Hard Tissue Reconstruction Research Articles

Developing of Load-bearing Bones Replacement Based on Cerium Compounds/Nano-hydroxyapatite Composites

The importance of implantable biomaterials is growing up in recent days for modern medicine, especially fixation, replacement, and regeneration of load-bearing bones. Through the past several years, metals, ceramics, polymers, and their composites, have been used for the reconstruction of hard tissues. Special standards such as adequate mechanical and biocompatible properties are required to avoid rejection reactions of the tissues. Recently, a number of novel advanced biomaterials are developed as promising candidates. Amongst those, cerium-based biomaterials acquired attention as a substitution material for hard tissues reconstruction because of cerium antioxidative properties, which enabled it to be used to decrease mediators of inflammation. In addition, the eminent mechanical properties, as well as the perfect chemical and biological compatibilities, make cerium-based biomaterials attractive for biomedical application.

Primary cilia in hard tissue development and diseases.

Bone and teeth are hard tissues. Hard tissue diseases have a serious effect on human survival and quality of life. Primary cilia are protrusions on the surfaces of cells. As antennas, they are distributed on the membrane surfaces of almost all mammalian cell types and participate in the development of organs and the maintenance of homeostasis. Mutations in cilium-related genes result in a variety of developmental and even lethal diseases. Patients with multiple ciliary gene mutations present overt changes in the skeletal system, suggesting that primary cilia are involved in hard tissue development and reconstruction. Furthermore, primary cilia act as sensors of external stimuli and regulate bone homeostasis. Specifically, substances are trafficked through primary cilia by intraflagellar transport, which affects key signaling pathways during hard tissue development. In this review, we summarize the roles of primary cilia in long bone development and remodeling from two perspectives: primary cilia signaling and sensory mechanisms. In addition, the cilium-related diseases of hard tissue and the manifestations of mutant cilia in the skeleton and teeth are described. We believe that all the findings will help with the intervention and treatment of related hard tissue genetic diseases.

Interdisciplinary management of skull base surgery

Skull base surgery remains one of the challenging areas in the field of cranio-maxillofacial surgery, otolaryngology and neurosurgery. Subsequent reconstruction of bone and soft tissue are an essential component to restore function and appearance after ablative surgery.Establishment of interdisciplinary tumor boards with presentation of the individual patient cases have become standard. Multiplanar reconstruction using MRI or CT imaging techniques combined with virtual 3D planning allow precise planning of the procedures. Intraoperative navigation helps for complete resection of malignant findings with safety margins; surgical approaches provide a good overview of the surgical site. Reconstruction using local flaps have a low complication rate with equally reliable results in reconstruction of small tissue defects. Free flap surgery makes reconstruction of large tissue defects possible. Alloplastic materials are alternatively used for reconstruction of bone defects.Based on selected patients, treatment algorithms and standard surgical procedures in extracerebral skull base surgery will be illustrated. Current techniques and new approaches will be discussed with emphasize on hard and soft tissue reconstruction.

Surface modification of Zirconium based alloys for bio application by Micro-arc oxidation process: A Review

Because of their superior mechanical properties, metal implants are the ideal choice for long-term reconstruction of hard tissues like the hip and knee joints. Zr and its alloys are widely recognized as biocompatible metal implants because of the self-regulating oxide coating that prevents the surface from corrosion and restricts ion release. The Osseo incorporation of these critical elements requires surface modification. The surface of metal implants is modified via micro-arc oxidation (MAO). The goal of this study is to give a summary of contemporary Micro-arc oxidation (MAO) research on zirconium and related alloys in biometal implants.

Surgical Application of Human Amniotic Membrane and Amnion-Chorion Membrane in the Oral Cavity and Efficacy Evaluation: Corollary With Ophthalmological and Wound Healing Experiences.

