Journal of Functional Biomaterials

16 pages, 721 KB

Open AccessArticle

Original Locking Rod System Designed for Diaphyseal Fractures of Long Bones

by Liviu-Coriolan Misca, Cristian Constantin Croicu, Adrian Emil Lazarescu, Mihai-Alexandru Sandesc, Jenel Marian Patrascu, Jr., Sorin Florescu and Jenel Marian Patrascu, Sr.

J. Funct. Biomater. 2025, 16(9), 348; https://doi.org/10.3390/jfb16090348 - 15 Sep 2025

Abstract

Introduction: Intramedullary nailing is widely used for long bone fractures. Traditional systems are reliable, but they present some complications regarding lack of modularity or possible growth plate damage. Methods: A novel locking rod–screw system featuring a central rod and a grooved [...] Read more.

Introduction: Intramedullary nailing is widely used for long bone fractures. Traditional systems are reliable, but they present some complications regarding lack of modularity or possible growth plate damage. Methods: A novel locking rod–screw system featuring a central rod and a grooved screw with a secondary interlocking mechanism was developed and tested. Mechanical testing followed ASTM F543 and ISO 6475 standards using a 3.0 mm steel alloy prototype. Results: The system withstood mechanical testing >200,000 cycles at loads up to 200 N with no rates of failure or loosening, significantly outperforming other implants of the same size (3.0 mm TENS). Conclusions: The proposed implant demonstrates superior biomechanical performance in vitro, enabled by its unique hollow screw and secondary locking configuration. This modular and minimally invasive system shows promise for use in cases of smaller long bones, personalized paediatric fractures, and all types of diaphyseal fractures, but does warrant in vivo validation. Full article

(This article belongs to the Section Bone Biomaterials)

13 pages, 3100 KB

Open AccessArticle

Biocompatibility Evaluation of Porcine-Derived Collagen Sheets for Clinical Applications: In Vitro Cytotoxicity, In Vivo Sensitization, and Intracutaneous Reactivity Studies

by Tae-Hoon Koo, Jason K. Lee, Shawn P. Grogan and Darryl D. D'Lima

J. Funct. Biomater. 2025, 16(9), 347; https://doi.org/10.3390/jfb16090347 - 15 Sep 2025

Abstract

Biocompatibility evaluation of medical devices is essential for ensuring safety, with ISO 10993 series being the standard. However, these tests can be time-consuming and resource-intensive. This study assessed the early-stage biocompatibility of a collagen matrix derived from porcine dermis using three selective ISO [...] Read more.

Biocompatibility evaluation of medical devices is essential for ensuring safety, with ISO 10993 series being the standard. However, these tests can be time-consuming and resource-intensive. This study assessed the early-stage biocompatibility of a collagen matrix derived from porcine dermis using three selective ISO tests: in vitro cytotoxicity, in vivo sensitization, and irritation. Collagen was hydrolyzed, purified from miniature pig skin, and then processed into porous sheets via lyophilization. Extracts were prepared using both polar and non-polar extraction vehicles for biological testing. Cytotoxicity testing with mouse fibroblast cells showed no significant cytotoxic effects, with cell morphology and viability comparable to controls. Sensitization testing in guinea pigs, involving intradermal and topical exposure, revealed no allergic responses. Irritation testing in rabbits showed no signs of irritation. The cytotoxicity test took 3 days, the sensitization test 28 days, and the irritation test 7 days, all of which proved suitable for early biocompatibility screening. These results confirmed that the collagen matrix is non-cytotoxic, non-sensitizing, and non-irritant for a month. The use of these three tests enables early identification of unsafe materials, reducing time, cost, and animal use before advancing to more complex ISO 10993 studies. Therefore, they are appropriate and necessary for early feasibility decisions in medical device development. Full article

(This article belongs to the Special Issue Biocompatible Research of Materials in Biomedical Applications)

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16 pages, 3705 KB

Open AccessArticle

Anti-Swelling Antibacterial Hydrogels Based on Electrostatic Repulsion and Hydrophobic Interactions for Human Motion Sensing

by Zexing Deng, Litong Shen, Qiwei Cheng, Ying Li, Tianming Du and Xin Zhao

J. Funct. Biomater. 2025, 16(9), 346; https://doi.org/10.3390/jfb16090346 - 14 Sep 2025

Abstract

The development of high-performance sensing materials is critical for advancing bioelectronics. Conductive hydrogels, with their unique flexibility, are promising candidates for biomedical sensors. However, traditional conductive hydrogels often suffer from excessive swelling and undesirable antibacterial activity, limiting their practical use. To overcome these [...] Read more.

The development of high-performance sensing materials is critical for advancing bioelectronics. Conductive hydrogels, with their unique flexibility, are promising candidates for biomedical sensors. However, traditional conductive hydrogels often suffer from excessive swelling and undesirable antibacterial activity, limiting their practical use. To overcome these challenges, anti-swelling, antibacterial, and ionically conductive hydrogels were built through free radical polymerization. The preparation was conducted using a monomer mixture comprising acrylic acid (AA), the antibacterial zwitterionic compound [2-(methacryloyloxy)ethyl]dimethyl-(3-sulfopropyl)ammonium hydroxide (SBMA), and the hydrophobic monomer lauryl methacrylate (LMA). The protonation of SBMA by AA enables electrostatic repulsion, thereby imparting anti-swelling properties to the hydrogel. The introduction of hydrophobic LMA components further enhances the anti-swelling and mechanical performance of hydrogel. The resulting hydrogel exhibits excellent anti-swelling property with a swelling ratio of 59.36% after 120 h and good mechanical performance with a tensile strength of 158 kPa, an elongation at break of 176%, and a compressive strength of 0.37 MPa at 80% strain. In addition, hydrogels possess superior sensing performance for strain sensing with a gauge factor of 1.315 within 40–60% of strain, 330 ms of response time, and 177 ms of recovery time. Furthermore, the hydrogel is capable of monitoring human motion and physiological signals. These attributes make it highly suitable for wearable sensors and biomedical monitoring applications. Full article

(This article belongs to the Special Issue Biomaterials, Bioconjugated Materials, and Biomaterial Composites with Antimicrobial Properties)

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18 pages, 3059 KB

Open AccessArticle

Clinical and Radiological Evaluation of Flap and Flapless Procedures with Biomaterials in Alveolar Ridge Preservation

by Ewa Dolińska, Ewa Duraj, Marcin Bernaczyk, Magdalena Sulewska and Małgorzata Pietruska

J. Funct. Biomater. 2025, 16(9), 345; https://doi.org/10.3390/jfb16090345 - 14 Sep 2025

Abstract

Although ridge preservation procedures have been shown to prevent post-extraction bone loss, the effectiveness of using a flap or flapless surgical approach remains unclear. The aim of the study was to compare the mentioned above alveolar ridge preservation procedures in the esthetic region [...] Read more.

Although ridge preservation procedures have been shown to prevent post-extraction bone loss, the effectiveness of using a flap or flapless surgical approach remains unclear. The aim of the study was to compare the mentioned above alveolar ridge preservation procedures in the esthetic region of maxilla. Twenty-nine patients were randomly assigned to receive flap (n = 14) or flapless (n = 15) alveolar ridge preservation procedure. Sockets were grafted with alloplastic biomaterial, then covered with a collagen membrane in both groups. Clinical examinations were performed over a 6-month observation period and radiological (CBCT) examination was conducted before and 6 months after treatment. For both after flap and flapless procedures, there was a reduction in interdental papillae height and keratinized tissue width, increase in buccal soft tissues thickness with a decrease in radiological buccal bone plate width, decrease in radiological buccal and lingual plate height (significantly for the flapless group) and radiological alveolar process width reduction (significantly in flapless group at the height of 5 mm and 7 mm from the bottom of the socket). A decrease in the radiological buccal bone plate width was observed, where the further measuring point was from the bottom of the alveolus. In the mucoperiosteal flap preparation, group buccal bone plate width reduction at the height 3 mm, 5 mm and 7 mm was significant and in the flapless group a significant decrease was observed from 5 to 9 mm from the bottom of the socket. Despite ridge preservation, there is soft tissue thickening and a decrease in bone height and width regardless of the flap/flapless method used. Full article

(This article belongs to the Special Issue Functional Biomaterial for Bone Regeneration (2nd Edition))

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20 pages, 5379 KB

Open AccessArticle

Antibacterial Activity of a Trace-Cu-Modified Mg Alloy in Simulated Intestinal Fluid

by Baiyun Zhong, Zemeng Wei, Yi Yao, Lixun Jiang, Manli Zhou, Jinping Li, Weidong Liu, Xin Li and Ming-Chun Zhao

J. Funct. Biomater. 2025, 16(9), 344; https://doi.org/10.3390/jfb16090344 - 12 Sep 2025

Viewed by 82

Abstract

Mg alloys hold promise for biodegradable gastrointestinal implants, but most evaluations rely on simplified media like Hank’s solution, which lacks organic components and fails to replicate the acidic-to-alkaline transition of intestinal fluid, risking underestimation of biodegradation rates and clinical relevance. This work investigated [...] Read more.

