Abteilung für Funktionswerkstoffe der Medizin und der Zahnheilkunde
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Synthetic bone replacement materials have their application in non-load bearing defects with the function of (re-)construction or substitution of bone. This tissue itself represents a biological composite material based on mineralized collagen fibrils and combines the mechanical strength of the mineral with the ductility of the organic matrix. By mimicking these outstanding properties with polymer-cement-composites, an imitation of bone is feasible. A promising approach for such replacement materials are dual setting systems, which are generated by dissolution-precipitation reaction with cement setting in parallel to polymerization and gelation of the organic phase forming a coherent hydrogel network. Hereby, the high brittleness of the pure inorganic network was shifted to a more ductile and elastic behavior.
The aim of this thesis was focused on the development of different dual setting systems to modify pure calcium phosphate cements’ (CPCs’) mechanical performance by incorporation of a hydrogel matrix.
A dual setting system based on hydroxyapatite (HA) and cross-linked 2-hydroxyethyl methacrylate (HEMA) via radical polymerization was advanced by homogenous incorporation of a degradable cross-linker composed of poly(ethylene glycol) (PEG) as well as poly(lactic acid) (PLA) with reactive terminal methacrylate functionalities (PEG-PLLA-DMA). By integration of this high molecular weight structure in the HEMA-hydrogel network, a significant increase in energy absorption (toughness) under 4-point bending testing was observed. An addition of only 10 wt% hydrogel precursor (referred to the liquid phase) resulted in a duplication of stress over a period of 8 days. Additionally, the calculated elasticity was positively affected and up to six times higher compared to pure HA. With a constantly applied force during compressive strength testing, a deformation and thus strain levels of about 10 % were reached immediately after preparation.
For higher degradability, the system was modified in a second approach regarding organic as well as inorganic phase. The latter component was changed by brushite forming cement that is resorbable in vivo due to solubility processes. This CPC was combined with a hydrogel based on PEG-PLLA-DMA and other dimethacrylated PEGs with different molecular weights and concentrations. Hereby, new reaction conditions were created including a shift to acidic conditions. On this ground, the challenge was to find a new radical initiator system. Suitable candidates were ascorbic acid and hydrogen peroxide. that started the polymerization and successful gelation in this environment. These highly flexible dual set composites showed a very high ductility with an overall low strength compared to HA-based models. After removal of the applied force during compressive strength testing, a complete shape recovery was observed for the samples containing the highest polymeric amount (50 wt%) of PEG-PLLA-DMA.
Regarding phase distribution in the constructs, a homogenously incorporated hydrogel network was demonstrated in a decalcifying study with ethylenediaminetetraacetic acid. Intact, coherent hydrogels remained after dissolution of the inorganic phase via calcium ion complexation.
In a third approach, the synthetic hydrogel matrix of the previously described system was replaced by the natural biopolymer gelatin. Simultaneously to brushite formation, physical as well as chemical cross-linking by the compound genipin was performed in the dual setting materials. Thanks to the incorporation of gelatin, elasticity increased significantly, in which concentrations up to 10.0 w/v% resulted in a certain cohesion of samples after compressive strength testing. They did not dissociate in little pieces but remained intact cuboid specimens though having cracks or fissures. Furthermore, the drug release of two active pharmaceutical ingredients (vancomycin and rifampicin) was investigated over a time frame of 5 weeks. The release exponent was determined according to Korsmeyer-Peppas with n = 0.5 which corresponds to the drug liberation model of Higuchi. A sustained release was observed for the antibiotic vancomycin encapsulated in composites with a gelatin concentration of 10.0 w/v% and a powder-to-liquid ratio of 2.5 g/mL.
With respect to these developments of different dual setting systems, three novel approaches were successfully established by polymerization of monomers and cross-linking of precursors forming an incorporated, homogenous hydrogel matrix in a calcium phosphate network. All studies showed an essential transfer of mechanical performance in direction of flexibility and bendability.
