Cellular responses evoked by different surface characteristics of intraosseous titanium implants

The Evaluation of Osteoblastic Cell Behavior on Treated Titanium Surface

Background:

There are several potential advantages in optimizing the initial events of osseointegration in the benefit of clinical outcome.

Objective:

The objective of the present study was to evaluate the behavior of osteoblastic cells on surfaces treated by double acid etching using HNO3 and H2SO4.

Methods:

Commercially pure titanium (grade 4) discs measuring 6 mm in diameter and 2 mm in thickness were used. The discs were divided into two groups: machined group and double acid-etched discs (HNO3 and H2SO4). Surface characteristics were assessed using Scanning Electron Microscopy. Pre-osteoblastic MC3T3-E1 cells were used for cell culture on the tested surfaces to assess proliferation, viability (MTT), as well as secretion (ELISA) and cytoplasmic expression (Western blot) of type I collagen.

Results:

The data obtained were analyzed using t-test or two-way ANOVA followed by Bonferroni’s test at 95% significance. The titanium surfaces showed average roughness values for the machined and treated surfaces of 0.29 and 1.16, respectively (p<0.05). An increase in cell proliferation was observed, which was corroborated by the viability assay. Both type I collagen secretion and intracellular expression were higher on the double acid-etched surface compared to the machine surfaces (p<0.05).

Conclusion:

Implant surfaces treated by double acid etching positively affected the early events of the interaction between titanium and osteoblastic cells, suggesting optimization of osseintegration.

Cytotoxicity Evaluation of The Bioresorbable and Titanium Plates/Screws Used in Maxillofacial Surgery on Gingival Fibroblasts and Human Mesenchymal Bone Marrow Stem Cells

Objective

Bioresorbable and titanium plates/screws are considered as a standard treatment for fixation of the bone segments of craniofacial area and paying attention to their biocompatibility is an important issue along with other aspects of application. The purpose of the study was to evaluate the cell viability of two types of plate and screw used in maxillofacial surgeries in contact with gingival fibroblasts and bone marrow stem cells.

Materials and Methods

In this experimental study after extraction and cultivation of cells from healthy human gingival tissue and alveolar bone of jaw, cytotoxicity of device was evaluated. In direct contact method, samples had near vicinity contact with the both cell lines and in indirect contact method, by-products released, like ions, from samples after 8 weeks were used to assess cytotoxicity. Then cytotoxicity was evaluated on the 2^nd, 4^th and 6^th day with MTS tests and microscopy. The data were analyzed by one-way ANOVA and independent t tests.

Results

There was a statistically significant difference between the German plate and screw and all the samples studied on day 6 (P<0.05). Furthermore, a statistically significant difference was observed between both metal samples and both bio-absorbable samples on day 6 and both cell lines (P<0.05). Comparisons between the two groups with each other for both cell lines on the 6^th day were statistically significant (P<0.05).

Conclusion

Our results suggest that that cytotoxicity of biomaterial, from different brands, were not similar and some of the biomaterial showed lower degree of toxicity compared to others and specialist using these products showed be aware of this differences. Our investigation indicates more biocompatibility of bioresorbable plates and screws compared to titanium. In addition our results suggest that biomaterials were not completely neutral.

Accentuated osseointegration in osteogenic nanofibrous coated titanium implants

Anchoring of endosseous implant through osseointegration continues to be an important clinical need. Here, we describe the development of superior endosseous implant demonstrating enhance osseointegration, achieved through surface modification via coating of osteogenic nanofibres. The randomized bio-composite osteogenic nanofibres incorporating polycaprolactone, gelatin, hydroxyapatite, dexamethasone, beta-glycerophosphate and ascorbic acid were electrospun on titanium implants mimicking bone extracellular matrix and subsequently induced osteogenesis by targeting undifferentiated mesenchymal stem cells present in the peri-implant niche to regenerate osseous tissue. In proof-of-concept experiment on rabbit study models (n = 6), micro-computed tomography (Micro-CT), histomorphometric analysis and biomechanical testing in relation to our novel osteogenic nanofibrous coated implants showed improved results when compared to uncoated controls. Further, no pathological changes were detected during gross examination and necropsy on peri-implant osseous tissues regenerated in response to such coated implants. The findings of the present study confirm that osteogenic nanofibrous coating significantly increases the magnitude of osteogenesis in the peri-implant zone and favours the dynamics of osseointegration.

Dental Implants With a Platform-Switched Morse Taper Connection and an Osteo Growth Induction Surface

AIM

The aim of this study was to analyze the clinical outcomes after using an innovative implant system characterized by a modern platform-switched Morse taper connection and an osteo growth induction titanium surface (a particular type of SLA surface). Peri-implant bone loss (PBL) and implant success rate were examined after a 1- to 3-year follow-up.

METHODS

The study was conducted as a cross-sectional analysis on all patients treated from January 2011 to December 2014 using CLC CONIC implants. Implants were divided into 3 main groups, based on the duration of the follow-up (1 year, 2 years, and 3 years), then subgrouped by diameter, length, and type of prosthetic rehabilitation to compare differences in PBL. X-rays were taken at the time of surgery, at prosthetic loading, at 1 year, and then annually thereafter. Previously-established success criteria were used to assess the implants. Frequency analyses and comparisons between the means (with 95% CI) were conducted for the statistical analysis of the data collected.

RESULTS

One hundred twenty patients met inclusion and exclusion criteria, and completed the follow-up, and were thus eligible for the study, with a total of 261 CLC CONIC implants. The mean follow-up was 22.45 months. No implants failed, giving an overall success rate of 100%. The average PBL at 1-year follow-up was 0.047 mm, at 2 years it was 0.128 mm, and at 3 years it was 0.236 mm.

CONCLUSIONS

The CLC CONIC implant system had a high success rate after 1 to 3 years of follow-up, in line with previous reports in the scientific literature. Combining platform switching with the Morse taper connection enabled stable bone levels to be achieved in the short to medium term.

