Effect of chitosan/inorganic nanomaterial scaffolds on bone regeneration and related influencing factors in animal models: A systematic review

Abstract

Bone tissue engineering (BTE) provides a promising alternative for transplanting. Due to biocompatibility and biodegradability, chitosan-based scaffolds have been extensively studied. In recent years, many inorganic nanomaterials have been utilized to modify the performance of chitosan-based materials. In order to ascertain the impact of chitosan/inorganic nanomaterial scaffolds on bone regeneration and related key factors, this study presents a systematic comparison of various scaffolds in the calvarial critical-sized defect (CSD) model. A total of four electronic databases were searched without publication date or language restrictions up to April 2022. The Animal Research Reporting of In Vivo Experiments 2.0 guidelines (ARRIVE 2.0) were used to assess the quality of the included studies. Moreover, the risk of bias (RoB) was evaluated via the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) tool. After the screening, 22 studies were selected. None of these studies achieved high quality or had a low RoB. In the available studies, scaffolds reconstructed bone defects in radically different extensions. Several significant factors were identified, including baseline characteristics, physicochemical properties of scaffolds, surgery details, and scanning or reconstruction parameters of micro-computed tomography (micro-CT). Further studies should focus on not only improving the osteogenic performance of the scaffolds but also increasing the credibility of studies through rigorous experimental design and normative reports.

Biodegradable Polymers in Veterinary Medicine—A Review

“…The requirements for biomaterials used as scaffolds include biocompatibility, biodegradability, appropriate mechanical strength and the possibility to be easily shaped into different shapes and preserve the anatomical tissue volume and shape, lack of toxicity, allergic reactions or other side effects, controlled deliverability of bioactive molecules, proper porosity to enable adhesion of cells, and half-life long enough to ensure the growth of a specific tissue, and chitosan either alone or in combination with other agents meets them all [ 79 , 81 , 82 , 83 ]. Moreover, chitosan’s chemical structure resembles glycosaminoglycans, which are the primary component of several human and animal tissues [ 41 ].…”

“…Chitosan-based scaffolds have been successfully tested in the regeneration of bones, tendons, cartilage, and periodontal tissue [ 41 , 80 , 81 ]. Due to the unique properties beneficial for wound-healing mentioned above (see Section 4.1.1 .…”

“…Chitosan in wound management) that include activation of cell growth, differentiation, and proliferation factors—enhancing the production of cytokines and cell migration—and stimulation of collagen production, chitosan seems a perfect material for such purposes. Chitosan biodegradability (e.g., by lysozymes) allows its reduction to oligomers after fulfilling its role in tissue regeneration [ 81 ].…”

Bone Regeneration with Mesenchymal Stem Cells in Scaffolds: Systematic Review of Human Clinical Trials

“…In order to enhance both the survival and differentiation of cells, composite biomaterials have been proposed, which combine more than two different materials, increasing the degree of tissue regeneration. However, most of the concepts of stem cells and scaffolds for bone regeneration have been tested in vitro and in animal models [ 19 – 24 ].…”