The aim of this thesis was the application of the functional prepolymer NCO-sP(EO-stat-PO) for the development of new biomaterials. First, the influence of the star-shaped polymers on the mechanical properties of biocements and bone adhesives was investigated. 3-armed star-shaped macromers were used as an additive for a mineral bone cement, and the influence on the mechanical properties was studied. Additionally, a previously developed bone adhesive was examined regarding cytocompatibility. The second topic was the examination of novel functionalization steps which were performed on the surface of electrospun fibers modified with NCO-sP(EO-stat-PO). This established method of functionalizing electrospun meshes was advanced regarding the modification with proteins which was then demonstrated in a biological application. Two different kinds of antibodies were immobilized on the fiber surface in a consecutive manner and the influence of these proteins on the cell behavior was investigated. The final topic involved the quantification of surface-bound peptide sequences. By functionalization of the peptides with the UV-reactive molecule 2-mercaptopyridine it was possible to quantify this compound via UV measurements by cleavage of disulfide bridges and indirectly draw conclusions about the number of immobilized peptides.
In the field of mineral biocements and bone adhesives, NCO-sP(EO-stat-PO) was able to influence the setting behavior and mechanical performance of mineral bone cements based on calcium phosphate chemistry. The addition of NCO-sP(EO-stat-PO) resulted in a pseudo-ductile fracture behavior due to the formation of a hydrogel network in the cement, which was then mineralized by nanosized hydroxyapatite crystals following cement setting. Accordingly, a commercially available aluminum silicate cement from civil engineering could be modified.
In addition, it could be shown that the use of NCO-sP(EO-stat-PO) is beneficial for adjusting specific material properties of bone adhesives. Here, the crosslinking behavior of the prepolymer in an aqueous medium was exploited to form an interpenetrating network (IPN) together with a photochemically curing poly(ethylene glycol) dimethacrylate (PEGDMA) matrix. This could be used for the development of a bone adhesive with an improved adhesion to bone in a wet environment. The developed bone adhesive was further investigated in terms of possible influences of the initiator systems. In addition, the material system was tested for cytocompatibility by using different cell lines.
Moreover, the preparation of electrospun fiber meshes via solution electrospinning consisting of poly(lactide-co-glycolide) (PLGA) as a backbone polymer and NCO-sP(EO-stat-PO) as functional additive is an established method for the application of the meshes as a replacement of the native extracellular matrix (ECM). In general, these fibers reveal diameters in the nanometer range, are protein and cell repellent due to the hydrophilic properties of the prepolymer and show a specific biofunctionalization by immobilization of peptide sequences. Here, the isocyanate groups presented on the fiber surface after electrospinning were used to carry out various functionalization steps, while retaining the properties of protein and cell repellency. The modification of the electrospun fibers involved the immobilization of analogs or antagonists of tumor necrosis factor (TNF) and the indirect detection of these by interaction with a light-producing enzyme. Here, a multimodal modification of the fiber surface with RGD to mediate cell adhesion and two different antibodies could be achieved. After culturing the cell line HT1080, the pro- or anti-inflammatory response of cells could be detected by IL-8 specific ELISA measurements.
Furthermore, the quantification of molecules on the surface of electrospun fibers was investigated. It was tested whether the detection by means of super-resolution microscopy would be possible. Therefore, experiments were performed with short amino acid sequences such as RGD for quantification by fluorescence microscopy. Based on earlier results, in which a UV-spectrometrically active molecule was used to detect the quantification of RGD, it was shown that short peptides can also be quantified in a small scale on flat functional substrates (2D) such as NCO-sP(EO-stat-PO) hydrogel coatings, and modified electrospun fibers produced from PLGA and NCO-sP(EO-stat-PO) (3D). In addition, a collagen sequence was used to prove that a successful quantification can be carried out as well for longer peptide chains.
