Giulia Molino

For long time, osteoporosis (OP) was exclusively associated with an overall bone mass reduction, leading to lower bone strength and to a higher fracture risk. For this reason, the measurement of bone mineral density through dual X-ray absorptiometry was considered the gold standard method for its diagnosis. However, recent findings suggest that OP causes a more complex set of bone alterations, involving both its microstructure and composition. This review aims to provide an overview of the most evident osteoporosis-induced alterations of bone quality and a résumé of the most common imaging techniques used for their assessment, at both the clinical and the laboratory scale. A particular focus is dedicated to the micro-computed tomography (micro-CT) due to its superior image resolution, allowing the execution of more accurate morphometric analyses, better highlighting the architectural alterations of the osteoporotic bone. In addition, micro-CT has the potential to perform densitometric measurements and finite element method analyses at the microscale, representing potential tools for OP diagnosis and for fracture risk prediction. Unfortunately, technological improvements are still necessary to reduce the radiation dose and the scanning duration, parameters that currently limit the application of micro-CT in clinics for OP diagnosis, despite its revolutionary potential.

Over the recent years, mesoporous bioactive glasses (MBGs) gained interest as bone regeneration systems, due to their excellent bioactivity and ability to release therapeutic molecules. In order to improve the bone regeneration ability of MBGs, the incorporation of Sr²⁺ ions, due to its recognized pro-osteogenenic potential, represents a very promising strategy. In this study, MBGs based on the SiO₂–CaO system and containing different percentages (2 and 4 mol %) of strontium were prepared by two synthesis methods, in the form of microspheres and nanoparticles. Sr-containing MBGs were characterized by FE-SEM, XRD and N₂ adsorption/desorption analysis. The in vitro bioactivity in SBF resulted excellent. The assessment of fibroblast cell (line L929) viability showed that Sr-containing MBGs were biocompatible both in form of micro- and nanoparticles. The osteogenic response of osteoblast-like SAOS-2 cells was investigated by analysing the expression of GAPDH, COL1a1, RANKL, SPARC, OPG and ALPL genes, as cell differentiation markers. The results indicate that the incorporation of Sr into MBG is beneficial for bone regeneration as promotes a pro-osteogenic effect, paving the way to the design of advanced devices enabled by these nanocarriers also in combination with drug release, for the treatment of bone pathologies, particularly in patients with osteoporosis.

Highly porous bioactive glass-ceramic scaffolds were effectively fabricated by an inorganic gel casting technique, based on alkali activation and gelification, followed by viscous flow sintering. Glass powders, already known to yield a bioactive sintered glass-ceramic (CEL2) were dispersed in an alkaline solution, with partial dissolution of glass powders. The obtained glass suspensions underwent progressive hardening, by curing at low temperature (40 °C), owing to the formation of a C–S–H (calcium silicate hydrate) gel. As successful direct foaming was achieved by vigorous mechanical stirring of gelified suspensions, comprising also a surfactant. The developed cellular structures were later heat-treated at 900–1000 °C, to form CEL2 glass-ceramic foams, featuring an abundant total porosity (from 60% to 80%) and well-interconnected macro- and micro-sized cells. The developed foams possessed a compressive strength from 2.5 to 5 MPa, which is in the range of human trabecular bone strength. Therefore, CEL2 glass-ceramics can be proposed for bone substitutions.