Scaffolds For Bone Regeneration Research Articles

Characterization and biocompatibility of a bilayer PEEK-based scaffold for guiding bone regeneration

BackgroundPolyetheretherketone (PEEK) is well known for its excellent physical–chemical properties and biosafety. The study aimed to open up a new method for clinical application of PEEK to reconstruct large-scale bone defects.MethodsA bilayer scaffold for bone regeneration was prepared by combining a sulfonated PEEK barrier framework (SPEEK) with a hydrogel layer loaded with aspirin (ASA) and nano-hydroxyapatite (nHAP) by the wet-bonding of Polydopamine (PDA).ResultsThe hydrogel was successfully adhered to the surface of SPEEK, resulting in significant changes including the introduction of bioactive groups, improved hydrophilicity, and altered surface morphology. Subsequent tests confirmed that the bilayer scaffold exhibited enhanced compression resistance and mechanical compatibility with bone compared to a single hydrogel scaffold. Additionally, the bilayer scaffold showed stable and reliable bonding properties, as well as excellent biosafety verified by cell proliferation and viability experiments using mouse embryo osteoblast precursor (MC3T3-E1) cells.ConclusionThe bilayer bone regeneration scaffold prepared in this study showed promising potential in clinical application for bone regeneration.

Strontium-Modified porous attapulgite composite hydrogel scaffold with advanced angiogenic and osteogenic potential for bone defect repair

Nano-attapulgite (nano-ATP) has shown potential in promoting mesenchymal stem cell (MSC) adhesion, growth and osteogenic gene expression. In this study, we investigated a 3D-bioprinted porous Sr-ATP (strontium-doped nano-ATP)/GelMA/chitosan composite hydrogel scaffold for bone regeneration. The experiment was divided into four groups based on the concentration of Sr-ATP: control (0%), 0.5%, 1.0% and 2.0%. The primary novelty of our research lies in the incorporation of Sr-ATP, which enhances the biological and mechanical properties of scaffolds. Additionally, we utilized a stable Pickering emulsion templating technique combined with 3D printing to fabricate the scaffold, ensuring a uniform and stable porous structure. The biological and mechanical properties of the scaffold were evaluated in vitro, and its potential to promote angiogenesis and osteogenesis was assessed in vivo using cranial defect model. Our results indicate that the scaffold presents a promising solution for bone formation in bone defects, demonstrating significant improvements in both angiogenesis and osteogenesis.

The Role of Chitosan and Gelatin-Based Scaffolds in Bone Regeneration: A Systematic Review.

Guided bone regeneration facilitates the growth of new bone in areas where there is a bone defect or insufficiency. This technique involves placing a barrier membrane over the bone graft site, and the membrane prevents the invasion of soft tissue (such as gingival tissue) into the bone graft area. This allows the slower-growing bone cells to populate the area without competition, promoting proper bone regeneration. When combined, chitosan and gelatin create composite scaffolds that leverage the strengths of both materials. Chitosan provides structural integrity and antimicrobial properties, and gelatin enhances cell attachment and proliferation, which improves mechanical properties and makes it more suitable for supporting bone regeneration in load-bearing areas.This systematic review aims to evaluate the effectiveness ofchitosan and gelatin-based scaffolds in bone regeneration. Various databases such as PubMed, Cochrane Library, LILAC, and Google Scholar were screened to adhere to the eligibility criteria. The included studies in the review were the in vivo and in vitro assessment of the chitosan and gelatin efficiency as a scaffold. Six studies were investigated for the involvement of chitosan and gelatin-based scaffolds in bone regeneration. Of these, two in vivostudies examined bone regeneration by measuring alkaline phosphatase activity (ALP) using different staining techniques, while the remaining four in vitro studies used histologic and histometric analysis where stem cells, chemicals, and other biopolymers were compared. Chitosan and gelatin scaffolds consistently showed better results in terms of bone repair throughout all six experiments. Gelatin's capacity for regeneration can be increased by mixing itwith chitosan. For additional advancement, future researchers need to focus on incorporating biopolymers.The potential of scaffolds composed of gelatin and chitosan to replace tissue lost due to periodontitis shows great clinical significance.

Microsphere-Composite Hydrogel for Recruiting Stem Cells and Promoting Osteogenic Differentiation.

