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S. Chowdhury et al.
NiTi alloys shine in 3 medical devices: coils (for aneurysm clotting), stents (for blood ow restoration), and micro guidewires (for stent positioning). These alloys offer unique advantages like shape memory and controlled force, making them ideal for delicate procedures. They even help treat neuromuscular syndromes by restoring function and independence [12]. SMAs revolutionize minimally invasive surgery (MIS) with their exibility and “remembered” shapes. From SMA baskets retriev­ing stones to intra-aortic balloons unblocking arteries, these unique materials enable less intrusive procedures. Even breast cancer surgery benets from SMAs, helping position and isolate tumors before removal. While NiTi SMAs excel at large deec­tions, the reusable versions used in MIS tools prioritize lower strain limits (5%) to prevent permanent deformation. Superelastic SMA shines in guidewires and expanding stents, aiding radiology and treating narrowing caused by tumors [13]. In short, SMA is transforming MIS, offering surgeons new tools for less invasive, more precise procedures.

11.3 Shape Memory Polymers

SMPs were rst discovered around the 1960s, when gamma-ray irradiated polyeth­ylene exhibited a one-way shape memory effect with a temperature change [14]. SMPs are a unique portfolio of polymers marked by distinct molecular phases, switching segments, and netpoints [15]. This distinct molecular architecture in SMP enables reversible shape recovery through a thermomechanical programming cycle, i.e., xation and recovery. SMPs can change between permanent and temporary shapes. The driving force behind shape memory is the entropic elasticity of the polymeric chains, which is subject to change by specic processing steps. It is to be noted that shape memory is not a fundamental property of a polymer. Rather, it must be induced through fabrication programming [16]. The thermo-mechanical pro­gramming process of SMPs involves a cascade of events: deformation, shape xing, and reheating to dissipate the stored internal energy (as depicted in Fig.11.1) [18]. The polymers are rst subjected to deformation under external stress and heating. A high temperature raises the entropy of the polymer, thereby decreasing the activa­tion energy barrier and giving access to manipulating its shape. After the deforma­tion into a pre-programmed temporary shape, it can be xed using chemical crosslinks, crystallization, or supramolecular interactions [17]. The pre-programmed shape can be maintained indenitely as long as no exposure to external stimulus exists. However, upon suitable thermal stimulation, the polymeric chains regain mobility by dissipation of stored energy, enabling the recovery to their original shape [19].
Various stimuli can be used to trigger shape memory in SMPs by incorporating suitable nanollers in them, which are discussed in the following section.
11 Biological Smart Biomaterials: Materials forBiomedical Applications
Fig. 11.1 (A) Activation energy plot of a thermoresponsive SMP at different states. (a) High entropy original/permanent state, (b) transition state wherein the SMP is deformed, and chains are mobile to be reorganized, (c) low entropy metastable temporary state. (B) Schematic of the differ­ent steps of the thermomechanical programming procedure in a SMP [17]. (Reproduced with per­mission from Wiley)
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11.3.1 Heat

Contact heating is the most widely adopted actuation method for SMPs. As shown in Fig. 11.2, the macroscopic thermomechanical programming cycle of a SMP includes fabrication of the SMP into an original shape, heating it above triggering temperature (Ttrans), and deformation of the SMP via an external force, cooling the SMP below Ttrans, withdrawal of the external force to dene a temporary pre­programmed shape, and nally reheating the SMP above its Ttrans to obtain the original shape (recovered shape) [21].
However, the recovery rate is small for SMPs, as most polymers exhibit low thermal conductivity. This necessitates that the surrounding medium be heated to higher temperatures to trigger the shape recovery [22]. Also, thermally-triggered SMPs exhibit low storage modulus and low shape recovery speed, making it imper­ative to modify them into SMP composites for various applications. SMPs. Most shape-memory polymers reported so far belong to the category of thermo- responsive SMPs. The trigger for these polymers, as the name suggests, is a temperature change, which could be glass transition temperature (Tg) for purely amorphous polymers or glass transition temperature and/or crystallization temperature (Tc) for semicrystalline polymers [20]. The driving mechanism behind this property is entropic elasticity, i.e., when an SMP is subjected to a temperature lower than its Tg, the segmental motion of the chains is reduced, and they become frozen [22].
Above the Tg, some polymer chains regain mobility, and this effect can be used to x the SMP into a temporary shape. Deformation of the polymer at a temperature above its Tg causes the polymer chains to lose their random coil conguration and enter into a low entropy state7. Cooling the polymer below its Tg restricts the motion of molecular chains, thereby locking it in this temporary shape [20]. The original shape can only be then recovered by reheating the polymer above its Tg, thereby enabling chain motion and the polymer going into a high entropy random coil state. To emphasize the role of polymer architecture in the entire process, the permanent shape is governed by netpoints, which can be physical or chemical cross­links. At the same time, the switching segments are the more ordered, i.e.,
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Fig. 11.2 Role of polymer architectures in thermal-triggered SMPs [20]. (Reproduced with permission)
crystalline regions in the SMP.Depending on whether the netpoints are physical or chemical will determine the shape recovery efciency and rate. Physical net points tend to be microscopic domains in the structure, which makes them reprocessable [23]. Chemical crosslinks enable superior shape recovery but are not reprocessable. A smart approach uses dynamic chemical crosslinks as net points, such as Diels­Alder moieties, to achieve reprocessability and good shape memory capabilities [24]. Switching segments are associated with reversible thermal transitions, such as glass transition, melting-crystallization, etc. (shown in Fig.11.2).

