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08 April 2025, Volume 29 Issue 10 Previous Issue    Next Issue

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Effect of surface roughness of polydimethylsiloxane on osteogenic differentiation of bone marrow mesenchymal stem cells under stretching conditions Hu Zezun, Yang Fanlei, Xu Hao, Luo Zongping 2025, 29 (10):  1981-1989.  doi: 10.12307/2025.405 Abstract ( 103 )   PDF (2151KB) ( 116 )   Save BACKGROUND: Numerous studies have shown that mechanical stimulation is essential for the lineage-specific differentiation of bone marrow mesenchymal stem cells. However, osteogenic differentiation of bone marrow mesenchymal stem cells on surfaces with different roughnesses under mechanical stretching conditions is unknown. OBJECTIVE: To investigate the effects and action mechanisms of different roughness surfaces of polydimethylsiloxane (PDMS) on osteogenic differentiation of bone marrow mesenchymal stem cells under stretching conditions.  METHODS: Three morphologies with different roughnesses (PDMS-120M, PDMS-1000M, and PDMS-10000M) were constructed on PDMS surfaces by means of different grits of sandpaper (120 grits, 1 000 grits and 10 000 grits), and PDMS surfaces in contact with air served as a control group. With different amplitudes of 0%, 2%, 4%, and 6%, osteogenesis-related gene expression of bone marrow mesenchymal stem cells on different PDMS surfaces under static and stretching conditions was detected by RT-qPCR. RT-qPCR and western blot assay were used to detect the expression of SIRT1 gene and protein as well as osteogenesis-related genes and proteins in bone marrow mesenchymal stem cells on different roughness surfaces under 2% stretching conditions. Alkaline phosphatase staining and alizarin red staining were further used to observe the osteogenic differentiation ability of bone marrow mesenchymal stem cells on different PDMS surfaces under 2% stretching conditions. RESULTS AND CONCLUSION: (1) Bone marrow mesenchymal stem cells on the PDMS-1000M surface with a roughness of (13.51±2.11) µm had better osteogenic gene expression under static conditions. (2) Bone marrow mesenchymal stem cells on the PDMS surface in contact with air had better osteogenic differentiation under 4% stretching conditions, while bone marrow mesenchymal stem cells on the PDMS-1000M surface had better osteogenic differentiation under 2% stretching conditions. (3) Bone marrow mesenchymal stem cells on the PDMS-1000M surface with a roughness of (13.51±2.11) µm had better osteogenic differentiation under 2% stretching conditions, which may be related to activation of SIRT1 signaling pathway.  Figures and Tables | References | Related Articles | Metrics

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Effects of microstructured bone implant material surfaces on osteogenic function of MC3T3-E1 osteoblasts Huang Liping, Li Hui, Wang Xinge, Wang Rui, Chang Bei, Li Shiting, Lan Xiaorong, Li Guangwen 2025, 29 (10):  1990-1996.  doi: 10.12307/2025.230 Abstract ( 221 )   PDF (2612KB) ( 164 )   Save BACKGROUND: The micro/nanostructured gradient biomimetic surface of implant materials can simulate the structure of the extracellular environment in human bone tissue, thereby achieving perfect bone integration function. However, further research is needed on the mechanisms by which the surface microstructure of bone implant materials regulates cell function and promotes osteogenesis. OBJECTIVE: To analyze the effect of titanium sheet microstructure surface on osteogenic differentiation of MC3T3-E1 osteoblasts.  METHODS: (1) At a constant voltage of 5 V or 20 V, nanotube arrays of different diameters were prepared on the surface of titanium sheets by acid etching and anodic oxidation techniques, and were recorded as group R5 and group R20, respectively. The surface morphology, roughness, and hydrophilicity of pure titanium sheet (without acid etching or anodizing treatment) were measured in group R5 and group R20. (2) MC3T3-E1 osteoblasts of logarithmic growth stage were inoculated on the surface of pure titanium sheets, R5 group and R20 group respectively. After 24 hours of osteogenic induction culture, the expression of mechanical sensitive channel protein 1 was analyzed by RT-PCR and immunofluorescence staining. Osteoblast inducible base with or without the mechanosensitive channel protein 1 activator Yada1 was added, and alkaline phosphatase staining was performed after 7 days of culture. Alizarin red staining was performed after 14 days of culture. RESULTS AND CONCLUSION: (1) The surface of pure titanium sheets was smooth under scanning electron microscope. Relatively uniform and orderly nanotube arrays with average diameters of about 30 nm and 100 nm were observed on the surface of titanium sheets of groups R5 and R20, respectively. The results of scanning electron microscope were further verified by atomic force microscopy. The surface roughness of titanium sheet of group R5 was higher than that of pure titanium (P < 0.05), and the water contact angle was lower than that of pure titanium (P < 0.05). The surface roughness of titanium sheet in group R20 was higher than that in group R5 (P < 0.05), and the water contact angle was lower than that in group R5 (P < 0.05). (2) RT-PCR and immunofluorescence staining showed that the expression of mechanosensitive channel protein 1 in group R5 was higher than that in pure titanium group (P < 0.05), and the expression of mechanosensitive channel protein 1 in group R20 was higher than that in group R5 (P < 0.05). Under the osteogenic induction, compared with the condition without Yada1, there were no significant changes in the activity of alkaline phosphatase and the deposition of calcified nodules in pure titanium group after Yada1 addition, while the activity of alkaline phosphatase and the deposition of calcified nodules in groups R5 and R20 after Yada1 addition were significantly increased (P < 0.05). With or without Yada1, the alkaline phosphatase activity and calcified nodule deposition in group R5 were higher than those in pure titanium group (P < 0.05), and the alkaline phosphatase activity and calcified nodule deposition in group R20 were higher than those in group R5 (P < 0.05). (3) The results show that the surface microstructure of titanium sheet can promote the osteogenic differentiation of osteoblast MC3T3-E1 by activating mechanosensitive channel protein 1. Figures and Tables | References | Related Articles | Metrics

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Preparation of polyphenol-mediated copper ion coating on titanium surface and antibacterial and antioxidant properties Guan Zhenju, Xie Yonglin, Xiang Shougang, Zhang Chengdong, Li Xiaolong, Li Xingping, Pu Chao, Zhang Bo, Luo Xuwei, Xiao Dongqin 2025, 29 (10):  1997-2005.  doi: 10.12307/2025.417 Abstract ( 145 )   PDF (2770KB) ( 185 )   Save BACKGROUND: Titanium implants are widely used in clinical practice because of their high strength and good biocompatibility. However, during implantation, bacterial infection and tissue damage environment produce a large number of reactive oxygen species, which can easily lead to delayed tissue healing and surgical failure. Consequently, the development of titanium implants with antimicrobial and antioxidant properties becomes paramount. OBJECTIVE: Considering the potent antimicrobial attributes of copper ions and the remarkable antioxidant qualities of polyphenols, we proposed the fabrication of polyphenol-mediated copper ion coatings on titanium surfaces. These coatings were subsequently assessed for their in vitro antimicrobial and antioxidant properties. METHODS: Nanostructures were generated on the titanium surface using the alkali thermal method. The titanium was immersed in a solution containing tannic acid and copper ions to achieve polyphenol-mediated copper ion coatings. The surface morphology and water contact angle were detected. The loading and release of copper ions were examined using atomic absorption spectroscopy. Staphylococcus aureus was inoculated on the surface of pure titanium sheet (blank group), alkali heat treated titanium sheet (control group), and polyphenol mediated copper ion modified titanium sheet (experimental group) to observe the bacterial survival status. Osteoblast precursor cells MC3T3-E1 were co-cultivated on the surface of three groups of titanium sheets to assess their antioxidant properties and bioactivity.  RESULTS AND CONCLUSION: (1) Scanning electron microscopy showed that the polyphenol-mediated copper ion modified titanium sheet had rod-like nanostructures and no cracks on the surface. The surface hydrophilicity of copper ion modified titanium sheet mediated by polyphenol was close to that of pure titanium sheet. Atomic absorption spectrometry results showed a 51% increase in the loading capacity of copper ions after polyphenol mediation, with a uniform release of copper ions. (2) The antibacterial rates of titanium sheets in the blank group, control group, and experimental group were 0%, 21.65%, and 93.75%, respectively. The live/dead staining and CTC staining showed that the live bacteria on the surface of titanium plates in the blank group were the most, and the live bacteria on the surface of titanium plates in the experimental group were the least. (3) The results of live/dead staining and CCK-8 assay showed that the three groups of titanium sheets had good cytocompatibility, and the titanium sheets in the experimental group were more conducive to the proliferation of MC3T3-E1 cells. Active oxygen fluorescence probe detection exhibited that compared with the other two groups, the fluorescence intensity of active oxygen on the surface of the experimental group was significantly reduced. The results of alkaline phosphatase and alizarin red S staining showed that the osteogenic differentiation and extracellular matrix mineralization of MC3T3-E1 cells on the surface of titanium sheets in the experimental group were stronger than those in the other two groups. (4) These results show that the polyphenol-mediated copper ion coating has strong antibacterial and antioxidant properties and promotes osteogenic differentiation. Figures and Tables | References | Related Articles | Metrics