These studies have revealed that NCO-sP(EO-stat-PO) can serve as a functional additive for many applications and should be considered for further studies on the development of novel biomaterials. The rapid crosslinking reaction, the resulting hydrogel formation and the biocompatibility are to be mentioned as positive properties, which makes the prepolymer interesting for future applications.
Biofabrication is an advancing new research field that might, one day, lead to complex products like tissue replacements or tissue analogues for drug testing. Although great progress was made during the last years, there are still major hurdles like new types of materials and advanced processing techniques. The main focus of this thesis was to help overcoming this hurdles by challenging and improving existing fabrication processes like extrusion-based bioprinting but also by developing new techniques. Furthermore, this thesis assisted in designing and processing materials from novel building blocks like recombinant spider silk proteins or inks loaded with charged nanoparticles.
A novel 3D printing technique called Melt Electrospinning Writing (MEW) was used in Chapter 3 to create tubular constructs from thin polymer fibers (roughly 12 μm in diameter) by collecting the fibers onto rotating and translating cylinders. The main focus was put on the influence of the collector diameter and its rotation and translation on the morphology of the constructs generated by this approach. In a first step, the collector was not moving and the pattern generated by these settings was analyzed. It could be shown that the diameter of the stationary collectors had a big impact on the morphology of the constructs. The bigger the diameter of the mandrel (smallest collector diameters 0.5 mm, biggest 4.8 mm) got, the more the shape of the generated footprint converged into a circular one known from flat collectors. In a second set of experiments the mandrels were only rotated. Increasing the rotational velocity from 4.2 to 42.0 rpm transformed the morphology of the constructs from a figure-of-eight pattern to a sinusoidal and ultimately to a straight fiber morphology. It was possible to prove that the transformation of the pattern was comparable to what was known from increasing the speed using flat collectors and that at a critical speed, the so called critical translation speed, straight fibers would appear that were precisely stacking on top of each other. By combining rotation and translation of the mandrel, it was possible to print tubular constructs with defined winding angles. Using collections speeds close to the critical translation speed enabled higher control of fiber positioning and it was possible to generate precisely stacked constructs with winding angles between 5 and 60°.
In Chapter 4 a different approach was followed. It was based on extrusion-based bioprinting in combination with a hydrogel ink system. The ink was loaded with nanoparticles and the nanoparticle release was analyzed. In other words, two systems, a printable polyglycidol/hyaluronic acid ink and mesoporous silica nanoparticles (MSN), were combined to analyze charge driven release mechanism that could be fine-tuned using bioprinting. Thorough rheological evaluations proved that the charged nanoparticles, both negatively charged MSN-COOH and positively charged MSN-NH2, did not alter the shear thinning properties of the ink that revealed a negative base charge due to hyaluronic acid as one of its main components. Furthermore, it could be shown that the particles did also not have a negative effect on the recovery properties of the material after exposure to high shear. During printing, the observations made via rheological testing were supported by the fact that all materials could be printed at the same settings of the bioprinter. Using theses inks, it was possible to make constructs as big as 12x12x3 mm3 composed of 16 layers. The fiber diameters produced were about 627±31 μm and two-component constructs could be realized utilizing the two hydrogel print heads of the printer to fabricate one hybrid construct. The particle distribution within those constructs was homogeneous, both from a microscopic and a macroscopic point of view. Particle release from printed constructs was tracked over 6 weeks and revealed that the print geometry had an influence on the particle release. Printed in a geometry with direct contact between the strands containing different MSN, the positively charged particles quickly migrated into the strand previously containing only negatively charged MSN-COOH. The MSN-COOH seemed to be rather released into the surrounding liquid and also after 6 weeks no MSN-COOH signal could be detected in the strand previously only containing MSN-NH2. In case of a geometry without direct contact between the strands, the migration of the positively charged nanoparticles into the MSN-COOH containing strand was strongly delayed. This proved that the architecture of the printed construct can be used to fine-tune the particle release from nanoparticle containing printable hydrogel ink systems.