By recruiting stem cells into scaffolds and differentiating them into osteoblasts, stem cells can be mobilized to directly repair bone defects, which avoids a series of disadvantages of exogenous stem cell implantation. In this study, a microsphere-composite hydrogel for the recruitment and osteogenic differentiation of stem cells was constructed. Methacrylic anhydride modified gelatin (GelMA) and heparin (HepMA), as well as nanohydroxyapatite (nHAP), were used to prepare microspheres followed by adsorbing platelet-derived growth factor BB (PDGF-BB) whose loading efficiency was 53.7 ± 2.2%. Then the microspheres were compounded to the GelMA hydrogel encapsulated with simvastatin (SIM) to obtain microsphere-composite hydrogel GHnH-P@GS. GHnH-P@GS hydrogel could slowly release SIM and PDGF-BB, and the extents of release within 7 days were 44.1 ± 2.0% and 32.8 ± 1.1%. The synergistic effect of small molecule drugs and growth factors not only induced the recruitment of rabbit bone marrow-derived mesenchymal stem cells, but also promoted the osteogenic differentiation of stem cells, which was confirmed by experiments of cell migration, alkaline phosphatase, and alizarin red staining. Collectively, the microsphere-composite hydrogel GHnH-P@GS has a certain reference significance for the design of scaffolds for alveolar bone repair and regeneration.

In vitro degradation of 3D-printed polycaprolactone\\biomimetic hydroxyapatite scaffolds: Impact of the sterilization method

In the transition from the laboratory to the clinic, the sterilization of medical devices becomes a fundamental and mandatory step to ensure patient safety. This work evaluates the impact of three different sterilization methods - autoclave, ethylene oxide and gamma irradiation - on the physicochemical properties and degradation kinetics of 3D-printed polycaprolactone\\calcium deficient hydroxyapatite (PCL\\CDHA) scaffolds for bone regeneration. The in vitro degradation test was performed in phosphate buffer saline solution at 47 °C for 18 weeks by recording the evolution of pH, scaffold morphology, swelling degree, mass loss as well as polymer content, molecular weight and crystallinity. The results showed that under thermally accelerated degradation, the scaffolds underwent hydrolytic bulk degradation without altering the pH of the soaking medium nor compromising the morphology and integrity of the constructs. Although the structural integrity of the scaffolds was maintained, autoclaving severely deteriorated the properties of the polymer, resulting in a faster degradation pattern, confirming that it is not an appropriate sterilization method for PCL\\CDHA scaffolds. While ethylene oxide had no significant effect on degradation, gamma irradiation slightly accelerated hydrolysis by chain scission. However, due to the porous nature of the scaffolds, the use of ethylene oxide is inadvisable due to the risk of gas trapping in the pores. Therefore, gamma irradiation, a non-toxic, effective, predictable and reproducible sterilization method, is considered the most appropriate.

Hierarchical microstructure design of multifunctional soft collagen-incorporated 3D hard polyetherketoneketone scaffolds for augmented bone regeneration

Implant-associated infections and insufficient osseointegration are still great challenges in clinical load-bearing applications. Exploiting the antibacterial effects and immunomodulatory properties of biomaterials has garnered substantial attention. Inspired by structural and functional cues in bone regeneration, a universal approach was proposed in which a hydroxyapatite (HAp) coating was built on 3D printed polyetherketoneketone (PEKK) scaffold, and a bioactive component-loaded soft mineralized collagen hydrogel was incorporated into 3D hard PEKK scaffold. While the PEKK scaffold exhibited exceptional mechanical performance, in vitro and in vivo data confirmed that exosomes derived from rat bone marrow mesenchyme stem cells (rBMSCs) loaded on collagen hydrogel facilitate efficient osteoimmunomodulation of the PEKK-based scaffold (denoted as the PEKK-HAp-Col/Exo scaffold). Additionally, vancomycin-loaded nanoparticles cross-linked with collagen hydrogel endowed the PEKK-based scaffold (denoted as the PEKK-HAp-Col/Van scaffold) with enhanced antibacterial effects. Overall, this study not only sheds light on the significance of exosomes in the osteoimmunomodulation of an implant but also presents a universal material–structure–function integrated strategy to fabricate multifunctional scaffolds with a soft-hard hybrid structure for clinical large-scale bone defect repair.