Mg alloys hold promise for biodegradable gastrointestinal implants, but most evaluations rely on simplified media like Hank’s solution, which lacks organic components and fails to replicate the acidic-to-alkaline transition of intestinal fluid, risking underestimation of biodegradation rates and clinical relevance. This work investigated a trace-Cu-modified Mg alloy (Mg-0.05Cu) in simulated intestinal fluid (SIF) versus Hank’s solution. Microstructural analysis confirmed Mg₂Cu intermetallic phases as Cu reservoirs. Electrochemical and immersion tests revealed significantly accelerated biodegradation in SIF, due to its disruption of protective layer formation, sustaining loose biodegradation products. The biodegradation rate of the trace-Cu-modified Mg alloy in SIF was consistent with reported values for Mg alloys in similar media, as was that in Hank’s solution. Remarkably, Mg-0.05Cu exhibited potent antibacterial activity against E. coli, achieving 99.3% eradication within 12 h and 100% elimination by 24–48 h, alongside excellent cytocompatibility with L929 cells (>95% viability). This efficacy arose from the synergistic Cu²⁺ release and high-pH microenvironment. These findings demonstrate that trace Cu alloying in high-purity Mg balances rapid antibacterial action with controlled biodegradation in a physiologically relevant SIF. This positions Mg-0.05Cu as a highly promising candidate for practical applications, such as biodegradable intestinal stents, anti-adhesion barriers, anastomosis rings, and anti-obesity devices, where rapid infection control and predictable degradation are critical for clinical success. This work underscores the importance of using biomimetic media for evaluating gastrointestinal implants and establishes Mg-0.05Cu as a promising strategy for developing infection-resistant biodegradable devices. Full article

(This article belongs to the Special Issue Antimicrobial Biomaterials for Medical Applications)

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27 pages, 11472 KB

Open AccessArticle

Electrophoretic Coatings for Orthodontic Implants: Evaluation of Surface Properties, Adhesion, and Antibacterial Activity in Simulated Implantation Trials

by Maria Biegun-Żurowska, Karolina Klesiewicz, Katarzyna Matysiak, Marcin Gajek, Alicja Rapacz-Kmita and Magdalena Ziąbka

J. Funct. Biomater. 2025, 16(9), 343; https://doi.org/10.3390/jfb16090343 - 12 Sep 2025

Viewed by 140

Abstract

In this study, the properties of electrophoretically deposited (EPD) coatings on orthodontic implants made from Ti-6Al-4V alloy were evaluated during simulated implantation trials on animal bones. Three types of chitosan-based coatings were prepared using EPD: titanium nitride microparticles (TiNPs), titanium nitride nanoparticles (TiNNPs), [...] Read more.

In this study, the properties of electrophoretically deposited (EPD) coatings on orthodontic implants made from Ti-6Al-4V alloy were evaluated during simulated implantation trials on animal bones. Three types of chitosan-based coatings were prepared using EPD: titanium nitride microparticles (TiNPs), titanium nitride nanoparticles (TiNNPs), and boron nitride particles (BNPs). Each of these coatings was also modified by adding a polylactic acid (PLA) layer using a dip-coating technique to compare their properties with and without this additional layer. The coatings were analysed using optical microscopy, confocal microscopy, and scanning electron microscopy (SEM) with elemental analysis. Surface roughness measurements of the coated implants were also conducted to highlight differences that could significantly influence the type and strength of the bone-implant interface, directly affecting the stability of the implant as an anchorage unit. Eventually, to evaluate the antibacterial properties of the EPD coatings, their antibacterial activity against both Gram-positive and Gram-negative bacteria strains was tested. Scanning electron observations confirmed the homogenous distribution of micro- and nanoparticles in all coatings. The highest surface roughness values were observed in layers containing titanium nitride nanoparticles (TiNNPs) and chitosan. The presence of an additional dip-coating PLA layer improved the adhesion, and its effect on the surface roughness depended on the particle size. While the antibacterial properties of the coatings show promising results, achieving optimal adhesion of the coatings to implants remains a challenge that requires further development. Full article

(This article belongs to the Special Issue Surface Analyses, Physicochemical and Mechanical Properties of Dental Biomaterials (2nd Edition))

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Graphical abstract

12 pages, 1140 KB

Open AccessReview

Influence of Design Parameters on Implant Abutment Performance: A Scoping Review

by Vladimir Prpic, Petar Kosec, Stanko Skec and Amir Catic

J. Funct. Biomater. 2025, 16(9), 342; https://doi.org/10.3390/jfb16090342 - 11 Sep 2025

Viewed by 186

Abstract

Implant abutments serve as the critical interface between dental implants and prosthodontic restorations, playing a central role in the functional and aesthetic success of implant-supported rehabilitations. With the development of CAD/CAM technologies, dental implantology has experienced a significant transformation. The latest and still [...] Read more.

Implant abutments serve as the critical interface between dental implants and prosthodontic restorations, playing a central role in the functional and aesthetic success of implant-supported rehabilitations. With the development of CAD/CAM technologies, dental implantology has experienced a significant transformation. The latest and still unexplored field of science includes an advanced algorithm-driven process known as generative design. Generally, generative design is used to investigate a broad spectrum of design alternatives that satisfy predetermined criteria established by a designer. Prior to the application of generative design, it is essential to define the key parameters that influence the optimization of the designed object’s configuration, such as a hybrid implant abutment. A bibliographic search was performed using PubMed and Scopus databases to identify relevant studies published up to 1 July 2025. Studies that investigated transmucosal and prosthodontic height of implant abutments were selected for inclusion. Only 13 studies met inclusion criteria and were further analyzed. Included studies showed the importance of transmucosal and prosthodontic height of implant abutments in order to reduce possible complications. The review highlights the importance of optimizing the transmucosal and transgingival heights of implant abutments. For predictable biological and mechanical outcomes, both dimensions should be at least 2 mm. The obtained parameter values will be used to create the initial parametric model, which will then be utilized in the generative design process of hybrid implant abutments. Full article

(This article belongs to the Special Issue The Development and Future of Dental Implants)

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48 pages, 1146 KB

Open AccessSystematic Review

Types of Bone Substitutes and Their Application in Regenerative Medicine: A Systematic Review

by Nikoleta Ivanova, Stoyan Ivanov, Stefan Peev and Tsanka Dikova

J. Funct. Biomater. 2025, 16(9), 341; https://doi.org/10.3390/jfb16090341 - 9 Sep 2025

Viewed by 348

Abstract

Background: The growing demand for effective methods of bone tissue regeneration highlights the relevance of studying modern bone substitutes and their applications in regenerative medicine. The aim of this work was to conduct a comprehensive analysis of the biological, mechanical, and clinical characteristics [...] Read more.