The Effect of Ultraviolet Photofunctionalization on a Titanium Dental Implant with Machined Surface: An In Vitro and In Vivo Study

Ultraviolet (UV) photofunctionalization has been suggested as an effective method to enhance the osseointegration of titanium surface. In this study, machined surface treated with UV light (M + UV) was compared to sandblasted, large-grit, acid-etched (SLA) surface through in vitro and in vivo studies. Groups of titanium specimens were defined as machined (M), SLA, and M + UV for the disc type, and M + UV and SLA for the implant. The discs and implants were assessed using scanning electron microscopy, confocal laser scanning microscopy, electron spectroscopy for chemical analysis, and the contact angle. Additionally, we evaluated the cell attachment, proliferation assay, and real-time polymerase chain reaction for the MC3T3-E1 cells. In a rabbit tibia model, the implants were examined to evaluate the bone-to-implant contact ratio and the bone area. In the M + UV group, we observed the lower amount of carbon, a 0°-degree contact angle, and enhanced osteogenic cell activities (p < 0.05). The histomorphometric analysis showed that a higher bone-to-implant contact ratio was found in the M + UV implant at 10 days (p < 0.05). In conclusion, the UV photofunctionalization of a Ti dental implant with M surface attained earlier osseointegration than SLA.

Biological events related to corticotomy-facilitated orthodontics

Corticotomy-facilitated orthodontics is a clinical treatment modality comprising the application of conventional orthodontic forces combined with selective decortication of the alveolar process of the bone, which generates a localized process of bone remodeling (turnover) that enables accelerated orthodontic tooth movement. Compared with conventional orthodontic treatment, corticotomy-facilitated orthodontics is associated with reduced treatment time and reduces the frequency of apical external root resorption; however, this modality increases morbidity and financial costs. Although the clinical outcomes of corticotomy-facilitated orthodontics appear favorable, no results of evidence-based investigations of long-term outcomes are available in the literature, and the long-term effects of corticotomy-facilitated orthodontics on the teeth and periodontium are unclear. This narrative review discusses the biological events associated with corticotomy-facilitated orthodontics. Authoritative articles found in relevant databases were critically analyzed and the findings were integrated and incorporated in the text.

Investigation of a novel sterilization method for biofilms formed on titanium surfaces

The development of effective methods to disinfect biofilms on dental materials is medically important. This study evaluated the bactericidal effects of peroxynitric acid (HOONO₂; PNA) on biofilms formed on titanium surfaces. Streptococcus gordonii was cultured on either machined or rough titanium discs that were then used to evaluate the bactericidal effects of seven reagents, i.e., normal saline, benzalkonium chloride disinfectant solution, chlorhexidine digluconate solution, three concentration types of PNA, and inactivated PNA. Using low concentration of PNA, the bacterial count based on a CFU assay reached an undetectable level within 10 s; this bactericidal effect was the strongest observed for the seven tested reagents. Thus, PNA may be more useful than other disinfectants for sterilizing biofilms on titanium surfaces that have been contaminated with bacteria.

Laser Surface Texturing of Alumina/Zirconia Composite Ceramics for Potential Use in Hip Joint Prosthesis

The use of metal shell to fix an acetabular cup to bone in hip joint prosthesis carries some limitations, including restrictions in prosthetic femur ball diameter and in patient’s range of motion. These drawbacks could be ideally overcome by using a monolithic ceramic acetabular cup, but the fixation of such an implant to host bone still remains a challenge. Since porous surfaces are known to promote more bone tissue interlocking compared to smooth materials, in this work the surfaces of sintered alumina/zirconia composite ceramics were treated by a pulsed laser radiation at 1064 nm with a pulse width in the nanosecond range, in order to impart controlled textural patterns. The influence of laser process parameters (e.g., energy per pulse, repetition rate, scanning speed, repetition number, angle of laser beam, and number of cycles) on the roughness and texture orientation was systematically investigated. The obtained surface topographies were inspected by optical and scanning electron microscopy, and the roughness was assessed by contact profilometry. Surface roughness could be modulated in the range of 3 to 30 µm by varying the processing parameters, among which the number of cycles was shown to play a major role. The laser treatment was also successfully adapted and applied to ceramic acetabular cups with a curved profile, thus demonstrating the feasibility of the proposed approach to process real prosthetic components.

A nanostructure platform for live-cell manipulation of membrane curvature

Membrane curvatures are involved in essential cellular processes, such as endocytosis and exocytosis, in which they are believed to act as microdomains for protein interactions and intracellular signaling. These membrane curvatures appear and disappear dynamically, and their locations are difficult or impossible to predict. In addition, the size of these curvatures is usually below the diffraction limit of visible light, making it impossible to resolve their values using live-cell imaging. Therefore, precise manipulation of membrane curvature is important to understanding how membrane curvature is involved in intracellular processes. Recent studies show that membrane curvatures can be induced by surface topography when cells are in direct contact with engineered substrates. Here, we present detailed procedures for using nanoscale structures to manipulate membrane curvatures and probe curvature-induced phenomena in live cells. We first describe detailed procedures for the design of nanoscale structures and their fabrication using electron-beam (E-beam) lithography. The fabrication process takes 2 d, but the resultant chips can be cleaned and reused repeatedly over the course of 2 years. Then we describe how to use these nanostructures to manipulate local membrane curvatures and probe intracellular protein responses, discussing surface coating, cell plating, and fluorescence imaging in detail. Finally, we describe a procedure to characterize the nanostructure-cell membrane interface using focused ion beam and scanning electron microscopy (FIB-SEM). Nanotopography-based methods can induce stable membrane curvatures with well-defined curvature values and locations in live cells, which enables the generation of a library of curvatures for probing curvature-related intracellular processes.

Evaluation of Biological Response of STRO-1/c-Kit Enriched Human Dental Pulp Stem Cells to Titanium Surfaces Treated with Two Different Cleaning Systems

Peri-implantitis-an infection caused by bacterial deposition of biofilm-is a common complication in dentistry which may lead to implant loss. Several decontamination procedures have been investigated to identify the optimal approach being capable to remove the bacterial biofilm without modifying the implant surface properties. Our study evaluated whether two different systems-Ni-Ti Brushes (Brush) and Air-Polishing with 40 µm bicarbonate powder (Bic40)-might alter the physical/chemical features of two different titanium surfaces-machined (MCH) and Ca⁺⁺ nanostructured (NCA)-and whether these decontamination systems may affect the biological properties of human STRO-1⁺/c-Kit⁺ dental pulp stem cells (hDPSCs) as well as the bacterial ability to produce biofilm. Cell morphology, proliferation and stemness markers were analysed in hDPSCs grown on both surfaces, before and after the decontamination treatments. Our findings highlighted that Bic40 treatment either maintained the surface characteristics of both implants and allowed hDPSCs to proliferate and preserve their stemness properties. Moreover, Bic40 treatment proved effective in removing bacterial biofilm from both titanium surfaces and consistently limited the biofilm re-growth. In conclusion, our data suggest that Bic40 treatment may operatively clean smooth and rough surfaces without altering their properties and, consequently, offer favourable conditions for reparative cells to hold their biological properties.