Osteogenic potentials in canine mesenchymal stem cells: unraveling the efficacy of polycaprolactone/hydroxyapatite scaffolds in veterinary bone regeneration

BackgroundThe integration of stem cells, signaling molecules, and biomaterial scaffolds is fundamental for the successful engineering of functional bone tissue. Currently, the development of composite scaffolds has emerged as an attractive approach to meet the criteria of ideal scaffolds utilized in bone tissue engineering (BTE) for facilitating bone regeneration in bone defects. Recently, the incorporation of polycaprolactone (PCL) with hydroxyapatite (HA) has been developed as one of the suitable substitutes for BTE applications owing to their promising osteogenic properties. In this study, a three-dimensional (3D) scaffold composed of PCL integrated with HA (PCL/HA) was prepared and assessed for its ability to support osteogenesis in vitro. Furthermore, this scaffold was evaluated explicitly for its efficacy in promoting the proliferation and osteogenic differentiation of canine bone marrow-derived mesenchymal stem cells (cBM-MSCs) to fill the knowledge gap regarding the use of composite scaffolds for BTE in the veterinary orthopedics field.ResultsOur findings indicate that the PCL/HA scaffolds substantially supported the proliferation of cBM-MSCs. Notably, the group subjected to osteogenic induction exhibited a markedly upregulated expression of the osteogenic gene osterix (OSX) compared to the control group. Additionally, the construction of 3D scaffold constructs with differentiated cells and an extracellular matrix (ECM) was successfully imaged using scanning electron microscopy. Elemental analysis using a scanning electron microscope coupled with energy-dispersive X-ray spectroscopy confirmed that these constructs possessed the mineral content of bone-like compositions, particularly the presence of calcium and phosphorus.ConclusionsThis research highlights the synergistic potential of PCL/HA scaffolds in concert with cBM-MSCs, presenting a multidisciplinary approach to scaffold fabrication that effectively regulates cell proliferation and osteogenic differentiation. Future in vivo studies focusing on the repair and regeneration of bone defects are warranted to further explore the regenerative capacity of these constructs, with the ultimate goal of assessing their potential in veterinary clinical applications.

Investigating the Promising P28 Peptide-Loaded Chitosan/Ceramic Bone Scaffolds for Bone Regeneration.

Bone has the ability to heal itself; however, bone defects fail to heal once the damage exceeds a critical size. Bone regeneration remains a significant clinical challenge, with autograft considered the ideal bone graft material due to its sufficient porosity, osteogenic cells, and biological growth factors. However, limitations to bone grafting, such as limited bone stock and high resorption rates, have led to a great deal of research into developing bone graft substitutes. The P28 peptide is a small molecule bioactive biomimetic alternative to mimic the bone morphogenetic protein 2 (BMP-2). In this study, we investigated the potential of P28-loaded hybrid scaffolds to mimic the natural bone structure for enhancing the bone regeneration process. We hypothesized that the peptide-loaded scaffolds and nude scaffolds both have the potential to promote bone healing, and the bone healing process is accelerated by the release of the peptide. To verify our hypothesis, C2C12 cells were evaluated for the presence of calcium deposits by histological stain at 7 and 14 days in cultures with hybrid scaffolds. Total RNA was isolated from C2C12 cells cultured with hybrid scaffolds for 7 and 14 days to assess osteoblast differentiation. The project findings demonstrated that the hybrid scaffold could enhance osteoblast differentiation and significantly improve the therapeutic effects of the scaffold in bone regeneration.

3D printing of strontium-enriched biphasic calcium phosphate scaffolds for bone regeneration

Calcium phosphate (CaP) scaffolds doping with therapeutic ions are one of the focuses of recent bone tissue engineering research. Among the therapeutic ions, strontium stands out for its role in bone remodeling. This work reports a simple method to produce Sr-doped 3D-printed CaP scaffolds, using Sr-doping to induce partial phase transformation from β-tricalcium phosphate (β-TCP) to hydroxyapatite (HA), resulting in a doped biphasic calcium phosphate (BCP) scaffold. Strontium carbonate (SrCO3) was incorporated in the formulation of the 3D-printing ink, studying β-TCP:SrO mass ratios of 100:0, 95:5, and 90:10 (named as β-TCP, β-TCP/5-Sr, and β-TCP/10-Sr, respectively). Adding SrCO3 in the 3D-printing ink led to a slight increase in viscosity but did not affect its printability, resulting in scaffolds with a high printing fidelity compared to the computational design. Interestingly, Sr was incorporated into the lattice structure of the scaffolds, forming hydroxyapatite (HA). No residual SrO or SrCO3 were observed in the XRD patterns of any composition, and HA was the majority phase of the β-TCP/10-Sr scaffolds. The addition of Sr increased the compression strength of the scaffolds, with both β-TCP/5-Sr and β-TCP/10-Sr performing better than the β-TCP. Overall, β-TCP/5-Sr presented higher mineralized nodules and mechanical strength, while β-TCP scaffolds presented superior cell viability. The incorporation of SrCO3 in the ink formulation is a viable method to obtain Sr-BCP scaffolds. Thus, this approach could be explored with other CaP scaffolds aiming to optimize their performance and the addition of alternative therapeutic ions.

