In this study, we developed and characterized a fully biodegradable composite bone cement reinforced with short, randomly oriented amorphous magnesium fibers. Fibers of composition Mg60Zn35Ca5 (in at.%) with 50 μm diameter and 2 mm length were produced by wire spinning and then mixed with a magnesium calcium phosphate cement using fiber volume fractions between 10 and 20 %. The interface strength between the fibers and cement was improved by treating the fibers with diammonium hydrogen phosphate. Compared to the reference cement without fibers, flexural strength was increased by 18 % for the composites with 13 and 18 vol% fibers, and the work of fracture was increased by over 1000× in all cases (p < 0.05, n = 6). Immersion in simulated body fluid for two and four weeks showed that the cement's struvite phase degrades first, and overall, the composite degrades slower. The degradation rate can be tailored to the application by changing the fiber percentage or the cement/fiber composition. Murine pre-osteoblastic cells (MC3T3) cultured in extracts of reference and composite cements had significantly higher cell viability, and composites with 13 vol% fibers also had a significantly higher number of cells compared to the control, indicating that the fibers can enhance and promote pre-osteoblastic cell growth. The results demonstrate that amorphous magnesium fibers enhance both the mechanical and biological properties of ceramic bone cement, expanding their prospects for clinical application.

Bone defects in the context of fracture treatment or tumor surgery represent a major challenge regarding their treatment. Sticky and drillable magnesium phosphate cements could revolutionize the intraoperative reconstruction of complex fractures close to the joint due to their properties as bone adhesive and filler at the same time, enabling the technique of first reduction of the fracture fragments by bonding with the cement and then applying stabilization with screws and/or plates.

Lateral split-depression fractures of the proximal tibia were generated in 27 porcine specimens, which were then randomized into 3 groups of 9 each. In group A, a new operative technique was applied by reducing the fracture using a newly formulated magnesium phosphate cement (MgP cement) and then applying stabilization by plate osteosynthesis. In the other two groups, plate osteosynthesis was performed first, as in the current standard operative procedure, followed by the injection of a bone graft substitute through a gap in the fracture area of the tibia, group B with MgP cement, group C with hydroxyapatite cement. The following parameters were determined during the cyclic testing phase of 3000 test cycles: The total displacement and the optical displacement of the lateral plateau [mm]. During load-to-failure tests, the stiffness [N/mm], the maximum load [N] and the normalized maximum load [%] were determined.

The results revealed a comparable stability for all groups with no significant differences in all forms of displacement, with group A demonstrating the lowest values for displacement. Maximum load was highest for group C (group B; C [p = 0.04]; group A; C [p < 0.01]), however considering normalized maximum load, no significant difference between the three groups could be found.

This study presents a breakthrough approach using a bone cement as both a bone adhesive and a filler at the same time. The adhesive and drillable magnesium phosphate cement proved to be a versatile solution featuring a new surgical method in which the fracture was anatomically reduced using only the cement. Furthermore, with this new technique, the cement demonstrated comparable, if not slightly superior, biomechanical stability in the porcine tibial split depression fracture model compared to the current standard of surgical treatment using primary plate osteosynthesis and a commercial hydroxyapatite cement.

The biomechanical similarity of magnesium to cortical bone, along with its biocompatibility and biodegradability, makes it promising for orthopedic implants. However, rapid degradation compromises the structural integrity and fixation, causing failure. To address this issue, we developed a hard-soft dual-state coating to regulate degradation and improve performance. A dense magnesium hydroxide hard coating was formed by sodium hydroxide treatment, and the hydrogel soft coating formed by freeze-drying was 44.5 μm thick. The dual coating significantly improved the corrosion resistance and mechanical properties. Mg-OH-Hy implants exhibited a reduced corrosion rate of 0.61 mm/year (±0.02), an ultimate fracture force of 750 N (±10), and a pullout force of 350 N (±10). Electrochemical testing revealed an Ecorr of -1.08 V and an Icorr of 10-3·8 mA/cm2. This dual coating approach improves mechanical stability, controls degradation, and promotes bone integration, providing personalized solutions for diverse clinical applications.

Biodegradable porous magnesium alloy (pMg) scaffolds hold significant potential for repair of bone defects owing to favorable mechanical properties and biocompatibility. However, a critical challenge remains in matching the degradation rate of pMg scaffolds with the pace of bone regeneration. Low-intensity pulsed ultrasound (LIPUS) has emerged as a promising therapeutic strategy to enhance bone repair. In this study, femoral bone defects in Sprague-Dawley rats were implanted with pMg scaffolds, and LIPUS was applied to the defect sites post-operatively. This study primarily investigated the degradation behavior of pMg scaffolds in vivo experiments, as well as their reparative effects on bone defects under LIPUS intervention. In vivo analysis revealed that LIPUS intervention accelerated the degradation of pMg scaffolds by loosening the degradation layer, making it more susceptible to erosion. Concurrently, LIPUS enhanced the accumulation of beneficial calcium and phosphorus compounds on the surface of the pMg scaffolds. Furthermore, the pMg + LIPUS group exhibited enhanced bone formation and mineralization around the degradation site compared to the pMg group alone, attributed to the increasing osteocalcin (OCN) and type I collagen (COL-I) as well as reduction in osteolysis by pMg and LIPUS-induced osteogenesis effect. At the 24-week post-surgery, the hardness value (HV) of regeneration bone in the pMg + LIPUS group had a 15% increase compared to the pMg group and approached the HV of healthy bone. In conclusion, the promotion of bone tissue growth rate under the intervention of LIPUS in conjunction with the degradation rate of pMg scaffolds offers a novel clinical strategy for the repair of bone defects.

A simple, fast and sensitive method based on the fluorescence quenching of carbon dots was developed for the determination of Mg2+ in environmental and biological sample. Carbon dots (CDs) were synthesized from arugula seeds by hydrothermal method. The precursor is cheap, easily available and environment friendly. CDs were characterized by selected techniques. They showed a bright blue fluorescent under UV light while under day light the synthesized CDs showed brown colour. The CDs were highly fluorescent. The interaction of CDs with various selected cations such as Ni2+, Sr2+, Cd2+, Mg2+, Cu2+, Al3+, Co2+, K+, Ca2+, Pb2+, Cr3+, Na+, Zn2+, Fe2+, Cu+, Mn2+, Mo6+, Sb3+, Sn4+, Cr6+, Ba2+, Li+ and Fe3+ was studied to check the probable potential application for the studied ions. All the studied ions did not show any effect on the intensity of CDs except Mg2+ which quenched the intensity of the CDs. A linear relation was found between the quenching of CDs intensity and Mg2+ concentration. The quenching was explained with the Stern-Volmer equation that produced the Stern-Volmer constant ([Formula: see text]). [Formula: see text], detection limit (DL) and quantification limit (QL) were observed in the order 2.85 × 105 mol L- 1, 32.6 n mol L- 1 and 108 n mol L- 1 correspondingly. Method based on the fluorescence quenching of CDs is reproducible and useful for the Mg2+ determination in environmental and biological samples.