What is the Best Micro and Macro Dental Implant Topography?

Implant surface micro and macro topography plays a key role in early osseointegration. The physicochemical features of the implant surface (ie, chemical composition, hydrophobicity/hydrophilicity and roughness) influence the deposition of extracellular matrix proteins, the precipitation of bone mineral, and the stimulation of cells. Modification of the implant topography provides better primary stability and faster osseointegration, allowing for immediate placement or immediate loading. Randomized clinical trials are warranted to compare the response of osseointegration with various implant micro and macro surface topographies in people with various local or systemic risk factors.

The effects of graphene and mesenchymal stem cells in cutaneous wound healing and their putative action mechanism

This study provides a review of the therapeutic potential of graphene dressing scaffolds and mesenchymal stem cells (MSCs) and their synergistic effects with respect to cutaneous wound healing. This study also considers their putative action mechanism based on the antibacterial, immunomodulating, angiogenic, matrix remodeling effects of materials belonging to the graphene family and MSCs during the wound healing process. In addition, this study discusses the cytocompatibility of graphene, its uses as a platform for skin substitutes, the properties it possesses with respect to providing protection against microbial invasion as well as strategies aimed at minimizing the chance of the occurrence of sepsis. MSCs are capable of secreting several factors that exert a therapeutic impact on reparative processes and tissue regeneration. In light of experiments conducted to date, graphene combined with MSCs appears to have the potential to enhance both the wound healing process and infection control at the injury site.

Surface engineering of LENS-Ti-6Al-4V to obtain nano- and micro-surface topography for orthopedic application

Two distinct surface topographies consisting of micro- and nano-surface were developed using laser texturing (LT) and anodization process respectively and their effect on the surface-related properties of Ti-6Al-4V fabricated using Laser Engineered Net Shaping (LENS) were determined. The topographies developed using laser texturing (25, 50 and 75% overlap) were examined using 3D profilometer, whereas, Field Emission Scanning Electron Microscopy (FE-SEM) was used to analyze Titania NanoTubes (TNT) formed using anodization. Though all the surface modified specimens exhibited hydrophilic behavior, least contact angle values were observed for the specimen surface modified with TNT. 25LT and 50LT specimens offered about 8 fold higher corrosion resistance than TNT specimens. All the surface modified samples exhibited non-toxicity to blood cells as well as to the mesenchymal stem cells (hMSCs) with a higher rate of proliferation and differentiation hMSCs observed on 75LT specimens and TNT specimen.

Naturally-Derived Biphasic Calcium Phosphates through Increased Phosphorus-Based Reagent Amounts for Biomedical Applications

Calcium carbonate from marble and seashells is an eco-friendly, sustainable, and largely available bioresource for producing natural bone-like calcium phosphates (CaPs). Based on three main objectives, this research targeted the: (i) adaptation of an indirect synthesis route by modulating the amount of phosphorus used in the chemical reaction, (ii) comprehensive structural, morphological, and surface characterization, and (iii) biocompatibility assessment of the synthesized powdered samples. The morphological characterization was performed on digitally processed scanning electron microscopy (SEM) images. The complementary 3D image augmentation of SEM results also allowed the quantification of roughness parameters. The results revealed that both morphology and roughness were modulated through the induced variation of the synthesis parameters. Structural investigation of the samples was performed by Fourier transform infrared spectroscopy and X-ray diffraction. Depending on the phosphorus amount from the chemical reaction, the structural studies revealed the formation of biphasic CaPs based on hydroxyapatite/brushite or brushite/monetite. The in vitro assessment of the powdered samples demonstrated their capacity to support MC3T3-E1 pre-osteoblast viability and proliferation at comparable levels to the negative cytotoxicity control and the reference material (commercial hydroxyapatite). Therefore, these samples hold great promise for biomedical applications.

Changes in proinflammatory gene expression in human whole blood after contact with UV-conditioned implant surfaces

OBJECTIVES

The aim of this in vitro study was to assess changes in the gene expression of proinflammatory cytokines in human whole blood after contact with titanium implant surfaces conditioned by UV light. To this end, expression levels of proinflammatory cytokines were analyzed in vitro in human whole blood.

MATERIALS AND METHODS

Dental implants made of grade 4 titanium were conditioned by UV light in a UV device and submerged in human whole blood. Unconditioned implants served as controls, and blood samples without implants served as the negative control group. Sampling was performed at 1, 8, and 24 h. Changes in the expression levels of interleukin-1β (IL1B) and tumor necrosis factor alpha (TNF) were assessed using RT-qPCR at the mRNA level.

RESULTS

The gene expression of IL1B was significantly suppressed in the test group over the observation period compared to the control group during the 1-8 h after having contact between the implant surface and the blood. The gene expression of TNF was not significantly altered by UV conditioning after 1 and 8 h of observation, but both cytokine expression levels were increased significantly after 24 h.

CONCLUSIONS

Differences in the gene expression of proinflammatory cytokines after insertion of UV-conditioned titanium implants can be assessed using a human whole blood test. UV-conditioned implant surfaces apparently suppress the release of IL1B in vitro.

CLINICAL RELEVANCE

The results of our publication demonstrate that modulation of the early inflammatory response in human whole blood is possible by surface treatment with UV light. In particular, the suppression of IL1B expression, especially after the initial contact of blood cells, may be beneficial in the osseointegration of titanium implants by positively influence the balance between rejection and acceptance of an implant.

Titanium Surface Properties Influence the Biological Activity and FasL Expression of Craniofacial Stromal Cells

Mesenchymal stromal cells (MSCs) can be easily isolated form craniofacial bones during routine dentistry procedures. Due to their embryological origin from neural crest, they represent a suitable cell population to study cell-biomaterial interaction in the craniofacial field, including osteoinductive/osteointegrative processes. The biological and immunomodulatory properties of MSCs may be influenced by chemistry and topography of implant surfaces. We investigated if and how three different titanium surfaces, machined (MCH), sandblasted with resorbable blasting medium (RBM), and Ca⁺⁺-nanostructured (NCA), may affect biological activity, osseointegration, and immunomodulatory properties of craniofacial MSCs. Cell proliferation, morphology, osteogenic markers, and FasL were evaluated on MSCs isolated from the mandibular bone after seeding on these three different surfaces. No statistically significant differences in cell proliferation were observed whereas different morphologies and growth patterns were detected for each type of surface. No difference in the expression of osteogenic markers was revealed. Interestingly, FasL expression, involved in the immunomodulatory activity of stem cells, was influenced by surface properties. Particularly, immunofluorescence analysis indicated that FasL expression increased on MCH surface compared to the others confirming the suggested role of FasL in promoting osteogenic differentiation. Titanium surface treatments and topography might reflect different biological behaviours of craniofacial MSCs and influence their osseointegration/immunomodulation properties.