Composite bioink incorporating cell-laden liver decellularized extracellular matrix for bioprinting of scaffolds for bone tissue engineering

The field of bone tissue engineering (BTE) has witnessed a revolutionary breakthrough with the advent of three-dimensional (3D) bioprinting technology, which is considered an ideal choice for constructing scaffolds for bone regeneration. The key to realizing scaffold biofunctions is the selection and design of an appropriate bioink, and existing bioinks have significant limitations. In this study, a composite bioink based on natural polymers (gelatin and alginate) and liver decellularized extracellular matrix (LdECM) was developed and used to fabricate scaffolds for BTE using 3D bioprinting. Through in vitro studies, the concentration of LdECM incorporated into the bioink was optimized to achieve printability and stability and to improve the proliferation and osteogenic differentiation of loaded rat bone mesenchymal stem cells (rBMSCs). Furthermore, in vivo experiments were conducted using a Sprague Dawley rat model of critical-sized calvarial defects. The proposed rBMSC-laden LdECM–gelatin–alginate scaffold, bioprinted layer-by-layer, was implanted in the rat calvarial defect and the development of new bone growth was studied for four weeks. The findings showed that the proposed bioactive scaffolds facilitated angiogenesis and osteogenesis at the defect site. The findings of this study suggest that the developed rBMSC-laden LdECM–gelatin–alginate bioink has great potential for clinical translation and application in solving bone regeneration problems.

Toxicological Assessment of Biodegradable Poli-ε-Caprolactone Polymer Composite Materials Containing Hydroxyapatite, Bioglass, and Chitosan as Potential Biomaterials for Bone Regeneration Scaffolds.

Polycaprolactone (PCL) is a biodegradable polyester that might be used in tissue engineering to obtain scaffolds for bone reconstruction using 3D-printing technologies. New material compositions based on PCL, with improved physicochemical properties and excellent biocompatibility, would improve its applicability in bone regeneration. The aim of this study was to assess the potential toxic effects of PCL-based composite materials containing 5% hydroxyapatite (PCL/SHAP), 5% bioglass (PCL/BIO), or 5% chitosan (PCL/CH) on MG-63 human fibroblast-like cells in vitro. Material tests were carried out using X-ray diffraction, differential thermal analysis/thermal gravimetry, BET specific surface analysis, and scanning electron microscopy. The effect of the biomaterials on the MG-63 cells was then assessed based on toxicity tests using indirect and direct contact methods. The analysis showed that the tested biomaterials did not significantly affect cell morphology, viability, proliferation, or migration. We concluded that biodegradable PCL-based scaffolds may be suitable for tissue scaffold production, and the addition of bioglass improves the growth of cultured cells.

Carbon fiber felt scaffold from Brazilian textile PANfiber for regeneration of critical size bone defects in rats: A histomorphometric and microCT study.

The objective of the present study was to evaluate the carbon fiber obtained from textile PAN fiber, in its different forms, as a potential scaffolds synthetic bone. Thirty-four adult rats were used (Rattus norvegicus, albinus variation), two critical sized bone defects were made that were 5 mm in diameter. Twenty-four animals were randomly divided into four groups: control (C)-bone defect + blood clot, non-activated carbon fiber felt (NACFF)-bone defect + NACFF, activated carbon fiber felt (ACFF)-bone defect + ACFF, and silver activated carbon fiber felt (Ag-ACFF)-bone defect + Ag-ACFF, and was observed by 15 and 60 days for histomorphometric, three-dimensional computerized microtomography (microCT) and mineral apposition analysis. On histomorphometric and microCT analyses, NACFF were associated with higher proportion of neoformed bone and maintenance of bone structure. On fluorochrome bone label, there was no differences between the groups. NACFF has shown to be a promising synthetic material as a scaffold for bone regeneration.