Polyetheretherketone (PEEK) is a high-performance polymer material for developing varying orthopedic, spine, cranial, maxillofacial, and dental implants. Despite their commendable mechanical properties and biocompatibility, the major limitation of PEEK implants is their low affinity to osseointegrate with the neighboring bone. Over the last two decades, several efforts have been made to incorporate bioactive components such as bioceramic particles in PEEK to enhance its osseointegration capacity. However, one major limitation is that the bioceramic particles embedded in the PEEK matrix can degrade over time, compromising the implant's long-term bioactivity and mechanical properties. To address this limitation, in this study, we utilized a unique bioceramic known as amorphous magnesium phosphate (AMP). AMP is a metastable phase of magnesium phosphate that nanocrystallizes in a physiological medium to stable bioactive phases exhibiting low degradation kinetics and high bioactivity. Thus, based on this property of AMP, we hypothesize that AMP-PEEK composites will exhibit sustained biodegradation kinetics, help maintain long-term osseointegration, and inhibit mechanical property degradation. Herein, we reported on a detailed in vitro degradation analysis of the developed AMP-PEEK composite 3D-printable filaments and the osseointegration capacity when implanted in a rat femoral model. The AMP-PEEK composite demonstrates controlled degradation kinetics, with tensile strength progressively decreasing from 120 to 70 MPa over a 28-day period due to hydrolytic degradation, which aligns with its role as a bioresorbable material. Notably, our findings confirm that AMP-PEEK composite osseointegration is on par with clinical gold-standard titanium implants. Thus, this study establishes a unique magnesium phosphate and PEEK-based bioactive composite material with promising potential for developing standalone dental and craniofacial implants.

Calcium phosphate-based bioscaffolds are used for bone tissue regeneration because of their physical and chemical resemblance to human bone. Calcium, phosphate, sodium, potassium, magnesium, and silicon are important components of human bone. The successful biomimicking of human bone characteristics involves incorporating all the human bone elements into the scaffold material. In this work, Mg-Whitlockite (WH) and Calcium Silicate (CS) were selected as matrix and reinforcement respectively, because of their desirable elemental composition and regenerative properties. The magnesium in WH increases mineralization in bone, and the silicon ions in CS support vascularization. The Mg-WH was synthesized using the wet chemical method, and powder characterization tests were performed. Response surface methodology (RSM) is used to design the experiments with a combination of material compositions, infill ratios (IFs), and sintering temperatures (STs). The WH/CS bioceramic composite is 3D printed in three different compositions: 100/0, 75/25, and 50/50 wt%, with IFs of 50%, 75%, and 100%. The physical and mechanical characterization study of printed samples is conducted and the result is optimized using RSM. ANOVA (Analysis of Variance) is used to establish the relationship between input parameters and responses. The optimized input parameters were the WH/CS composition of 50/50 wt%, IF of 50%, and ST of 1150 °C, which bring out the best possible combination of physical and mechanical characteristics. The RSM optimized response was a density of 2.27 g cm-3, porosity of 36.74%, wettability of 45.79%, shrinkage of 25.13%, compressive strength of 12 MPa, and compressive modulus of 208.49 MPa with 92% desirability. The biological characterization studies were conducted for the scaffold samples prepared with optimized input parameters. The biological studies confirmed the capabilities of the WH/CS composite scaffolds in bone regenerative applications.

Inorganic nanoparticles are promising materials for bone tissue engineering due to their chemical resemblance to the native bone structure. However, most studies are unable to capture the entirety of the defective environment, providing limited bone regenerative abilities. Hence, this study aims to develop a multifunctional nanoparticle to collectively control the defective bone niche, including immune, angiogenic, and osteogenic systems. The nanoparticles, self-assembled by biomimetic mineralization and tannic acid (TA)-mediated metal-polyphenol network (MPN), are released sustainably after the incorporation within a gelatin cryogel. The released nanoparticles display a reduction in M1 macrophages by means of reactive oxygen species (ROS) elimination. Consequently, osteoclast maturation is also reduced, which is observed by the minimal formation of multinucleated cells (0.4%). Furthermore, the proportion of M2 macrophages, osteogenic differentiation, and angiogenic potential are consistently increased by the effects of magnesium from the nanoparticles. This orchestrated control of multiple systems influences the in vivo vascularized bone regeneration in which 80% of the critical-sized bone defect is regenerated with new bones with mature lamellar structure and arteriole-scale micro-vessels. Altogether, this study emphasizes the importance of the coordinated modulation of immune, osteogenic, and angiogenic systems at the bone defect site for robust bone regeneration.

Fabricating bone tissue engineering substitutes with functional activity remains a challenge for bone defect repair requiring coordinated coupling between osteogenesis and angiogenesis. In this research, we evaluated and analyzed magnesium silicate/β-Tricalcium phosphate (MS/β-TCP) scaffold on angiogenesis and bone regeneration in vitro and in vivo, and the mechanism of its action were described. Achieving magnesium and silicon ions sustained release, 3D printed MS/β-TCP scaffolds possessed appropriate mechanical properties and had excellent biocompatibility that was suitable for osteoblastic MC3T3-E1 cells and human umbilical vein endothelial cells (HUVECs) with proliferation, adhesion, and migration. Combined techniques of Transwell co-culture, we studied the effect of MS/β-TCP scaffold activated cell-level specific regulatory network, which promotes the osteogenic differentiation of MC3T3-E1 and the endothelial formation of HUVEC by significantly up-regulating the expression of related genes and proteins. In addition, RNA sequencing (RNA-seq) revealed MS/β-TCP scaffold plays a dual role in osteogenesis and angiogenesis by activating PI3K/Akt signal pathway, whereas the expression of genes and proteins associated with osteogenesis and angiogenesis was significantly downregulated the PI3K/Akt signaling pathway was inhibited. Additionally, in vivo studies showed that MS/β-TCP scaffolds increased the growth of vascular and promoted the bone regeneration at the bone defect sites in rats. In summary, 3D printed MS/β-TCP scaffolds with effectively osteogenic and angiogenic induction will be an ideal bone substitute applied in bone defect repair for clinical application in the future.

