*3.4.4 Vitamin E*

Another implant was prepared with a bioglass composite film consisting of poly (3-hydroxybutyrate) and vitamin E. The incorporation of vitamin E was done to increase the protein adsorption and hydrophilicity on the surface of the film. This

**Figure 2.** *Cassia occidentalis.*

#### *Novel Dental Implants with Herbal Composites: A Review DOI: http://dx.doi.org/10.5772/intechopen.101489*

composite film was subjected to various characterized studies and the results reported that they can be applied [45] in tissue engineering as a better matrix material for cell adhesion [46]. Chin et al. worked on preparing a novel multi-component skin substitute by using collagen as a matrix material which typically depicts the normal architecture of the skin. This implanting material has a main advantage in producing a cost-effective bone substitute. A novel prepared magnetic fibrin incorporated with nanoparticles and characterized those nanoparticles by various physicochemical techniques using Saos 2 cells, the cell viability, adhesion, and alkaline phosphatase assay. The study revealed that the [47] material exhibited good osteogenic property and hence it can be used in bone tissue engineering .

#### *3.4.5 Collagen*

Auxenfans et al. [48], a researcher investigated a scaffold that contains collagen and glycosaminoglycans (GAG). The matrix was seeded with fibroblast and the study found that it forms a typical reconstructed skin or hemicornea once epithelialization completes. Another study analyzed the rate of degradation of pure collagen and collagen–HAP beads using collagenase enzyme. This enzyme was able to digest pure collagen quickly compared to collagen-HAP gel beads. The HAP provides resistance for quick degradation and the matrix structure could be maintained for a greater period and it supports the cell to adhere, proliferate, and then differentiate [49].

#### *3.4.6 Gluataraldehyde and barium sulfate*

Another research study reported the collagen type II scaffolds by cross-linking with glutaraldehyde and scaffold without cross-linking with glutaraldehyde. The study explained that the scaffolds were seeded with chondrocytes and observed the interaction of cells with the scaffold. The cell adherence on the surface of the scaffold was high which was confirmed by SEM analysis [50]. Another implant using used barium sulfate and zirconia as additives to implant as a bone cement was created to enhance the visualization through X-ray imaging. The incorporation of these additives in bone cement helps to locate the material placed in the bone defect areas [51]. Brown et al. [52, 53] formulated a bone cement consisting of tetra calcium phosphate (TTCP) and dicalcium phosphate (DCPA or DCPD) with a P/L ratio of 4:1 and mixed with water. The mixture was allowed to set for 30 min which formed calcium-deficient HAP. The formed material was hardened and molded and has wide applications in craniofacial surgery. Yamaguchi et al. [54] suggested the inclusion of zinc along with bone cement which induces osteoblast formation at the localized area and eventually new bone formation happens. Another material was developed where Co-Cr alloy was coated with bioactive glass by a process of enameling. The coated alloy was immersed in SBF for 30 days to observe the deposition of HAP on its surface which eventually increases the bioactivity of the material. This has also had wide applications in the tissue engineering field [55].

#### *3.4.7 Agarose and BSA*

Another new fabrication was created using a porous scaffold containing foam-like bioglass and poly (lactide-co-glycolide) PLGA. The scaffold showed high microporosity and also the material was favorable for cell adhesion and hence this scaffold was widely applied in tissue engineering [56]. Another researcher [57] also developed

a scaffold containing BCP and agarose gel. He analyzed the compression behavior of the scaffold and found that agarose improved the property of BCP by imparting elasticity, ductility, and toughness to the material. Hence, this scaffold could be used in the tissue engineering process. Another researcher [58] too prepared a scaffold comprising of two proteins namely bovine serum albumin and alpha casein by a cold gelation process. The developed scaffold can perform better in its porosity, cytotoxicity, and swelling ratio and the pH changes unalters the scaffold performance. An Indian researcher [59] also prepared bone grafts containing fibrin functionalized graphene oxide (FGO) and graphene oxide (GO) on to which HAP was grown by wet precipitation method. An *in vitro* analysis was performed to study its biocompatibility, cell viability, alkaline phosphatase activity, and protein expression studies. The graft containing FGO–HAP showed a better osteoconductive compared to the GO– HAP graft and the results clearly indicated that FGO–HAP can be used in repairing bone defects.

## *3.4.8 Terminalia arjuna bark*

Another Indian scientist team [60] prepared a bone substitute with the incorporation of the extracts of *Terminalia arjuna* bark. The bark extracts were collected, added with BCP, casein gel, and cast into cylindrical bone grafts. The grafts were immersed in SBF for 21 days and analyzed using conventional techniques. The graft was subjected to *in vitro* cell studies to observe its ossification property. The plant bark extract was traditionally used in fracture healing and hence its incorporation in the graft to enhance the osteogenic property of the graft which was evident in *in vitro* studies. Santhosh et al. [61] synthesized a bone graft containing BCP, biocompatible casein, and the extracts of *Myristica fragans*. The prepared graft was analyzed for *in vitro* bioactivity and subjected to *in vitro* cell analysis. The results revealed the deposition of apatite on the graft after immersing in SBF and also the ALP activity was high when treated with MG-63 cells, NIH-3 T3, and Saos 2 cell lines. This study indicates that the inclusion of plant extract enhances the osteogenic property of the graft.