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A finite element analysis of different bone cement injection volumes and distribution patterns in bilateral percutaneous vertebral augmentation Bao Xiong, Wu Xiao, Tang Xijie, Zhang Yougao, Cai Jinkui, Li Zhanghua 2025, 29 (10):  2006-2014.  doi: 10.12307/2025.265 Abstract ( 65 )   PDF (3406KB) ( 122 )   Save BACKGROUND: The authors found that when the bilateral percutaneous vertebral augmentation is used to treat osteoporotic vertebral compression fractures with a total bone cement injection of 4 mL or more, different distribution patterns were usually presented on the X-rays; however, there were few reports addressing the effects of these patterns of bone cement distribution on the biomechanical properties of fractural vertebrae. Objective: To further explore the biomechanical effects of different bone cement filling doses and distribution patterns on biomechanics of the fractural vertebrae using the finite element method. Methods: The L1-L3 finite element models of osteoporosis were established, and the vertebral compression fractures were simulated in L2. Four distribution patterns bilateral partial fusion (FH type), full fusion (FO type), symmetrical separation (SA type), and asymmetric segregation (SN type) were simulated in 4 and 6 mL injections in the osteoporotic vertebral compression fracture models, respectively, and a total of nine sets of models were obtained. These models were solved under the same boundary conditions and compared with the stress and displacement of the L2 fractural vertebra. Results and conclusion: (1) The maximum stresses of the nine groups of models were concentrated in the L2 fractural area, and the maximum stress and maximum displacement of each filling model were lower than in the osteoporotic vertebral compression fracture model, indicating the effectiveness of bone cement filling in the treatment of osteoporotic vertebral compression fracture. (2) Compared with 4 mL bone cement filling, 6 mL bone cement filling could significantly reduce the stress of fractured vertebrae and enhance the strength of fractured vertebrae while improving the stability of fractured vertebrae. (3) In the same state of movement, the FH type stress was the least, followed by the SA type, both of which were close. FO type stress was the largest, especially in the lateral bend, which might be associated with its cluster shape resulting in the concentration of lateral stress. In the aspect of displacement, FH type was the least and FO type was the largest. (4) The results show that increased dose of bone cement injection reduces fractural vertebral stress and improves stability, but increases the risk of leakage. Bilateral symmetrical dispersed bone cement (FH type, SA type) is superior in restoring vertebral strength and stability than full fusion (FO type), asymmetric separated (SN type) bone cement. Therefore, when clinically performing bilateral percutaneous vertebral augmentation treatment of osteoporotic vertebral compression fractures, the bilateral symmetric dispersions of the distribution are first guaranteed; priority is recommended for FH type distribution, for appropriate stress stimulation and best stability. Figures and Tables | References | Related Articles | Metrics

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Effect of cement distribution on clinical efficacy of vertebral compression fractures in unilateral percutaneous vertebroplasty Abuduwupuer·Haibier, Kutiluke·Shoukeer, Alimujiang·Yusufu, Lin Hang, Tuerhongjiang·Abudurexiti 2025, 29 (10):  2015-2022.  doi: 10.12307/2025.226 Abstract ( 95 )   PDF (1501KB) ( 114 )   Save BACKGROUND: Although studies have shown that symmetrical distribution of bone cement can reduce postoperative vertebral refractures and help improve prognosis. However, achieving better bone cement distribution during percutaneous vertebroplasty remains an important issue for surgeons. OBJECTIVE: To explore the effect of cement distribution on the efficacy of unilateral percutaneous vertebroplasty to provide effective preventive and therapeutic measures to prevent postoperative vertebral fracture. METHODS: The 193 patients who underwent unilateral percutaneous vertebroplasty in Sixth Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2022 were selected and divided into group I (bone cement not touching the upper and distal end plates; n=59), group II (bone cement only touching the upper or lower end plate; n=80), and group III (bone cement touching both the upper and distal end plates; n=54). Basic data, operation-related indicators, including operation time, total hospital cost, postoperative hospital time, cement injection, visual analog scale and Oswestry disability index scores of low back pain, postoperative vertebral height recovery rate, local kyphosis angle, incidence of injured vertebral body and adjacent vertebrae were compared among the three groups. Follow-up results of all patients were recorded. RESULTS AND CONCLUSION: (1) In group III, the visual analog scale and Oswestry disability index scores were significantly lower than those in groups I and II, and the difference was statistically significant (P < 0.05). (2) The incidence of injured vertebral refracture and incidence of total vertebral fractures in groups I and II were significantly higher than that in group III, and the differences were all statistically significant (P < 0.05). (3) There were no significant differences in other indicators of patients of the three groups, such as bone cement leakage, Oswestry disability index, and visual analog scale score at 1 week, 1 month after surgery, and during last follow-up, postoperative vertebral height recovery rate, local kyphosis angle, operation time, total hospital cost, and postoperative hospital stay (P > 0.05). (4) It is indicated that compared with groups I and II, patients of group III get better long-term prognosis, and bone cement touching both the upper and distal end plates can significantly reduce the incidence of injured vertebral and total vertebral fractures. Surgeons should fully grasp the diffusion of bone cement, and develop targeted prevention and treatment strategies, so as to reduce the risk of further fracture in the future. Figures and Tables | References | Related Articles | Metrics

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effect of graphene oxide/hydroxyapatite composite coating on immune activity of RAW264.7 macrophages Ma Lisha, He Huiyu, Wufanbieke·Baheti, Lyu Shangyi, Han Xiangzhen 2025, 29 (10):  2023-2029.  doi: 10.12307/2025.212 Abstract ( 90 )   PDF (2572KB) ( 247 )   Save BACKGROUND: There are some problems such as bone fusion failure or peri-implant infection after implantation of pure titanium implants. Therefore, surface improvement of titanium implants has become a hot topic in research. Macrophages are an immune defense line of the body in response to external stimuli, and the relevant immune response of any biomaterials implanted in the body is related to macrophages. OBJECTIVE: The graphene oxide/hydroxyapatite composite coating on titanium alloy surface was prepared by electrochemical deposition method. The surface characteristics of the coating and the growth and polarization of macrophage RAW264.7 on the surface were analyzed.  METHODS: The graphene oxide coating and graphene oxide/hydroxyapatite composite coating on titanium alloy surface was prepared by electrochemical deposition method. The physical properties of the coating were characterized. Pure titanium sheets (blank group), titanium sheets deposited with pure GO coating (control group) and titanium sheets deposited with graphene oxide/hydroxyapatite composite coating (experimental group) were co-cultured with macrophages RAW264.7, respectively. Cell proliferation was detected by CCK-8 assay and DAPI staining. Cell adhesion on the surface of titanium was observed by scanning electron microscopy, and cell polarization phenotype was detected by flow cytometry.  RESULTS AND CONCLUSION: (1) Under scanning electron microscope, the pure titanium sheet showed directional scratches and a few punctate pits. After the pure graphene oxide coating was deposited, the surface of titanium sheet showed more cracks, gullies and particles of uneven size, and the wrinkle-like structure characterized by graphene oxide. After the composite coating was deposited, the surface of the titanium sheet was smooth, and the pellet size was more uniform. The water contact angle of composite coated titanium sheet was lower than that of pure titanium sheet and pure graphene oxide coated titanium sheet (P < 0.05). (2) CCK-8 assay and DAPI staining showed that compared with the blank group and the control group, the cell proliferation in the experimental group was faster. Scanning electron microscopy showed that RAW264.7 cells all adhered to the surface of the three groups of titanium sheets. With the extension of culture time, cell morphology changed from round to spindle shape. After 7 days of culture, cells in the blank group extended short and few pseudopods; cells in the control group extended long and more pseudopods, and cells in the experimental group extended short and more pseudopods, and the overall cell fullness in the experimental group was the best. Flow cytometry results showed that the cells in the experimental group showed a higher proportion of M2 polarization in the anti-inflammatory direction. (3) These findings conclude that graphene oxide/hydroxyapatite composite coating has good physical, chemical, and biological properties.  Figures and Tables | References | Related Articles | Metrics