Due to its intrinsic properties, there has been growing interest in human amniotic membrane (hAM) in recent years particularly for the treatment of ocular surface disorders and for wound healing. Herein, we investigate the potential use of hAM and amnion-chorion membrane (ACM) in oral surgery. Based on our analysis of the literature, it appears that their applications are very poorly defined. There are two options: implantation or use as a cover material graft. The oral cavity is submitted to various mechanical and biological stimulations that impair membrane stability and maintenance. Thus, some devices have been combined with the graft to secure its positioning and protect it in this location. This current opinion paper addresses in detail suitable procedures for hAM and ACM utilization in soft and hard tissue reconstruction in the oral cavity. We address their implantation and/or use as a covering, storage format, application side, size and number, multilayer use or folding, suture or use of additional protective covers, re-application and resorption/fate. We gathered evidence on pre- and post-surgical care and evaluation tools. Finally, we integrated ophthalmological and wound healing practices into the collected information. This review aims to help practitioners and researchers better understand the application of hAM and ACM in the oral cavity, a place less easily accessible than ocular or cutaneous surfaces. Additionally, it could be a useful reference in the generation of new ideas for the development of innovative protective covering, suturing or handling devices in this specific indication. Finally, this overview could be considered as a position paper to guide investigators to fulfill all the identified criteria in the future.

Nano-Topographical Control of Ti-Nb-Zr Alloy Surfaces for Enhanced Osteoblastic Response.

Nano-scale surface roughening of metallic bio-implants plays an important role in the clinical success of hard tissue reconstruction and replacement. In this study, the nano-topographical features of titanium-niobium-zirconium (TNZ) alloy surfaces were controlled by using the target-ion induced plasma sputtering (TIPS) technique to improve the in vitro osteoblastic response. The TIPS technique is a novel strategy for etching the surface of metallic bio-implants using bombardment of target metal cations, which were accelerated by an extremely high negative bias voltage applied to the substrates. The nano-topography of the TNZ surfaces was successfully controlled by modulating experimental variables (such as the ion etching energy and the type of substrate or target materials) of TIPS. As a result, various nanopatterns (size: 10–210 nm) were fabricated on the surface of the TNZ alloys. Compared with the control group, experimental groups with nanopattern widths of ≥130 nm (130 and 210 nm groups) exhibited superior cell adhesion, proliferation, and differentiation. Our findings demonstrate that TIPS is a promising technology that can impart excellent biological functions to the surface of metallic bio-implants.

Interview with José Carlos Martins da Rosa

In this interview, the innovative technique “Immediate Dentoalveolar Restoration” is presented by its developer and main researcher, Dr. José Carlos Rosa. It is noteworthy the discussion about biological aspects, based on cellular components of tuberosity grafts used in this technique. Additionally, the reader has also the opportunity to learn about this therapeutic alternative for the treatment of compromised sockets and the aesthetic reconstruction of soft and hard peri-implant tissues, as well as its indications, advantages and limitations. ©

The effect of Mg concentration to mechanical strength of hydroxyapatite derived from eggshell

Hydroxyapatite (HA) of Ca(I)4Ca(II)6(PO4)6(OH)2 is a biomaterial that is currently being developed for several biomedical applications, such as for the reconstruction of hard tissues of human bones and teeth. HA can be synthesized from raw materials that are easily found in large quantities in the world, such as eggshells. However, due to its low mechanical properties, the doping of metal ions of Mg in its structure is needed to improve the physical properties of HA. Five sets of HA-Mg composites with HA synthesized from eggshells and various MgO concentrations of 0.25, 0.50, 0.75, and 1.00 mol% were prepared by the hydrothermal method at 90 °C for 24 h to observe the effect of the amount of Mg doping on the structural, morphological, and mechanical properties of HA-Mg composites. Doping of Mg ion in HA has increased the secondary phase formation of whitlockite and enlarged the hardness value. The maximum hardness value of 88.7 HV was obtained from the highest Mg concentration of 1.00 mol%.

Cellular Technologies in Traumatology: from Cells to Tissue Engineering

Severe injuries of the musculoskeletal system with damage of bone and cartilaginous tissue are associated with the necessity to find ways for replacement of defects. Current methods of treatment including the usage of autografts and modern synthetic materials are often not effective enough. The article deals with the prospects for developing the new areas in the traumatological pathology treatment based on the cell technologies application. Both medical and ethical aspects of the cell technology usage and the utilizing various sources of cell material for transplantation are discussed in detail. Special attention is devoted to application of the mesenchymal stem cells as the most suitable material for bone and cartilage repair. These cells possess the properties of multipotent stem cells that can adhere to plastic surfaces, differentiate into various cells, including chondroblasts, osteoblasts, and migrate to the damaged area. It is shown that the number and biological characteristics of the isolated cells depend on the tissue, the cell isolation method, and the culture medium. During the cultivation of mesenchymal stem cells, the true marker of which is Stro-1, it is necessary to monitor the duration and number of passages, because these values are inversely correlated with the differentiating potential of cells, and spontaneous transformation according to oncogenic pathway may occur. Thus, mesenchymal stem cells represent a current material for the reconstruction of hard tissues. Despite ethical and technological problems, cell technologies are a promising approach in regenerative medicine.