Bone defects that exceed the critical defect value, resulting from fractures and diseases, are often difficult to heal. Although bone tissue engineering is a promising treatment for extensive osseous defects, orthopedic-implant-related infections increase the likelihood of failure. Bioactive glass (BG) has been widely used in the manufacture of artificial bone scaffolds, owing to its excellent biocompatibility and osteoinductivity. Nevertheless, considering that infection conditions and trauma can affect the osteogenic capacity of bioactive glass, this study combined BG with magnesium and strontium to promote osteogenesis and confer significant antimicrobial activity. Novel bioactive glass doped with magnesium-strontium (BGMSN) with good biocompatibility, excellent antibacterial properties, and promising osteogenic induction ability was constructed from 45S5, Mg, and Sr carbonates via a melt-quenching approach. The results of an in vitro cell biocompatibility study indicated that the BGMSN exhibited good cellular compatibility. Furthermore, osteogenic alkaline phosphatase, osteocalcin, and osteopontin genes were upregulated upon BGMSN/MC3T3-E1 coculture. BGMSN exhibited potent in vitro antibacterial effects against Staphylococcus aureus, Escherichia coli, and Streptococcus mutans. Animal experiments further demonstrated the exceptional bone-inducing ability of BGMSN. Accordingly, owing to their excellent antimicrobial properties, BGMSN can be used for bone regeneration, particularly under infected conditions.

We report a case of pulseless electrical activity (PEA) associated with profound hypermagnesemia immediately after cementation of a novel magnesium-based cement in spine surgery. During T8 to T12 posterior instrumentation and decompression laminectomy for vertebral metastasis secondary to lung cancer, a 61-year-old Chinese woman developed sudden hypotension and went into PEA immediately after injection of a novel magnesium-based cement. Intraoperative fluoroscopic imaging did not show any notable cement extravasation. Resuscitation using intravenous epinephrine with five doses of 1-mg epinephrine in 1:10,000 dilution was instituted, and the patient had return of spontaneous circulation after 5 minutes. After successful resuscitation, surgery was expedited and completed. Intraoperative and postoperative investigations were notable for profound hypermagnesemia and hyperphosphatemia requiring diuresis. No echocardiographic or computerized tomographic evidence of pulmonary embolism was found. The patient was transferred to the surgical intensive care unit and remained on dual inotropic support over the next few days. She subsequently weaned off inotropic support and electrolyte imbalances resolved before making a full recovery. This case report demonstrates the severe magnesium toxicity and PEA related to the use of novel magnesium-based cement in spine surgery. Further studies need to be conducted to understand the potential complications related to its use and compare them to the standard bone cement implantation syndrome.

In dental implant surgery, infection is identified as the primary factor contributing to the failure of bone grafts. There is an urgent need to develop bone graft materials possessing antibacterial characteristics to facilitate bone regeneration. Magnesium phosphate bone cement (MPC) is highly desirable for bone regeneration due to its favorable biocompatibility, plasticity, and osteogenic capabilities. However, the limited porosity of conventional MPC hinders the nutrient supply, gas diffusion, and cell infiltration, thereby compromising its osteogenic efficacy. This research focused on the fabrication of a highly porous MPC (CaCO3/CA-MPC) by incorporating citric acid (CA) and calcium carbonate (CaCO3) as foaming agents. The resulting material demonstrated enhanced physicochemical properties, bioactivity, and antimicrobial effects. When compared with conventional MPC, human periodontal ligament stem cells (hPDLSCs) showed improved osteogenic differentiation when cultured with CaCO3/CA-MPC. The inclusion of foaming agents significantly enhanced the antimicrobial efficacy of MPC against both Gram-positive bacteria (Staphylococcus aureus) and Gram-negative bacteria (Escherichia coli). The results of in vivo anti-infection experiments in rats revealed that 3%CaCO3/CA-MPC displayed superior bactericidal activity compared with Bio-Oss and control groups (p < 0.05), thereby enhancing the anti-infective outcomes post-bone grafting and stimulating osteogenesis in the infected bone defect region. The study demonstrated that MPC containing 3%CaCO3/CA exhibited excellent antimicrobial and osteogenic properties both in vitro and in vivo, suggesting its potential as a promising candidate as bone graft material for dental implant surgeries.

Over eight million surgical procedures are conducted annually in the United Stats to address organ failure or tissue losses. In response to this pressing need, recent medical advancements have significantly improved patient outcomes, primarily through innovative reconstructive surgeries utilizing tissue grafting techniques. Despite tremendous efforts, repairing damaged tissues remains a major clinical challenge for bioengineers and clinicians. 3D bioprinting is an additive manufacturing technique that holds significant promise for creating intricately detailed constructs of tissues, thereby bridging the gap between engineered and actual tissue constructs. In contrast to non-biological printing, 3D bioprinting introduces added intricacies, including considerations for material selection, cell types, growth, and differentiation factors. However, technical challenges arise, particularly concerning the delicate nature of living cells in bioink for tissue construction and limited knowledge about the cell fate processes in such a complex biomechanical environment. A bioink must have appropriate viscoelastic and rheological properties to mimic the native tissue microenvironment and attain desired biomechanical properties. Hence, the properties of bioink play a vital role in the success of 3D bioprinted substitutes. This review comprehensively delves into the scientific aspects of tissue-centric or tissue-specific bioinks and sheds light on the current challenges of the translation of bioinks and bioprinting.

Magnesium phosphate-based cements are highly regarded for their bioactive properties, making them excellent candidates as bone substitutes. Despite their promising attributes, challenges such as high reaction temperature, limited injectability, and brittleness limit their application. This study introduces a dual-setting biocomposite cement, which encompasses both cement hydration and hydrogel's cross-linking. The composition features magnesium potassium phosphate (MKP) combined with ionically cross-linked kappa-carrageenan (kC) plasticized with sorbitol (Sor). The investigation delves into the properties of the resultant biocomposite, with a particular focus on evaluating kC incorporation's influence on the main MKP properties. Our findings reveal that those biocomposites offer multiple benefits over traditional ceramic cements. The main advantages include: a longer setting time (up to ~15 min), lower setting temperature (~45 °C), different crystalline phase (bobierrite), better wettability (~22°), and improved injectability of the paste characterized by more stable cohesion. Specifically, the MKP (4:1 Mg/P ratio) with 1.5 % kC and Sor hydrogel obtained with 3.0 g/mL powder-to-liquid ratio demonstrated the most promising properties with no adverse effects on the microstructure diversity, the mechanical strength, the porosity, the biodegradation rate, and the osteoblasts cytocompatibility. Overall, our research indicates that these innovative cements hold significant potential for biomedical applications, especially minimally invasive orthopedic procedures.

