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WIREs Nanomed Nanobiotechnol
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Self‐healing biomaterials: The next generation is nano

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Abstract The U.S. Agency for Healthcare Research and Quality estimates that there are over 1 million total hip and total knee replacements each year in the U.S. alone. Twenty five percent of those implants will experience aseptic loosening, and bone cement failure is an important part of this. Bone cements are based on poly(methyl methacrylate) (PMMA) systems that are strong but brittle polymers. PMMA‐based materials are also essential to modern dental fillings, and likewise, the failure rates are high with lifetimes of 3–10 years. These brittle polymers are an obvious target for self‐healing systems which could reduce revision surgeries and visits to dentist. Self‐healing polymers have been described in the literature since 1996 and examples from Roman times are known, but their application in medicine has been challenging. This review looks at the development of self‐healing biomaterials for these applications and the challenges that lie between development and the clinic. Many of the most promising formulations involve introducing nanoscale components which offer substantial potential benefits over their microscale counterparts especially in composite systems. There is substantial promise for translation, but issues with toxicity, robustness, and reproducibility of these materials in the complex environment of the body must be addressed. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Implantable Materials and Surgical Technologies > Nanomaterials and Implants
Methacrylate is a key component of both dental resins and bone cements
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This image portrays the self‐healing dental composite developed by Huyang et al. (a) A crack forms, and water enters the composite. (b) A microcapsule is broken due to the propagation of the crack, and the healing liquid is released. (c) The healing liquid and healing powder react to form GIC. Reprinted with permission from Huyang, Debertin, and Sun (2016)
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This SEM image portrays the healed fracture plane for the dual UF microcapsule self‐healing system (10 wt% capsules loadings). Reprinted with permission from Dailey et al. (2014)
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This figure displays an optical image of crushed microcapsules and the healing liquid films being released from the capsules. Reprinted with permission from J. Wu et al. (2016)
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This image depicts microcapsules with healing agents added to a composite matrix containing catalyst throughout the composite as in a mono capsule self‐healing system. From top to bottom of this image, one can see a crack forming in the matrix. In the second box, the crack ruptures the capsule and releases the self‐healing agent. Then, in the bottom box, the healing agent comes into contact with the catalyst and polymerization occurs. Reprinted with permission from White et al. (2001)
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(a) The dual capsule‐based self‐healing system contains two sets of capsules, one with the monomer and one with the initiator. (b) The mono capsule‐based self‐healing system only contains one set of capsules
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Linear and Poisson regression model projections of primary total joint arthroplasty (TJA) procedures volume in the U.S. from 2000 to 2030. Reprinted with permission from Sloan, Premkumar, and Sheth (2018). Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are broken out in the graphs
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Implantable Materials and Surgical Technologies > Nanomaterials and Implants
Nanotechnology Approaches to Biology > Nanoscale Systems in Biology
Therapeutic Approaches and Drug Discovery > Emerging Technologies

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