Titanium discs coated with 3,4-dihydroxy-l-phenylalanine promote osteogenic differentiation of human bone mesenchymal stem cells in vitro

The bioinspired material 3,4-dihydroxy-l-phenylalanine (DOPA) is commonly used as a basic layer in surface modification for osteogenesis; however, its effects on bone remodeling and the underlying mechanisms remain unclear. Here, we investigated the effect of DOPA-coated surfaces on human bone marrow-derived mesenchymal stem cells in vitro. Cells cultured on DOPA-modified titanium discs exhibited enhanced cellular adhesion and spreading compared with cells on non-treated surfaces. Moreover, DOPA-coating promoted greater cell proliferation and osteogenic differentiation, as determined using cell counting kit-8 (CCK-8) assay, alkaline phosphatase activity test and quantitative mineralization measurements. Furthermore, microarray analysis revealed that genes participating in focal adhesion were upregulated on DOPA-coated surfaces. Our results indicate that the application of a simple DOPA coating can promote osteogenic differentiation of osteoprogenitor cells, improving new bone formation and bone remodeling around implantable devices in tissue engineering.

Titanium discs with simple 3,4-dihydroxy-l-phenylalanine coating enhanced BM-MSC adhesion, spreading, proliferation and differentiation, and upregulated expression of genes involved in focal adhesion in vitro.

Evaluation of Chemical Mechanical Polishing-Based Surface Modification on 3D Dental Implants Compared to Alternative Methods

Chemical mechanical polishing (CMP) has been introduced in previous studies as a synergistic technique to modify the surface chemistry and topography of titanium-based implants to control their biocompatibility. In this study, the effectiveness of CMP implementation on titanium-based implant surface modification was compared to machined implants, such as baseline and etching and biphasic calcium phosphate (BCP) particle-based sand blasting treatments, in terms of the surface chemical and mechanical performance. Initially, a lab-scale 3D CMP technique was developed and optimized on commercial dental implant samples. The mechanical competitiveness of the dental implants treated with the selected methods was examined with the Vickers microhardness test as well as pull-out force and removal torque force measurements. Furthermore, the surface structures were quantified through evaluation of the arithmetic mean roughness parameter (Ra). Subsequently, the surface chemistry changes on the treated implants were studied as wettability by contact angle measurement, and surface passivation was evaluated through electrochemical methods. In each evaluation, the CMP treated samples were observed to perform equal or better than the baseline machined implants as well as the current method of choice, the BCP treatment. The ability to control the surface topography and chemistry simultaneously by the use of CMP technique is believed to be the motivation for its adaptation for the modification of implant surfaces in the near future.

Effect of titanium surface functionalization with bioactive glass on osseointegration: An experimental study in dogs

PURPOSE

The purpose of this study was to evaluate the effect of surface functionalization with bioactive glass BSF18 on the osseointegration of sandblasted and dual acid-etched surface (AE) implants.

METHODS AND MATERIALS

Forty Morse taper implants with an AE surface as controls (C) or with an AE surface functionalized with BSF18 (BF) were placed in the mandibles of 10 beagles. Implants were analyzed after 2 and 4 weeks of healing. Implant stability quotient (ISQ) values were registered immediately after installation and prior to sacrifice. Samples were analyzed for bone-to-implant contact (BIC) and bone density (BD). The characterization of BF implants included surface roughness analysis with atomic force microscopy and contact angle (CA) analysis to evaluate wettability. Data were analyzed using two-way ANOVA followed by Tukey's test (p < 0.05).

RESULTS

Surface roughness was not affected by BF treatment. CA was lower in the BF group compared to the C group. No significant difference was observed in ISQ values between surfaces (p = 0,231), irrespective of time. Significantly higher ISQ values were observed for both implants after 4 weeks when compared with baseline (p = 0.04). Significantly higher BIC (p = 0.011) and BD (p = 0.025) values were observed for the BF compared to the C group at 2 weeks. Significantly higher BIC (p = 0.030) and BD (p = 0.015) values for the C group were observed at 4 weeks compared to 2 weeks. No significant difference was observed in the BF group between 2 and 4 weeks.

CONCLUSIONS

Implant functionalization with BSF18 improved the wettability of the implant surface; enhancing BIC and BD at 2 weeks.

A critical review of multifunctional titanium surfaces: New frontiers for improving osseointegration and host response, avoiding bacteria contamination

Evolution of metal implants progressively shifted the focus from adequate mechanical strength to improved biocompatibility and absence of toxicity and, finally, to fast osseointegration. Recently, new frontiers and challenges of Ti implants have been addressed to improvement of bioactivity, fighting of bacterial infection and biofilm formation, as well as modulation of inflammation. This is closely related to the clinical demand of multifunctional implants able to simultaneously have a number of specific responses with respect to body fluids, cells (osteoblasts, fibroblasts, macrophages) and pathogenic agents (bacteria, viruses). This complex system of multiple biological stimuli and surface responses is a major arena of the current research on biomaterials and biosurfaces. This review covers the strategies explored to this purpose since 2010 in the case of Ti and Ti alloys, considering that the number of related papers doubled about in the last seven years and no review has comprehensively covered this engaging research area yet. The different approaches followed for producing multifunctional Ti-based surfaces involve the use of thick and thin inorganic coatings, chemical surface treatments, and functionalization strategies coupled with organic coatings.

STATEMENT OF SIGNIFICANCE

According to the clinical demand of multifunctional implants able to simultaneously have a number of specific responses with respect to body fluids, cells and pathogenic agents, new frontiers of Ti implants have been addressed to improvement of bioactivity, fighting of bacterial infection and biofilm formation, as well as modulation of inflammation. Literature since 2010 is here reviewed. Several strategies for getting bioactive and antibacterial actions on Ti surfaces have been suggested, but they still need to be optimized with respect to several concerns. A further step will be to combine on the same surface a proven ability of modulation of inflammatory response. The achievement of multifunctional surfaces able to modulate inflammation and to promote osteogenesis is a grand challenge.