Background: The growing demand for effective methods of bone tissue regeneration highlights the relevance of studying modern bone substitutes and their applications in regenerative medicine. The aim of this work was to conduct a comprehensive analysis of the biological, mechanical, and clinical characteristics of various types of bone substitutes to determine their potential in regenerative medicine. Methods: The study was performed as a systematic literature review in accordance with PRISMA guidelines, analyzing 68 high-quality scientific sources from 2019 to May 2025, using the PubMed, Scopus, Web of Science, and Google Scholar databases. Results: It was established that autogenous grafts exhibit the highest osteogenic properties due to the presence of growth factors BMP-2, BMP-7, and concentrated growth factors; however, their use is limited by donor site morbidity in 20–30% of patients and the requirement to treat 6% of fractures complicated by non-union. Allogeneic and xenogeneic substitutes provide structural support for large defects but require intensive processing in accordance with European Directives 2004/23/EC and 2006/86/EC to minimize the risk of infection transmission. Synthetic substitutes based on calcium phosphate ceramics with pore sizes ranging from 23 to 210 micrometres demonstrate excellent biocompatibility and controlled degradation, with β-tricalcium phosphate exhibiting optimal characteristics for long-term applications compared to calcium sulphate. Conclusions: The findings of the study highlight the necessity of a personalized approach in selecting bone substitutes, considering the specific requirements of medical specialities, and support the development of hybrid biomaterials to combine structural strength with biological activity. Full article

(This article belongs to the Special Issue The 15th Anniversary of JFB—Functional Biomaterials: Bioactive Properties and Medical Applications)

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16 pages, 2649 KB

Open AccessArticle

Intraoperative Biologization of β-TCP and PCL-TCP by Autologous Proteins

by Andrea Sowislok, Gerrit Gruber, Farnusch Kaschani, Markus Kaiser, Eleftherios Papaeleftheriou and Marcus Jäger

J. Funct. Biomater. 2025, 16(9), 340; https://doi.org/10.3390/jfb16090340 - 9 Sep 2025

Viewed by 266

Abstract

Protein adsorption on orthopedic biomaterials during the initial intraoperative contact critically influences biological responses and osseointegration. Osteoconductive grafts such as β-tricalcium phosphate (β-TCP) and poly (ε-caprolactone)-β-TCP (PCL-TCP) can be functionally activated by exposure to autologous tissue. However, the composition and relevance of the [...] Read more.

Protein adsorption on orthopedic biomaterials during the initial intraoperative contact critically influences biological responses and osseointegration. Osteoconductive grafts such as β-tricalcium phosphate (β-TCP) and poly (ε-caprolactone)-β-TCP (PCL-TCP) can be functionally activated by exposure to autologous tissue. However, the composition and relevance of the resulting protein layer still remain unclear. In this study involving 10 patients undergoing primary total hip arthroplasty, β-TCP and PCL-TCP samples were incubated both in the femoral medullary cavity and within a surgical tissue collector harvesting autologous tissue (blood, bone fragments, muscle, and fat). Surface morphology was assessed microscopically, and protein adsorption was characterized via high-resolution LC-MS/MS with subsequent bioinformatics and statistical analysis. Both materials adsorbed over 2000 different autologous proteins. β-TCP showed higher overall protein concentrations, while PCL-TCP demonstrated greater proteomic diversity and incubation method-dependent shifts in protein profiles, influenced by surface roughness and wettability. Samples incubated in the tissue collector exhibited less protein variability and smaller material-specific differences compared to incubation in the femoral cavity, particularly for PCL-TCP. Predominant proteins were linked to immune regulation, stress response, and protein metabolism. These findings emphasize the impact of material properties and incubation environment on protein adsorption, with ex vivo incubation leading to more consistent protein adsorption patterns. Full article

(This article belongs to the Special Issue Functional Scaffolds for Bone and Joint Surgery)

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17 pages, 3394 KB

Open AccessArticle

Impact of 45S5-Bioactive Glass on Chondrocytes in Knee Osteoarthritis—In Vitro Study Exploring Cellular Responses

by Max Marinescu, Sébastien Hagmann, Jörg Fellenberg, Elena Tripel, Simone Gantz, Ravikumar Mayakrishnan, Aldo R. Boccaccini, Tobias Renkawitz, Babak Moradi, Fabian Westhauser and Hadrian Platzer

J. Funct. Biomater. 2025, 16(9), 339; https://doi.org/10.3390/jfb16090339 - 9 Sep 2025

Viewed by 315

Abstract

Osteoarthritis (OA), the most common joint disease, is marked by cartilage degradation and chronic inflammation. While 45S5-bioactive glass (45S5-BG) is well-established in bone regeneration and has been suggested to exert immunomodulatory effects, its impact on OA chondrocytes remains largely unexplored. Therefore, this in [...] Read more.

Osteoarthritis (OA), the most common joint disease, is marked by cartilage degradation and chronic inflammation. While 45S5-bioactive glass (45S5-BG) is well-established in bone regeneration and has been suggested to exert immunomodulatory effects, its impact on OA chondrocytes remains largely unexplored. Therefore, this in vitro study investigated the effects of 45S5-BG microparticles (0.125 mg/mL) on chondrocytes derived from OA patients, evaluating its therapeutic potential in OA. Chondrocytes were cultured with or without 45S5-BG for 1 and 7 days. Gene expression of cartilage markers, cytokines, matrix metalloproteinases (MMPs), and toll-like receptors (TLRs) was analyzed by qPCR. Protein levels were assessed by ELISA. 45S5-BG stimulation significantly altered chondrocyte activity, inducing upregulation of IL-6, IL-1β, TNF-α, MMP-1/-3/-13, and TLR4. Expression of ACAN and COL2A1 was reduced, while COL10A1—a marker of chondrocyte hypertrophy—was significantly increased at day 1. These findings show a catabolic and pro-inflammatory shift in chondrocyte phenotype upon 45S5-BG exposure, showing no therapeutic benefit of 45S5-BG on OA chondrocytes. However, considering the pronounced effects on chondrocyte activity and the well-established bioactivity and biocompatibility of 45S5-BG, our findings suggest that modified BG formulations could be developed to enhance chondroprotective and anti-inflammatory properties, warranting further investigation in co-culture and in vivo models. Full article

(This article belongs to the Special Issue Bioactive Glass in Tissue Engineering Applications)

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28 pages, 5311 KB

Open AccessReview

Modified Polysaccharides: Potential Biomaterials for Bioprinting

by Tao Jiang, Yun Yang, Zening Lin, Yang Hong and Zirong Luo

J. Funct. Biomater. 2025, 16(9), 338; https://doi.org/10.3390/jfb16090338 - 9 Sep 2025

Viewed by 382

Abstract

Polysaccharides have emerged as promising biomaterials for 3D bioprinting due to their inherent biocompatibility, biodegradability, and structural diversity. However, their limited mechanical strength, insufficient bioactivity, and suboptimal printability hinder their direct application in fabricating complex tissue constructs. This review systematically summarizes universal modification [...] Read more.

Polysaccharides have emerged as promising biomaterials for 3D bioprinting due to their inherent biocompatibility, biodegradability, and structural diversity. However, their limited mechanical strength, insufficient bioactivity, and suboptimal printability hinder their direct application in fabricating complex tissue constructs. This review systematically summarizes universal modification strategies to address these challenges by tailoring polysaccharides’ physicochemical and biological properties. We first analyse the fundamental requirements of bioprinting materials, emphasising on the critical role of shear-thinning behaviours, post-printing structural fidelity, and cell-instructive functions. Subsequently, we highlight the advantages and limitations of representative polysaccharides, including chitosan, alginate, and hyaluronic acid. Chemical functionalisation, physical reinforcement, and biological hybridisation are proposed as versatile approaches to synergistically enhance printability, mechanical robustness, and bioactivity to tackle the limitations. Furthermore, dynamic crosslinking mechanisms enabling self-healing and stimuli-responsive behaviours are discussed as emerging solutions for constructing biomimetic architectures. Finally, we outline future directions in balancing material processability with cellular viability and scaling up modified polysaccharides for clinical translation. This review aims to provide a design blueprint for engineering polysaccharide-based bioinks toward next-generation regenerative medicine. Full article

(This article belongs to the Special Issue Review Papers in Biomaterials for Tissue Engineering and Regenerative Medicine)

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13 pages, 8569 KB

Open AccessArticle

Comparative Evaluation of the Bone Regenerative Potential of a Novel Calcium Silicate-Modified Calcium Carbonate Graft Material: Histological and Micro-Computed Tomography Assessment Using a Rat Calvarial Defect Model

by Masataka Nakayama, Yu Kataoka, Naoki Kitamura, Chie Watanabe, Satoko Kujiraoka, Kikue Yamaguchi, Yuma Seki, Toshitake Furusawa, Hidero Unuma and Motohiro Munakata

J. Funct. Biomater. 2025, 16(9), 337; https://doi.org/10.3390/jfb16090337 - 9 Sep 2025

Viewed by 260

Abstract

In the present study, we evaluated the usefulness of a porous sintered calcium carbonate body with CaSiO₃ by comparing its osteogenic capacity with that of calcium carbonate without CaSiO₃ and that of β-tricalcium phosphate (TP). A cranial defect model of eight-week-old [...] Read more.