Ankle arthritis is a common degenerative disease that progresses as cartilage damage in the lower tibia and upper talus progresses, resulting in loss of joint function. In addition to typical arthritis, there is also structural bone loss in the talus due to diseases such as talar avascular necrosis. Total talus replacement surgery is the procedure of choice in end-stage ankle arthritis and consists of a tibial, talar component and an insert. However, in cases of severe cartilage and bone damage to the talar bone with less damage to the tibial cartilage, a talar component hemiarthroplasty may be considered. Although the application of total talus replacement surgery using ceramics has been studied, reports on the application of metal 3D printing technology are limited. We aimed to investigate the feasibility of partial talar components using ceramic and titanium 3D printing technology in terms of biocompatibility and stability through animal experiments.

Preoperative 3D CT was acquired and converted to STL files to fabricate a partial talus component for ankle hemiarthroplasty using ceramic and titanium. Six minipigs with an average age of 17 months were implanted with three ceramic (C-group) and three titanium talar components (T-group) in the hind limb ankle joint. The surgery was performed under anesthesia in a sterile operating room and was performed by two experienced foot and ankle specialist orthopedic surgeons. Blood analysis and CT were performed before surgery and every month for 3 months after surgery to assess the extent of inflammatory response and physical stability, sacrifices were performed 3 months after surgery, and H&E staining and micro-CT analysis were performed to compare histological biocompatibility. A grading score was calculated to semi-quantitative assess and compare the two groups.

In the postsurgical evaluation, blood analysis revealed that both groups had increased white blood cell counts on the postoperative day after surgery. The white blood cell count increased more in the titanium group (1.85-fold) than in the ceramic group (1.45-fold). After 3 months, all values normalized. During the study, CT analysis confirmed that all artificial samples were displaced from their initial positions. In micro-CT analysis, the adhesive tissue score of the ceramic artificial sample was better than that of the titanium sample (average threshold = 3027.18 ± 405.92). In histologic and grading scores for the inflammatory reactions, the average inflammation indices of the ceramic and titanium groups were 2.0 and 1.21, respectively. Also, the average grade score confirmed based on the results of fibrous tissue proliferation and new blood vessels was 18.4 in the ceramic application group and 12.3 in the titanium application group.

In conclusion, both titanium and ceramics have excellent biocompatibility for artificial joints, and ceramic materials can be used as novel artificial joints. Further research on the strength and availability of these ceramics is required.

The cross-linking process of collagen is one of the more important ways to improve the mineralization ability of collagen. However, the regulatory effect of dynamic cross-linking on biomineralization in vitro remains unclear. Dynamic-cross-linked mineralized collagen under different cross-linking processes, according to the process of cross-linking and mineralization of natural bone, was prepared in this study. Mineralization was performed for 12 h at 4, 8, and 12 h of collagen cross-linking. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) showed the characteristics of dynamic-cross-linked mineralization in terms of morphological transformation and distribution. Fourier transform infrared spectroscopy (FTIR) analysis showed the crystallinity characteristics of the hydroxyapatite (HA) crystal formation. Pre-cross-linked dynamic-cross-linked mineralization refers to the process of cross-linking for a period of time and then side cross-linked mineralization. The mineral content, enzyme stability, and mechanical properties of mineralized collagen were improved through a dynamic cross-linking process of pre-cross-linking. The swelling performance was reduced through the dynamic cross-linking process of pre-cross-linking. This study suggests that the dynamic cross-linking process through pre-cross-linking could make it easier for minerals to permeate and deposit between collagen fibers, improve mineralization efficiency, and, thus, enhance the mechanical strength of biomineralization. This study can provide new ideas and a theoretical basis for designing mineralized collagen scaffolds with better bone repair ability.

With the population aging, osteoporosis (OP) is becoming more and more common, seriously affecting patients' quality of life and their families, and how to prevent and treat osteoporosis has become a hot topic. However, the current conventional method of treating OP is oral anti-osteoporosis medication, which has drawbacks such as first-pass elimination and gastrointestinal adverse effects. At the same time, osteoporosis can lead to microbial infections and the need to promote angiogenesis for bone healing, among other needs that often cannot be met with conventional treatments, and there is a risk of resistance to oral antibiotics for microbial infections. Metal-organic frameworks (MOFs) having a high specific surface area, high porosity, controlled degradation, and variable composition; they can not only be used as a carrier to control drug release, but can also play multiple roles in the treatment of OP and microbial infections by releasing metal ions, etc., so they have inherent advantages for OP, which is a disease that requires long-term treatment. Therefore, this paper reviews the research progress of MOFs and their biomacromolecular composites in therapeutic applications for osteoporosis, categorized by MOF type, and briefly describes the mechanism of osteoporosis, and different synthesis methods of MOFs and MOF-based composites, and finally presents the main existing problems and future perspectives, aiming to make MOFs more helpful for OP treatment.

Magnesium-doped hydroxyapatite (HAp-Mg) nanofibers show promise for medical applications due to their structural similarity to bone minerals and enhanced biological properties, such as improved biocompatibility and antimicrobial activity. This study synthesized HAp-Mg nanofibers using a microwave-assisted hydrothermal method (MAHM) to evaluate their cytotoxicity, biocompatibility, and antimicrobial efficacy compared to commercial hydroxyapatite (HAp). Characterization through X-ray diffraction (XRD), scanning electron microscopy (SEM), Transmission Electron Microscopy (TEM), energy-dispersive X-ray spectroscopy (EDS), and Fourier transform infrared spectroscopy (FTIR) confirmed the successful incorporation of magnesium, producing high-purity, crystalline nanofibers with hexagonal morphology. Rietveld refinement showed slight lattice parameter shortening, indicating Mg2+ ion integration. Cell viability assays (MTT and AlamarBlue) revealed a significant increase in fibroblast proliferation with 2% and 5% HAp-Mg concentrations compared to controls (p < 0.05), demonstrating non-cytotoxicity and enhanced biocompatibility. Antimicrobial tests (disk diffusion method, 100 µg/mL) showed that HAp-Mg had strong antibacterial effects against Gram-positive and Gram-negative bacteria and moderate antifungal activity against Candida albicans. In contrast, commercial HAp showed no antimicrobial effects. These results suggest HAp-Mg nanofibers have significant advantages as biomaterials for medical applications, particularly in preventing implant-related infections and supporting further clinical development.