Biomimetic oligopeptide formed enamel-like tissue and dentin tubule occlusion via mineralization for dentin hypersensitivity treatment.

Dentin hypersensitivity (DH) is a common oral disease with approximately 41.9% prevalence. Reconstruction of dental hard tissues is the preferred treatment for relieving DH. Here, we applied biomineralization method using oligopeptide simulating cementum protein 1 (CEMP1) to regenerate hard tissues on demineralized dentin. The self-assembly and biomineralization property of the oligopeptide were detected by scanning electron microscopy (SEM), circular dichroism spectroscopy, and transmission electron microscopy. Oligopeptide's binding capacity to demineralized dentin was evaluated by SEM and attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). Remineralization was characterized using SEM, ATR-FTIR, X-ray diffraction, and nanoindentation. Oligopeptide's biocompatibility was evaluated using periodontal ligament cells. Oligopeptides self-assembled into nano-matrix and templated mineral precursor formation within 24 h. Moreover, oligopeptide nano-matrix bound firmly on demineralized dentin and resisted water rinsing. Then, bound nano-matrix served as a template to initiate nucleation and transformation of hydroxyapatite on demineralized dentin. After 96 h, oligopeptide nano-matrix regenerated an enamel-like tissue layer with a thickness of 15.35 μm, and regenerated crystals occluded dentin tubules with a depth of 31.27 μm. Furthermore, the oligopeptide nano-matrix had good biocompatibility when co-cultured with periodontal ligament cells. This biomimetic oligopeptide simulating CEMP1 effectively induced remineralization and reconstructed hard tissues on demineralized dentin, providing a potential biomaterial for DH treatment.

Long-Term Effect of Honeycomb β-Tricalcium Phosphate on Zygomatic Bone Regeneration in Rats.

In recent years, artificial bones with high biocompatibility have been developed for hard tissue reconstruction. However, current bone replacement methods are inadequate for large defects, causing infection, exposure, and damage. We have developed a new honeycomb β-tricalcium phosphate (TCP) material, which achieved good bone regeneration after implantation in a rat complete zygomatic bone defect. In this study, we further investigated the ability of honeycomb β- TCP for remodeling after bone regeneration as a long-term result. Bone morphogenic protein (BMP)-2-free honeycomb β-TCP (TCP group) and honeycomb β-TCP with BMP-2 (BMP group) were implanted in the zygomatic bone of rats. Micro-computed tomography was performed to track the zygomatic bone morphology, and specimens were histologically examined for osteogenesis and remodeling. In the TCP group, no bone formation was observed at 1 month, but it was observed at 6 months. Bone formation was observed in the BMP group at 1 month, and β-TCP absorption reproducing the zygomatic bone morphology was observed at 6 months. This honeycomb β-TCP with BMP-2 may provide appropriate remodeling that reproduces good bone formation in the early stage and good morphology in the long term, offering an alternative bone reconstruction material to vascularized bone grafts.

Compositional dependence of the apatite formation ability of Ti-Zr alloys designed for hard tissue reconstruction.

Ti-Zr alloys are expected to be novel biomaterials with low stress shielding owing to their lower Young's moduli than pure Ti. The drawback of metallic biomaterials is that their bone-bonding abilities are relatively low. NaOH and heat treatments have been performed to provide Ti-50Zr with apatite-forming ability in the body environment, which is essential for bone bonding. However, the systematic compositional dependence of apatite formation has not been revealed. In the present study, NaOH treatment of Ti-Zr alloys with various compositions and bone-bonding abilities was assessed in vitro by apatite formation in simulated body fluid (SBF). The corrosion current density in NaOH aqueous solution and the amount of Na incorporated into the surface tended to decrease with increasing Zr content. The apatite-forming ability of the treated alloy significantly decreased when the Zr content was ≥60 atom%. This phenomenon is attributed to the (1) low OH content on the surface, (2) low Na incorporation into the treated alloy surface, which enhances apatite formation, and (3) low ability of P adsorption to the Ti-Zr alloy in SBF following Ca adsorption to trigger apatite nucleation. Although the adhesion of the titanate/zirconate layer formed on the surfaces to the substrates increased as Zr content increased, the adhesion between the apatite and the substrate was still low.