In the present study, we evaluated the usefulness of a porous sintered calcium carbonate body with CaSiO₃ by comparing its osteogenic capacity with that of calcium carbonate without CaSiO₃ and that of β-tricalcium phosphate (TP). A cranial defect model of eight-week-old male Wistar rats was divided into three groups: calcium carbonate (CC), calcium carbonate-CaSiO₃ composite (CC+CS), and TP. Micro-computed tomography (CT) and histological analysis were performed at four and eight weeks postoperatively. Upon quantitative evaluation of newly formed bone volume by radiography, the CC+CS group demonstrated the highest value at eight weeks postoperatively and exhibited significantly more new bone formations than the CC group (p < 0.05). Upon histological evaluation, the CC+CS group demonstrated significantly higher new bone formation than the CC group (p < 0.05). Furthermore, in terms of residual graft material ratio, at eight weeks postoperatively, the amount of residual graft material in the CC+CS group was significantly higher than that in the TP group (p < 0.05). Therefore, the addition of CaSiO₃ enhances the functional regulation of calcium carbonate-based artificial bone and can be incorporated in bone graft materials. Full article

(This article belongs to the Section Biomaterials and Devices for Healthcare Applications)

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22 pages, 1268 KB

Open AccessSystematic Review

Propolis as a Natural Remedy in Reducing Dental Plaque and Gingival Inflammation: A Systematic Review and Meta-Analysis

by Magdalena Sycińska-Dziarnowska, Liliana Szyszka-Sommerfeld, Monika Bugajska, Magdalena Ziąbka, Izabela Szućko-Kociuba, Gianrico Spagnuolo, Krzysztof Woźniak and Hyo-Sang Park

J. Funct. Biomater. 2025, 16(9), 336; https://doi.org/10.3390/jfb16090336 - 8 Sep 2025

Viewed by 375

Abstract

Dental plaque, if not regularly removed through proper oral hygiene, can lead to tooth decay, gingivitis, and more severe periodontal disease. Effective plaque removal is essential in preventing gingivitis, the precursor to periodontitis. Propolis, a bee product known for its antibacterial, anti-inflammatory, and [...] Read more.

Dental plaque, if not regularly removed through proper oral hygiene, can lead to tooth decay, gingivitis, and more severe periodontal disease. Effective plaque removal is essential in preventing gingivitis, the precursor to periodontitis. Propolis, a bee product known for its antibacterial, anti-inflammatory, and antioxidant properties, has shown potential in dental applications. This systematic review and meta-analysis was conducted to evaluate the efficacy of propolis-containing mouthwashes and toothpastes in reducing dental plaque and gingival inflammation. Materials and Methods: The study protocol was registered in PROSPERO (CRD42023467573), and the review was conducted in accordance with PRISMA guidelines. A comprehensive search of PubMed, PubMed Central, Embase, Scopus, and Web of Science was performed up to 10 May 2025 to identify randomized controlled trials and observational studies assessing propolis-based mouthwashes or toothpastes. Data synthesis used random-effects meta-analysis due to anticipated heterogeneity among studies. Results: Seven randomized controlled trials were included in the meta-analysis, evaluating the efficacy of propolis alcohol-free mouthwash on plaque index (PI) and gingival index (GI). For PI, the pooled standardized mean difference (SMD) was 1.74 (95% CI: 0.19–3.29; p = 0.036), with low between-study heterogeneity (I² = 13.7%). For GI, the pooled SMD was 2.19 (95% CI: 1.10–3.29; p = 0.005), with no observed heterogeneity (I² = 0.0%). Propolis mouthwashes demonstrated large effect sizes, significantly reducing plaque accumulation and gingival inflammation compared to baseline. Conclusions: The evidence supports the potential of propolis-containing mouthwashes and toothpastes in managing dental plaque and gingival health. Propolis-based oral care products could be a valuable addition to preventive strategies in dental hygiene, offering an alternative for reducing dental plaque and gingival inflammation. Full article

(This article belongs to the Special Issue Dental Biomaterials in Implantology and Orthodontics)

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12 pages, 1949 KB

Open AccessArticle

Comparison of Commercial and Experimental Fibre-Reinforced Composites in Restoring Endodontically Treated Teeth with Minimal Coronal Dentine: An In Vitro Study

by Amre R Atmeh, Faisal Masaud, Luba AlMuhaish, Abdulkarim Alanazi, Hadeel Almutiri, Saqib Ali, Hassan Almoqhawi and Abdul Samad Khan

J. Funct. Biomater. 2025, 16(9), 335; https://doi.org/10.3390/jfb16090335 - 8 Sep 2025

Viewed by 366

Abstract

Aim: To compare the fracture resistance of teeth with varying degrees of residual coronal dentine after restoration using two fibre-reinforced composite core materials. Materials and Methods: Seventy extracted human lower premolars were divided into four groups: sound (control), one missing proximal wall (Cl-II), [...] Read more.

Aim: To compare the fracture resistance of teeth with varying degrees of residual coronal dentine after restoration using two fibre-reinforced composite core materials. Materials and Methods: Seventy extracted human lower premolars were divided into four groups: sound (control), one missing proximal wall (Cl-II), two missing proximal walls (MOD), and endocrown (EC). Subgroups were restored with either a short fibre-reinforced flowable composite (EverX Flow) or an experimental fibre-reinforced composite. Except for the control, teeth underwent endodontic treatment and were restored accordingly. Fracture resistance was tested using a universal testing machine. Statistical analysis compared fracture resistance across groups. Results: Teeth in EC exhibited the highest fracture resistance (1153.43 ± 332.52 N), comparable to sound teeth (1114.03 ± 185.58 N) and not significantly different from the experimental composite group (1006.89 ± 200.51 N) (p = 0.304). Cl-II restorations with EverX had significantly lower strength (652.48 ± 314.04 N) compared to MOD (773.02 ± 261.18 N) and EC (p < 0.05). The experimental composite showed a similar trend, with MOD having the lowest strength (408.6 ± 168.85 N). Significant differences were noted between materials in the MOD group (p = 0.009). Scanning electron microscopy revealed distinct fracture patterns. Conclusions: Endocrowns using direct fibre-reinforced composites provided protection for endodontically treated teeth with higher fracture resistance compared to teeth with MOD and Cl-II cavities. This gives direct composite endocrowns a potential for high-stress applications, though design and material selection remain critical. Full article

(This article belongs to the Special Issue Advanced Dental Restorative Composite Materials)

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25 pages, 7887 KB

Open AccessArticle

Sustainable Thermal Post-Processing of PLA 3D Prints: Increased Dimensional Precision and Autoclave Compatibility

by Florina Chiscop, Carmen-Cristiana Cazacu, Dragos-Alexandru Cazacu and Costel Emil Cotet

J. Funct. Biomater. 2025, 16(9), 334; https://doi.org/10.3390/jfb16090334 - 8 Sep 2025

Viewed by 374

Abstract

This study investigates the thermal properties and sterilization efficacy of polylactic acid (PLA) components fabricated via fused deposition modeling (FDM), focusing on PLA’s compatibility with autoclave sterilization protocols. While PLA is extensively recognized for its biobased and biodegradable characteristics, its limited thermal stability [...] Read more.

This study investigates the thermal properties and sterilization efficacy of polylactic acid (PLA) components fabricated via fused deposition modeling (FDM), focusing on PLA’s compatibility with autoclave sterilization protocols. While PLA is extensively recognized for its biobased and biodegradable characteristics, its limited thermal stability has traditionally restricted its application in high-temperature sterilization settings, such as in medical contexts. In our research, we examined three distinct specimen geometries—cylindrical, rectangular, and curved—subjecting them to thermal post-processing through constrained annealing, employing salt or silicone as the embedding medium. Following this process, we exposed the specimens to elevated temperatures, simulating typical sterilization conditions. The outcomes indicated that the annealed PLA specimens exhibited dimensional stability at temperatures exceeding 170 °C, thereby demonstrating their viability for steam sterilization procedures. To translate these findings into practical applications, we selected a small, complex geometrically relevant component, the Easy Bone Collector (EBC) shell, for autoclave testing at 134 °C. Post-sterilization, the part successfully retained its shape and functionality, indicating that, with appropriate thermal conditioning, PLA can be effectively utilized to manufacture cost-efficient, autoclavable components suitable for medical use. These results reveal a promising and sustainable approach to producing reusable, sterilization-compatible PLA devices, particularly in low-volume or single-use applications where biodegradability is advantageous. Full article

(This article belongs to the Section Synthesis of Biomaterials via Advanced Technologies)

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16 pages, 6323 KB

Open AccessArticle

Finite Element Analysis of Trabecular-Surfaced Implants and Implant Angulation in Different Mandibular Arch Forms

by Ahmet İlter Atay, Bahattin Alper Gültekin and Serdar Yalçın

J. Funct. Biomater. 2025, 16(9), 333; https://doi.org/10.3390/jfb16090333 - 8 Sep 2025

Viewed by 408

Abstract

Finite element analysis is commonly used to evaluate implant biomechanics, yet limited data exist on arch form and trabecular-surfaced implants. This study aimed to investigate the biomechanical impact of a designed trabecular surface compared with a standard implant surface in full-arch, four-implant-supported restorations, [...] Read more.