Background: Magnesium alloys degrade rapidly in salt solutions, which limits their use without passivating treatments. AZ31 alloy is particularly promising for implant applications owing to its biodegradability and mechanical properties, necessitating effective corrosion-resistant coatings. Aim: In this study, a self-passivating reactive coating was designed and evaluated for AZ31 magnesium alloy plates using β-tricalcium phosphate (TCP) to enhance corrosion resistance and biocompatibility. Methods: Solutions of TCP, trisodium citrate, magnesium nitrate, hydroxyethyl cellulose (HEC), and sodium chloride were used to dip-coat AZ31 plates. The coated samples were immersed in 3.5 wt% NaCl solution. Phase evolution was analysed using gravimetry, X-ray diffraction (XRD), energy-dispersive X-ray (EDX) spectroscopy, and scanning electron microscopy (SEM). The biological response of the coated samples was evaluated through MTT and resazurin assays. Results: The coating formed a stable TCP/HEC layer that gradually dissolved over two weeks, converting the surface to magnesium hydroxide, magnesium oxychloride, and magnesium phosphate phases. The formation of brucite, responsible for passivation in the long term, was observed. The coating effectively prevented excessive magnesium oxychloride formation and stabilised magnesium hydroxide after one week. Biological characterization indicated that the coating on AZ31 is safe on the Saos-2 and L929 cell lines. Conclusion: The TCP-based coating enhances the corrosion resistance of AZ31 alloy in salt solutions, promoting passivating phases and limiting corrosive products, thereby ameliorating biocompatibility issues. This coating demonstrates substantial potential for extending the longevity and functionality of magnesium alloy implants.

The repair of bone defects has always been a significant challenge in clinical medicine. To address this challenge, doctors often utilize autologous bone grafts, allogeneic bone grafts and artificial bone substitutes. However, the former two methods may result in additional trauma and complications, while allogeneic bone grafts carry the risks of immune rejection and disease transmission. Magnesium phosphate cement (MPC), as a artificial bone substitutes, has been a potential biomaterial for repairing bone defects, but its clinical application is limited by insufficient mechanical strength and poor osteoinductive activity.

In this study, the cement liquid phase base on rhBMP-2 and chitosan solution into MPC were obtained and investigated. After mixing with a cement liquid, the structural and phase composition, morphology, chemical structure, setting time, compressive strength, degradation behavior, solubility, and cellular responses and bone regeneration in response to CHI-rhBMP2 MPC were investigated in vitro and in vivo.

After the chemical component modification, CHI-rhBMP2 MPC possessed controllable degradation rate, moderate setting time, appropriate cuing temperature, good injectability, and improved initial strength. In vitro tests showed that the CHIrhBMP2 MPC could promote cell proliferation and adhesion, as well as that contribute to osteoblast differentiation and mineralization. In addition, cement materials were implanted into the rabbit femoral condyles for in vivo osseointegration evaluation. The results displayed that more new bone grew around CHI-rhBMP2 MPC, verifying improved osseointegration capacity. Transcriptome analysis revealed that focal adhesion, Forkhead box O（FoxO） signaling pathway and P13K/AKT signaling pathway were may involved in CHI-rhBMP2 MPC induced new bone formation.

This work provides a new strategy for the rational design of potential bone repair candidate materials.

To date, severe bone defects remain a significant challenge to the quality of life. All clinically used bone grafts have their limitations. Bone tissue engineering offers the promise of novel bone graft substitutes. Various biomaterial scaffolds are fabricated by mimicking the natural bone structure, mechanical properties, and biological properties. Among them, gelatin methacryloyl (GelMA), as a modified natural biomaterial, possesses a controllable chemical network, high cellular stability and viability, good biocompatibility and degradability, and holds the prospect of a wide range of applications. However, because they are hindered by their mechanical properties, degradation rate, and lack of osteogenic activity, GelMA hydrogels need to be combined with other materials to improve the properties of the composites and endow them with the ability for osteogenesis, vascularization, and neurogenesis. In this paper, we systematically review and summarize the research progress of GelMA composite hydrogel scaffolds in the field of bone defect repair, and discuss ways to improve the properties, which will provide ideas for the design and application of bionic bone substitutes.

Additive Manufacturing (AM) encompasses various techniques creating intricate components from digital models. The aim of incorporating 3D printing (3DP) in the healthcare sector is to transform patient care by providing personalized solutions, improving medical procedures, fostering research and development, and ultimately optimizing the efficiency and effectiveness of healthcare delivery. This review delves into the historical beginnings of AM's 9 integration into medical contexts exploring various categories of AM methodologies and their roles within the medical sector. This survey also dives into the issue of material requirements and challenges specific to AM's medical applications. Emphasis is placed on how AM processes directly enhance human well-being. The primary focus of this paper is to highlight the evolution and incentives for cross-disciplinary AM applications, particularly in the realm of healthcare by considering their principle, materials and applications. It is designed for a diverse audience, including manufacturing professionals and researchers, seeking insights into this transformative technology's medical dimensions.

To overcome critical size bone defects, calcium phosphate (CaP)-based ceramics have been widely explored. The compositional similarity with bone matrix and degradability are the main reasons for their selection in orthopaedic biomaterials. However, the low solubility rate under in vivo conditions raises concerns about these CaP groups, particularly hydroxyapatite (HA) and tricalcium phosphate (TCP) ceramics. Therefore, reliable and suitable degradable ceramics for bone defect repair are always an important research direction for researchers. The magnesium phosphate (MgP) group of bioceramics has been studied for orthopaedic applications and is comparatively new compared to traditional CaP ceramics. The role of magnesium in different biochemical processes, such as DNA stabilization, bone density maintenance, regulating Ca and Na ion channels, and cell proliferation and differentiation enhancement, is a key parameter for the development of MgP bioceramics. This article aims to give a comprehensive review of MgP ceramics in bone tissue engineering. Here, we have highlighted several preparation techniques, the existence of porosity, and the impact of metal ion doping on MgP bioceramics. Finally, in vitro and in vivo responses of MgP bioceramics in bone formation are discussed.