Effects of thermal treatment on the adhesion strength and osteoinductive activity of single-layer graphene sheets on titanium substrates

In recent years, dental implants have become the preferred approach for the restoration of missing teeth. At present, most dental implants are made of pure titanium, and are affected by peri-implantitis and bone resorption, which usually start from the implant neck, due to the complex environment in this region. To address these issues, in this study we modified the surface of titanium (Ti) implants to exploit the antibacterial and osteoinductive effects of single-layer graphene sheets. Chemical vapor deposition (CVD)-grown single-layer graphene sheets were transferred to titanium discs, and a method for improving the adhesion strength of graphene on Ti was developed due to compromised adhesion strength between graphene and titanium surface. A thermal treatment of 2 h at 160 °C was found to enhance the adhesion strength of graphene on Ti to facilitate clinical transformation. Graphene coatings of Ti enhanced cell adhesion and osteogenic differentiation, and imparted antibacterial activity to Ti substrate; these favorable effects were not affected by the thermal treatment. In summary, the present study elucidated the effects of a thermal treatment on the adhesion strength and osteoinductive activity of single-layer graphene sheets on titanium substrates.

Nanoscale Topographical Characterization of Orbital Implant Materials

The search for an ideal orbital implant is still ongoing in the field of ocular biomaterials. Major limitations of currently-available porous implants include the high cost along with a non-negligible risk of exposure and postoperative infection due to conjunctival abrasion. In the effort to develop better alternatives to the existing devices, two types of new glass-ceramic porous implants were fabricated by sponge replication, which is a relatively inexpensive method. Then, they were characterized by direct three-dimensional (3D) contact probe mapping in real space by means of atomic force microscopy in order to assess their surface micro- and nano-features, which were quantitatively compared to those of the most commonly-used orbital implants. These silicate glass-ceramic materials exhibit a surface roughness in the range of a few hundred nanometers (S_q within 500–700 nm) and topographical features comparable to those of clinically-used “gold-standard” alumina and polyethylene porous orbital implants. However, it was noted that both experimental and commercial non-porous implants were significantly smoother than all the porous ones. The results achieved in this work reveal that these porous glass-ceramic materials show promise for the intended application and encourage further investigation of their clinical suitability.

Influence of the wettability of different titanium surface topographies on initial cellular behavior

This study examined the influence of the time-dependent wettability of different surface topographies on initial cellular behavior. Titanium disks with smooth topography (SM) and three kinds of rough topography (sandblasted (SA), microtopography (M) and nanotopography (N)) were prepared. Time-dependent changes in surface wettability were observed in all surfaces as shown in previous studies. On SM surfaces, hydrophobic alteration influenced cell spreading and the activity of RhoA (a small GTPase protein of the Rho family), while no alterations were observed on rough surfaces except for the number of adherent cells. Serum adsorption could recover these functional deteriorations by hydrophobic alteration. These findings suggest that surface topography is a more potent regulator in initial cellular behaviors such as cell spreading and RhoA activation than surface wettability.

Effects of interfacial micromotions on vitality and differentiation of human osteoblasts

Objectives

Enhanced micromotions between the implant and surrounding bone can impair osseointegration, resulting in fibrous encapsulation and aseptic loosening of the implant. Since the effect of micromotions on human bone cells is sparsely investigated, an in vitro system, which allows application of micromotions on bone cells and subsequent investigation of bone cell activity, was developed.

Methods

Micromotions ranging from 25 µm to 100 µm were applied as sine or triangle signal with 1 Hz frequency to human osteoblasts seeded on collagen scaffolds. Micromotions were applied for six hours per day over three days. During the micromotions, a static pressure of 527 Pa was exerted on the cells by Ti6Al4V cylinders. Osteoblasts loaded with Ti6Al4V cylinders and unloaded osteoblasts without micromotions served as controls. Subsequently, cell viability, expression of the osteogenic markers collagen type I, alkaline phosphatase, and osteocalcin, as well as gene expression of osteoprotegerin, receptor activator of NF-κB ligand, matrix metalloproteinase-1, and tissue inhibitor of metalloproteinase-1, were investigated.

Results

Live and dead cell numbers were higher after 25 µm sine and 50 µm triangle micromotions compared with loaded controls. Collagen type I synthesis was downregulated in respective samples. The metabolic activity and osteocalcin expression level were higher in samples treated with 25 µm micromotions compared with the loaded controls. Furthermore, static loading and micromotions decreased the osteoprotegerin/receptor activator of NF-κB ligand ratio.

Conclusion

Our system enables investigation of the behaviour of bone cells at the bone-implant interface under shear stress induced by micromotions. We could demonstrate that micromotions applied under static pressure conditions have a significant impact on the activity of osteoblasts seeded on collagen scaffolds. In future studies, higher mechanical stress will be applied and different implant surface structures will be considered.

Cite this article: J. Ziebart, S. Fan, C. Schulze, P. W. Kämmerer, R. Bader, A. Jonitz-Heincke. Effects of interfacial micromotions on vitality and differentiation of human osteoblasts. Bone Joint Res 2018;7:187–195. DOI: 10.1302/2046-3758.72.BJR-2017-0228.R1.

Harnessing Nanotopography to Enhance Osseointegration of Clinical Orthopedic Titanium Implants-An in Vitro and in Vivo Analysis

Despite technological advancements, further innovations in the field of orthopedics and bone regeneration are essential to meet the rising demands of an increasing aging population and associated issues of disease, injury and trauma. Nanotopography provides new opportunities for novel implant surface modifications and promises to deliver further improvements in implant performance. However, the technical complexities of nanotopography fabrication and surface analysis have precluded identification of the optimal surface features to trigger osteogenesis. We herein detail the osteoinductive potential of discrete nanodot and nanowire nanotopographies. We have examined the ability of modified titanium and titanium alloy (Ti64) surfaces to induce bone-specific gene activation and extracellular matrix protein expression in human skeletal stem cells (SSCs) in vitro, and de novo osteogenic response within a murine calvarial model in vivo. This study provides evidence of enhanced osteogenic response to nanowires 300 surface modifications, with important implications for clinical orthopedic application.

Early cell response of osteogenic cells on differently modified implant surfaces: Sequences of cell proliferation, adherence and differentiation

OBJECTIVES

Osseointegration of dental implants is a crucial prerequisite for long-term survival. Therefore, surface modifications are needed to interact with the extracellular environment and to trigger osteogenic cell responses such as cell proliferation, adherence, and differentiation. The purpose of this study was to investigate different surface modifications in vitro over 2 weeks.

