Calcium phosphates (CaPs) are the most widely used bone substitutes in bone tissue engineering due to their compositional similarities to bone mineral and excellent biocompatibility. In recent years, CaPs, especially hydroxyapatite and tricalcium phosphate, have attracted significant interest in simultaneous use as bone substitute and drug delivery vehicle, adding a new dimension to their application. CaPs are more biocompatible than many other ceramic and inorganic nanoparticles. Their biocompatibility and variable stoichiometry, thus surface charge density, functionality, and dissolution properties, make them suitable for both drug and growth factor delivery. CaP matrices and scaffolds have been reported to act as delivery vehicles for growth factors and drugs in bone tissue engineering. Local drug delivery in musculoskeletal disorder treatments can address some of the critical issues more effectively and efficiently than the systemic delivery. CaPs are used as coatings on metallic implants, CaP cements, and custom designed scaffolds to treat musculoskeletal disorders. This review highlights some of the current drug and growth factor delivery approaches and critical issues using CaP particles, coatings, cements, and scaffolds towards orthopedic and dental applications.

The general trends in synthetic bone grafting materials are shifting towards approaches that can illicit osteoinductive properties. Pharmacologics and biologics have been used in combination with calcium phosphate (CaP) ceramics, however, recently have become the target of scrutiny over the safety. The importance of trace elements in natural bone health is well documented. Ions, e.g. lithium, zinc, magnesium, manganese, silicon, strontium etc. have shown to increase osteogenesis and neovascularization. Incorporation of dopants into CaPs can provide a platform for safe and efficient delivery in clinical applications where increased bone healing is favorable. This review highlights use of trace elements in CaP biomaterials, and offers an insight into the mechanisms of how metal ions can enhance both osteogenesis and angiogenesis.

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We report here the fabrication of three dimensional (3D) interconnected macro porous tricalcium phosphate (TCP) scaffolds with controlled internal architecture by direct 3D printing (3DP), and high mechanical strength by microwave sintering. TCP scaffolds with 27%, 35% and 41% designed macro porosity having pore sizes of 500 μm, 750 μm, and 1000 μm, respectively, have been fabricated via direct 3DP. These scaffolds are then sintered at 1150 °C and 1250 °C in conventional electric muffle furnace as well as microwave furnace. Total open porosity between 42% and 63% is obtained in the sintered scaffolds due to the presence of intrinsic micro pores along with the designed pores. A significant increase in compressive strength, between 46% and 69%, is achieved by microwave sintering as compared to conventional sintering as a result of efficient densification. A maximum compressive strength of 10.95 ± 1.28 MPa and 6.62 ± 0.67 MPa is achieved for scaffolds with 500 μm designed pores (~400 μm after sintering) sintered in microwave and conventional furnaces, respectively. An increase in cell density with a decrease in macro pore size is observed during in vitro cell-material interactions using human osteoblast cells. Histomorphological analysis reveals that the presence of both micro and macro pores facilitated osteoid like new bone formation when tested in the femoral defect on Sprague-Dawley rats. Our results show that bioresorbable 3D printed TCP scaffolds have great potential in tissue engineering applications for bone tissue repair and regeneration.

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