Trimagnesium phosphate (TMP) bioceramic scaffolds are deemed as promising bone grafts, but their mechanical and biological properties are yet to be improved. In the study, strontium orthosilicate (SrOS) was used to modify the TMP scaffolds, whose macroporous structure was constructed by the filament deposition-type 3D printing method. The new phases of SrMg2(PO4)2 and Sr2MgSi2O7, which showed nanocrystalline topography, were produced in the 3D-printed TMP/SrOS bioceramic composite scaffolds. The compressive strength (1.8-64.1 MPa) and porosity (39.7%-71.4%) of the TMP/SrOS scaffolds could be readily tailored by changing the amounts of SrOS additives and the sintering temperature. The TMP/SrOS scaffolds gradually degraded in the aqueous solution, consequently releasing ions of magnesium, strontium and silicon. In contrast with the TMP scaffolds, the TMP/SrOS bioceramic scaffolds had profoundly higher compressive strength, and enhanced cell proliferative and osteogenic activities. The TMP/SrOS scaffolds incorporated with 5 wt% SrOS had the highest mechanical strength and beneficial cellular function, which made them promising for treating different sites of bone defects.

The magnesium alloy bionic cannulated screw (MABCS) was designed in a previous study promoting cortical-cancellous biphasic healing of femoral neck fractures. The main purpose was to analyze the bore diameters that satisfy the torsion standards and further analyze the optimal pore and implantation direction for stabilizing femoral neck fractures.

The MABCS design with bionic holes with a screw diameter of less than 20% met the torsion standard for metal screws. The MABCS was utilized to repair the femoral neck fracture via Abaqus 6.14 software, which simulated the various stages of fracture healing to identify the optimal biomechanical environment for bionic hole size (5%, 10%, 15%, and 20%) and implantation direction (0°, 45°, 90°, and 135°).

The stress distribution of the MABCS fracture fixation model is significantly improved with an implantation orientation of 90°. The MABCS with a bionic hole and a screw diameter of 10% provides optimal stress distribution compared with the bionic cannulated screw with diameters of 5%, 15%, and 20%. In addition, the cannulated screw fixation model with a 10% bionic hole size has optimal bone stress distribution and better internal fixation than the MABCS fixation models with 5%, 15%, and 20% screw diameters.

In summary, the MABCS with 10% screw diameter bionic holes has favorable biomechanical characteristics for stabilizing femoral neck fractures. This study provides a biomechanical foundation for further optimization of the bionic cannulated screw.

It is known that magnesium phosphate cements (MPCs) show appreciable mechanical strength and biocompatibility, but the hydration reaction processes often lead to intense heat release while the hydration products present weak resistance to mechanical decay and low bioactivity. Herein we developed an MPC-based system, which was low-heat-releasing and fast-curing in this study, by compounding with self-curing calcium silicate cements (CSCs). The MPC composed of magnesium oxide (MgO), potassium dihydrogen phosphate (KH2PO4), disodium hydrogen phosphate (Na2HPO4), magnesium hydrogen phosphate trihydrate (MgHPO4·3H2O) and chitosan were weakly basic, which would be more stable in vivo. The physicochemical properties indicated that the addition of CSCs could increase the final setting time while decrease the heat release. Meanwhile, the CSCs could endow MPC substrate with apatite re-mineralization reactivity, especially, which add 25 wt.% CSCs showed the most significant apatite deposition. What's more, the mechanical evolution in buffer demonstrated CSCs could enhance and sustain the mechanical strength during degradation, and the internal constructs of cement implants could still be reconstructed by μCT analysis in rabbit femoral bone defect model in vivo. Particularly, appropriate CSCs adjusted the biodegradation and promoted new bone tissue regeneration in vivo. Totally, the MPC/CSCs composite system endows bioactivity and sustains mechanical strength of the MPC, which may be promising for expending the clinical applications of MPC-based bone cements.

This article presents a new method for preparing multifunctional composite biomaterials with applications in advanced biomedical fields. The biomaterials consist of dicalcium phosphate (DCPD) and bioactive silicate glasses (SiO2/Na2O and SiO2/K2O), containing the antibiotic streptomycin sulfate. Materials were deeply characterized by X-ray diffraction and attenuated total reflectance Fourier transform infrared spectroscopy, and zeta potential analysis, UV-visible spectrophotometry, and ion-exchange measurement were applied in a simulating body fluid (SBF) solution. The main results include an in situ chemical transformation of dicalcium phosphate into an apatitic phase under the influence of silicate solutions and the incorporation of the antibiotic. The zeta potential showed a decrease in surface charge from ζ = -24.6 mV to ζ = -16.5 mV. In addition, a controlled and prolonged release of antibiotics was observed over a period of 37 days, with a released concentration of up to 755 ppm. Toxicity tests in mice demonstrated good tolerance of the biomaterials, with no significant adverse effects. Moreover, these biomaterials have shown potent antibacterial activity against various bacterial strains, including Listeria monocytogenes, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa, suggesting their potential use in tissue engineering, drug delivery, and orthopedic and dental implants. By integrating the antibiotic into the biomaterial composites, we achieved controlled release and prolonged antibacterial efficacy. This research contributes to advancing biomaterials by exploring innovative synthetic routes and showcasing their promise in regenerative medicine and controlled drug delivery.

In this research, a novel MgSiO3 fiber membrane (MSFM) loaded with indocyanine green (ICG) and doxorubicin (DOX) was prepared. Because of MgSiO3's unique lamellar structure composed of a silicon-oxygen tetrahedron, magnesium ion (Mg2+) moves easily and can be further replaced with other cations. Therefore, because of the positively charged functional group of ICG, MSFM has a rather high drug loading for ICG. In addition, there is electrostatic attraction between DOX (a cationic drug) and ICG (an anionic drug). Hence, after loading ICG, more DOX can be adsorbed into MSFM because of electrostatic interaction. The ICG endows the MSFM outstanding photothermal therapy (PTT) performance, and DOX as a chemotherapeutic drug can restrain tumor growth. On the one hand, H+ exchanged with the positively charged DOX based on the MgSiO3 special lamellar structure. On the other hand, the thermal effect could break the electrostatic interaction between ICG and DOX. Based on the above two points, both tumor acidic microenvironment and photothermal effect can trigger DOX release. What's more, in vitro and in vivo antiosteosarcoma therapy evaluations displayed a superior synergetic PTT-chemotherapy anticancer treatment and excellent biocompatibility of DOX&ICG-MSFM. Finally, the MSFM was proven to greatly promote cell proliferation, differentiation, and bone regeneration performance in vitro and in vivo. Therefore, MSFM provides a creative perspective in the design of multifunctional scaffolds and shows promising applications in controlled drug delivery, antitumor performance, and osteogenesis.

