Carter Amber, Popowski Kristen, Cheng Ke, Greenbaum Alon, Ligler Frances S, Moatti Adele
Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA.
Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA.
Bioelectricity. 2021 Dec 1;3(4):255-271. doi: 10.1089/bioe.2021.0019. Epub 2021 Dec 16.
Serious bone injuries have devastating effects on the lives of patients including limiting working ability and high cost. Orthopedic implants can aid in healing injuries to an extent that exceeds the natural regenerative capabilities of bone to repair fractures or large bone defects. Autografts and allografts are the standard implants used, but disadvantages such as donor site complications, a limited quantity of transplantable bone, and high costs have led to an increased demand for synthetic bone graft substitutes. However, replicating the complex physiological properties of biological bone, much less recapitulating its complex tissue functions, is challenging. Extensive efforts to design biocompatible implants that mimic the natural healing processes in bone have led to the investigation of piezoelectric smart materials because the bone has natural piezoelectric properties. Piezoelectric materials facilitate bone regeneration either by accumulating electric charge in response to mechanical stress, which mimics bioelectric signals through the direct piezoelectric effect or by providing mechanical stimulation in response to electrical stimulation through the converse piezoelectric effect. Although both effects are beneficial, the converse piezoelectric effect can address bone atrophy from stress shielding and immobility by improving the mechanical response of a healing defect. Mechanical stimulation has a positive impact on bone regeneration by activating cellular pathways that increase bone formation and decrease bone resorption. This review will highlight the potential of the converse piezoelectric effect to enhance bone regeneration by discussing the activation of beneficial cellular pathways, the properties of piezoelectric biomaterials, and the potential for the more effective administration of the converse piezoelectric effect using wireless control.
严重的骨损伤对患者的生活有着毁灭性的影响，包括限制工作能力和高昂的成本。骨科植入物在促进损伤愈合方面的作用超出了骨骼自然修复骨折或大骨缺损的再生能力。自体骨移植和异体骨移植是常用的标准植入物，但诸如供体部位并发症、可移植骨量有限以及成本高等缺点，导致对合成骨移植替代物的需求增加。然而，复制生物骨的复杂生理特性，更不用说重现其复杂的组织功能，具有挑战性。为设计模仿骨自然愈合过程的生物相容性植入物所做的大量努力，促使人们对压电智能材料进行研究，因为骨骼具有天然的压电特性。压电材料通过响应机械应力积累电荷来促进骨再生，这通过直接压电效应模拟生物电信号，或者通过逆压电效应响应电刺激提供机械刺激。虽然这两种效应都有益，但逆压电效应可以通过改善愈合缺损的机械反应来解决因应力屏蔽和固定不动导致的骨萎缩问题。机械刺激通过激活增加骨形成和减少骨吸收的细胞途径，对骨再生产生积极影响。本综述将通过讨论有益细胞途径的激活、压电生物材料的特性以及使用无线控制更有效施加逆压电效应的潜力，来突出逆压电效应在增强骨再生方面的潜力。