Finite element analysis is commonly used to evaluate implant biomechanics, yet limited data exist on arch form and trabecular-surfaced implants. This study aimed to investigate the biomechanical impact of a designed trabecular surface compared with a standard implant surface in full-arch, four-implant-supported restorations, using two mandibular arch forms and four placement configurations. Finite element analyses were conducted under a 250-N oblique load applied at 30° to the posterior segment. The prosthesis was modeled as a titanium–acrylic hybrid structure. Stress distribution was evaluated in cortical and cancellous bones, implants, and prosthetic frameworks. Implants with a trabecular surface demonstrated lower stress concentrations in both bone and implant structures. The von Mises stress at the neck of the posterior implant decreased from 383.3 MPa (standard implant, hyperbolic arch, configuration 1) to 194.9 MPa (trabecular-surfaced implant, U-shaped arch, configuration 4). Similarly, the average maximum principal tensile stress in cortical bone reduced from 44.32 to 40.99 MPa with the trabecular design. Among placement strategies, Configuration 3 (all implants tilted distally) yielded the highest bone stress, whereas Configurations 2 and 4 provided more favorable load distribution. Stress concentrations were also higher in hyperbolic arches, whereas U-shaped arches exhibited a more uniform distribution. These findings emphasized the biomechanical advantage of the designed trabecular surface in reducing stress across bone and implant components, indicating that trabecular titanium may represent a more reliable and cost-effective alternative for clinical applications, potentially enhancing long-term stability. Independently, the arch form and placement strategy also significantly influenced load distribution. Despite assumptions such as isotropic, homogeneous, and linearly elastic material properties, and the use of a single oblique loading condition, this study offers valuable biomechanical insights such as the stress-reducing effect of the trabecular surface, the influence of three-dimensional arch anatomy on stress concentration sites, and the necessity of selecting implant configurations according to arch forms, which may inform future full-arch implant rehabilitations. Full article

(This article belongs to the Section Dental Biomaterials)

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36 pages, 2482 KB

Open AccessReview

Micro- and Nanoplastics and the Oral Cavity: Implications for Oral and Systemic Health, Dental Practice, and the Environment—A Narrative Review

by Federica Di Spirito, Veronica Folliero, Maria Pia Di Palo, Giuseppina De Benedetto, Leonardo Aulisio, Stefano Martina, Luca Rinaldi and Gianluigi Franci

J. Funct. Biomater. 2025, 16(9), 332; https://doi.org/10.3390/jfb16090332 - 6 Sep 2025

Viewed by 450

Abstract

Background: Micro- and nanoplastics (MNPs) have emerged as increasing environmental and public health concerns. Dentistry contributes to this exposure through polymer-based materials and personal oral care products. This review summarizes the current evidence on the sources, release mechanisms, physicochemical properties, and toxicological and [...] Read more.

Background: Micro- and nanoplastics (MNPs) have emerged as increasing environmental and public health concerns. Dentistry contributes to this exposure through polymer-based materials and personal oral care products. This review summarizes the current evidence on the sources, release mechanisms, physicochemical properties, and toxicological and biological effects of MNPs derived from dental sources and oral care products, as well as the synergistic effects of MNP oral exposure with environmental exposure. Methods: An electronic search was performed across the PubMed/MEDLINE, Scopus, and Web of Science databases to identify studies investigating the source, release mechanisms, physico/chemical properties, and toxicological/biological impact of MNPs related to dental materials, oral care products, and the synergic effects of MNPs oral and environmental exposure. Results: MNPs are released in the dental setting from resin-based composites, clear aligners, and prosthetic and impression materials through degradation, wear, and handling processes. Home-use products like toothpastes, toothbrushes, floss, and mouthwashes contribute to chronic oral exposure. Evidence from in vitro, in vivo, and human biomonitoring studies supports the biological activity and systemic distribution of MNPs. Despite this, clinical awareness remains limited, and regulatory oversight insufficient. Conclusions: Dentistry is both a source and vector of MNP exposure. Encouraging the use of safer, MNP-free materials, and raising awareness among dental professionals, may support more responsible and health-conscious practices. Further research and alignment with global policy strategies could help guide future innovation and risk mitigation in the dental field. Full article

(This article belongs to the Special Issue Biomaterials in Dentistry: Current Status and Advances)

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13 pages, 1078 KB

Open AccessArticle

Polydatin Modulates Inflammatory Cytokine Expression in Lipoteichoic Acid-Stimulated Human Dental-Pulp Stem Cells

by Rawan Al-Ateeq, Mona Elsafadi, Manikandan Muthurangan and Solaiman Al-Hadlaq

J. Funct. Biomater. 2025, 16(9), 331; https://doi.org/10.3390/jfb16090331 - 5 Sep 2025

Viewed by 416

Abstract

Gram-positive bacteria are responsible for initiating dental caries. In this process, lipoteichoic acid (LTA), which is expressed on Gram-positive bacteria cell walls, binds to the dental pulp cells, triggering an immune response, followed by inflammation and eventually pulp necrosis. Polydatin is a polyphenolic [...] Read more.

Gram-positive bacteria are responsible for initiating dental caries. In this process, lipoteichoic acid (LTA), which is expressed on Gram-positive bacteria cell walls, binds to the dental pulp cells, triggering an immune response, followed by inflammation and eventually pulp necrosis. Polydatin is a polyphenolic compound that has been shown to modulate inflammatory mediators in a manner favorable to healing. The purpose of this study was to assess levels of expression of the most prevalent cytokines in the inflamed pulp after polydatin treatment of LTA-stimulated human dental-pulp stem cells (hDPSCs). LTA-stimulated hDPSCs were treated with polydatin in three different concentrations (0.01 µM, 0.1 µM, and 1 µM). Interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) levels were measured using reverse transcription–quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA) were quantified. Treatment with all concentrations of polydatin significantly decreased IL-6 and TNF-α levels as evaluated by ELISA and RT-qPCR, respectively. In addition, a significant reduction was observed in IL-8 levels of mRNA and in ELISA, with 0.01 µM and with 1 µM of polydatin in RT-qPCR. On the other hand, IL-10 levels increased with all of the concentrations. In conclusion, polydatin treatment of LTA-stimulated hDPSCs modulated inflammatory cytokine production by suppressing IL-6, IL-8, and TNF-α levels while elevating IL-10 levels. Full article

(This article belongs to the Section Dental Biomaterials)

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16 pages, 11359 KB

Open AccessArticle

Fracture Resistance of 3-Unit Zirconia Fixed Dental Prostheses Differing in Wall Thickness Fabricated by Either 3D-Printing or Milling

by Stefan Rues, Jannis Crocoll, Sebastian Hetzler, Johannes Rossipal, Peter Rammelsberg and Andreas Zenthöfer

J. Funct. Biomater. 2025, 16(9), 330; https://doi.org/10.3390/jfb16090330 - 5 Sep 2025

Viewed by 507

Abstract

Background: To evaluate the fracture resistance of 3D-printed 3-unit fixed dental prostheses (FDPs) made from tetragonal zirconia polycrystal (3Y-TZP). Methods: Based on a maxillary typodont model with a missing first molar and neighboring teeth with full crown preparations, FDPs differing in wall thickness [...] Read more.