Polyetheretherketone (PEEK) is considered as an excellent biomaterial for bone grafting and connective tissue replacement. The clinical potential is, however, limited by its bioinertness, poor osteoconduction, and weak antibacterial activity. These disadvantages can be overcome by introducing suitable additives to produce mineral-polymer composites or coatings. In this work, a PEEK-based bioactive composite has been obtained by blending the polymer with magnesium phosphate (Mg3(PO4)2) particles in amounts ranging from 1 to 10 wt.% using the hot press technique. The obtained composite exhibited improved mechanical and physical properties, above the lower limits set for bone engineering applications. The tested grafts were found to not induce cytotoxicity. The presence of magnesium phosphate induced the mineralisation process with no adverse effects on the expression of the marker crucial for osteoblastic differentiation. The most promising results were observed in the grafts containing 1 wt.% of magnesium phosphate embedded within the PEEK matrix. The improved bioactivity of grafts, together with suitable physical-chemical and mechanical properties, indicate this composite as a promising orthopaedic implant material.

The regeneration of critical-size bone defects, especially those with irregular shapes, remains a clinical challenge. Various biomaterials have been developed to enhance bone regeneration, but the limitations on the shape-adaptive capacity, the complexity of clinical operation, and the unsatisfied osteogenic bioactivity have greatly restricted their clinical application. In this work, we construct a mechanically robust, tailorable and water-responsive shape-memory silk fibroin/magnesium (SF/MgO) composite scaffold, which is able to quickly match irregular defects by simple trimming, thus leading to good interface integration. We demonstrate that the SF/MgO scaffold exhibits excellent mechanical stability and structure retention during the degradative process with the potential for supporting ability in defective areas. This scaffold further promotes the proliferation, adhesion and migration of osteoblasts and the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. With suitable MgO content, the scaffold exhibits good histocompatibility, low foreign-body reactions (FBRs), significant ectopic mineralisation and angiogenesis. Skull defect experiments on male rats demonstrate that the cell-free SF/MgO scaffold markedly enhances bone regeneration of cranial defects. Taken together, the mechanically robust, personalised and bioactive scaffold with water-responsive shape-memory may be a promising biomaterial for clinical-size and irregular bone defect regeneration.

Bone substitutes are ideally biocompatible, osteoconductive, degradable and defect-specific and provide mechanical stability. Magnesium phosphate cements (MPCs) offer high initial stability and faster degradation compared to the well-researched calcium phosphate cements (CPCs). Calcium magnesium phosphate cements (CMPCs) should combine the properties of both and have so far shown promising results. The present study aimed to investigate and compare the degradation and osseointegration behavior of 3D powder-printed wedges of CMPC and MPC in vivo. The wedges were post-treated with phosphoric acid (CMPC) and diammonium hydrogen phosphate (MPC) and implanted in a partially loaded defect model in the proximal rabbit tibia. The evaluation included clinical, in vivo µ-CT and X-ray examinations, histology, energy dispersive X-ray analysis (EDX) and scanning electron microscopy (SEM) for up to 30 weeks. SEM analysis revealed a zone of unreacted material in the MPC, indicating the need to optimize the manufacturing and post-treatment process. However, all materials showed excellent biocompatibility and mechanical stability. After 24 weeks, they were almost completely degraded. The slower degradation rate of the CMPC corresponded more favorably to the bone growth rate compared to the MPC. Due to the promising results of the CMPC in this study, it should be further investigated, for example in defect models with higher load.

The insufficient osteogenesis of magnesium phosphate cement (MPC) limits its biomedical application. It is of great significance to develop a bioactive MPC with osteogenic performance. In this study, an injectable MPC was reinforced by the incorporation of a near infrared (NIR)-responsive nanocontainer, which was based on simvastatin (SIM)-loaded mesoporous silica nanoparticles (MSNs) modified with a polydopamine (PDA) bilayer, named SMP. In addition, chitosan (CHI) was introduced into MPC (K-struvite) to enhance its mechanical properties and cytocompatibility. The results showed that nanocontainer-incorporated MPC possessed a prolonged setting time, almost neutral pH, excellent injectability, and enhanced compressive strength. Immersion tests indicated that SMP-CHI MPC could suppress rapid degradation. Based on its physicochemical features, the SMP-CHI MPC had good biocompatibility and osteogenesis properties, as shown via in vitro and in vivo experiments. These findings can provide a simple way to produce a multifunctional MPC with improved osteogenesis for further orthopedic applications.

An unexplored hybrid superporous hydrogel (MHSPH) of Dillenia indica fruit mucilage (DIFM) and carrageenan blend embedded with green synthesized magnesium oxide nanoparticles (MNPs) is utilized as an effective wound dressing material with appreciable mechanical strength in murine model. The prepared MNPs and the optimized MHSPH were characterized using X-ray diffraction (XRD), thermogravimetric analysis (TGA), Fourier transform infrared (FT- IR) spectroscopy. Size, zeta potential and morphology of MNPs was assessed using Dynamic light scattering technique (DLS) and field-emission scanning electron microscopy (FESEM) respectively. The MHSPH grades were further optimized using swelling study in phosphate buffer solution at pH 1.2, 7.0, and 8. Both MNPs and the optimized grade of MHSPH were evaluated based on hemolysis assay, and protein denaturation assays indicating them to be safe for biological use. Acute toxicity studies of the optimized MHSPH on Zebra fish model, revealed no observable toxic effect on the gill cells. Wound healing in Swiss albino mice with application of optimized grade of MHSPH took only 11 days for healing when compared to control mice where healing took 14 days, thus concluding that MHSPH as an effective dressing material as well as tissue regrowth scaffold.

In recent years, the use of Magnesium alloy implants have gained renewed popularity, especially after the first commercially available Conformité Européenne approved Magnesium implant became available (MAGNEZIX® CS, Syntellix) in 2013.

To document our clinical and radiographical outcomes using magnesium implants in treating peri-articular elbow fractures.

Our paper was based on a retrospective case series design. Intra-operatively, a standardized surgical technique was utilized for insertion of the magnesium implants. Post - operatively, clinic visits were standardized and physical exam findings, functional scores, and radiographs were obtained at each visit. All complications were recorded.