In vivo endocultivation of CAD/CAM hybrid scaffolds in the omentum majus in miniature pigs

PurposeCorrection of bony mandibular defects is a challenge in oral and maxillofacial surgery due to aesthetic and functional requirements. This study investigated the potential of a novel hybrid scaffold for bone regeneration and degradation assessment of the ceramic within the omentum majus over 6 months and the extent to which rhBMP-2 as a growth factor, alone or combined with a hydrogel, affects regeneration. Materials and methodsIn this animal study, 10 Göttingen minipigs each had one scaffold implanted in the greater omentum. Five animals had scaffolds loaded with a collagen hydrogel and rhBMP-2, and the other five animals (control group) had scaffolds loaded with rhBMP-2 only. Fluorochrome injections and computed tomography (CT) were performed regularly. After 6 months, the animals were euthanized, and samples were collected for microCT and histological evaluations. ResultsFluorescent and light microscopic and a CT morphological density evaluation showed continuous bone growth until week 16 in both groups. Regarding the ratio of bone attachment to the Zr02 support struts, the rhBMP-2 loaded collagen hydrogel group showed with 63% a significantly higher attachment (p > 0.001) than the rhBMP-2 control group (49%). ConclusionIn this study, bone growth was induced in all omentum majus specimens until post-operative week 16. Furthermore, hydrogel and rhBMP-2 together resulted in better bone-scaffold integration than rhBMP-2 alone. Further studies should investigate whether implantation of the scaffolds in the jaw after an appropriate period of bone regeneration leads to a stable situation and the desired results.

Collagen-hydroxyapatite based scaffolds for bone trauma and regeneration: recent trends and future perspectives.

Regenerative therapy, a key area of tissue engineering, holds promise for restoring damaged organs, especially in bone regeneration. Bone healing is natural to the body but becomes complex under stress and disease. Large bone deformities pose significant challenges in tissue engineering. Among various methods, scaffolds are attractive as they provide structural support and essential nutrients for cell adhesion and growth. Collagen and hydroxyapatite (HA) are widely used due to their biocompatibility and biodegradability. Collagen and nano-scale HA enhance cell adhesion and development. Thus, nano HA/collagen scaffolds offer potential solutions for bone regeneration. This review focuses on the use and production of nano-sized HA/collagen composites in bone regeneration.

Four-Dimensional Perspective on Biomimetic Design and Fabrication of Bone Scaffolds for Comprehensive Bone Regeneration

Four-Dimensional Perspective on Biomimetic Design and Fabrication of Bone Scaffolds for Comprehensive Bone Regeneration

Precision pore structure optimization of additive manufacturing porous tantalum scaffolds for bone regeneration: A proof-of-concept study

Currently, the treatment of bone defects in arthroplasty is a challenge in clinical practice. Nonetheless, commercially available orthopaedic scaffolds have shown limited therapeutic effects for large bone defects, especially for massiveand irregular defects. Additively manufactured porous tantalum, in particular, has emerged as a promising material for such scaffolds and is widely used in orthopaedics for its exceptional biocompatibility, osteoinduction, and mechanical properties. Porous tantalum has also exhibited unique advantages in personalised rapid manufacturing, which allows for the creation of customised scaffolds with complex geometric shapes for clinical applications at a low cost and high efficiency. However, studies on the effect of the pore structure of additively manufactured porous tantalum on bone regeneration have been rare. In this study, our group designed and fabricated a batch of precision porous tantalum scaffolds via laser powder bed fusion (LPBF) with pore sizes of 250 μm (Ta 250), 450 μm (Ta 450), 650 μm (Ta 650), and 850 μm (Ta 850). We then performed a series of in vitro experiments and observed that all four groups showed good biocompatibility. In particular, Ta 450 demonstrated the best osteogenic performance. Afterwards, our team used a rat bone defect model to determine the in vivo osteogenic effects. Based on micro-computed tomography and histology, we identified that Ta 450 exhibited the best bone ingrowth performance. Subsequently, sheep femur and hip defect models were used to further confirm the osteogenic effects of Ta 450 scaffolds. Finally, we verified the aforementioned in vitro and in vivo results via clinical application (seven patients waiting for revision total hip arthroplasty) of the Ta 450 scaffold. The clinical results confirmed that Ta 450 had satisfactory clinical outcomes up to the 12-month follow-up. In summary, our findings indicate that 450 μm is the suitable pore size for porous tantalum scaffolds. This study may provide a new therapeutic strategy for the treatment of massive, irreparable, and protracted bone defects in arthroplasty.

