Biocompatibility of titanium implants modified by microarc oxidation and hydroxyapatite coating

Systematic strontium substitution in hydroxyapatite coatings on titanium via micro-arc treatment and their osteoblast/osteoclast responses

This study attempts to enhance the osseointegration of titanium implants by adopting a micro-arc treatment (MAT) capable of replacing calcium (Ca) with different percentages of strontium (Sr) in order to fabricate strontium-containing hydroxyapatite (Sr-HAp) coatings. Sr, regarded as a significant therapy promoting bone mass and bone strength, has a dual mechanism, enhancing osteoblast differentiation and inhibiting osteoclast differentiation. This study also investigates how Sr content affects the microstructure of and osteoblast/osteoclast growth on the coatings. Experimental results indicate that an increase in the Sr content in the electrolyte bath results in a greater degree of Sr substitution at Ca sites within the HAp phase, facilitating the formation of Sr-HAp coatings with Sr fully solid soluble in the HAp phase. Irrespective of the Sr content, most coatings are similar in porous morphology and pore size. Additionally, the Sr-HAp coating shows higher osteoblast compatibility than raw titanium metal and the HAp coating. Moreover, cell adhesion and proliferation after 48 h was greater than that after 4 h, indicating that Sr can stimulate osteoblast adhesion and proliferation. Further, Sr significantly inhibits osteoclast differentiation when the Sr-HAp coatings exceed 38.9 at.% Sr.

A treatment algorithm for patients with large skull bone defects and first results

Large skull bone defects resulting from craniotomies due to cerebral insults, trauma or tumours create functional and aesthetic disturbances to the patient. The reconstruction of large osseous defects is still challenging. A treatment algorithm is presented based on the close interaction of radiologists, computer engineers and cranio-maxillofacial surgeons. From 2004 until today twelve consecutive patients have been operated on successfully according to this treatment plan. Titanium and polyetheretherketone (PEEK) were used to manufacture the implants. The treatment algorithm is proved to be reliable. No corrections had to be performed either to the skull bone or to the implant. Short operations and hospitalization periods are essential prerequisites for treatment success and justify the high expenses.

Influence of oxidation treatment on fatigue and fatigue-induced damage of commercially pure titanium

In this investigation, the cyclic deformation behaviour of commercially pure titanium was characterized in axial stress controlled constant amplitude and load increase tests, as well as in rotating bending tests. The influence of different clinically relevant surface treatments (polishing, thermal and anodic oxidizing) on the fatigue behaviour was investigated. All tests were realized in oxygen-saturated Ringer's solution. The cyclic deformation behaviour was characterized by mechanical hysteresis measurements. In addition, the change of the free corrosion potential and the corrosion current during the fatigue tests in simulated physiological media indicated such types of surface damage as slip bands, microcracks and oxide film ablation. Microstructural changes on the specimen surfaces were examined by scanning electron microscopy.

Formation of hydroxyapatite within porous TiO(2) layer by micro-arc oxidation coupled with electrophoretic deposition

Micro-arc oxidation (MAO) is commonly used to modify the surface of Ti-based medical implants with a bioactive and porous titanium oxide (TiO(2)) layer. This study reports a novel method of incorporating hydroxyapatite (HA) within the TiO(2) layer by coupling MAO with an electrophoretic deposition (EPD) process. A HA-incorporated, porous TiO(2) layer was produced successfully on the Ti substrate using the EPD-coupled MAO treatment, as confirmed by electron microscopy observations. Addition of ethanol to the electrolyte solution containing the fine HA particles was essential to reduce the level of gaseous emission on the anode, which obstructs the attachment of HA particles. In vitro cellular assays showed that the incorporation of HA significantly improved the osteoblastic activity on the coating layer.

Cellular responses on anodized titanium discs after laser irradiation

BACKGROUND AND OBJECTIVES

Although the laser is one of the widely used systems in dental field, literature about the biological effects of laser irradiation on the titanium surface is rare. The aim of this study was to investigate the responses of osteoblast-like cells seeded onto laser irradiated anodized titanium discs, using a CO(2) (carbon dioxide) and Er,Cr:YSGG (erbium chromium-doped yttrium scandium gallium garnet) laser, with reference to cellular proliferation and differentiation in vitro.