11.3.2 Light

Light is a potential stimulus that triggers remote shape recovery and provides many additional functionalities, such as safety to human tissues, the ability to travel long distances, focusing on specic areas, etc. For the fabrication of light-triggered SMP
11 Biological Smart Biomaterials: Materials forBiomedical Applications
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composites, photothermal nanollers that may be metallic, polymeric, or carbona­ceous are incorporated in the matrices of SMPs. Metallic nanoparticles generate heat from incident photons (light energy) through the surface plasmonic effect, while polymeric and composite materials exhibit photothermal capabilities due to their strong light absorption [25]. Usually, the light-induced heating is rapid and non-equilibrium in nature. Some common examples of metallic nanostructures include gold nanoparticles (AuNPs), nanorods (AuNRs), and silver nanoparticles (Ag NPs). SMPs such as Poly(ethylene oxide)(PEO) [26], poly(vinyl alcohol) (PVA) [27], and polyurethane [28] are reported as matrices in combination with metallic nanollers such as AuNPs and AuNRs to yield light-responsive SMP com­posites. The visible and NIR regions of the light wavelengths (530, 532, 785, 805, and 860 nm) have mostly been used owing to their benign nature and relatively deeper tissue penetration capabilities [27]. The laser power densities and nanoller content inuence the shape recovery efciency of the SMP composite. This, in turn, allows for precise spatial and temporal control of the entire process, which is bene­cial for biomedical applications.

11.3.3 Magnetic Field

Magnetic eld is an athermal way of triggering the shape recovery in SMP compos­ites. Most magneto-thermal-based SMPCs are fabricated by incorporating magnetic particles in the SMP matrices that can generate heat via inductive heating under the magnetic eld to trigger indirect shape recovery [29]. An amorphous SMP was incorporated with two kinds of magnetic particles (Fe3O4 and NdFeB), wherein the Fe3O4 particles enable inductive heating under alternating magnetic eld and enable shape switching between temporary and permanent shapes. In contrast, the NdFeB particles are magnetized for programmable shape deformation under actuat­ing magnetic eld [30]. PLA and PLA-copolymer-based SMPs incorporated with Fe3O4 nanollers have also been reported for minimally invasive biomedical appli­cations, such as deployable stents [31] and tissue scaffolds (Fig.11.3) [25]. Since Fe3O4 nanollers act as localized heating centers under alternating magnetic elds, the SMP composite is also heated, and once the transition temperature is attained, the composite undergoes contactless shape recovery. The important consideration is that the temperatures attained from inductive heating should be within physiologi­cal levels to avoid any thermal necrosis of surrounding tissues. However, compared with other athermal stimulation, the magnetism-driven SMPCs require a strong magnetic eld (bulky setup) to generate enough heat, which can be deleterious for the human body due to the many side effects, including nanoparticle-associated toxicities.
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Fig. 11.3 Magnetic eld-triggered SMP composites for biomedical applications. (a) Tracheal stents and (b) porous bone scaffolds of PLA-Fe3O4 nanocomposites [32]. (Reproduced with permission)
S. Chowdhury et al.