Chapter 5 discusses an approach using hydrogel inks based on recombinant spider silk proteins processed via extrusion-based bioprinting. The ink could be applied for printing at protein concentrations of 3 % w/v without the addition of thickeners or any post process crosslinking. Both, the recombinant protein eADF4(C16) and a modification introducing a RGD-sequence to the protein (eADF4(C16)-RGD), could be printed revealing a very good print fidelity. The RGD modification had positive effect on the adhesion of cells seeded onto printed constructs. Furthermore, human fibroblasts encapsulated in the ink at concentrations of 1.2 million cells per mL did not alter the print fidelity and did not interfere with the crosslinking mechanism of the ink. This enabled printing cell laden constructs with a cell survival rate of 70.1±7.6 %. Although the cell survival rate needs to be improved in further trials, the approach shown is one of the first leading towards the shift of the window of biofabrication because it is based on a new material that does not need potentially harmful post-process crosslinking and allows the direct encapsulation of cells staying viable throughout the print process.
Calcium phosphate cements (CPC) represent valuable synthetic bone grafts, as they are self-setting, biocompatible, osteoconductive and in their composition similar to the inorganic phase of human bone. Due to their long shelf-life, neutral setting and since water is sufficient for setting, hydroxyapatite (HA) forming cements are processed in different paste formulations. Those comprise dual setting, Ca2+ binding and premixed cement systems. With dual setting formulations, both dissolution and precipitation of the cement raw powder occur simultaneously to the polymerization of water-soluble monomers to form a hydrogel. Chelating agents are able to form complexes with Ca2+ released from the raw powder. Premixed systems mostly contain the raw powder of the cement and a non-aqueous binder liquid which delays the setting reaction until application in the moist physiological environment. In the present work, two of those reaction mechanisms allowed the development of HA based cement applications.
Drillable cements are of high clinical interest, as the quality of screw and plate osteosynthesis techniques can be improved by cement augmentation. A drillable, dual setting composite from HA and a poly(2-hydroxyethyl methacrylate) hydrogel was analyzed with respect to the influence of monomer content and powder-to-liquid ratio on setting kinetics and mechanical outcome. While the conversion to HA and crystal growth were constantly confined with increased monomer amount, a minimum concentration of 50 % was required to see impressive ameliorations including a low bending modulus and high fracture energy at improved bending strength. Increasing the liquid amount enabled injection of the paste as well as drilling after 10 min of pre-setting.
While classic bone wax formulations have drawbacks such as infection, inflammation, hindered osteogenesis and a lack of biodegradability, the as-presented premixed formulation is believed to exhibit outmatching properties. It consisted of HA raw powders and a non-aqueous, but water-miscible carrier liquid from poly(ethylene glycol) (PEG). The bone wax was proved to be cohesive and malleable, it withstood blood pressure conditions and among deposition in an aqueous environment, PEG was exchanged such that porous, nanocrystalline HA was formed. Incorporation of a model antibiotic proved the suitability of the novel bone wax formulation for drug release purposes.
Prefabricated laminates from premixed carbonated apatite forming cement and poly(ε-caprolactone) fiber mats with defined pore architecture were presented as a potential approach for the treatment of 2-dimensional, curved cranial defects. They are flexible until application and were produced in a layer-by-layer approach from both components such that the polymer scaffold prevents the cement from flowing. It was demonstrated that solution electrospinning with a patterned collector for the fabrication of perforated fiber mats was suitable, as high fiber volume contents in combination with an appropriate interface enabled the successful fabrication of mechanically reinforced laminates. Mild immersion of the scaffolds under alkaline conditions additionally improved the interphase followed by an increase in bending-strength.