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Hydroxyapatite-graphene oxide composite coating promotes bone defect repair in rats Dumanbieke·Amantai, He Huiyu, Han Xiangzhen 2025, 29 (10):  2030-2037.  doi: 10.12307/2025.224 Abstract ( 134 )   PDF (3261KB) ( 209 )   Save BACKGROUND: Titanium and titanium-coated materials are widely used in the field of oral implantology, but there are still phenomena such as peri-implantitis, implant loss and loosening. Therefore, the surface modification of pure titanium has become a hot topic in oral medicine research.  OBJECTIVE: To investigate the physical and osteogenic properties of hydroxyapatite-graphene oxide composite coating on titanium surface. METHODS: Hydroxyapatite-graphene oxide composite coatings were prepared on the titanium surface by electrodeposition at voltages of 10, 30, and 50 V. The micromorphology and hydrophilic properties of the coatings were characterized, and the composite coatings prepared under the optimal voltage conditions were screened for animal experiments. Fifty-four SD rats were selected to prepare defects of 2 mm in diameter and 7 mm in depth on the femoral head of both hind limbs, and were randomly divided into 3 groups with 18 rats in each group: no titanium material was implanted in the blank group; pure titanium material was implanted in the pure titanium group, and coated titanium material loaded with hydroxyapatite-graphene oxide composite coating was implanted in the coated group. The osteogenesis effect was observed by X-ray, Micro-CT scan, and pathological section staining at 4, 8, and 12 weeks after implantation.  RESULTS AND CONCLUSION: (1) Under scanning electron microscopy, when the voltage was 10 V, there were a lot of cracks and clumps in the coating. When the voltage rose to 30 V, there were still some small clumps in the coating, but the overall uniformity was relatively flat. When the voltage was 50 V, the coating was more evenly distributed and cracks and spots were reduced. The hydrophilicity of the composite coating prepared at 50 V voltage was the best. In summary, the composite coating material prepared at 50 V voltage was selected in animal experiments. (2) The X-ray film showed that the implant position was relatively fixed, and no serious postoperative inflammation occurred. The results of Micro-CT scan showed that the new bone formation rate and bone formation volume on the implant surface of the coated group were better than those of the pure titanium group (P < 0.001). The results of Micro-CT scan were further confirmed by hematoxylin-eosin staining and Masson staining in pathological sections. Immunohistochemical staining of pathological sections showed that the expressions of osteopontin and bone morphogenetic protein 2 in the pure titanium group were higher than those in the blank group at week 12 after implantation (P < 0.001), and those in the coated group were higher than those in the pure titanium group at week 12 after implantation (P < 0.001). (3) The results show that the hydroxyapatite-graphene oxide composite coating material has good physical and osteogenic properties. Figures and Tables | References | Related Articles | Metrics

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Ilizarov bone transport combined with antibiotic bone cement promotes junction healing of large tibial bone defect Zhang Zhibo, Wang Zhaolin, Wang Zhigang, Li Peng, Jiang Jianhao, Zhang Kai, Yang Shuye, Du Gangqiang 2025, 29 (10):  2038-2043.  doi: 10.12307/2025.268 Abstract ( 108 )   PDF (1555KB) ( 111 )   Save BACKGROUND: Ilizarov bone transport is very effective in the treatment of open large tibial bone defects, but there are still complications, among which the difficulty of junction healing is one of the difficult points in treatment.  Objective: To investigate the effect of Ilizarov bone transport combined with antibiotic bone cement on junction healing after operation of open large tibial bone defect.  Methods: Totally 51 patients with open large tibial bone defect (bone defect > 4 cm) admitted to Binzhou Medical University Hospital from August 2010 to January 2022 were selected, of which 28 received Ilizarov bone transport alone (control group) and 23 received Ilizarov bone transport combined with antibiotic bone cement treatment (trial group). External fixation time, bone healing time, bone healing index, visual analog scale score during bone removal, bone defect limb function, junction healing and complications at the final follow-up were statistically compared between the two groups. Results and Conclusion: (1) All the 51 patients were followed up for a mean of (22.53±5.77) months. External fixation time, bone healing time, bone healing index, postoperative infection rate, and non-healing rate of junction were less in the trial group than those in the control group (P < 0.05). There was no significant difference between the two groups in visual analog scale scores at 6 months after the second surgery and in the functional excellence and good rate of limb with bone defect at the final follow-up (P > 0.05). (2) These findings indicate that compared with the Ilizarov bone transport alone, Ilizarov bone transport combined with antibiotic bone cement treatment can promote the healing of open tibial fracture junction and increase the rate of bone healing. Figures and Tables | References | Related Articles | Metrics

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Autogenous bone and platelet-rich fibrin in repair of severe alveolar bone defects Liu Zilue, Wang Zhi, Song Wenshang, Li Suna, Cai Shixin 2025, 29 (10):  2044-2051.  doi: 10.12307/2025.440 Abstract ( 102 )   PDF (1643KB) ( 165 )   Save BACKGROUND: The combination of platelet-rich fibrin and autogenous bone has achieved good results in the treatment of periodontal bone defects, but the study of the combination of the two in the treatment of severe alveolar bone defects is scarce.  OBJECTIVE: To observe the effect of autologous bone transplantation plus platelet-rich fibrin on the repair of severe alveolar bone defects. METHODS: A total of 102 patients with severe alveolar bone defects in Hengshui People’s Hospital from April 2022 to February 2023 were selected and divided into control and observation groups (n=51 per group) by random number table method. Guided tissue regeneration was performed in both groups. The bone defect was filled with autogenous bone in the control group, and the observation group underwent platelet-rich fibrin+autogenous bone filling for bone defects during the operation. The clinical efficacy, changes in tooth mobility, periodontal microecological environment (probing depth, clinical attachment loss, and bleeding index), height and density of alveolar bone, gingival crevicular fluid indicators (transforming growth factor-β, serine protease inhibitor, and matrix metalloproteinase-3) before and after surgery, as well as adverse reactions were observed between the two groups.  RESULTS AND CONCLUSION: Six months after operation, there was no significant difference in treatment efficacy rate between the two groups (P > 0.05). At 3 and 6 months after surgery, the levels of tooth mobility, probing depth, clinical attachment loss, and bleeding index in the observation group were lower than those in the control group (P < 0.05). At 6 months after surgery, the height of alveolar bone in the observation group was higher than that in the control group (P < 0.05). At 3 and 6 months after surgery, the levels of transforming growth factor-β in gingival crevicular fluid in the observation group were higher than those in the control group (P < 0.05). At 3 and 6 months after surgery, the levels of serine protease inhibitor and matrix metalloproteinase-3 in the observation group were lower than those in the control group (P < 0.05). The results suggest that using platelet-rich fibrin+autogenous bone filling in guided tissue regeneration treatment of patients with severe alveolar bone defects can improve the periodontal microenvironment, reduce gingival tissue inflammation, promote alveolar bone tissue regeneration and repair, and reduce tooth mobility.  Figures and Tables | References | Related Articles | Metrics

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Finite element analysis of various root shield thicknesses in maxillary central incisor socket-shield technique Chen Guangneng, Luo Siyang, Wang Mei, Ye Bin, Chen Jiawen, Liu Yin, Zuo Yuwen, He Xianyu, Shen Jiajin, Ma Minxian 2025, 29 (10):  2052-2060.  doi: 10.12307/2025.258 Abstract ( 105 )   PDF (2493KB) ( 81 )   Save BACKGROUND: Socket-shield technique can effectively maintain labial soft and hard tissues, but the incidence of postoperative complications such as exposure and displacement of root shield is relatively high. It is speculated that the root shield may be exposed and displaced due to excessive load after long-term function of dental implants. OBJECTIVE: Through three-dimensional finite element analysis, we aim to study the influence of varying root shield thicknesses on the stress distribution, equivalent stress peaks, and displacement in the root shield, periodontal ligaments, implant, and surrounding alveolar bone under normal occlusal loading. We also attempt to analyze the correlation between the thickness of the root shield and occurrence of mechanical events such as root shield exposure, displacement, and fracture.  METHODS: Cone-beam CT data of a patient who met the indication standard of socket-shield technique for maxillary central incisor were retrieved from database. Reverse engineering techniques were used to build models of the maxillary bone and root shield, while forward engineering was used to create models for the implant components based on their parameters. Models depicting various root shield thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were created using Solidworks 2022 software. ANSYS Workbench 2021 software was then used to simulate and analyze the effects of varying root shield thicknesses on stress distribution, equivalent stress peaks, and displacement of the root shields, periodontal ligaments, implants, and surrounding alveolar bone under normal occlusion. RESULTS AND CONCLUSION: (1) In all root shield models, the stress was concentrated on the palatal cervical side, both sides of the edges and the lower edge of the labial side. As the thickness of the root shield increased, the equivalent stress peak and displacement showed a decreasing trend. The 0.5 mm thickness model produced a stress concentration of 176.20 Mpa, which exceeded the yield strength (150 Mpa) of tooth tissue. (2) The periodontal ligament stress in each group was concentrated in the neck margin and upper region. With the increase of root shield thickness, the equivalent stress peak and displacement of periodontal ligament showed a decreasing trend. (3) Implant stress in all models was concentrated in the neck of the implant and the joint of the implant-repair abutment, and the labial side was more concentrated than the palatal side. With the increase of root shield thickness, the equivalent stress peak of the implant in the model showed an increasing trend. (4) In each group of models, stress of cortical bone concentrated around the neck of the implant and the periphery of the root shield, and the labial side was more concentrated than the palatal side. With the increase of the thickness of the root shield, the equivalent stress peak around the root shield decreased; the peak value of the equivalent stress of the bone around the neck of the implant showed an increasing trend. In the model, the stress of cancellous bone was mainly concentrated around the neck of the lip of the implant, the top of the thread, the root tip and the lower margin of the root shield, and the labial side was more concentrated than the palatal side. With the increase of the thickness of the root shield, the peak value of the equivalent stress of the bone around the root shield in the model showed a decreasing trend. The minimum principal stress of cortical bone in each group of models was concentrated around the neck of the implant, exhibiting a fan-shaped distribution. As the thickness of the root shield increased, the minimum principal stress of cortical bone showed an increasing trend. (5) These results indicate that different thicknesses of the root shield have different biomechanical effects. The root shield with a thickness of 0.5 mm is easy to fracture. For patients with sufficient bone width, the root shield with a thickness of 2.0 mm is an option to reduce the risk of complications such as root shield exposure, fracture, and displacement. Meanwhile, it should be taken into account to protect the periodontal ligament in the preparation process, and rounding treatments ought to be carried out on both sides and the lower edge of the root shield. Figures and Tables | References | Related Articles | Metrics