Background: To evaluate the fracture resistance of 3D-printed 3-unit fixed dental prostheses (FDPs) made from tetragonal zirconia polycrystal (3Y-TZP). Methods: Based on a maxillary typodont model with a missing first molar and neighboring teeth with full crown preparations, FDPs differing in wall thickness (d = 0.6 mm / d = 0.8 mm / d = 1.0 mm) were designed. For all test groups, 12 samples were fabricated from 3Y-TZP by either 3D-printing or milling. For 3D-printing, pontic designs were modified by basal slots to enable regular firing times. After luting on CoCr dies, samples underwent artificial aging. Loads tilted by 30° were applied on the mesio-buccal cusp of the pontic, and fracture resistance F_u was assessed. Welch ANOVA and Dunnett-T3 tests were used for statistical evaluation. Results: Significant differences in F_u were identified (Welch ANOVA, p < 0.001). For milled FDPs, fracture originated from connector areas, and F_u increased with increasing wall thickness (d = 0.6 mm: 1536 ± 131 N, d = 0.8 mm: 2226 ± 145 N, d = 1.0 mm: 2686 ± 127 N, significant differences but for the comparison d = 0.8 mm vs. d = 1.0 mm). For 3D-printed FDPs, the loaded cusp fractured, and F_u did not change with FDP wall thicknesses (p > 0.779, F_u = 1110 ± 26 N for all PZ FDPs). Milled FDPs showed significantly higher F_u when compared to 3D-printed FDPs with identical wall thickness. Conclusions: Although 3D-printed zirconia FDPs still show lower fracture resistance values than their milled counterparts, all tested FDP configurations clearly exceed the clinical reference thresholds and can therefore be recommended for clinical use. Full article

(This article belongs to the Section Dental Biomaterials)

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19 pages, 5577 KB

Open AccessArticle

Comparative Analysis of the Effects of Acidic and Alkaline Beverages on the Optical Properties, Surface Topography, and Bacterial Activity of Zirconia Materials

by Nasser M. Alahmari

J. Funct. Biomater. 2025, 16(9), 329; https://doi.org/10.3390/jfb16090329 - 5 Sep 2025

Viewed by 418

Abstract

This study aimed to evaluate how acidic and alkaline staining solutions affect the optical properties (mean color change, ΔE*), geometric characteristics (surface roughness, Ra), and bacterial adhesion of zirconia Ceramill Zolid PS computer-aided design/computer-aided manufacture (CAD/CAM) material after 21 days of immersion. Ninety-six [...] Read more.

This study aimed to evaluate how acidic and alkaline staining solutions affect the optical properties (mean color change, ΔE*), geometric characteristics (surface roughness, Ra), and bacterial adhesion of zirconia Ceramill Zolid PS computer-aided design/computer-aided manufacture (CAD/CAM) material after 21 days of immersion. Ninety-six zirconia CAD/CAM Ceramill Zolid multilayer PS specimens were prepared and allocated to eight groups based on the pH values of the immersion solutions; the acidic solutions included Mirinda Citrus, CodeRed, yerba mate tea, Saudi coffee, and Nescafe (A–E), and the alkaline solutions included artificial saliva, DZRT (tobacco-free nicotine pouches), and smokeless tobacco (F–H). The specimens were immersed for 21 days at 37 °C, with the solutions replaced every 12 h to ensure consistency. Color changes were measured using a VITA Easyshade V spectrophotometer, and Ra was evaluated via white-light interferometric microscopy. The bacterial adhesion of Streptococcus mutans was quantified by counting colony-forming units (CFUs, CFU/mm²). Statistical analyses included the Shapiro–Wilk test for normality, one-way ANOVA with Tukey’s HSD post hoc test for group comparisons, and paired t-tests, with significance set at <0.05. The recorded pH values of the staining materials ranged from acidic (Mirinda Citrus: 3.23) to alkaline (smokeless tobacco: 8.54). Smokeless tobacco caused the most unacceptable mean color change (ΔE* = 6.84), followed by DZRT (ΔE* = 6.46), whereas artificial saliva produced the least discoloration (ΔE* = 2.15), with statistically significant differences among the solutions (p < 0.001). The Ra measurements varied significantly (p < 0.001), with Nescafe demonstrating the lowest value (0.486 µm) and DZRT the highest (0.748 µm). S. mutans adhesion was the highest for CodeRed (546.75 CFU) and the lowest for smokeless tobacco (283.92 CFU), demonstrating significant variation across groups (ANOVA, p < 0.001). The acidic and alkaline solutions significantly altered the optical properties, Ra, and bacterial adhesion of zirconia Ceramill Zolid PS CAD/CAM, with acidic solutions leading to higher bacterial adhesion. Full article

(This article belongs to the Section Dental Biomaterials)

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29 pages, 2415 KB

Open AccessReview

Recent Advances in 3D Bioprinting of Porous Scaffolds for Tissue Engineering: A Narrative and Critical Review

by David Picado-Tejero, Laura Mendoza-Cerezo, Jesús M. Rodríguez-Rego, Juan P. Carrasco-Amador and Alfonso C. Marcos-Romero

J. Funct. Biomater. 2025, 16(9), 328; https://doi.org/10.3390/jfb16090328 - 4 Sep 2025

Viewed by 825

Abstract

3D bioprinting has emerged as a key tool in tissue engineering by facilitating the creation of customized scaffolds with properties tailored to specific needs. Among the design parameters, porosity stands out as a determining factor, as it directly influences critical mechanical and biological [...] Read more.

3D bioprinting has emerged as a key tool in tissue engineering by facilitating the creation of customized scaffolds with properties tailored to specific needs. Among the design parameters, porosity stands out as a determining factor, as it directly influences critical mechanical and biological properties such as nutrient diffusion, cell adhesion and structural integrity. This review comprehensively analyses the state of the art in scaffold design, emphasizing how porosity-related parameters such as pore size, geometry, distribution and interconnectivity affect cellular behavior and mechanical performance. It also addresses advances in manufacturing methods, such as additive manufacturing and computer-aided design (CAD), which allow the development of scaffolds with hierarchical structures and controlled porosity. In addition, the use of computational modelling, in particular finite element analysis (FEA), as an essential predictive tool to optimize the design of scaffolds under physiological conditions is highlighted. This narrative review analyzed 112 core articles retrieved primarily from Scopus (2014–2025) to provide a comprehensive and up-to-date synthesis. Despite recent progress, significant challenges persist, including the lack of standardized methodologies for characterizing and comparing porosity parameters across different studies. This review identifies these gaps and suggests future research directions, such as the development of unified characterization and classification systems and the enhancement of nanoscale resolution in bioprinting technologies. By integrating structural design with biological functionality, this review underscores the transformative potential of porosity research applied to 3D bioprinting, positioning it as a key strategy to meet current clinical needs in tissue engineering. Full article

(This article belongs to the Special Issue Bio-Additive Manufacturing in Materials Science)

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30 pages, 7652 KB

Open AccessArticle

Advancing Scaffold Architecture for Bone Tissue Engineering: A Comparative Study of 3D-Printed β-TCP Constructs in Dynamic Culture with pBMSC

by Yannick M. Sillmann, Ana M. P. Baggio, Pascal Eber, Benjamin R. Freedman, Cynthia Liu, Youssef Jounaidi, Alexander Schramm, Frank Wilde and Fernando P. S. Guastaldi

J. Funct. Biomater. 2025, 16(9), 327; https://doi.org/10.3390/jfb16090327 - 4 Sep 2025

Viewed by 609

Abstract

Scaffold architecture is a key determinant of cell behavior and tissue regeneration in bone tissue engineering, yet the influence of pore size under dynamic culture conditions remains incompletely understood. This study aimed to evaluate the effects of scaffold pore size on osteogenic differentiation [...] Read more.