Since few years, magnesium phosphate cements (MPC) have attracted increasing attention for bone replacement. Compared to CPC, MPC exhibit a higher degradation potential and high early strength and they release biologically valuable Mg2+. However, common systems offer some challenges while using them in non-classic cement formulations such as the need for foreign ion supply, the potential acidity of the reaction or the fast setting kinetics. Here, it was possible to develop a chelate-setting MPC paste with a broad spectrum of potential applications.
The general mechanism of the novel setting principle was tested in a proof-of-principle manner. The cement paste consisted of farringtonite with differently concentrated phytic acid solution for chelate formation with Mg2+ from the raw powder. Adjusting the phytic acid content and adding a magnesium oxide as setting regulator to compensate its retarding effect resulted in drillable formulations. Additionally, there is a strong clinical demand for well working bone adhesives especially in a moist environment. Mostly the existing formulations are non-biodegradable. Ex vivo adhesion of the above presented MPC under wet conditions on bone demonstrated over a course of 7 d shear strengths of 0.8 MPa. Further, the hardened cement specimens showed a mass loss of 2 wt.% within 24 d in an aqueous environment and released about 0.17 mg/g of osteogenic Mg2+ per day. Together with the demonstrated cytocompatibility towards human fetal osteoblasts, this cement system showed promising characteristics in terms of degradable biocements with special application purposes.
The aim of the work was the development of thiol-ene cross-linked hydrogels based on functionalized poly(glycidol)s (PG) and hyaluronic acid (HA) for extrusion based 3D bioprinting. Additionally, the functionalization of the synthesized PG with peptides and the suitability of these polymers for physically cross-linked gels were investigated, in a proof of principle study in order to demonstrate the versatile use of PG polymers in hydrogel development.
First, the precursor polymers of the different hydrogel systems were synthesized. For thiol-ene cross-linked hydogels, linear allyl-functionalized PG (P(AGE-co-G)) and three different thiol-(SH-)functionalized polymers, ester-containing PG-SH (PG SHec), ester-free PG-SH (PG-SHef) and HA-SH were synthesized and analysed, The degree of functionalization of these polymers was adjustable.
For physically cross-linked hydrogels, peptide-functionalized PG (P(peptide-co-G)), was synthesized through polymer analogue thiol-ene modification of P(AGE-co-G).
Subsequently, thiol-ene cross-linked hydrogels were prepared with the synthesized thiol- and allyl-functionalized polymers. Depending on the origin of the used polymers, two different systems were obtained: on the one hand synthetic hydrogels consisting of PG-SHec/ef and P(AGE-co-G) and on the other hand hybrid gels, consisting of HA-SH and P(AGE-co-G). In synthetic gels, the degradability of the gels was determined by the applied PG-SH. The use of PG-SHec resulted in hydrolytically degradable hydrogels, whereas the cross-linking with PG-SHef resulted in non-degradable gels.
The physical properties of these different hydrogel systems were determined by swelling, mechanical and diffusion studies and subsequently compared among each other. In swelling studies the differences of degradable and non-degradable synthetic hydrogels as well as the differences of synthetic compared to hybrid hydrogels were demonstrated.
Next, the stiffness and the swelling ratios (SR) of the established hydrogel systems were examined in dependency of different parameters, such as incubation time, polymer concentration and UV irradiation. In general, these measurements revealed the same trends for synthetic and hybrid hydrogels: an increased polymer concentration as well as prolonged UV irradiation led to an increased network density. Moreover, it was demonstrated that the incorporation of additional non-bound HMW HA hampered the hydrogel cross-linking resulting in gels with decreased stiffness and increased SR. This effect was strongly dependent on the amount of additional HMW HA.
The diffusion of different molecular weight fluorescein isothiocyanate-dextran (FITC-dextran) through hybrid hydrogels (with/without HMW HA) gave information about the mesh size of these gels. The smallest FITC-dextran (4 kDa) completely diffused through both hydrogel systems within the first week, whereas only 55 % of 40 kDa and 5-10 % HMW FITC-dextrans (500 kDa and 2 MDa) could diffuse through the networks.