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Stress analysis of computer aided design/computer aided manufacture post-core materials with different elastic moduli Xu Liangwei, Tian Xitian, Chen Lin, Gao Hongyan, Zhu Xian, Yang Guican, Chen Yinghao 2025, 29 (10):  2061-2066 .  doi: 10.12307/2025.267 Abstract ( 84 )   PDF (1320KB) ( 97 )   Save BACKGROUND: Post and core restoration is a common choice for tooth defects, but the repair effects of various post and core materials are different. Objective: To evaluate the stress distribution at the post and core, tooth root, and bonding agent site of post and core models made of different elastic modulus post and core materials using finite element method.  Methods: A three-dimensional root canal treated maxillary central incisor model was built using three-dimensional modeling software, which was restored with a full ceramic crown. The post and core materials in the restoration used nanoceramic resin (elastic modulus=12.8 GPa), composite resin (elastic modulus=16 GPa), hybrid ceramic (elastic modulus=34.7 GPa), glass ceramic (elastic modulus=95 GPa), titanium alloy (elastic modulus=112 GPa), and zirconia (elastic modulus=209.3 GPa). The model was fixed in cortical bone. A 100 N concentrated force of 45° from the long axis of the tooth was applied to 1/3 of the crown and tongue side of the central incisor. The stress distribution of the post and core, dentin, and tooth-root bonding agent in the model was repaired by the maximum principal stress criterion. Results and conclusion: (1) When the post and core materials with higher elastic modulus was used, the post-core stress in the repair model was more concentrated. When the elastic modulus of the post and core materials (nanoceramic resin and composite resin) was close to dentin, the stress distribution of the post and core was more uniform. The stress distribution of dentin in all restoration models was similar regardless of post and core materials. When the post and core with higher elastic modulus was used, more stress concentration was shown at the post and root bonding agent in the repair model. (2) The maximum stress values at the post and core, tooth root, and the bonding agent site of post and tooth root in the nanoceramic resin model were 31.00, 33.21, and 0.51 MPa, respectively. The maximum stress values at the post and core, tooth root, and the bonding agent between the post and tooth root in the composite resin model were 36.84, 33.14, and 0.59 MPa, respectively. In the mixed ceramic model, the maximum stress values at the post and core, tooth root, and the bonding agent between the post and tooth root were 64.05, 32.83, and 1.00 MPa, respectively. In the glass ceramic model, the maximum stress values at the post and core, tooth root, and the bonding agent between the post and tooth root were 112.30, 32.69, and 1.73 MPa, respectively. In the titanium alloy model, the maximum stress values of the post and core, tooth root, and the bonding agent between the post and tooth root were 120.00, 32.17, and 1.86 MPa, respectively. In the zirconia model, the maximum stress values of the post and core, tooth root, and the bonding agent between the post and tooth root were 148.80, 31.85, and 2.28 MPa, respectively. (3) The higher the elastic modulus of the post and core material, the higher the maximum stress at the post and core during restoration. The elastic modulus of the post and core material had no significant effect on the maximum stress of the dental bonding agent and dentin. Figures and Tables | References | Related Articles | Metrics

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Effects of different activators on platelet-rich plasma growth factors Liu Jianxiang, Feng Xingxing, Wang Shuxia, Zhou Rong, Lyu Mengxing, Qu Kexuan 2025, 29 (10):  2067-2073.  doi: 10.12307/2025.266 Abstract ( 125 )   PDF (1321KB) ( 92 )   Save BACKGROUND: Growth factor is the key effect molecule that plays a role in platelet-rich plasma in clinical treatment. There are differences in the concentration of growth factor after different activators activate platelet-rich plasma, which is an important factor affecting clinical efficacy. OBJECTIVE: To analyze the influence of different activators on the mass concentration of growth factors in platelet-rich plasma. METHODS: Totally 12 healthy volunteers were recruited to collect EDTA-K2 anticoagulant venous blood. Secondary centrifugation was used to prepare platelet-rich plasma. The difference in mass concentrations of growth factors was compared between venous blood and platelet-rich plasma. The platelet-rich plasma was mixed with four activators (normal saline, thrombin, calcium gluconate, calcium gluconate + thrombin) according to the volume ratio of 10:1, and incubated in a constant temperature water bath at 37 °C for 30 minutes. After centrifugation, the supernatant was extracted and the mass concentration of growth factor was detected. The bacterial growth in supernatant was measured by blood agar plate. Pearson correlation was used to analyze the correlation between different activators and the mass concentration of growth factor in platelet-rich plasma, and the correlation between the value of thrombocytometer and the mass concentration of growth factors in platelet-rich plasma. RESULTS AND CONCLUSION: (1) The mass concentrations of platelet-derived growth factor-BB, platelet-derived growth factor-AB, vascular endothelial growth factor, and epidermal growth factor in platelet-rich plasma were 8.7, 22.2, 2.3, and 2.8 times of those in venous blood, respectively (P < 0.05). (2) Compared with normal saline group, the mass concentrations of platelet-derived growth factor BB, platelet-derived growth factor AB, vascular endothelial growth factor, and epidermal growth factor were increased in the thrombin group, calcium gluconate group, and calcium gluconate + thrombin group (P < 0.05). The mass concentration of platelet-derived growth factor BB in the thrombin group and calcium gluconate group was higher than that in the calcium gluconate + thrombin group (P < 0.05), and the mass concentration of platelet-derived growth factor AB in the thrombin group was higher than that in the calcium gluconate group and calcium gluconate + thrombin group (P < 0.05). Epidermal growth factor mass concentration in the thrombin group was lower than that in the calcium gluconate group and calcium gluconate + thrombin group (P < 0.05). (3) The results of blood agar plate test showed no bacterial growth in the supernatant of the four groups. (4) Pearson correlation analysis showed that the mass concentration of platelet-derived growth factor BB in platelet-rich plasma was strongly positively correlated with thrombin (r=0.683, P < 0.05), and the mass concentration of vascular endothelial growth factor was strongly positively correlated with thrombin, calcium gluconate, calcium gluconate + thrombin stimulant (r=0.730, 0.789, 0.686, P < 0.05). There was no correlation between the value of thrombocytometer and the mass concentration of four kinds of growth factors (P > 0.05). (5) The results suggest that different activators have an impact on the concentration of growth factors in platelet-rich plasma. It is suggested to choose different activators to improve clinical efficacy according to different growth factor mass concentrations and treatment needs. Figures and Tables | References | Related Articles | Metrics