STUDY DESIGN/MATERIALS AND METHODS

Osteoblast-like HOS cells were cultured on four differently treated anodized titanium disc surfaces. Group 1, anodized (control); group 2, CO(2) laser irradiated; group 3, Er,Cr:YSGG laser irradiated (150 J/cm(2)); group 4, Er,Cr:YSGG laser irradiated (300 J/cm(2)). MTS-based cell proliferation assay and alkaline phosphatase (ALP) activity test were used to compare cellular responses after 1 and 3 days. Three-way analysis of variance (ANOVA) and post hoc method were carried out to determine the statistical significance of the differences.

RESULTS

The cells proliferated actively on all substrates; greatest cellular proliferation was observed in group 4, followed by groups 2, 3, and 1, respectively (P<0.05). The test groups also presented significantly higher ALP activities than the control group (P<0.05) except group 3. For both tests, measured optical densities at 3 days were greater than that of 1 day in control and all test groups (P<0.001).

CONCLUSION

The data shows that irradiation with a CO(2) laser or Er,Cr:YSGG laser may induce a measurable positive effect on osteoblast proliferation and differentiation.

Effects of bioactive glass and beta-TCP containing three-dimensional laser sintered polyetheretherketone composites on osteoblasts in vitro

Because of their excellent physical properties nonresorbable thermoplastic polymers have become more important for the field of reconstructive surgery. Aim of the present study was to investigate the effects of laser sintered polyetheretherketone (PEEK) with incorporated osteoconductive and bioactive bone substitution materials on osteoblasts in vitro. Human osteoblasts (hFOB 1.19) were seeded onto laser sintered PEEK samples containing nano-sized carbon black, beta-tricalciumphosphate (beta-TCP), and bioactive glass 45S5. Osteoblasts were investigated for cell viability, cell proliferation and cell morphology. A constant proliferation of osteoblasts could be observed on all samples with the highest values for bioactive glass containing samples at day 7 (OD 1.76 +/- 0.22) and day 14 (OD 3.75 +/- 0.31) and lowest values for beta-TCP containing probes throughout the study compared with the PEEK pure control group. Highest cell viability was observed for Bioglass containing probes (95.5 +/- 3.32)% whereas osteoblasts seeded on beta-TCP containing probes showed reduced viability (84.4 +/- 4.32)%. Laser sintered PEEK implants seem to be attractive candidates for use as bone substitutes for reconstructive surgery because of their biocompatibility, individual shape, and the possibility of compounding bioinert polymer powder with osteoconductive and bioactive materials which might benefit bone formation in vivo.

Implanting hydroxyapatite-coated porous titanium with bone morphogenetic protein-2 and hyaluronic acid into distal femoral metaphysis of rabbits

OBJECTIVE

To assess the osseointegration capability of hydroxyapatite-coated porous titanium with bone morphogenetic protein-2 (BMP-2) and hyaluronic acid to repair defects in the distal femur metaphysis in rabbits.

METHODS

Porous titanium implants were made by sintering titanium powder at high temperature, which were coated with hydroxyapatite by alkali and heat treatment and with BMP-2 combined with bone regeneration materials. And hyaluronic acid was further used as delivery system to prolong the effect of BMP-2. The implants were inserted into the metaphysis of the distal femur of rabbits. The animals were killed at 6, 12 and 24 weeks to accomplish histological and biomechanical analyses.

RESULTS

According to the result of histological analysis, the osseointegration in BMP-2 group was better than that of the HA-coated porous titanium group. In push-out test, all the samples had bigger shear stress as time passed by. There was statistical difference between the two groups in 6 and 12 weeks but not in 24 weeks.

CONCLUSION

Hydroxyapatite-coated porous titanium with BMP-2 and hyaluronic acid has a good effect in repairing defects of distal femur in rabbits, which is a fine biotechnology for future clinical application.