Complex Mandibular Reconstruction for Head and Neck Squamous Cell Carcinoma-The Ongoing Challenge in Reconstruction and Rehabilitation.

Simple SummaryCancer therapy includes a broad range of microvascular free flaps that may restore defects and improve patients’ quality of life. This is particularly important for head and neck squamous cell carcinoma (HNSCC) and composite mandibular reconstructions, containing tissues of bone, muscle, and skin, which may be problematic due to their magnitude and sensitive location. The subscapular system offers a highly valuable donor site with the most versatility and the potential for rapid rehabilitation. Interestingly, other donor sites are more commonly used internationally. Therefore, we evaluated the use of the subscapular system free flap (SFF), which is the most commonly used free flap at our department. To our knowledge, this retrospective study represents the largest number of SFF cases reported to date in the literature. Furthermore, we examined the quality of life in a subgroup of patients, combining prospective occurrences to provide insight into overall rehabilitation from the patients’ viewpoints.Large head and neck squamous cell carcinoma (HNSCC) tumors affecting the mandible require a versatile reconstruction to maintain form, function, and quality of life. Large defect reconstruction of soft and hard tissue in the head and neck necessitates, at best, one vascular system including various tissues by large dimensions. The subscapular flap system seems to meet these standards. A retrospective study was conducted focusing on clinical data, including an analysis of the quality of life with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires, (QLQ-C30 and QLQ-H&N43). A total of 154 patients (122 males, 32 females; age range: 31–71 years, mean: 54.5 years) treated at our department from 1983 through to 2019 were included. Of the subscapular system free flaps (SFFs), 147 were based on the angular artery branch of the thoracodorsal pedicle (95.45%), and the remaining seven cases (4.55%) were lateral scapular border flaps. Mean mandible defect length was 7.3 cm. The mean skin paddle dimension was 86.8 cm2. The most common recipient artery was the thyroid superior artery (79.22%). Major postoperative complications occurred in 13 patients (8.44%). This study confirms that SFFs offer excellent soft and hard tissue quality, component independence, a large arc of rotation length, and a large gauge of pedicle, making them the gold standard for the reconstruction of large composite defects of mandibular HNSCC tumors.

Comprehensive analysis of compatible natural fibre as sacrificial porogen template for tailored ceramic 3D bioproducts destined for hard tissue reconstruction

For successful bone remodelling, the implantable 3D structures require suitable internal architectures which can be achieved by the use of fibres as natural templates. The ability of fibres to generate complex configurations for 3D bioceramic products was preliminary reported by sacrificial fibrous-porogen method. This study aims to demonstrate the safe-prospect of repurposing natural-fibres (i.e. luffa, hemp, wool) for embedment into a calcium phosphate (CaPs) matrix prepared through a completely reproducible route, and the beneficial influence of fibres upon structural, topographic and mechanical features of CaPs-products, since a complete assessment of the fibres-combustion-products resulted after thermal treatment was not yet disclosed. The complex investigation program based on i) thermo-gravimetric (TGA-DTG), ii) structural (XRD, FTIR-ATR), iii) morpho-compositional (SEM/EDS) and, most importantly, iv) biological cytotoxicity assays of fibres-derived chars, clearly indicated that luffa-fibres are the safest (>95% cell-survival) to be considered for bioceramic porous-orthopaedic-implants. Further, as exposed by nano-CT, the high temperature pyrolysis of luffa-fibres led to 3D interconnected channels inside the products, which allows a suitable vascularization and osteointegration. The topographic reconstruction of channels-inside-surface revealed a secondary 3D network of micro-pores. Along with the mechanical features, the novel bioceramic porous structures stand as reliable bone-repair alternatives.

In Vivo Modulation of Angiogenesis and Immune Response on a Collagen Matrix via Extracorporeal Shockwaves.