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Methacrylated dermal extracellular matrix hydrogel promotes repair of abdominal wall defects Liu Zhongyu, Li Wenya, Fan Yonghong, Lyu Shuang, Pei Juan, Chen Yaqin, Liu Beiyu, Sun Hongyu 2025, 29 (10):  2074-2082.  doi: 10.12307/2025.409 Abstract ( 149 )   PDF (2052KB) ( 161 )   Save BACKGROUND: Synthetic polymers, such as polypropylene and polyester, used for the treatment of abdominal wall defects not only lack biodegradability and bioactivity but also fail to meet the demands of complex and irregular wounds. Therefore, finding bioactive materials with low immunogenicity and good histocompatibility has become a hot spot in the repair of abdominal wall defects.  OBJECTIVE: To prepare methacryloyl modified dermal extracellular matrix hydrogel and explore its potential application in abdominal wall defect.  METHODS: (1) The porcine dermis was acellular with 0.25% trypsin and 1% Triton X-100 in turn to obtain the dermal extracellular matrix. After pepsin digestion and methacrylic anhydride modification, the methacrylated dermal extracellular matrix hydrogel was formed by photocrosslinking. The microscopic morphology of the hydrogel was observed by scanning electron microscope, and its rheological properties, swelling properties and other physical and chemical properties were tested. (2) Mice fibroblasts (L929) were inoculated into methacrylated dermal extracellular matrix hydrogel to detect the cell compatibility. (3) Totally 12 SD rats were randomly divided into two groups (n=6) to create abdominal wall defect model with peritoneum preserved. The defect site of the polypropylene group was filled with polypropylene material, and the hydrogel group was filled with methacrylated dermal extracellular matrix hydrogel. The wound skin of both groups was covered with polypropylene material. The wound healing was observed and histological analysis was carried out. RESULTS AND CONCLUSION: (1) Enzymatic hydrolysis had a good decellularization effect on porcine dermis after decellularization, and the original glycosaminoglycans and collagen were well retained. Scanning electron microscope observation revealed that the dermal extracellular matrix hydrogel presented loose and porous structure. The aperture was between 70 and 120 µm. The swelling ratio was (16.88±3.24)% and the water absorption was (94.24±1.11)%.  The rheological property test showed that the methacrylated dermal extracellular matrix hydrogel was stable and had shear thinning characteristics, with injectability. (2) CCK-8 assay and live/dead staining showed that methacrylated dermal extracellular matrix hydrogel had good cell compatibility. (3) The results of animal experiments showed that the skin wound healing rate of the experimental group was higher than that of the control group at 7, 10, and 14 days after operation (P < 0.05). Hematoxylin-eosin and Masson staining of skin and muscle tissue exhibited that compared with the polypropylene group, the skin wound epithelialization, hair follicle formation, collagen fiber arrangement, and neovascularization were better in the hydrogel group 14 days after surgery. The skin wound new tissue structure was similar to the normal tissue at 28 days after surgery, and scar hyperplasia was less. A small amount of muscle regeneration was observed on day 28 after operation. (4) The results show that the methacrylated dermal extracellular matrix hydrogel can promote wound skin healing and muscle tissue regeneration in rats with abdominal wall defect.  Figures and Tables | References | Related Articles | Metrics

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Finite element analysis of safety and efficacy of a novel scored balloon for coronary arteries Cao Zheng, Zheng Xiaoxin, Jiang Xuejun 2025, 29 (10):  2083-2090.  doi: 10.12307/2024.528 Abstract ( 99 )   PDF (2420KB) ( 89 )   Save BACKGROUND: Currently, the pre-dilatation balloons used in clinical coronary intervention are mainly the traditional high-pressure balloon and papillary balloon. They may slip off in the diseased vessel and then bruise the vessel.  OBJECTIVE: To evaluate the safety and effectiveness of the new coronary rotary scoring balloon in vasodilatation.  METHODS: (1) Finite element analysis: The three-dimensional finite element model of blood vessel was established by collecting relevant human tissue data, and then the three-dimensional finite element model of papillary balloon implantation in blood vessel and the three-dimensional finite element model of rotary scored balloon implantation in blood vessel were established to analyze the vascular stress, vascular displacement, balloon stress and balloon displacement  during balloon expansion under different aeration pressures. (2) Animal experiments: Eight New Zealand rabbits with large ears were randomly divided into two groups, and the papillary balloon and rotary scored balloon were implanted in the iliac artery for expansion, with four rabbits in each group. After the balloon was withdrawn, samples were taken. Hematoxylin-eosin staining and transmission electron microscopy were used to observe the vascular injury. RESULTS AND CONCLUSION: (1) Finite element analysis: There was no significant difference in the elastic properties of the two types of balloon. Under the same aeration pressure, the vascular stress, vascular displacement, balloon stress, and balloon displacement of the papillary balloon group were much greater than those of the rotary scored balloon group, and the uniformity of each index was better than that of the rotary scored balloon group. With the increase of inflatable pressure, the increase of blood vessel stress, blood vessel displacement, balloon stress and balloon displacement in the papillary balloon group was much greater than that in the rotary scored balloon group. (2) Animal experiments: Hematoxylin-eosin staining and transmission electron microscope observation showed that the vascular damage caused by rotary scored balloon expansion was limited to the intima, while the vascular damage caused by papillary balloon expansion was more serious, and the intima and media were seriously damaged. Hematoma formation could be seen in some segments; more inflammatory cells were found around the blood vessels, and local macrophage accumulation could be seen. (3) The results show that compared with papillary balloon dilatation, the risk of vascular occlusion and dissection caused by rotary scored balloon dilatation was less, but there was a certain probability of balloon bending.  Figures and Tables | References | Related Articles | Metrics

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Promotion of endometrial cell proliferation evaluated by platelet-rich plasma based on microfluidic chips Wen Zhejia, Lyu Fang 2025, 29 (10):  2091-2096.  doi: 10.12307/2025.410 Abstract ( 77 )   PDF (1931KB) ( 123 )   Save BACKGROUND: Platelet-rich plasma is used to promote the proliferation of thin endometrial cells, but there are problems with difficult dose control and sampling. Microfluidic-chips have the advantages of high throughput, low consumption, and simplified operation, providing a new approach to simulate the in vivo microenvironment of endometrial cells.  OBJECTIVE: To establish a model of promoting endometrial cell proliferation with platelet-rich plasma by the three-channel microfluidic-chip. METHODS: Platelet-rich plasma was extracted from peripheral venous blood of a female. Human endometrial stromal cells were cultured in serum-free cell media with different concentrations of platelet-rich plasma [0%(control), 0.5%, 1%, and 2%]. Cell migration was detected by scratch test. Cell proliferation was detected by CCK-8 assay. A microfluidic chip was prepared by using polydimethylsiloxane adhesive. The microfluidic chip was designed with three channels. The middle channel was the extracellular matrix hydrogel channel. Human endometrial stromal cells and platelet-rich plasma channels were found on the left and right sides. There was an area between the three channels that could communicate with each other and realize material exchange. Human endometrial stromal cells (labeled with green fluorescent protein GFP) and serum-free medium containing 0.5% platelet-rich plasma were added to both sides of the experimental group. Human endometrial stromal cells (labeled with green fluorescent protein GFP) and serum-free cell media were added to both sides of the control group. After co-culture for 48 hours, the cell proliferation and migration were observed by Ki67 immunofluorescence staining.  RESLUTS AND CONCLUSION: (1) The results of cell scratch test and CCK-8 assay showed that compared with the control group, platelet-rich plasma at 0.5%, 1%, and 2% concentrations could promote the migration and proliferation of human endometrial stromal cells (P < 0.05). In addition, the promotion of cell migration and proliferation of platelet-rich plasma with 0.5% concentration was stronger than that of the other two concentrations (P < 0.05). (2) Ki67 immunofluorescence staining showed that compared with the control group, the proliferation and migration abilities of endometrial stromal cells were stronger in the experimental group. (3) The experiment proves that the microenvironment of endometrial cells can be simulated by the three-channel microfluidic chip. At the same time, the system has proven that platelet-rich plasma can significantly promote the proliferation and migration of endometrial stromal cells.  中国组织工程研究杂志出版内容重点：生物材料；骨生物材料；口腔生物材料；纳米材料；缓释材料；材料相容性；组织工程 Figures and Tables | References | Related Articles | Metrics

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Field-driven medical micro-robots: application prospect of continuously optimizing material preparation process Xiao Wenqian, Han Hongjuan, Yang Haocheng, Li Bo, He Binyan 2025, 29 (10):  2097-2104.  doi: 10.12307/2025.408 Abstract ( 167 )   PDF (1213KB) ( 370 )   Save BACKGROUND: Micro-robots have the characteristics of small size, flexibility, and strong targeting, and can complete complex tasks in a single or clustered manner in a narrow environment. With the continuous optimization of materials, preparation processes, and driving approaches, they have shown increasingly important application value in the field of biomedicine. OBJECTIVE: To analyze the application of field-driven micro-robots in medical field and to look forward to their application prospect. METHODS: Using “microrobots, nanorobots, drivers, biomedical, medical” as Chinese keywords and “microrobots, micro-robots, nanorobots, micromachine, microswimmer, medical” as English keywords, WanFang Data and PubMed databases were searched, respectively. The search time range was from January 2010 to January 2024, and a small number of long-term articles were included. Through reading the titles and preliminarily screening the abstracts, the repetitive studies, low-quality journals, and irrelevant literature were excluded. After reading the entire text, 66 papers were finally included for review. RESULTS AND CONCLUSION: Field-driven medical micro-robots mainly include magnetic, optical, thermal, ultrasonic, and multi-mixed factor-driven robots. Field-driven robots have been used in intestinal diagnosis, drug targeting therapy, and stem cell therapy. Medical micro-robots are currently only used in a small number of clinical applications, but most of which are still in the theoretical and experimental stages. Medical micro-robots will face many challenges in future, such as large-scale preparation, precise control of micro-robots, recycling or degradation in vivo, whether the materials used will cause adverse reactions to the human body, and the related minimally invasive medical procedures. Figures and Tables | References | Related Articles | Metrics