The applicability of synthetic and hybrid hydrogels for cartilage regeneration purpose was investigated through by biological examinations. It was proven that both gels support the survival of embedded human mesenchymal stromal cells (hMSCs) (21/28 d in vitro culture), however, the chondrogenic differentiation was significantly improved in hybrid hydrogels compared to synthetic gels. The addition of non-bound HMW HA resulted in a slightly less distinct chondrogenesis.
Lastly the printability of the established hydrogel systems was examined. Therefore, the viscoelastic properties of the hydrogel solutions were adjusted by incorporation of non-bound HMW HA. Both systems could be successfully printed with high resolution and high shape fidelity.
The introduction of the double printing approach with reinforcing PCL allowed printing of hydrogel solutions with lower viscosities. As a consequence, the amount of additional HMW HA necessary for printing could be reduced allowing successful printing of hybrid hydrogel solutions with embedded cells. It was demonstrated that the integrated cells survived the printing process with high viability measured after 21 d. Moreover, by this reinforcing technique, robust hydrogel-containing constructs were fabricated.
In addition to thiol-ene cross-linked hydrogels, hydrogel cross-linking via ionic interactions was investigated with a hybrid hydrogel based on HMW HA and peptide-functionalized PG. Rheological measurements revealed an increase in the viscosity of a 2 wt.% HMW HA solution by the addition of peptide-functionalized PG. The increase in viscosity could be attributed to the ionic interactions between the positively charge PG and the negatively charge HMW HA.
In conclusion, throughout this thesis thiol-ene chemistry and PG were introduced as promising cross-linking reaction and polymer precursor for the field of biofabrication. Furthermore, the differences of hybrid and synthetic hydrogels as well as chemically and physically cross-linked hydrogels were demonstrated.
Moreover, the double printing approach was demonstrated to be a promising tool for the fabrication of robust hydrogel-containing constructs. It opens the possibility of printing hydrogels that were not printable yet, due to too low viscosities.
The reliability of implantable blood sensors is often hampered by unspecific adsorption of plasma proteins and blood cells. This not only leads to a loss of sensor signal over time, but can also result in undesired host vs. graft reactions. Within this study we evaluated the hemocompatibility of isocyanate conjugated star shaped polytheylene oxide-polypropylene oxide co-polymers NCO-sP(EO-stat-PO) when applied to gold surfaces as an auspicious coating material for gold sputtered blood contacting sensors. Quartz crystal microbalance (QCM) sensors were coated with ultrathin NCO-sP(EO-stat-PO) films and compared with uncoated gold sensors. Protein resistance was assessed by QCM measurements with fibrinogen solution and platelet poor plasma (PPP), followed by quantification of fibrinogen adsorption. Hemocompatibility was tested by incubation with human platelet rich plasma (PRP). Thrombin antithrombin-III complex (TAT), beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) were used as coagulation activation markers. Furthermore, scanning electron microscopy (SEM) was used to visualize platelet adhesion to the sensor surfaces. Compared to uncoated gold sensors, NCO-sP(EO-stat-PO) coated sensors revealed significant better resistance against protein adsorption, lower TAT generation and a lower amount of adherent platelets. Moreover, coating with ultrathin NCO-sP(EO-stat-PO) films creates a cell resistant hemocompatible surface on gold that increases the chance of prolonged sensor functionality and can easily be modified with specific receptor molecules.
The aim of this thesis was the development of a multifunctional coating system for AuNPs based on thioether polymers, providing both excellent colloidal stability and a variable possibility to introduce functionalities for biological applications.
First, two thioether-polymer systems were synthesised as a systematic investigation into colloidal stabilisation efficacy. Besides commonly used monovalent poly(ethylene glycol) (PEG-SR), its structural analogue linear poly(glycidol) (PG-SR) bearing multiple statistically distributed thioether moieties along the backbone was synthesised. Additionally, respective thiol analogues (PEG-SH and PG-SH) were produced and applied as reference.