The effective management of tissue integration and immunological responses to transplants decisively co-determines the success of soft and hard tissue reconstruction. The aim of this in vivo study was to evaluate the eligibility of extracorporeal shock wave therapy (ESWT) with respect to its ability to modulate angiogenesis and immune response to a collagen matrix (CM) for tissue engineering in the chorioallantoic membrane (CAM) assay, which is performed with fertilized chicken eggs. CM were placed on the CAM on embryonic development day (EDD) 7; at EDD-10, ESWT was conducted at 0.12 mJ/mm2 with 500 impulses each. One and four days later, angiogenesis represented by vascularized area, vessel density, and vessel junctions as well as HIF-1α and VEGF gene expression were evaluated. Furthermore, immune response (iNOS2, MMP-9, and MMP-13 via qPCR) was assessed and compared between ESWT- and non-ESWT-groups. At EDD-14, the vascularized area (+115% vs. +26%) and the increase in vessel junctions (+751% vs. +363%) were significantly higher in the ESWT-group. ESWT significantly increased MMP-9 gene expression at EDD-11 and significantly decreased MMP-13 gene expression at EDD-14 as compared to the controls. Using the CAM assay, an enhanced angiogenesis and neovascularization in CM after ESWT were observed. Furthermore, ESWT could reduce the inflammatory activity after a latency of four days.

Electrospun Nanofibers for Improved Angiogenesis: Promises for Tissue Engineering Applications.

Angiogenesis (or the development of new blood vessels) is a key event in tissue engineering and regenerative medicine; thus, a number of biomaterials have been developed and combined with stem cells and/or bioactive molecules to produce three-dimensional (3D) pro-angiogenic constructs. Among the various biomaterials, electrospun nanofibrous scaffolds offer great opportunities for pro-angiogenic approaches in tissue repair and regeneration. Nanofibers made of natural and synthetic polymers are often used to incorporate bioactive components (e.g., bioactive glasses (BGs)) and load biomolecules (e.g., vascular endothelial growth factor (VEGF)) that exert pro-angiogenic activity. Furthermore, seeding of specific types of stem cells (e.g., endothelial progenitor cells) onto nanofibrous scaffolds is considered as a valuable alternative for inducing angiogenesis. The effectiveness of these strategies has been extensively examined both in vitro and in vivo and the outcomes have shown promise in the reconstruction of hard and soft tissues (mainly bone and skin, respectively). However, the translational of electrospun scaffolds with pro-angiogenic molecules or cells is only at its beginning, requiring more research to prove their usefulness in the repair and regeneration of other highly-vascularized vital tissues and organs. This review will cover the latest progress in designing and developing pro-angiogenic electrospun nanofibers and evaluate their usefulness in a tissue engineering and regenerative medicine setting.

Flow Chart for Reconstructive Head and Neck Surgery in Composite Soft and Hard Tissue Defects.

Virtual planning of reconstructive surgical procedures in patients with osseous and composite defects in the head and neck region is becoming increasingly a state of the art modality. However, computational algorithms lack the capability of planning the involved soft tissue and vascular pedicle position. The authors present a flow-chart to solve this problem in the reconstruction of defects of the upper and lower jaw. Clinical records from 2013 to 2018 from a tertiary care center were screened for patients undergoing osseous reconstruction in the head and neck region. A flow-chart considering soft tissue positioning and the anatomical course of the vascular pedicle was assessed in consideration of the defect and donor-site. A total of 81 osseous and composite microvascular reconstructive procedures have been conducted. Defects of the lower jaw were the most common (n = 61). The free fibula flap was the most common reconstructive measure and showed a wide versatility of surgical options to reconstruct these defects. The flow charts were assessed accordingly in these procedures. Soft tissue and vascular pedicle positioning can be planned pre-operatively by the use of virtual planning and should be considered as an enhancement tool to the already existing computational algorithms of planning hard tissue reconstruction.

A modified surgical approach for hard and soft tissue reconstruction of severe periimplantitis defects: laser-assisted periimplant defect regeneration (LAPIDER)