Five patients with 6 fractures were recruited (2 coronoid, 3 radial head and 1 capitellum). The mean patient age and length of follow up was 54.6 years and 11 months respectively. All fractures healed, and none exhibited loss of reduction or complications requiring revision surgery. No patient developed synovitis of the elbow joint or suffered electrolytic reactions when titanium implants were used concurrently.

Although there is still a paucity of literature available on the subject and further studies are required, magnesium implants appear to be a feasible tool for fixation of peri-articular elbow fractures with promising results in our series.

In this study, we have formulated a novel apatite bone cements derived from natural sources (i.e. eggshell and fishbone) with improved qualities that is, porosity, resorbability, biological activity, and so forth. The naturally-derived apatite bone cement (i.e. FBDEAp) was prepared by mixing hydroxyapatite (synthesized from fishbone) and tricalcium phosphate (synthesized from eggshell) as a solid phase with a liquid phase (a dilute acidic blend of cement binding accelerator and biopolymers like gelatin and chitosan) with polysorbate (as liquid porogen) to get a desired bone cement paste. The prepared cement paste sets within the clinically acceptable setting time (≤20 min), easily injectable (>85%) through hands and exhibits physiological pH stability (7.3-7.4). The pure apatite phased bone cement was confirmed by x-ray diffraction and Fourier transform infrared spectroscopy analyses. The FBDEAp bone cement possesses acceptable compressive strength (i.e. 5-7 MPa) within trabecular bone range and is resorbable up to 28% in simulated body fluid solution within 12 weeks of incubation at physiological conditions. The FBDEAp is macroporous in nature (average pore size ~50-400 μm) with interconnected pores verified by SEM and micro-CT analyses. The FBDEAp showed significantly increased MG63 cell viability (>125% after 72 h), cell adhesion, proliferation, and key osteogenic genes expression levels (up to 5-13 folds) compared to the synthetically derived, synthetic and eggshell derived as well as synthetic and fishbone derived bone cements. Thus, we strongly believe that our prepared FBDEAp bone cement can be used as potential trabecular bone substitute in orthopedics.

Stem cell senescence is characterized by progressive functional dysfunction and secretory phenotypic changes including decreased proliferation, dysfunction of osteogenic and angiogenic differentiation, increased secretion of the senescence-associated secretory phenotype (SASP), which bring difficulties for bone repair. Rescuing or delaying senescence of aged bone marrow mesenchymal stem cells (O-BMSCs) was considered as effective strategy for bone regeneration in aging microenvironment. Magnesium (Mg) ion released from bioceramics was reported to facilitate bone regeneration via enhancing osteogenesis and alleviating senescence. In this study, Akermanite biocreamics (Akt) containing Mg ion as a model was demonstrated to promote osteogenesis and angiogenesis effects of O-BMSCs by activating the MAPK signaling pathway in vitro. Moreover, the enhanced osteogenesis effects might be attributed to enhanced Mg-containing Akt-mediated exosomal miR-196a-5p cargo targeting Hoxa7 and activation of MAPK signaling pathway. Furthermore, the in vivo study confirmed that 3D-printed porous Mg-containing Akt scaffolds effectively increased bone regeneration in cranial defects of aged rats. The current results indicated that the exosomal-miR-196a-5p/Hoxa7/MAPK signaling axis might be the potential mechanism underlying Akt-mediated osteogenesis. The exosome-meditaed therapy stimulated by the released Mg ion contained in Akt biocreamics or other biomaterials might serve as a candidate strategy for bone repair in aged individuals.

Dental implant placement frequently requires preceding bone augmentation, for example, with hydroxyapatite (HA) or β-tricalcium phosphate (β-TCP) granules. However, HA is degraded very slowly in vivo and for β-TCP inconsistent degradation profiles from too rapid to rather slow are reported. To shorten the healing time before implant placement, rapidly resorbing synthetic materials are of great interest. In this study, we investigated the potential of magnesium phosphates in granular form as bone replacement materials.

Spherical granules of four different materials were prepared via an emulsion process and investigated in trabecular bone defects in sheep: struvite (MgNH4PO4·6H2O), K-struvite (MgKPO4·6H2O), farringtonite (Mg3(PO4)2) and β-TCP.

All materials except K-struvite exhibited promising support of bone regeneration, biomechanical properties and degradation. Struvite and β-TCP granules degraded at a similar rate, with a relative granules area of 29% and 30% of the defect area 4 months after implantation, respectively, whereas 18% was found for farringtonite. Only the K-struvite granules degraded too rapidly, with a relative granules area of 2% remaining, resulting in initial fibrous tissue formation and intermediate impairment of biomechanical properties.

We demonstrated that the magnesium phosphates struvite and farringtonite have a comparable or even improved degradation behavior in vivo compared to β-TCP. This emphasizes that magnesium phosphates may be a promising alternative to established calcium phosphate bone substitute materials.

The incorporation of biologically active metallic elements into nano/micron-scale coatings through micro-arc oxidation (MAO) shows significant potential in enhancing the biological characteristics and functionality of titanium-based materials. By introducing diverse metal ions onto titanium implant surfaces, not only can their antibacterial, anti-inflammatory and corrosion resistance properties be heightened, but it also promotes vascular growth and facilitates the formation of new bone tissue. This review provides a thorough examination of recent advancements in this field, covering the characteristics of commonly used metal ions and their associated preparation parameters. It also highlights the diverse applications of specific metal ions in enhancing osteogenesis, angiogenesis, antibacterial efficacy, anti-inflammatory and corrosion resistance properties of titanium implants. Furthermore, the review discusses challenges faced and future prospects in this promising area of research. In conclusion, the synergistic approach of micro-arc oxidation and metal ion doping demonstrates substantial promise in advancing the effectiveness of biomedical titanium and its alloys, promising improved outcomes in medical implant applications.

Three-dimensional (3D) bioprinting has emerged as a groundbreaking technology for fabricating intricate and functional tissue constructs. Central to this technology are the bioinks, which provide structural support and mimic the extracellular environment, which is crucial for cellular executive function. This review summarizes the latest developments in microparticulate inks for 3D bioprinting and presents their inherent challenges. We categorize micro-particulate materials, including polymeric microparticles, tissue-derived microparticles, and bioactive inorganic microparticles, and introduce the microparticle ink formulations, including granular microparticles inks consisting of densely packed microparticles and composite microparticle inks comprising microparticles and interstitial matrix. The formulations of these microparticle inks are also delved into highlighting their capabilities as modular entities in 3D bioprinting. Finally, existing challenges and prospective research trajectories for advancing the design of microparticle inks for bioprinting are discussed.