Successive modification of varyingly large AuNPs with aforementioned thiol- and thioether-polymers was performed via ligand exchange reaction on citrate stabilised AuNPs. An increased stabilisation efficacy of both thioether-polymers against biological and physiological conditions, as well as against freeze-drying compared to thiol analogues was determined.
Based on the excellent colloidal stabilisation efficacy and multi-functionalisability of thioether-PG, a plethora of functional groups, such as charged groups, hydrophilic/hydrophobic chains, as well as bio-active moieties namely diazirine and biotin was introduced to the AuNP surface. Moreover, the generic and covalent binding of diazirine-modified PG-SR with biomolecules including peptides and proteins was thoroughly demonstrated.
Lastly, diverse applicability and bioactivity of aforementioned modified particles in various studies was displayed, once more verifying the introduction of functionalities. On the one hand the electrostatic interaction of charged AuNPs with hydrogels based on hyaluronic acid was applied to tune the release kinetics of particles from three-dimensional scaffolds. On the other hand the strong complexation of siRNA onto two positively charged AuNPs was proven. The amount of siRNA payload was tuneable by varying the surface charge, ionic strength of the surrounding medium and the N/P ratio. Moreover, the biological activity and selectivity of the biotin-streptavidin conjugation was verified with respectively functionalised particles in controlled agglomeration test and in laser-triggered cell elimination experiments. In the latter, streptavidin-functionalised AuNPs resulted in excellent depletion of biotinylated cells whereas unfunctionalised control particles failed, excluding unspecific binding of these particles to the cell surface.
Calcium phosphate biocements based on calcium phosphate chemistry are well-established biomaterials for the repair of non-load bearing bone defects due to the brittle nature and low flexural strength of such cements. This article features reinforcement strategies of biocements based on various intrinsic or extrinsic material modifications to improve their strength and toughness. Altering particle size distribution in conjunction with using liquefiers reduces the amount of cement liquid necessary for cement paste preparation. This in turn decreases cement porosity and increases the mechanical performance, but does not change the brittle nature of the cements. The use of fibers may lead to a reinforcement of the matrix with a toughness increase of up to two orders of magnitude, but restricts at the same time cement injection for minimal invasive application techniques. A novel promising approach is the concept of dual-setting cements, in which a second hydrogel phase is simultaneously formed during setting, leading to more ductile cement-hydrogel composites with largely unaffected application properties.
Biomimetic calcium phosphate (CaP) coatings imitate the trabecular bones surface structure and have shown to promote osteogenic differentiation in multipotent cells. The work of this thesis focused on the problem of former CaP coatings cracking and flaking off when being put on a bendable core structure like a 3D-printed poly (ε-caprolactone) (PCL) scaffold. The aim was to provide a chemical linkage between PCL and CaP using a star-shaped polymer (sPEG) and a phosphonate, 2-aminoethylphosphonic acid (2-AEP). First, a published CaP coating protocol was revised and investigated in terms of etching parameters for the PCL scaffold. Results presented reproducible thick coatings for all groups. The protocol was then broadened to include subsequent scaffold incubation in sPEG and 2-AEP solutions. Homogenous CaP coatings of decreased thickness presented themselves, proving feasibility. However, as is often found with physical CaP coating depositions, there were some irregular outcomes even during the same experimental group. A lower consumption of the chemical 2-AEP, for economic reasons, meant that the protocol was altered to simultaneously incubate scaffolds with sPEG and 2-AEP including preceding calculations for molar ratios. For ratios 1:1, 1:2 and 1:3, again a homogenous CaP coating was produced on most of the samples, although reproducibility issues maintained. However, the mechanical bending to induce surface cracking showed that the CaP did strongly bond to the sPEG/2-AEP, while the control CaP coating flaked off the surface in large pieces. This research demonstrates that chemically-bound CaP coatings resist flaking off the fiber surface. Future investigations should focus on the mechanisms of CaP crystallization, to improve reproducibility.