BackgroundThe main problem in periimplantitis is often the combination of severe periimplant bone loss with a contaminated implant surface and an insufficient soft tissue situation. Classic surgical concepts with crestal access to the bony defect and debridement of the surface most often lead to partial defect regeneration and a soft tissue recession. An incision directly above the pathologic bony lesion is contrary to general surgical treatment rules.AimTo overcome this problem, a new surgical concept was developed which allows to clean the implant surface, reconstruct the bony defect, and improve soft tissue height and thickness without cutting the papilla complex. This publication presents the innovative regenerative treatment approach for severe periimplantitis defects.Material and methodsAfter diagnosis and non-surgical pre-treatment of a severe periimplantitis lesion, the following treatment protocol was applied: horizontal mucosal incision 5 mm apical to marginal mucosa, supraperiosteal preparation in apical direction, cutting through periosteum at the level of the implant apex, subperiosteal coronal flap elevation, exploration and cleaning of the periimplant defect, thorough debridement of the implant surface with the Er:YAG laser, subperiosteal grafting with connective tissue, grafting of the bony defect with autogenous bone chips from the mandibular ramus, and bilayered suturing of periosteum and mucosa. Implant survival, marginal bone levels, periimplant probing depths, recession, and facial mucosa thickness (PIROP ultrasonic measurement) were evaluated in a pilot case at 1-year follow-up examination.ResultsInter-proximal, oral, and buccal marginal bone levels increased significantly to the level of the implant shoulder from pre-operative to 1-year follow-up examination. No signs of suppuration or periimplant infection were present. Probing depths and recession decreased significantly, while the facial mucosa thickness improved from pre-operative to final examination.ConclusionsMarginal bone levels and soft tissue improvement suggest feasibility for the regeneration of severe periimplant hard and soft tissue deficiencies by this new treatment approach. With the use of this concept, the simultaneous implant surface cleansing and improvement of hard and soft tissue seem to be possible and unfavorable postoperative exposition of titanium surface might be prevented. Comparative studies are planned to quantify the effects of this new surgical protocol.

Non-suturing microvascular anastomosis in maxillofacial reconstruction- a comparative study

AimThe aim of the study is to compare the advantages and disadvantages of non-suturing anastomotic methods over conventional microsuturing for microvascular venous anastomosis. Materials and methodsAll patients reporting to the institute for hard and soft tissue reconstruction (Primary/secondary) were enrolled in the study. Patients with systemic comorbidities, peripheral vascular diseases, or anatomical aberration of the indicated donor site were excluded from the study. The patients selected for the study were randomly allocated to five groups of different techniques of venous anastomosis, namely Group I (conventional microsuturing), II (fibrin sealant reinforced microsuturing), III (couplers), IV (staplers), V (Laser Assisted Vascular Anastomosis (LAVA)). Intraoperative anastomotic time, flap ischaemic time, patency and leakage were the parameters that were assessed for all five groups. Results80 Patients were randomly allocated to five groups and each group comprised 16 patients. The mean ischaemic time and standard deviation of Group I and Group II were 256.19 ± 10.622 min and 255.19 ± 11.083 min, and for groups III, IV, and V were 193.38 ± 9.972 min, 139.06 ± 6.413 min, and 139.31 ± 6.364 min respectively (p < 0.001). Mean anastomotic time and standard deviation were 19.813 ± 1.5366 min in Group I and 20.281 ± 1.6514 min in Group II. The non-sutured anastomosis groups III, IV, and V showed a mean anastomotic time of 5.375 ± 0.9876 min, 4.175 ± 0.7664 min, and 3.856 ± 0.867 min respectively (p value < 0.001). In Groups I and II, 18.8% of patients had delayed patency and in Groups III, IV and V, immediate patency was observed in all subjects (p value 0.030). In Groups I and II, 18.8% and 6.3 % of patients respectively had leakage, whereas all patients in Groups III, IV, V had no leakage from the anastomotic site (p value 0.119). ConclusionBased on the results of the study, non-suturing techniques should be preferred over microsuturing technique whenever appropriate for venous anastomosis.

The Role of Calcium Phosphates and Electrospun 3D Scaffolds in Bone Tissue Engineering Scaffolds

Bone is a naturally occurring nano-composite structure bestowed with an innate regenerative potential. When this regenerative potential is not able to cope up with the bone loss, external assistance in the form of scaffolds, cells and signals are needed. This forms the basis of bone tissue engineering (BTE). CaP ceramics like hydroxyapatite (HA), calcium deficient hydroxyapatite (CDHA) and β-tricalcium phosphate (β-TCP) are an excellent choice of material for hard tissue reconstruction. However, they are brittle in nature and solid ceramic constructs are not conducive for vascularisation, thus limiting their application as scaffolds for BTE. Thus composite scaffolds of appropriate polymer/ceramic combination would greatly benefit BTE. Electrospinning is an extremely versatile methodology that is predominantly used for the fabrication of nanofibrous structures that closely mimic the ECM. Nevertheless, electrospinning of 3D structures is still a challenge. Various innovations in the electrospinning process are being tried out in order to produce true 3 dimensional structures that can act as scaffolds for BTE. The current paper reviews such technologies and also suggests the way forward for research in this area.