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Antibacterial piezoelectric materials: no selective killing of bacteria and no bacterial resistance Feng Nan, Li Yunfeng 2025, 29 (10):  2105-2112.  doi: 10.12307/2025.262 Abstract ( 162 )   PDF (1224KB) ( 314 )   Save BACKGROUND: Piezoelectric materials can catalyze the generation of reactive oxygen species, which can destroy bacteria by multiple ways without causing drug resistance. This indiscriminately attack bacteria strategy has obvious advantages over traditional antibiotic therapy, thus providing a novel idea for antibacterial strategies. OBJECTIVE: To summarize the properties and antibacterial mechanisms of piezoelectric materials and discuss the application status of several piezoelectric materials in the field of anti-bacteria. METHODS: The literature search was performed in PubMed, Web of Science, CNKI, and WanFang databases. Chinese search terms were “piezoelectric materials, piezoelectric catalysis, reactive oxygen species, antibacterial, bacterial infection, anti-infection, drug resistance.” English search terms were “piezoelectric materials, piezoelectricity, piezoelectric catalysis, piezocatalysis, reactive oxygen species, ROS, bacterial infection, antibacterial strategies, anti-infection, drug resistance, drug-resistant bacteria.” Retrieval time was from January 2013 to December 2023. Primary screening was conducted by reading the titles and abstracts. Repetitive studies and irrelevant articles were excluded. Finally, 68 articles were included for review after literature quality evaluation. RESULTS AND CONCLUSION: (1) Piezoelectric materials are stable and environment-friendly materials, most of which show good biocompatibility. (2) Piezoelectric materials can catalyze a large amount of reactive oxygen species in the process of piezoelectric effect, combined with extracellular oxidation and intracellular oxidation, reactive oxygen species can destroy the membrane of bacteria, intracellular proteins, enzymes, and nucleic acids, disorder the structure and function, even kill the bacteria. The antibacterial performance is related to the rate of catalytic generation of reactive oxygen species, and the catalytic efficiency is related to many factors such as material system, morphology, and external conditions. (3) Reactive oxygen species producted by piezoelectric catalysis can kill bacteria without selectivity and show spectral antibacterial activity. This strategy does not rely on antibiotics and does not cause drug resistance. (4) Combined with the advantages of non-invasive, controllable, and penetrating ultrasound, piezoelectric materials will have significant value and great potential in the future as adjunctive or alternative treatments for drug-resistant bacterial infections and other fields. (5) The current challenge of low catalytic efficiency of piezoelectric materials limits its application in the field of antibacterial, how to improve the piezoelectric catalytic efficiency has become the focus of scholars’ attention. Figures and Tables | References | Related Articles | Metrics

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Application of shape memory alloys in assistive devices and rehabilitation equipment Tan Xin, Zhang Hongyue, Zhao Yuchan, Qin Chun, Xu Shuogui 2025, 29 (10):  2113-2123.  doi: 10.12307/2025.401 Abstract ( 252 )   PDF (1786KB) ( 517 )   Save BACKGROUND: With the continuous progress of science and technology, the introduction of new technologies and methods will bring more possibilities and new breakthroughs for the application of shape memory alloys in the fields of assistive and rehabilitation. OBJECTIVE: To review the application status of shape memory alloys in assistive and rehabilitation equipment, discuss their main methods, techniques and results, summarize and put forward suggestions, hoping that shape memory alloys can be continuously optimized and bring more new changes for the development of assistive and rehabilitation equipment. METHODS: WanFang, PubMed, and Web of Science databases were searched by computer. “Shape memory alloys, application progress, orthodontics, orthopedic, prosthesis, rehabilitation, properties, implantation, mechanical properties, nickel-titanium memory alloys, actuation” were used as Chinese search terms. “Shape memory alloys, application, orthodontics, orthopedic, prosthetics, rehabilitation, properties, implant, drive, progress, prostheses” were used as English search terms. Finally, 91 articles were included for review. RESULTS AND CONCLUSION: (1) Shape memory alloy has the characteristics of corrosion resistance, wear resistance, biocompatibility, fatigue resistance, kink resistance and other properties. Compared with other traditional materials (stainless steel, titanium alloy, cobalt-chromium alloy, etc.), shape memory alloy has lower elastic modulus and no biological toxicity, which is suitable for long-term implantation as an implant prosthesis. Due to its shape memory effect and excellent mechanical properties, it is mainly used as a driving element or as a bridge connecting the device and the human body in artificial limbs, orthoses and rehabilitation equipment. (2) The use of shape memory alloy drive elements can reduce the weight of the device, eliminate noise, easy to operate, easy to carry, better assist joint movement; compared with the use of pneumatic, hydraulic, and electrical drive methods of the device, it has obvious advantages. (3) In addition, shape memory alloy can produce permanent and stable stress during deformation. Compared with stainless steel, titanium alloy and aluminum alloy, shape memory alloy has a higher material recovery rate and does not need to be replaced and adjusted frequently, so it is more practical in the correction of deformity. (4) At present, shape memory alloy is most commonly used in orthosis, and the best clinical application effect is in stapes prosthesis. However, due to the limitations of technology and cost, shape memory alloys are rarely used in artificial limbs and rehabilitation equipment, and there is a lack of large sample size studies on the application effect. (5) Although shape memory alloys have been developed in the field of auxiliary and rehabilitation, there are still many problems: it is difficult to accurately control the shape memory alloys; the cooling speed of shape memory alloy is slow; the deformation speed of shape memory alloy cannot be controlled; there is a lack of comparative research and expert consensus on shape memory alloys with different properties; shape memory alloys are costly and expensive. (6) In the future, attention should be paid to the development of new shape memory alloys, increase comparative research, and use new technologies and methods (such as 4D printing) to solve the existing problems, so as to develop high-performance assistive devices and rehabilitation equipment. Figures and Tables | References | Related Articles | Metrics

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Two-dimensional black phosphorus materials for bone tissue engineering Chen Jiahan, Feng Chao, Huang Xiaoxia, Niu Minghui, Wang Xin, Teng Yong 2025, 29 (10):  2124-2131.  doi: 10.12307/2025.411 Abstract ( 175 )   PDF (850KB) ( 221 )   Save BACKGROUND: Black phosphorus has a high degree of homology with human bone, so it has been extensively studied in the field of bone tissue engineering in recent years. Since 2014, two-dimensional black phosphorus materials have garned significant attention in the field of biomedicine due to their excellent exceptional physical, chemical, and biological properties.  OBJECTIVE: To summarize the advancements made in black phosphorus-based nanomaterials for bone tissue engineering, focus on the synthesis methods, osteogenic characteristics, and applications in biomaterials pertaining to two-dimensional black phosphorus nanomaterials. METHODS: Chinese and English key words were “black phosphorus, bone tissue engineering, bone defect, bone regeneration, osteogenesis.” Relevant articles in PubMed and CNKI databases from January 2014 to December 2023 were searched. After exclusion and screening, 96 articles were analyzed. RESULTS AND CONCLUSION: Black phosphorus nanomaterials play an important role in bone tissue engineering due to their good biocompatibility, biodegradability, photothermal action, antibacterial ability, drug loading performance, and special osteogenic effect, and are ideal candidate materials for promoting bone regeneration. The preparation of black phosphorus nanomaterials is mainly a top-down top-layer stripping method. The main principle is to weaken the van der Waals force between the black phosphorus layers by physical or chemical means to obtain a single or less layer of phosphanse, that is, black phosphorus nanosheets or quantum dots. Black phosphate-based nanocomposites are mainly divided into hydrogels, 3D printing scaffolds, composite scaffolds, electrospinning, bionic periosteum, microspheres, and bionic coatings. The research of nano-black phosphorus in bone tissue engineering is in its infancy, and still faces many challenges: the behavior of black phosphorus in vivo and the interaction mechanism with various biomolecules need to be further studied. The long-term potential toxicity of black phosphorus is unknown. The manufacturing process for black phosphorus is difficult to control. Therefore, how to develop uniform size, safe, reliable, and efficient nano black phosphorus and transform it into clinical application requires interdisciplinary research on modern biomedical technology, physicochemical technology, and precision manufacturing technology. Figures and Tables | References | Related Articles | Metrics