Structural evolution and adhesion of titanium oxide film containing phosphorus and calcium on titanium by anodic oxidation

This study investigated the microstructure evolution and defects of the titanium oxide layer containing calcium (Ca) and phosphorus (P) formed by anodic oxidation in a solution containing Ca and P compounds. Results show that the anodic film exhibited a two-layer structure: a pore-containing amorphous titanium oxide layer dispersed with nano-sized crystallites formed prior to sparking, and a porous overlay dotted with craters formed after sparking. Ca and P were predominantly incorporated in the porous overlay, in which the amorphous region contained more Ca and P than the crystalline region regardless of the anodizing voltages. Moreover, the ratio of amorphous to crystalline regions in the porous overlay changed insignificantly with anodizing voltage. Increasing anodizing voltage enhanced the incorporation of Ca and P in the anodic film, but deteriorated the adhesion of the anodic film to the substrate. This deterioration was related to two inherent adhesive weaknesses: the aligned pores in the titanium oxide layer and the craters in the major overlay, signifying that a new anodic oxidation process that can produce high Ca- and P-containing oxide film at relatively-low anodizing voltages, i.e. approximately 200 V, is a necessity.

Biological responses in osteoblast-like cell line according to thin layer hydroxyapatite coatings on anodized titanium

Several features of the implant surface, such as roughness, topography and composition play a relevant role in implant integration with bone. This study was conducted in order to determine the effects of various thin layer hydroxyapatite (HA) coatings on anodized Ti surfaces on the biological responses of a human osteoblast-like cell line (MG63). MG63 cells were cultured on 100 nm HA (100 nm HA coating on anodized surface), 500-700 nm HA (500-700 nm HA coating on anodized surface), 1 mum HA (1 mum HA coating on anodized surface) and anodize (non-HA coating on anodized surface) Ti. The morphology of these cells was assessed by scanning electron microscopy (SEM). The cDNAs prepared from the total RNAs of the MG63 were hybridized into a human cDNA microarray (1152 elements). The appearances of the surfaces observed by SEM were different on each of the four dental substrate types. MG63 cells cultured on 100 nm HA, 1 mum HA and anodize exhibited cell-matrix interactions. It was 500-700 nm HA surface showing cell-cell interaction. In the expression of genes involved in osseointegration, several genes, including bone morphogenetic protein 2, latent transforming growth factor beta binding protein 1, catenin (cadherin-associated protein), integrin, PDGFRB and GDF-1 growth differentiation factor 1 were up-regulated on the different surfaces. Several genes, including fibroblast growth factor receptor 3, fibroblast growth factor 12 and CD4 were down-regulated on the different surfaces. The attachment and expression of key osteogenic regulatory genes were enhanced by the surface morphology of the dental materials used.

Characteristic and in vitro bioactivity of a microarc-oxidized TiO(2)-based coating after chemical treatment

Microarc oxidation (MAO) was used to prepare a TiO(2)-based coating containing Ca and P on titanium alloy. An alkali treatment was developed to modify the surface of the MAO coating to improve the apatite-forming ability of the coating. The chemically treated MAO coating exhibits a modified layer, with the main constituents being O, Ti, Ca and Na, showing anatase. The modified MAO coating shows a rough and porous morphology containing numerous nanoflakes of approximately 100nm thickness. During the alkali treatment process, P on the surface of the MAO coating shows a main dynamic process of dissolution; however, Ca exhibits a re-deposition process as well as dissolution. The formation of the modified layer could be explained by this mechanism: negatively charged HTiO(3)(-) ions are formed on the MAO coating due to the attack of OH(-) ions on the TiO(2) phase. The HTiO(3)(-) ions could incorporate sodium from the alkali solution and calcium from the alkali solution and MAO coating. The apatite-forming ability of the MAO coating is improved remarkably by the simple chemical treatment, since the surface of the alkali-treated MAO coating could provide abundant Ti-OH groups probably formed by ionic exchanges between (Ca2+, Na+) ions of the alkali-treated MAO coating and H3O+ ions of a simulated body fluid (SBF). Moreover, Ca released from the alkali-treated MAO coating increases the degree of supersaturation of SBF, promoting the formation of apatite. The apatite induced by the alkali-treated MAO coating possesses carbonated structure and pore networks on the nanometer scale.