The main focus of this thesis was the processing of different calcium and magnesium phosphate cements together with an optimization of mechanical and biological properties. Therefore, different manufacturing techniques like 3D powder printing and centrifugally casting were employed for the fabrication of reinforced or biomedically improved implants.
One of the main problems during 3D powder printing is the low green strength of many materials, especially when they are only physically bonded and do not undergo a setting reaction. Such materials need post-treatments like sintering to exhibit their full mechanical performance. However, the green bodies have to be removed from the printer requiring a certain stability. With the help of fiber reinforcement, the green strength of printed gypsum samples could be increased by the addition of polymeric and glass fibers within the printing process. The results showed that fiber reinforcement during 3D powder printing is possible and opens up diverse opportunities to enhance the damage tolerance of green bodies as well as directly printed samples. The transfer to biomedically relevant materials like calcium and magnesium phosphate cements and biocompatible fibers would be the next step towards reinforced patient-specific implants.
In a second approach, centrifugally casting derived from construction industries was established for the fabrication of hollow bioceramic cylinders. The aim was the replacement of the diaphysis of long bones, which exhibit a tubular structure with a high density of cortical bone on the fringe. By centrifugation, cement slurries with and without additives could be fabricated to tubes. As a first establishment, the processing parameters regarding the material (e.g. cement composition) as well as the set-up (e.g. rotation times) had to be optimized for each system. In respect of mechanics, such tubes can keep up with 3D powder printed tubes, although the mechanical performance of 3D printed tubes is strongly dependent on printing directions. Additionally, some material compositions like dual setting systems cannot be fabricated by 3D powder printing. Therefore, a transfer of such techniques to centrifugally casting enabled the fabrication of tubular structures with an extremely high damage tolerance due to high deformation ability. A similar effect was achieved by fiber (mesh) addition, as already shown for 3D powder printing. Another possibility of centrifugally casting is the combination of different materials resulting in graded structures to adjust implant degradation or bone formation. This became especially apparent for the incorporation of the antibiotic vancomycin, which is used for the treatment of bacterial implant infections. A long-term release could be achieved by the entrapment of the drug between magnesium phosphate cement layers. Therefore, the release of the drug could be regulated by the degradation of the outer shell, which supports the release into an acidic bacterial environment. The centrifugally casting technique exhibited to be a versatile tool for numerous materials and applications including the fabrication of non-centrosymmetric patient-specific implants for the reconstruction of human long bones.
The third project aimed to manufacture strontium-substituted magnesium phosphate implants with improved biological behavior by 3D powder printing. As the promoting effect of strontium on bone formation and the inhibitory impact on bone resorption is already well investigated, the incorporation of strontium into a degradable magnesium phosphate cement promised a fast integration and replacement of the implant. Porous structures were obtained with a high pore interconnectivity that is favorable for cell invasion and bone ingrowth. Despite the porosity, the mechanical performance was comparable to pure magnesium phosphate cement with a high reliability of the printed samples as quantitatively determined by Weibull statistics. However, the biological testing was impeded by the high degradation rate and the relating ion release. The high release of phosphate ions into surrounding media and the detachment of cement particles from the surface inhibited osteoblast growth and activity. To distinguish those two effects, a direct and indirect cell seeding is always required for degradable materials. Furthermore, the high phosphate release compared to the strontium release has to be managed during degradation such that the adverse effect of phosphate ions does not overwhelm the bone promoting effect of the strontium ions.
The manufacturing techniques presented in this thesis together with the material property improvement offer a diverse tool box for the fabrication of patient-specific implants. This includes not just the individual implant shape but also the application like bone growth promotion, damage tolerance and local drug delivery. Therefore, this can act as the basis for further research on specific medical indications.