Scaffold architecture is a key determinant of cell behavior and tissue regeneration in bone tissue engineering, yet the influence of pore size under dynamic culture conditions remains incompletely understood. This study aimed to evaluate the effects of scaffold pore size on osteogenic differentiation of porcine bone marrow-derived mesenchymal stem cells (pBMSCs) cultured in a rotational oxygen-permeable bioreactor system (ROBS). Three-dimensionally (3D) printed beta-tricalcium phosphate (β-TCP) scaffolds with pore sizes of 500 µm and 1000 µm were seeded with pBMSC and cultured for 7 and 14 days under dynamic perfusion conditions. Gene expression analysis revealed significantly higher levels of osteogenic markers (Runx2, BMP-2, ALP, Osx, Col1A1) in the 1000 µm group, particularly at the early time point, with the later-stage marker Osteocalcin (Ocl) rising faster and higher in the 1000 µm group, after a lower expression at 7 days. ALP activity assays corroborated these findings. Despite having lower mechanical strength, the 1000 µm scaffolds supported a homogeneous cell distribution and high viability across all regions. These results suggest that larger pore sizes enhance early osteogenic commitment by improving nutrient transport and fluid flow in dynamic culture. These findings also support the use of larger-pore scaffolds in bioreactor-based preconditioning strategies and underscore the clinical importance of promoting early osteogenic differentiation to reduce in vitro culture time, an essential consideration for the timely preparation of implantable grafts in bone tissue engineering. Full article

(This article belongs to the Special Issue Bone Tissue Engineering: Recent Advances and Translation to Clinical Application)

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19 pages, 2901 KB

Open AccessArticle

Salivary Fistula as a Complication After the ORIF of a Mandibular Condylar Process Fracture: A Single-Centre Retrospective Study

by Paulina Agier, Marcin Kozakiewicz and Piotr Szymor

J. Funct. Biomater. 2025, 16(9), 326; https://doi.org/10.3390/jfb16090326 - 4 Sep 2025

Viewed by 406

Abstract

Surgical management of condylar process fractures is associated with postoperative complications, the most common being transient facial nerve palsy. Less frequent but noteworthy is the development of salivary fistulas, which, although rare, constitute a clinically relevant condition. This research aimed to investigate factors [...] Read more.

Surgical management of condylar process fractures is associated with postoperative complications, the most common being transient facial nerve palsy. Less frequent but noteworthy is the development of salivary fistulas, which, although rare, constitute a clinically relevant condition. This research aimed to investigate factors impacting salivary fistula formation and treatment in patients surgically treated for mandibular condylar process fracture. This study included 395 patients who underwent open rigid internal fixation (ORIF). Salivary fistula occurred in 5.8% of those treated. Multiple factors were assessed as potential contributors to post-operative fistula formation, but only gender demonstrated a statistically significant association as an independent risk factor (p < 0.05). The longer the surgical procedure, the sooner a fistula will appear in the postoperative follow-up period. Moderately elevated white blood cell and C-reactive protein levels were associated with faster resolution of salivary fistula. Treatment duration was longer for patients with a low body mass index. The most effective treatment method was disinfecting the fistula, applying a pressure dressing, and adhering to a tasteless diet (p < 0.05); both chemical cauterization and plastic surgery proved to be less effective. When a fistula occurs, it can be successfully resolved in a relatively short period of time (median 10 days); in most cases, conservative methods are sufficient. As this is a pioneering study, further research is necessary to validate the results. Full article

(This article belongs to the Section Dental Biomaterials)

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14 pages, 747 KB

Open AccessReview

The Remineralizing and Desensitizing Potential of Hydroxyapatite in Dentistry: A Narrative Review of Recent Clinical Evidence

by Jusef Naim and Sinan Sen

J. Funct. Biomater. 2025, 16(9), 325; https://doi.org/10.3390/jfb16090325 - 4 Sep 2025

Viewed by 1053

Abstract

Although caries is declining in industrialized countries, early childhood caries and molar–incisor hypomineralization (MIH) remain clinically relevant. To meet the demand for effective and well-tolerated preventive strategies, hydroxyapatite (HAp) has gained attention as a biocompatible, fluoride-free agent. A structured narrative review was conducted [...] Read more.

Although caries is declining in industrialized countries, early childhood caries and molar–incisor hypomineralization (MIH) remain clinically relevant. To meet the demand for effective and well-tolerated preventive strategies, hydroxyapatite (HAp) has gained attention as a biocompatible, fluoride-free agent. A structured narrative review was conducted to evaluate recent clinical evidence on the use of HAp. A PubMed search identified clinical trials from the past five years that investigated HAp-based products. Studies were included if they reported clinical outcomes related to remineralization, caries prevention, or desensitization. Fifteen clinical studies met the inclusion criteria. HAp seems to be a safe and effective alternative to flouride, especially for children or individuals at risk of overexposure. While both agents show similar efficacy in caries prevention, HAp may offer additional advantages in managing hypersensitivity and MIH. Compared to other remineralizing agents, such as calcium sodium phosphosilicate, HAp demonstrated comparable efficacy. Combination therapies show the most promising results. Future research should explore synergies of active ingredients and include standardized long-term studies to substantiate the clinical relevance of HAp. Full article

(This article belongs to the Special Issue Hydroxyapatite Composites for Biomedical Application)

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14 pages, 2248 KB

Open AccessArticle

Effect of Laser Scanning Parameters on Surface Morphology and Topography of Glass Solder-Coated Zirconia Substrate

by Fiona Hartung, Christian Moss, Hermann Seitz and Georg Schnell

J. Funct. Biomater. 2025, 16(9), 324; https://doi.org/10.3390/jfb16090324 - 3 Sep 2025

Viewed by 497

Abstract

Surface roughness and morphology, along with surface chemistry, are key features for improving ingrowth behavior and combating peri-implantitis after the insertion of dental implants. Using femtosecond laser texturing, this study aims to control both morphological and topographical surface properties of a glass solder [...] Read more.

Surface roughness and morphology, along with surface chemistry, are key features for improving ingrowth behavior and combating peri-implantitis after the insertion of dental implants. Using femtosecond laser texturing, this study aims to control both morphological and topographical surface properties of a glass solder coating on a zirconia substrate for dental applications. Experiments with varying laser and scanning parameters on the upper glass solder layer show the occurrence of two different surface morphologies. On the one hand, periodic wave-like structures are generated at relatively low pulse energy, with a high scanning pulse overlap of 80 to 90% and a scanning line overlap of 50%. On the other hand, a cauliflower-like structure can be observed at high pulse energies and a line overlap of up to 90%. Both surface morphologies represent a potential way to modify the glass solder surface to customize hard- and soft-tissue ingrowth, while realizing anti-adhesive properties for pathogenic bacteria in dental applications. Full article

(This article belongs to the Special Issue Advanced Technologies for Processing Functional Biomaterials)

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20 pages, 3353 KB

Open AccessArticle

Enhanced Unidirectional Cell Migration Induced by Asymmetrical Micropatterns with Nanostructures

by Kaixin Chen, Yuanhao Xu and Stella W. Pang

J. Funct. Biomater. 2025, 16(9), 323; https://doi.org/10.3390/jfb16090323 - 1 Sep 2025

Viewed by 699

Abstract

Directed cell migration is crucial for numerous biological processes, including tissue regeneration and cancer metastasis. However, conventional symmetrical micropatterns typically result in bidirectional cell migration guidance instead of unidirectional guidance. In this study, polydimethylsiloxane (PDMS)-based platforms with asymmetrical arrowhead micropatterns, nanopillars, and selective [...] Read more.

Directed cell migration is crucial for numerous biological processes, including tissue regeneration and cancer metastasis. However, conventional symmetrical micropatterns typically result in bidirectional cell migration guidance instead of unidirectional guidance. In this study, polydimethylsiloxane (PDMS)-based platforms with asymmetrical arrowhead micropatterns, nanopillars, and selective fibronectin coating were developed to enhance unidirectional cell migration. The platforms were fabricated using nanoimprint lithography and PDMS replication techniques, allowing for precise control over surface topography and biochemical modification. The MC3T3 osteoblastic cells cultured on these platforms demonstrated significantly enhanced directional migration, characterized by increased displacement, and directional alignment with micropattern orientation compared to symmetrical patterns. Quantitative analyses revealed that asymmetrical arrowheads combined with nanopillars induced more focal adhesions and F-actin polarization at cell front regions, supporting the observed unidirectional cell migration enhancement. These results confirm that integrating micropattern asymmetry, nanoscale features, and biochemical functionalization synergistically promotes unidirectional cell migration. The developed platforms offer valuable insights and practical strategies for designing advanced biomaterials capable of precise spatial cell guidance that can be applied to the designs of organ-on-a-chip systems. Full article

(This article belongs to the Section Synthesis of Biomaterials via Advanced Technologies)

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12 pages, 1642 KB

Open AccessArticle

Adhesion and Colonization Intensity of Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans on Smooth, Micro-Textured, and Macro-Textured Silicone Biomaterials

by Kirils Jurševičs, Ingus Skadiņš, Jeļena Krasiļņikova, Anna Lece, Andrejs Šķesters and Eduards Jurševičs

J. Funct. Biomater. 2025, 16(9), 322; https://doi.org/10.3390/jfb16090322 - 1 Sep 2025

Viewed by 603

Abstract

Implantable biomaterials are widely used in modern medicine, especially in orthopaedics, cardiovascular surgery, dentistry, and plastic and reconstructive surgery. The issue of the interaction of implants with body tissues and the risk of infection associated with them is one of the most studied [...] Read more.