MATERIALS AND METHODS

Commercially available cells from a human osteogenic cell line (HHOB-c) were cultivated on the following surfaces: titanium with smooth surfaces (polished titanium (P), machined titanium (M), polyetheretherketone (Peek)), titanium with rough and hydrophilised surfaces (acid etched titanium (A), sandblasted acid etched titanium (SA and SA2), sandblasted acid etched hydrophilised (SAH), titanium plasma painted titanium (TPS)), titanium with calcium phosphate-containing surfaces (titanium plasma painted calcium phosphate modified titanium (TPS-CaP), sandblasted calcium phosphate modified titanium (S-CaP), sandblasted acid etched calcium phosphate modified titanium (SA-CaP)), and zirconium-oxide (yttrium amplified zirconium (Z), yttrium amplified Ca²⁺ delivering zirconium (Z-Ca)). Tissue culture polystyrene (TCPS) served as a control. Cell count was assessed after 24 h, 48 h, 72 h, 7 d, and 14 d; osteogenic cell adherence and differentiation were analysed by using cellular Quantitative Immuno-Cytochemistry (QIC) assay for alkaline phosphatase (AP), osteocalcin (OC), integrin alpha V (ITGAV), and talin (T).

RESULTS

All tested surfaces showed a positive influence on the differentiation and adherence of osteogenic cells, especially P, M, A, TCPS, and Peek. After 48 h, the surfaces M, SA and SAH had induced a positive influence on adherence, whereas SA2, SA, and SAH triggered proliferation after 14 d.

CONCLUSIONS

Rough and hydrophilised surface modifications, such as SAH, trigger osteogenic cell responses. These in vitro results highlight the potential use of SAH surface modifications of dental implants and indicate further clinical studies are warranted.

Repositioning Titanium: An In Vitro Evaluation of Laser-Generated Microporous, Microrough Titanium Templates As a Potential Bridging Interface for Enhanced Osseointegration and Durability of Implants

Although titanium alloys remain the preferred biomaterials for the manufacture of biomedical implants today, such devices can fail within 15 years of implantation due to inadequate osseointegration. Furthermore, wear debris toxicity due to alloy metal ion release has been found to cause side-effects including neurotoxicity and chronic inflammation. Titanium, with its known biocompatibility, corrosion resistance, and high elastic modulus, could if harnessed in the form of a superficial scaffold or bridging device, resolve such issues. A novel three-dimensional culture approach was used to investigate the potential osteoinductive and osseointegrative capabilities of a laser-generated microporous, microrough medical grade IV titanium template on human skeletal stem cells (SSCs). Human SSCs seeded on a rough 90-µm pore surface of ethylene oxide-sterilized templates were observed to be strongly adherent, and to display early osteogenic differentiation, despite their inverted culture in basal conditions over 21 days. Limited cellular migration across the template surface highlighted the importance of high surface wettability in maximizing cell adhesion, spreading and cell-biomaterial interaction, while restricted cell ingrowth within the conical-shaped pores underlined the crucial role of pore geometry and size in determining the extent of osseointegration of an implant device. The overall findings indicate that titanium only devices, with appropriate optimizations to porosity and surface wettability, could yet play a major role in improving the long-term efficacy, durability, and safety of future implant technology.

Characterisation of porous knitted titanium for replacement of intervertebral disc nucleus pulposus

Effective restoration of human intervertebral disc degeneration is challenged by numerous limitations of the currently available spinal fusion and arthroplasty treatment strategies. Consequently, use of artificial biomaterial implant is gaining attention as a potential therapeutic strategy. Our study is aimed at investigating and characterizing a novel knitted titanium (Ti6Al4V) implant for the replacement of nucleus pulposus to treat early stages of chronic intervertebral disc degeneration. Specific knitted geometry of the scaffold with a porosity of 67.67 ± 0.824% was used to overcome tissue integration failures. Furthermore, to improve the wear resistance without impairing original mechanical strength, electro-polishing step was employed. Electro-polishing treatment changed a surface roughness from 15.22 ± 3.28 to 4.35 ± 0.87 µm without affecting its wettability which remained at 81.03 ± 8.5°. Subsequently, cellular responses of human mesenchymal stem cells (SCP1 cell line) and human primary chondrocytes were investigated which showed positive responses in terms of adherence and viability. Surface wettability was further enhanced to super hydrophilic nature by oxygen plasma treatment, which eventually caused substantial increase in the proliferation of SCP1 cells and primary chondrocytes. Our study implies that owing to scaffolds physicochemical and biocompatible properties, it could improve the clinical performance of nucleus pulposus replacement.

Interrelationships among hydrogen permeation, physiochemical properties and early adsorption abilities of titanium

This study aimed to investigate if the titanium samples with low hydrogen permeation which treated with a novel etching combination: phosphoric acid and sodium fluoride could influence the surface physiochemical properties and early adsorption ability. Titanium samples were treated with three different concentrations of the new formula, as groups A, B and C, and treated with the traditional etching formula, as group T. Zeta potential, contact angle, X-ray photoelectron spectroscopy (XPS) and fibronectin (FN)/vitronectin (VN) adsorption of Sprague-Dawley (SD) rat tibial osteotomies in the initial 30min and MG-63 adsorption in the initial 24 h were detected. Basing on the results of trails and pearson correlation analysis, the low hydrogen permeation into titanium didn't exert an impact on the surface morphology and surface stability. The adsorptions of F, P, S, acid hydroxyl and basic hydroxyl on the surfaces brought no bear on them as well. Surface concave depth and surface skewness showed highly positive correlation and moderate negative correlation with adsorption ability, respectively. Therefore, the surface morphology of titanium treated with the novel etching formula plays the only and primary role on the early adsorption. Because of its specific surface topography, group C showed the best performance which possessed slightly superiority than those of group B and group T, and with the lowest being group A. The low hydrogen permeation into titanium substrate was just benefit for improving the titanium mechanical properties, but not for the surface biochemical traits.