11.4 Shape-Changing Hydrogels

Hydrogels, polymers forming water-swollen networks, demonstrate signicant expansion in aqueous solutions. They have evolved into a crucial category of bioma­terials for diverse applications, including drug depots, wound dressings, and cell scaffolds [33]. Despite their numerous benets, hydrogels face challenges such as undesired temporal shape changes due to rapid swelling in aqueous solutions, lead­ing to brittle failure under mechanical stress [34]. Consequently, it is essential to design hydrogels that maintain their unique prole and mechanical belongings in aqueous environments. In addition to controlling the swelling dynamics, research is also focused on developing multi-component gels with distinct swelling properties to enable shape alterations over time [35]. Such strategies, exemplied by the use of a copolymer of PEG-PTMG and beeswax, have facilitated the creation of recongu­rable hygroscopic robots. This approach surpasses printer limitations, allowing for customization based on viscoelastic tissue properties [36]. For instance, a design­guided approach utilizing a multi-component gel system has been employed to fab­ricate tissue-mimetic structures, including hollow tubes for sutureless nerve guide conduits (Fig.11.3) [37]. Other innovative approaches involve [38] the use of aniso­tropic cellulose nanoparticles embedded in an acrylamide matrix for directional 4D printing and photocurable silk broin methacrylate-based gels for 4D bioprinting of tracheal constructs. Beyond tissue constructs, 4D printing of hydrogels offers opportunities for controlled drug delivery by incorporating micro and nanoscale structures that respond to physiological triggers such as light, humidity, and tem­perature [39].
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11.5 Biomedical Applications

Given the shortcomings of conventional treatments in meeting patient require­ments, the need for enhanced tissue and organ substitutes is pressing. Tissue engi­neering seeks to produce biomedical scaffolds with diverse functionalities, potentially offering effective solutions. Engineered materials’ ability to change shape holds signicant promise in tissue engineering, as it can facilitate less inva­sive surgical procedures, smooth integration, and replication of the dynamic mor­phologies of natural tissues and organs [4048]. In Fig. 11.4, the hydrogels changing shapes in an aqueous solution is shown. In cardiac tissue engineering, replicating the intricate architecture of natural tissues is crucial for successful regeneration. Mimicking native cellular environments through biomimetic topo­graphical cues enhances tissue and organ regeneration. Proper alignment of cardio­myocytes is essential for effective mechanical and electrical activation of the heart’s ventricles in cardiac tissue engineering. However, producing complex bio­mimetic tissue scaffolds with integrated topographical cues remains challenging. A possible remedy is provided by materials that can alter shape, allowing for creating dynamic scaffolds with distinctive micropatterns and architectures [44, 4955]. For instance, Zhang etal. utilized smart natural lipids, such as soybean oil epoxidized acrylate, to create biocompatible, 4D-dynamic shape-changing tissue scaffolds. These thin lm scaffolds, less than 300μm thick, are bent or self-assembled into rolling structures upon external stimulation (e.g., immersion in ethanol for 10min). Human mesenchymal stem cells (hMSCs) were successfully regulated in their behavior by this method, which offered stable surface structures across a wide region, biocompatibility, and excellent integration. hMSCs were able to proliferate along the created micropatterns and form continuous cellular sheets because of the scaffolds’exceptional cell compatibility. Further evidence of these printed scaffolds’high potential for cardiac tissue engineering applications comes from the dramatically elevated marker expression during the cardiomyogenic differentiation of hMSCs. Osteoprogenitor migration, proliferation, differentiation, and extracel­lular matrix (ECM) production are among the dynamic processes involved in bone tissue engineering. Scientists have investigated synthetic and biodegradable shape­memory polymer (SMP) scaffolds for this purpose, which show potential for mini­mally invasive surgical procedures. By using their ability to change shape, these scaffolds may be compressed and placed at the location of a defect to allow for less intrusive operations. Later, they could be activated to expand and regain their previ­ous shape. Furthermore, by better conforming to the uneven boundaries of bone defects, these scaffolds’ shape- memory capabilities offer advantages in bone tissue engineering.
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Fig. 11.4 Hydrogels that change form in aqueous solutions are 4D printed. (A) The printed con­struct’s many layers’ varying pore diameters result in a notable swelling and shape change varia­tion. (B) FEA models and related tests yield predictable shape changes that enable programmable movements by modifying inll angles [29]
S. Chowdhury et al.

11.6 Conclusion

Different types of smart classes of materials have been developed in recent years to meet the stringent and complex biomedical applications. Be it SMAs to SMPs to shape-changing hydrogels, the library of stimuli-responsive materials has expanded signicantly. With the power of simulations, a good deal of predictive shape changes are also enabled, giving control over the dynamics of the shape-changing process. However, regarding the complexity of the nal product and the physiological rele­vance of the stimulation method being used, the eld has to go a long way. While stimulation, like water and heat, is fairly simple and benign to use, other stimula­tions, such as light, even though advantageous, have not captured the size as much. More research is to be focused on developing a library of materials for better tuning the range of shape-changing efciencies, spatial and temporal control, and minimal side effects caused by the material, stimulation, and the interactions between them.
Acknowledgement The authors would like to acknowledge all the gures mentioned with per­mission from the copyright clearance center having license numbers for Fig.11.1 5722631382885, Fig.11.2 5723551495917, Fig.11.3a 5723571509318, Fig.11.3b 5723580183897 and Fig.11.4 5723560230163 form the concerned press.

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