Advanced Bioceramics: Properties, Fabrication and Applications

Bioceramics are engineered materials that achieve their applications in the medical field. Bioceramics are promising inorganic materials to create scaffolds for bone regeneration due to their desirable properties, such as biocompatibility, osteoconduction, and their similarity with bone composition. Bioceramics can operate as tissue replacement and can be used for coating metal implants to increase their biocompatibility. Bioceramics are classified into three types: bioinert ceramics, bioactive bioceramics, and biodegradable ceramics. There are different methods for the fabrication of bioceramics, they can be prepared by conventional powder processing methods or by some new unconventional methods. Bioceramics can be fabricated by a sintering process, which takes place through the hardening of the green bodies at a relatively high temperature lower than their melting point. Nowadays, microwave sintering is excellent in both heating efficiency, saving energy and time, and the concomitant processing cost. There are other methods used to obtain bioceramics; such as sol-gel, gas-foaming, gel-casting, and freeze-casting techniques. Recently, the CAD/CAM technique (computer-aided design/manufacture) was used in the fabrication of bioceramics and is applied in the dentistry field. The application of bioceramics connects to the repair of the skeletal system, which consists of joints, bones, and teeth, as well as both soft and hard tissues. Bioceramics can be used to replace parts of the cardiovascular system, especially heart valves.

Morphological, mechanical and biological assessment of PCL/pristine graphene scaffolds for bone regeneration

Scaffolds are physical substrates for cell attachment, proliferation, and differentiation, ultimately leading to the regeneration of tissues. They must be designed according to specific biomechanical requirements such as mechanical properties, surface characteristics, biodegradability, biocompatibility, and porosity. The optimal design of a scaffold for a specific tissue strongly depends on both materials and manufacturing processes. Polymeric scaffolds reinforced with electro-active particles could play a key role in tissue engineering by modulating cell proliferation and differentiation. This paper investigates the use of an extrusion additive manufacturing system to produce PCL/pristine graphene scaffolds for bone tissue applications. PCL/pristine graphene blends were prepared using a melt blending process. Scaffolds with regular and reproducible architecture were produced with different concentrations of pristine graphene. Scaffolds were evaluated from morphological, mechanical, and biological view. The results suggest that the addition of pristine graphene improves the mechanical performance of the scaffolds, reduces the hydrophobicity, and improves cell viability and proliferation.

Combination of 3D Printing, Plasma Polymerization, and Bioactive Coatings Towards Fabrication of Eggshell Biowaste/Polycaprolactone Composite Scaffolds for Bone Regeneration

Combination of 3D Printing, Plasma Polymerization, and Bioactive Coatings Towards Fabrication of Eggshell Biowaste/Polycaprolactone Composite Scaffolds for Bone Regeneration

3D Melt-Extrusion Printing of Medium Chain Length Polyhydroxyalkanoates and Their Application as Antibiotic-Free Antibacterial Scaffolds for Bone Regeneration.

In this work, we investigated, for the first time, the possibility of developing scaffolds for bone tissue engineering through three-dimensional (3D) melt-extrusion printing of medium chain length polyhydroxyalkanoate (mcl-PHA) (i.e., poly(3-hydroxyoctanoate-co-hydroxydecanoate-co-hydroxydodecanoate), P(3HO-co-3HD-co-3HDD)). The process parameters were successfully optimized to produce well-defined and reproducible 3D P(3HO-co-3HD-co-3HDD) scaffolds, showing high cell viability (100%) toward both undifferentiated and differentiated MC3T3-E1 cells. To introduce antibacterial features in the developed scaffolds, two strategies were investigated. For the first strategy, P(3HO-co-3HD-co-3HDD) was combined with PHAs containing thioester groups in their side chains (i.e., PHACOS), inherently antibacterial PHAs. The 3D blend scaffolds were able to induce a 70% reduction of Staphylococcus aureus 6538P cells by direct contact testing, confirming their antibacterial properties. Additionally, the scaffolds were able to support the growth of MC3T3-E1 cells, showing the potential for bone regeneration. For the second strategy, composite materials were produced by the combination of P(3HO-co-3HD-co-HDD) with a novel antibacterial hydroxyapatite doped with selenium and strontium ions (Se-Sr-HA). The composite material with 10 wt % Se-Sr-HA as a filler showed high antibacterial activity against both Gram-positive (S. aureus 6538P) and Gram-negative bacteria (Escherichia coli 8739), through a dual mechanism: by direct contact (inducing 80% reduction of both bacterial strains) and through the release of active ions (leading to a 54% bacterial cell count reduction for S. aureus 6538P and 30% for E. coli 8739 after 24 h). Moreover, the composite scaffolds showed high viability of MC3T3-E1 cells through both indirect and direct testing, showing promising results for their application in bone tissue engineering.