Porous titanium scaffolds with self-assembled micro/nano-hierarchical structure for dual functions of bone regeneration and anti-infection

Porous titanium (Ti) scaffolds are widely used for bone repair because of their good biocompatibility, mechanical properties, and corrosion resistance. However, pristine Ti scaffolds are bioinert and unable to induce bone regeneration. In this study, chitosan coated bovine serum albumin nanoparticles (CBSA NPs) and oxidized alginate (OSA) were in a layer-by-layer (LbL) manner on Ti scaffolds. The LbL film possessed micro/nano-hierarchical architectures, has the features of nanostructures, and possesses abundant functional groups from CBSA NPs and OSA to improve the surface biocompatibility and biofunctionality of Ti scaffolds. These groups provide active sites for stable and efficient immobilization of bone morphogenic protein-2 (BMP2) through chemical and physical interactions without compromising its bioactivity. The synergistic effect of the hierarchical structure of assembled films and immobilized BMP2 on the scaffold improves cell adhesion, proliferation, and induces osteogenic differentiation of bone marrow stromal cells in vitro. Moreover, this modification also enhances ectopic bone formation bone. Furthermore, grafting of vancomycin on OSA resulted in good antibacterial activity of Ti scaffolds for prevention of infection during the bone healing process. In summary, this NPs-assembling method is convenient and effective to produce nanostructures and to load growth factors and antibacterial agents into Ti scaffolds for bone tissue engineering. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3482-3492, 2017.

Plaque accumulation on titanium disks with different surface treatments: an in vivo investigation

Implants with rough surfaces are today widely used. It has been speculated that rough surfaces (Ra > 0.2 μm) provide a better "substrate" for retention and accumulation of plaque in terms of area, thickness and colony-forming unit that can eventually lead to peri mucositis and/or peri-implantitis. The aim of this investigation was to evaluate in vivo the plaque accumulation after 48 h on three implant surfaces with different treatments. For this investigation, we used 21 sterilized titanium disks, with a diameter of 8mm and a thickness of 3 mm, provided by the manufacturer: 7 with machined surface, as smooth control, 7 with HA grit sandblasted RBM surface and 7 with Ca⁺⁺ incorporated in titanium Xpeed surface. One disk for each surface treatment was characterized at time 0 by SEM and AFM to study, respectively, the surface morphology and roughness. The other 18 disks were mounted randomly on three upper acrylic bites in a buccal lateral position, worn for 48 h by three volunteer students for plaque accumulation. After 48 h each disk was removed and analyzed qualitatively and quantitatively by an independent operator, not involved into the study, in order to avoid bias. Data collected were statistically analyzed by one-way ANOVA. The qualitative analysis showed no differences in terms of total plaque accumulation between the surfaces. Data from quantitative analysis using Anova Test showed no significance between all groups. In this in vivo investigation all the surfaces studied promoted plaque formation. The degree of surface roughness seems not to be a critical factor for plaque accumulation.

Effect of crystalline phase changes in titania (TiO2) nanotube coatings on platelet adhesion and activation

OBJECTIVE

To explore the relationship between various crystalline phases of titania (TiO₂) nanotube (TNT) coatings and platelet adhesion and activation.

METHODS

TNT coatings were fabricated on pure titanium foils by anodization and then randomly divided into four groups. Three groups were annealed at 350°C, 450°C and 550°C in order to obtain different crystalline phases. The remaining group was not annealed and served as the control group. X-ray diffraction (XRD) was used to define the crystalline phases of different groups. Surface morphology, elemental composition, surface roughness, and contact angles were measured by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), laser scanning confocal microscopy (LSCM) and contact angle analysis, respectively. Platelets were cultured on the TNT coatings for 30min and 60min to assess the number, viability, distribution, and morphology of the adhered platelets. CD62P fluorescence expression and the amount of released platelet-derived growth factor (PDGF) were detected to evaluate platelet activation.

RESULTS

The un-annealed TNT coatings were amorphous and part of TNT converted to anatase after the 350°C annealing treatment. The quantity of anatase increased upon annealing at 450°C and transformed to rutile at 550°C. Nanotubes of all four groups maintained a well-ordered structure, but the wall thickness of the nanotubes increased from (11.874±1.660) nm for the un-annealed TNTs to (26.126±2.130) nm for the 550°C annealed TNTs. The surface roughness of the 550°C annealed TNT coatings was the lowest and the water contact angle was the largest at (28.117±1.182) °. The number and viability of adhered platelets after 30min and 60min were the highest on TNT coatings annealed at 450°C. LSCM and SEM images revealed that the platelets that adhered on the 450°C annealed TNT coatings aggregated, transformed, and spread most obviously. CD62P fluorescence expression results showed that the platelets on the 350°C and 450°C annealed TNT coating groups expressed the strongest fluorescence, followed by platelets on the 550°C annealed group and the un-annealed group. The quantity of released PDGF was highest for the 450°C annealed group at (4719±86) pg/mL, and lowest for the un-annealed group at (4241±74) pg/mL.

CONCLUSION

Crystalline TNT coatings encourage improved platelet adhesion and activation over amprphous analogues. The TNT coatings annealed at 450°C resulted in the most improved platelet behavior. The TNT crystalline phase was the predominant influencing factor in platelet adhesion and activation.

When epigenetics meets bioengineering-A material characteristics and surface topography perspective

The field of tissue engineering and regenerative medicine (TE/RM) involves regeneration of tissues and organs using implantable biomaterials. The term epigenetics refers to changes in gene expression that are not encoded in the DNA sequence, leading to remodeling of the chromatin and activation or inactivation of gene expression. Recently, studies have demonstrated that these modifications are influenced not only by biological cues but also by mechanical and topographical signals. This review highlights the current knowledge on emerging approaches in TE/RM with a focus on the effect of materials and topography on the epigenetic expression pattern in cells with potential impacts on modulating regenerative biology. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2065-2071, 2018.

How Not To Drown in Data: A Guide for Biomaterial Engineers

High-throughput assays that produce hundreds of measurements per sample are powerful tools for quantifying cell-material interactions. With advances in automation and miniaturization in material fabrication, hundreds of biomaterial samples can be rapidly produced, which can then be characterized using these assays. However, the resulting deluge of data can be overwhelming. To the rescue are computational methods that are well suited to these problems. Machine learning techniques provide a vast array of tools to make predictions about cell-material interactions and to find patterns in cellular responses. Computational simulations allow researchers to pose and test hypotheses and perform experiments in silico. This review describes approaches from these two domains that can be brought to bear on the problem of analyzing biomaterial screening data.

