparability of preclinical studies, and are detrimental to clinical translation. The purposes of this study were: (1) to conduct a systematic review of rat femoral defect models, summarizing and analyzing the surgical techniques; (2) to analyze surgical design and potential pitfalls via 3D anatomy and virtual surgeries for fostering future precision research; and (3) to establish a surgical classification system, for improving the reproducibility and comparability among studies, avoiding unnecessary repetitive experiments. The online database PubMed was searched to identify studies from January 2000 to June 2022 using keywords, including rat, femur, bone defect. Eligible publications were included for a review of surgical methods. Anatomical analysis and virtual surgeries were conducted based on micro-CT reconstruction of the rat femur for further investigation and establishment of a classification system. A total of 545 publications were included, revealing marked heterogeneity in surgical methods. Four major surgical designs were reported for inducing defects from the proximal to distal femur: bone tunnel, cortical window, segmental defect, and wedge-shaped defect. Anatomical analysis revealed potential pitfalls hindering efficient clinical translation. A classification system was established according to the anatomical region, surgical design, and fixation devices. This systematic review in combination with 3D analysis and virtual surgery provides a general overview of current surgical approaches to inducing femoral defects in rats, and establishes a surgical classification facilitating preclinical research of quality and translational value. Full article
(This article belongs to the Special Issue New Sight of Implants and Bone Regeneration: Updates and Future Directions)
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16 pages, 1277 KiB  
Concept Paper
The Biomechanical Profile of an Osseo-Integrated Rectangular Block Implant: A Pilot In Vivo Strain Analysis
by Efthimios Gazelakis, Roy B. Judge, Joseph E. A. Palamara and Mohsin Nazir
Bioengineering 2022, 9(9), 425; https://doi.org/10.3390/bioengineering9090425 - 30 Aug 2022
Viewed by 1307
Abstract
Aim: To load-test the osseo-integrated rectangular block implant (RBI), measure the generated cortical peri-implant strains, and relate these findings to known human physiological parameters. Materials and methods: Two RBIs were placed into the posterior mandibular saddle in a mature greyhound dog and [...] Read more.
Aim: To load-test the osseo-integrated rectangular block implant (RBI), measure the generated cortical peri-implant strains, and relate these findings to known human physiological parameters. Materials and methods: Two RBIs were placed into the posterior mandibular saddle in a mature greyhound dog and allowed to osseo-integrate. The half mandible (implants in situ) was mounted in a servohydraulic system. Four triple-stacked rosette gauges were placed cortically (mesial, distal, buccal, and lingual). A modified ISO-14801 protocol was used (1000 N, 300, 2 Hz, 1 h) and the generated principal strains (ep, eq) and their angular orientations (F), were calculated. Results: (1) Bucco-lingual “horizontal” dimension: dominant “horizontal” compressive stresses were on the lingual aspect and “horizontal” tensile stresses on the buccal aspect. The buccal cortex was elastically tensile-stretched, while the lingual cortex was elastically compressed. (2) Bucco-lingual “vertical” dimension: dominant vertical torsional stresses were oriented buccally and apically, with an overall buccally inclined torsional effect. This was also evidenced on the lingual aspect, where there remained high torsional rotation elements (high F and e2). (3) Mesio-distal “horizontal” dimension: dominant torsional stresses oriented as a distal-lingual “counter-clockwise” rotation. Conclusions: The applied off-axial loads generated a heterogeneous pattern of bucco-lingual and mesio-distal cortical strains, both vertically and horizontally. The short dimensioned osseo-integrated RBI design appeared to biomechanically withstand the applied loads and to maintain the strains generated to levels that were within physiological limits. More studies and statistical analyses are needed to confirm these findings. Full article
(This article belongs to the Special Issue New Sight of Implants and Bone Regeneration: Updates and Future Directions)
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