In situ engineered silicon-magnesium implants orchestrate sequential immunomodulation, angiogenesis, and osteogenesis for bone repair.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Magnesium (Mg) is a promising candidate for next-generation bone implants due to its favorable mechanical properties and biodegradability. However, its rapid corrosion causes local alkalization, hydrogen release, and inflammation, severely limiting clinical translation. Herein, we developed a multifunctional Mg-based implant, denoted as Mg/Mg 2 SiO 4 /PDA (MSP), by constructing an in situ Mg 2 SiO 4 interlayer on the Mg substrate through a one-pot hydrothermal process, followed by polydopamine (PDA) functionalization. This multilayered design orchestrates sequential bone regeneration: early antiinfection-immunoregulation and late vascularization and osteogenesis, which main arises from the different degradation rate and time-window effects of the PDA and Mg-Si layers. By harnessing a controlled initial alkaline burst, the implant effectively inhibits bacterial infection, with bacterial survival rates all below 20%, while the subsequent PDA-mediated immunomodulation promotes macrophage polarization toward the pro-regenerative M2 phenotype and suppressing pro-inflammatory cytokines. Concurrently, controlled release of Si 4+ and Mg 2+ from the Mg 2 SiO 4 layer, synergized with PDA, enhances endothelial cell migration and angiogenesis. Sustained Mg 2+ release further supports osteogenesis, amplified by the synergistic effects of Si 4+ and PDA. MSP exhibited effective antioxidative

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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