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Mechanisms by which microgravity causes osteoporosis Xiang Dejian, Liang Xiaoyuan, Wang Shenghong, Chen Changshun, Tian Cong, Yan Zhenxing, Geng Bin, Xia Yayi 2025, 29 (10):  2132-2140.  doi: 10.12307/2025.260 Abstract ( 156 )   PDF (983KB) ( 54 )   Save BACKGROUND: The imbalance between bone resorption and bone formation in microgravity environments leads to significant bone loss in astronauts. Current research indicates that bone loss under microgravity conditions is the result of the combined effects of various cells, tissues, and systems. OBJECTIVE: To review different biological effects of microgravity on various cells, tissues, or systems, and summarize the mechanisms by which microgravity leads to the development of osteoporosis. METHODS: Databases such as PubMed, Web of Science, and the Cochrane Database were searched for relevant literature from 2000 to 2023. The inclusion criteria were all articles related to tissue engineering studies and basic research on osteoporosis caused by microgravity. Ultimately, 85 articles were included for review.  RESULTS AND CONCLUSION: (1) In microgravity environment, bone marrow mesenchymal stem cells tend to differentiate more into adipocytes rather than osteoblasts, and hematopoietic stem cells in this environment are more inclined to differentiate into osteoclasts, reducing differentiation into the erythroid lineage. At the same time, microgravity inhibits the proliferation and differentiation of osteoblasts, promotes apoptosis of osteoblasts, alters cell morphology, and reduces the mineralization capacity of osteoblasts. Microgravity significantly increases the number and activity of osteoclasts. Microgravity also hinders the differentiation of osteoblasts into osteocytes and promotes the apoptosis of osteocytes. (2) In a microgravity environment, the body experiences changes such as skeletal muscle atrophy, microvascular remodeling, bone microcirculation disorders, and endocrine disruption. These changes lead to mechanical unloading in the bone microenvironment, insufficient blood perfusion, and calcium cycle disorders, which significantly impact the development of osteoporosis. (3) At present, the mechanism by which microgravity causes osteoporosis is relatively complex. A deeper study of these physiological mechanisms is crucial to ensuring the health of astronauts during long-term space missions, and provides a theoretical basis for the prevention and treatment of osteoporosis. Figures and Tables | References | Related Articles | Metrics

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Combination of effective ingredients of traditional Chinese medicine and bone tissue engineering materials for bone repair Wu Yaokun, Liu Chenglin, Fu Jiahao, Song Wei, Chen Hao, Xi Hongzhong, Liu Xin, Du Bin, Sun Guangquan 2025, 29 (10):  2141-2150.  doi: 10.12307/2025.404 Abstract ( 145 )   PDF (956KB) ( 433 )   Save BACKGROUND: How to repair bone defect has been a clinical problem for a long time. The effective ingredients of traditional Chinese medicine have good biological activity and therapeutic effect, and the combination of effective ingredients of traditional Chinese medicine and tissue engineering materials has a broad prospect in the field of bone repair. The combination of different effective ingredients of traditional Chinese medicine and scaffolds has similarities in their functional relationships. OBJECTIVE: To collect the cases of the combinations of effective ingredients of traditional Chinese medicine and scaffolds, then analogize tissue engineering scaffolds and effective ingredients of traditional Chinese medicine into two types of traditional Chinese medicine that generate compatibility relationships based on the inspiration of the compatibility of seven emotions and summarize the relationship between the two based on their functional relationships. METHODS: Relevant articles from January 1998 to January 2024 were searched in PubMed and China National Knowledge Infrastructure (CNKI), using English search terms “traditional Chinese medicine, Chinese medicine, traditional Chinese medicine monomers, bone defect, bone repair, bone tissue engineering, tissue engineering, scaffold” and Chinese search terms “traditional Chinese medicine, effective ingredients of traditional Chinese medicine, traditional Chinese medicine monomers, bone tissue engineering, bone tissue engineering scaffold, scaffold, tissue engineering, bone defect, bone repair.” A total of 88 articles were included for review and analysis. RESULTS AND CONCLUSION: (1) Both tissue engineering scaffold materials and active ingredients of traditional Chinese medicine have been widely used in the field of bone repair. Although they have obvious advantages in osteogenesis, there are still many shortcomings. Many studies are dedicated to preparing composite materials from the two, hoping to exert a detoxification and synergism through the interaction between the two. (2) Some drugs and materials can promote each other in osteogenesis, antibacterial, and promoting angiogenesis, enhancing their original effects. Inspired by the traditional concept of prescription compatibility, this article summarized it as a “Mutual promotion” relationship and provided examples to support it. (3) Some drugs can enhance the strength of materials, while some materials can achieve sustained release and controlled release effects, increase drug loading and stability, or achieve targeted delivery of drugs loaded on them. The article summarized this unilateral enhancement effect as a “Mutual assistance” relationship. (4) The combination of some traditional Chinese medicine and materials can reduce the toxic side effects of the other party. The article summarizes this detoxification relationship as “Mutual restraint and detoxification.” (5) The article provided a new perspective on traditional Chinese medicine composite scaffolds, inspired by the seven emotions compatibility relationship and based on the classification of action relationships. It introduced traditional Chinese medicine concepts into the field of tissue engineering, providing new research ideas for subsequent researchers of composite scaffolds, and providing certain convenience in material selection and matching. Figures and Tables | References | Related Articles | Metrics

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Multiple applications of metal-organic framework materials in bone tissue engineering and orthopedic disease treatment  Liu Yunxiang, Zhang Xiaoyu, Li Hao, Zhang Rong, Li Liping, Chen Chongwei 2025, 29 (10):  2151-2161.  doi: 10.12307/2025.261 Abstract ( 189 )   PDF (1137KB) ( 558 )   Save BACKGROUND: Metal-organic frameworks exhibited great potential for bone tissue engineering and bone disease treatment because of its unique merits including tunable porosity, a large specific surface area, good biocompatibility, and easy structure modification. OBJECTIVE: To review the advancements, application, strengths, and weaknesses of metal-organic framework materials in bone repair, arthritis, bone infection, and bone tumors, offering guidance and strategies for future research. METHODS: Web of Science, PubMed, and CNKI databases were searched using Chinese and English keywords “metal-organic frameworks, MOFs, orthopedics, bone repair, bone regeneration, orthopaedic applications, bone tissue engineering, bone infection, arthritis, bone tumor, osteosarcoma” for related literature published from 2015 to 2023. Following initial screening based on inclusion and exclusion criteria, 72 articles were finally included for review. RESULTS AND CONCLUSION: (1) During bone repair, metal ions of metal-organic frameworks can induce bone formation by activating specific signaling pathways, which include stimulating osteogenic gene expression, inhibiting osteoclasts, encouraging blood vessel formation, and speeding up bone mineralization. Hence, metal-organic frameworks with metals like calcium, strontium, cobalt, copper, and magnesium ions show significant potential in enhancing bone implant performance. (2)Metal-organic framework materials, especially zinc/cobalt-based metal-organic frameworks, exhibit enzyme-like activities and promote cartilage regeneration by scavenging reactive oxygen species. Compared with natural enzymes, it has the advantages of not easy inactivation and better stability. (3) Zinc-based metal-organic framework materials characterized with wide band gaps, efficient separation and migration of photogenerated carriers, and high stability, the enhancement of photocatalytic activity results from enhancing the excited electron-hole widely used for the eradication of bacteria and tumor cells. (4) Bimetallic metal-organic frameworks, the doping of additional metals, showed critical advantages in optimizing structural performance, such as zinc/magnesium-based metal-organic framework 74 offering increased stability for durable antibacterial activity, and the light absorption capacity and photocatalytic efficiency of tantalum/zirconium-based metal-organic framework greatly improved and thus enhancing the radiation therapy. (5) However, metal-organic framework materials still face challenges in clinical applications, such as the uncertainty of drug release, in vivo safety, and potential immune responses from long-term presence.  Figures and Tables | References | Related Articles | Metrics