Implantable biomaterials are widely used in modern medicine, especially in orthopaedics, cardiovascular surgery, dentistry, and plastic and reconstructive surgery. The issue of the interaction of implants with body tissues and the risk of infection associated with them is one of the most studied and topical issues in medicine. It is very important to find a biomaterial that effectively combines both microbiology and tissue compatibility aspects. The aim of this research work was to determine the adhesion and colonization rates of Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans on smooth, microtextured, and macro-textured silicone biomaterials in an in vitro study. A total of 90 silicone biomaterial samples were used, 30 for each type of biomaterial. In each of the biomaterial groups, half of the samples (n = 15) were used to determine the adhesion intensity and the other half to determine the colonization intensity on the active surface of the biomaterial samples. The study found that Staphylococcus epidermidis and Pseudomonas aeruginosa had the highest adhesion intensity on the macro-textured implant, while Candida albicans adhered best to smooth. Among the microorganisms, Pseudomonas aeruginosa demonstrated the highest colonization rate, followed by Staphylococcus epidermidis and then Candida albicans. The most intensive colonization of microorganisms was on the macro-textured implant, then on the micro-textured, and then on the smooth. The smooth and micro-textured implants did not show statistically significant differences in the intensity of adhesion and colonization. The biomaterials did not show pro-oxidant or anti-oxidant properties, and no lipid peroxidation was induced by the biomaterials. Full article

(This article belongs to the Section Antibacterial Biomaterials)

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19 pages, 1100 KB

Open AccessSystematic Review

A Histological and Clinical Evaluation of Long-Term Outcomes of Bovine Bone-Derived Xenografts in Oral Surgery: A Systematic Review

by Angelo Michele Inchingolo, Grazia Marinelli, Irma Trilli, Gaetano Del Vecchio, Angela Di Noia, Francesco Inchingolo, Massimo Del Fabbro, Andrea Palermo, Alessio Danilo Inchingolo and Gianna Dipalma

J. Funct. Biomater. 2025, 16(9), 321; https://doi.org/10.3390/jfb16090321 - 1 Sep 2025

Viewed by 738

Abstract

Background: Bovine bone-derived xenografts are widely used in regenerative dental procedures due to their osteoconductive properties and volumetric stability. However, their long-term behavior and biological integration remain a subject of debate. This systematic review aims to critically assess the histological and clinical outcomes [...] Read more.

Background: Bovine bone-derived xenografts are widely used in regenerative dental procedures due to their osteoconductive properties and volumetric stability. However, their long-term behavior and biological integration remain a subject of debate. This systematic review aims to critically assess the histological and clinical outcomes associated with bovine xenografts over extended follow-up periods. Methods: An electronic search was performed in PubMed, Scopus, and Web of Science, including studies published in the English language from 2005 to 2025 for a total of 217 records, which were initially identified from PubMed, Scopus, and Wos. Results: After duplicate removal, following title/abstract screening and full-text evaluation, 11 studies met the inclusion criteria. These studies reported on the use of bovine-derived xenografts in clinical contexts, assessing parameters such as graft integration, histological remodeling, complication incidence (e.g., chronic inflammation or foreign body reactions), and implant success rates over time. Conclusions: The current evidence suggests that bovine-derived xenografts, particularly Bio-Oss^®, are associated with favorable long-term outcomes in bone regenerative procedures, demonstrating satisfactory graft integration and implant survival rates. However, variations in study design, follow-up duration, and outcome measures warrant further high-quality, long-term randomized clinical trials to confirm these findings and guide clinical decision-making. Full article

(This article belongs to the Special Issue New Biomaterials in Periodontology and Implantology)

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19 pages, 3025 KB

Open AccessArticle

Antibiofilm Activity of a Novel Calcium Phosphate Cement Doped with Two Antibiotics

by Eneko Elezgaray, Cassandra Pouget, Fanny Salmeron, Catherine Flacard, Jean-Philippe Lavigne, Vincent Cavaillès and Mikhael Bechelany

J. Funct. Biomater. 2025, 16(9), 320; https://doi.org/10.3390/jfb16090320 - 31 Aug 2025

Viewed by 528

Abstract

This study presents the development of a degradable and biocompatible calcium phosphate cement (CPC) co-loaded with gentamicin (1.25 wt%) and vancomycin (4.25 wt%) for the local treatment of polymicrobial bone infections. The antibiotics were incorporated—individually or in combination—into the solid phase of Graftys [...] Read more.

This study presents the development of a degradable and biocompatible calcium phosphate cement (CPC) co-loaded with gentamicin (1.25 wt%) and vancomycin (4.25 wt%) for the local treatment of polymicrobial bone infections. The antibiotics were incorporated—individually or in combination—into the solid phase of Graftys^® Quickset (GQS), an injectable CPC. Antibiotic loading modifies some of the intrinsic properties of the GQS cement. Porosity exceeded 53%, compressive strength reduced around 5 MPa, which is comparable to calcium sulphates cements, and the setting time, although extended, remained within the clinically acceptable threshold (<20 min), ensuring suitable handling. A burst release of both antibiotics was observed within the first 24 h, with sustained release over time and no cytotoxic effects on human osteoblasts. The dual-loaded cement exhibited broad-spectrum antibacterial activity against both Gram-positive and Gram-negative strains, including methicillin-resistant isolates, in both planktonic and biofilm forms. Notably, the combination of both antibiotics demonstrated superior efficacy compared to either antibiotic alone. These findings suggest that this dual-antibiotic-loaded CPC offers a promising strategy for localised treatment of complex bone infections such as osteomyelitis, where polymicrobial involvement and antibiotic resistance pose significant therapeutic challenges. Full article

(This article belongs to the Section Bone Biomaterials)

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17 pages, 777 KB

Open AccessArticle

Bioactive Resin Cement Color Stability and Restoration Thickness as Determinants of the Final Shade in a Glass–Ceramic CAD/CAM Material

by Hanin E. Yeslam and Alaa Turkistani

J. Funct. Biomater. 2025, 16(9), 319; https://doi.org/10.3390/jfb16090319 - 31 Aug 2025

Viewed by 794

Abstract

Bioactive resin cements are gaining popularity for their clinical benefits, but concerns remain regarding their color stability. This study evaluated the color change (ΔE₀₀) and whiteness change (ΔWI_D) in bioactive resin cements and how their potential discoloration affects the [...] Read more.

Bioactive resin cements are gaining popularity for their clinical benefits, but concerns remain regarding their color stability. This study evaluated the color change (ΔE₀₀) and whiteness change (ΔWI_D) in bioactive resin cements and how their potential discoloration affects the shade of bonded CAD/CAM glass–ceramics at different ceramic thicknesses. VITA Mark II blocks were prepared in three thicknesses (0.5, 0.8, and 1.0 mm) and divided by resin cement: Panavia SA Universal (Pn), Predicta Bioactive Cement (Pr), and ACTIVA BioACTIVE Cement (Ac) (n = 10). Additionally, 10 specimens (10 × 2 mm) of each cement alone were prepared. Color was measured before and after 24 days of coffee immersion. Cement type significantly affected ΔE₀₀ (p < 0.001). Pn had the highest color stability, followed by Pr and Ac, with significant differences between each. ΔWI_D also varied by cement (p = 0.004), with Pn and Pr differing significantly from Ac. Ceramic thickness alone had no significant effect on ΔE₀₀ or ΔWI_D, but its interaction with cement type was significant (p < 0.001). While ceramic thickness does not directly affect the final shade, its combination with resin cement does. Choosing the right resin cement is key for long-term esthetic outcomes. Full article

(This article belongs to the Special Issue Latest Advances in Dental Materials)

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J. Funct. Biomater., Volume 16, Issue 9 (September 2025) – 44 articles

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