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Action mechanisms and application pathways of biomaterials in promoting corneal alkali burn repair Xiao Hui, Li Dongyan, Ji Jing, Wang Lizhen 2025, 29 (10):  2162-2170.  doi: 10.12307/2025.403 Abstract ( 139 )   PDF (1060KB) ( 209 )   Save BACKGROUND: Traditional treatments for corneal alkali burns are limited, especially in controlling inflammation, preventing neovascularization, and inhibiting corneal scarring. Natural, synthetic, or composite materials provide a wide range of treatment options. However, the mechanism by which biomaterials promote corneal alkali burn repair has not yet been systematically understood. OBJECTIVE: To summarize the current research on biomaterials in promoting corneal alkali burn repair in and outside China, and review the mechanism and application of biomaterials in repairing corneal alkali burn. METHODS: The first author searched “cornea, alkali burn, amniotic membrane, hyaluronic acid, collagen, chitosan, polymer materials” as Chinese keywords and “amniotic membrane, hyaluronic acid, collagen, chitosan, polymer, cornea, alkali burn” as English keywords in PubMed, Web of Science, CNKI, and WanFang databases. According to inclusion and exclusion criteria, 76 eligible articles were finally included for review. RESULTS AND CONCLUSION: (1) In the field of corneal alkali burn repair, biomaterials such as amniotic membrane, hyaluronic acid, collagen, chitosan, and degradable polymer materials have been widely studied and applied. Each of these biomaterials has its own characteristics, advantages, and disadvantages, and stands out in different aspects. (2) First and foremost, amniotic membranes are considered one of the most promising biomaterials due to their abundance of bioactive factors. They are biocompatible and can regulate the corneal inflammatory response. However, there are issues with donor shortages and susceptibility to infectious diseases. (3) Hyaluronic acid has good moisturizing properties and biocompatibility, and is able to improve the survival rate of corneal cells and increase corneal transparency. (4) The good biocompatibility and scaffold structure of collagen enable the promotion of corneal cell adhesion and proliferation, as well as the reconstruction of corneal tissue structure. (5) Chitosan is recognized for its good biocompatibility and degradability, making it suitable as a carrier for drug delivery and cell transplantation. (6) Degradable polymer materials have good controllability over degradation and can provide a good support and delivery platform for the repair of corneal alkali burns, but further research is needed on their stability and biocompatibility. (7) Overall, there is currently no single biomaterial that can completely address the repair problem of corneal alkali burns, and each biomaterial has its own specific application scenarios and limitations. (8) Future research directions should focus on further improving the properties and structure of biomaterials, exploring more effective combination applications, and deeply understanding the interaction mechanism between biomaterials and corneal tissue, in order to enhance the therapeutic effect of corneal alkali burns and the quality of life of patients.  Figures and Tables | References | Related Articles | Metrics

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Manufacture and mechanical property on zirconia abutments with a titanium base in dental implant restoration Wang Huan, Lu Jing, Li Ying, Meng Maohua, Shu Jiayu, Luo Yuncai, Li Wenjie, Dong Qiang 2025, 29 (10):  2171-2177.  doi: 10.12307/2025.254 Abstract ( 107 )   PDF (921KB) ( 101 )   Save BACKGROUND: With the development of computer-aided design and computer-aided manufacturing technology, zirconia abutments with a titanium base are widely used in clinic due to its good application advantages, but there are still some problems and a lack of consensus design standards. OBJECTIVE: To review the fabrication methods of Ti-base zirconia abutment, and the effect of abutment connection, emergence design, abutment angle, and bonding on mechanical properties of Ti-base zirconia abutment.  METHODS: Relevant literature published from 2010 to 2023 was searched in CNKI and PubMed databases with the search terms “zirconia abutment, titanium base” in Chinese and English, respectively. The search time limit was extended for some cl RESULTS AND CONCLUSION: It is recommended that clinicians try to select antirotational titanium bases or rotational titanium bases with a Morse taper connection. Implants should be placed in the correct axial angulation of not more than 15° or with an inclination to the palatal side when using angled zirconia abutments. When a ≥ 30° labial inclination is followed for implant placement, the bite force must be decreased effectively to reduce the risk of mechanical and biological complications of implants, abutments, and prostheses. Ti-base zirconia abutments with a higher gingival height should be selected, and its restorative angle should not exceed 40°. Multilink Hybrid Abutment could be the first choice for extraoral bonding of zirconia abutment to titanium bases. Figures and Tables | References | Related Articles | Metrics

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Hydrogels: role and problems in the repair of oral and maxillofacial defects Wu Zhixin, Jiang Wenwen, Zhan Jianhui, Li Yangshurun, Ren Wenyan, Wang Yiyu 2025, 29 (10):  2178-2188.  doi: 10.12307/2025.402 Abstract ( 290 )   PDF (1557KB) ( 460 )   Save BACKGROUND: Hydrogels have become a research hotspot due to their unique advantages in the biomedical field due to their superior mechanical and biological properties. At present, related research involves tissue engineering, wound dressing and so on. OBJECTIVE: To review the advantages and properties of hydrogels and the research progress of their application in the repair of oral and maxillofacial defects, discuss the current limitations and challenges of hydrogels in application and promotion, and provide new ideas for future research directions. METHODS: Relevant literature was searched in PubMed, CNKI, and WanFang database by computer. The search terms were “hydrogel, oral and maxillofacial defects, mechanical properties, tissue engineering, wound dressing” in Chinese and “hydrogel, oral and maxillofacial defects, mechanical properties, guided tissue regeneration, wound dressing” in English. Preliminary screening was carried out by reading titles and abstracts, and articles not related to the topic of the article were excluded. According to the inclusion and exclusion criteria, 108 articles were finally included for the result analysis. RESULTS AND CONCLUSION: (1) The hydrogel has good biological activity, mechanical controllability, and stimulation response. (2) Polymer, metal, and ceramic hydrogel composites have appropriate mechanical properties, biodegradability, and controlled release rate, which are suitable for maxillofacial bone tissue engineering. (3) Fibrin-based hydrogel could fill the hollow nerve conduit through the nerve defect area and promote the regeneration and growth of axons to restore the function of maxillofacial nerve. (4) Controlling the interaction between nanomaterials and hydrogels can improve the formation of muscle fiber oriented structure to promote maxillofacial muscle tissue regeneration. (5) Polysaccharide hydrogel has gradually become the first choice for repairing irregular periodontal defects due to its ability to control drug delivery, carry bioactive molecules, and combine with other materials to produce the best scaffold matching the extracellular matrix. (6) Calcium phosphate or calcium carbonate-based hydrogels can be used to fill irregular or fine tissue defects and remineralize hard tissues. The self-assembled hydrogels are simple to prepare and have good biological activity. (7) Salivary gland-derived extracellular matrix-like gel is expected to participate in the treatment of many salivary gland diseases. (8) Hydrogels can be used as wound dressings in combination with biological adhesives, acellular biomaterials, antimicrobials, antioxidants, or stem cells to treat various wounds. (9) Fibrin-based hydrogel has the most potential in the repair of oral and maxillofacial defects. It has excellent biocompatibility, flexibility, and plasticity. It can combine with cells, extracellular matrix proteins, and various growth factors, and promote the osteogenic differentiation of mesenchymal stem cells, axon regeneration and growth, angiogenesis, myotube differentiation, salivary gland tissue regeneration, and periodontal tissue regeneration. It has a broad prospect in the repair of oral and maxillofacial defects. However, its therapeutic effect depends on the function of the substance carried. The complex preparation process, its safety and long-term efficacy, and the special anatomical oral and maxillofacial structure is the problem that hinders its promotion, which also provides directions for future research. Figures and Tables | References | Related Articles | Metrics

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Platelet-rich plasma and hydrogel for spinal cord injury Zhao Wenqi, Yu Haichi, Song Yiru, Yuan Tianyang, Liu Qinyi 2025, 29 (10):  2189-2200.  doi: 10.12307/2025.407 Abstract ( 134 )   PDF (1291KB) ( 394 )   Save BACKGROUND: A large number of articles have reported the effect and mechanism of platelet-rich plasma and hydrogel in the treatment of spinal cord injury, but few articles have summarized their treatment strategies for spinal cord injury.  OBJECTIVE: To summarize the pathological process of spinal cord injury and the strategies of repairing spinal cord injury with platelet-rich plasma and hydrogel alone and in combination. METHODS: PubMed and CNKI databases were searched for articles published from inception to March 2024 by computer. The Chinese search terms were “spinal cord injury, platelet-rich plasma, hydrogel.” The English search terms were “spinal cord injury, spinal cord, platelet-rich plasma, hydrogel, angiogenesis, neuralgia, combination therapy.” Articles were screened according to inclusion and exclusion criteria, and 128 articles were finally included for review and analysis. RESULTS AND CONCLUSION: (1) The classification of platelet-rich plasma is complex and diverse, and the effects of platelet-rich plasma in the repair treatment of spinal cord injury are various, but they all show certain positive effects, that is, they can promote axon regeneration, stimulate angiogenesis, and treat neuropathic pain and so on. (2) The effect of platelet-rich plasma is mainly due to the growth factors contained in platelet-rich plasma. (3) There are many types of hydrogels, which mainly play the role of filling, simulating extracellular matrix, carrying drugs and biological products, and carrying cells as scaffolds in the repair treatment of spinal cord injury. (4) Compared with single therapy, combination therapy of platelet-rich plasma and hydrogel can promote nerve regeneration and spinal cord function recovery more effectively. Figures and Tables | References | Related Articles | Metrics