Evaluation of Metalloproteinase-8 Levels in Crevicular Fluid of Patients with Healthy Implants or Periodontitis

Evaluation of periodontal and peri-implant tissue condition is mainly based on clinical examination and imaging diagnostics. Some data imply that Metalloproteinase-8 (MMP-8) level examination in peri-implant sulcular fluid (PISF) might be useful for evaluating the condition of peri-implant tissues and monitoring a development of peri-implant inflammation, including both mucositis and peri-implantitis. Hence, in this study, we decided to evaluate the level of MMP-8 in PISF obtained from patients without clinical symptoms of mucositis or peri-implantitis and compare it with MMP-8 level in gingival crevicular fluid (GCF) obtained from patients with healthy periodontium and those with varying severity of periodontitis. A total of 189 subjects were included in the study, and GCF/PISF samples were analysed for MMP-8 level by ELISA test. We documented that MMP-8 level in PISF obtained from patients without symptoms of mucositis or peri-implantitis was significantly higher not only than in GCF of periodontally healthy patients but also, which seems to be very interesting, than in GCF of patients with varying degrees of periodontal inflammation, consistent with earlier studies. Our observation might imply that monitoring of MMP-8 level in PISF could help to diagnose mucositis/peri-implantitis in an early stage, prior to clinical manifestations, which may allow for quick start of appropriate therapy.

Mesenchymal stromal cell and osteoblast responses to oxidized titanium surfaces pre-treated with λ = 808 nm GaAlAs diode laser or chlorhexidine: in vitro study

Preservation of implant biocompatibility following peri-implantitis treatments is a crucial issue in odontostomatological practice, being closely linked to implant re-osseointegration. Our aim was to assess the responses of osteoblast-like Saos2 cells and adult human bone marrow-mesenchymal stromal cells (MSCs) to oxidized titanium surfaces (TiUnite^®, TiU) pre-treated with a 808 ± 10 nm GaAlAs diode laser operating in non-contact mode, in continuous (2 W, 400 J/cm²; CW) or pulsed (20 kHz, 7 μs, 0.44 W, 88 J/cm²; PW) wave, previously demonstrated to have a strong bactericidal effect and proposed as optional treatment for peri-implantitis. The biocompatibility of TiU surfaces pre-treated with chlorhexidine digluconate (CHX) was also evaluated. In particular, in order to mimic the in vivo approach, TiU surfaces were pre-treated with CHX (0.2%, 5 min); CHX and rinse; and CHX, rinse and air drying. In some experiments, the cells were cultured on untreated TiU before being exposed to CHX. Cell viability (MTS assay), proliferation (EdU incorporation assay; Ki67 confocal immunofluorescence analysis), adhesion (morphological analysis of actin cytoskeleton organization), and osteogenic differentiation (osteopontin confocal immunofluorescence analysis; mineralized bone-like nodule formation) analyses were performed. CHX resulted cytotoxic in all experimental conditions. Diode laser irradiation preserved TiU surface biocompatibility. Notably, laser treatment appeared even to improve the known osteoconductive properties of TiU surfaces. Within the limitations of an in vitro experimentation, this study contributes to provide additional experimental basis to support the potential use of 808 ± 10 nm GaAlAs diode laser at the indicated irradiation setting, in the treatment of peri-implantitis and to discourage the use of CHX.

Attachment, Proliferation, and Morphological Properties of Human Dermal Fibroblasts on Ovine Tendon Collagen Scaffolds: A Comparative Study

INTRODUCTION

Collagen type I is widely used as a biomaterial for tissue-engineered substitutes. This study aimed to fabricate different three-dimensional (3D) scaffolds using ovine tendon collagen type I (OTC-I), and compare the attachment, proliferation and morphological features of human dermal fibroblasts (HDF) on the scaffolds.

METHODS

This study was conducted between the years 2014 to 2016 at the Tissue Engineering Centre, UKM Medical Centre. OTC-I was extracted from ovine tendon, and fabricated into 3D scaffolds in the form of sponge, hydrogel and film. A polystyrene surface coated with OTC-I was used as the 2D culture condition. Genipin was used to crosslink the OTC-I. A non-coated polystyrene surface was used as a control. The mechanical strength of OTC-I scaffolds was evaluated. Attachment, proliferation and morphological features of HDF were assessed and compared between conditions.

RESULTS

The mechanical strength of OTC-I sponge was significantly higher than that of the other scaffolds. OTC-I scaffolds and the coated surface significantly enhanced HDF attachment and proliferation compared to the control, but no differences were observed between the scaffolds and coated surface. In contrast, the morphological features of HDF including spreading, filopodia, lamellipodia and actin cytoskeletal formation differed between conditions.

CONCLUSION

OTC-I can be moulded into various scaffolds that are biocompatible and thus could be suitable as scaffolds for developing tissue substitutes for clinical applications and in vitro tissue models. However, further study is required to determine the effect of morphological properties on the functional and molecular properties of HDF.

Early bone formation around immediately loaded implants with nanostructured calcium-incorporated and machined surface: a randomized, controlled histologic and histomorphometric study in the human posterior maxilla

OBJECTIVE

The aim of this randomized, controlled histologic/histomorphometric study was to compare the early bone formation around immediately loaded implants with nanostructured calcium-incorporated (NCI) and machined (MA) surface, placed in the human posterior maxilla.

MATERIALS AND METHODS

Fifteen fully edentulous patients (six males; nine females; mean age 57.9 ± 6.7 years) were selected for this study. Each patient was installed with two temporary transmucosal implants, with different surfaces: one NCI (test) and one MA (control) implant. All temporary implants were placed in the posterior maxilla, according to a split-mouth design, to help to support an interim complete maxillary denture. After 8 weeks, all temporary transmucosal implants were retrieved for histologic/histomorphometric evaluation. The bone-to-implant contact (BIC%) and the bone density (BD%) were calculated. The Wilcoxon matched-pairs signed-rank test was used to evaluate differences (BIC%, BD%) between the surfaces. The level of significance was set at 0.05.

RESULTS

Eight weeks after placement, 24 clinically stable implants (12 test, 12 control) were subjected to histologic/histomorphometric evaluation. In the MA implants, the histomorphometric evaluation revealed a mean BIC(±SD)% and BD(±SD)% of 21.2(±4.9)% and 29.8(±7.8)%, respectively. In the NCI implants, the histomorphometric analysis revealed a mean BIC(±SD)% and BD(±SD)% of 39.7(±8.7)% and 34.6(±7.2)%, respectively. A statistically significant difference was found between the two surfaces with regard to BIC% (p < 0.001), while no significant difference was found with regard to BD% (p = 0.09).

CONCLUSIONS

The NCI surface seems to increase the peri-implant endosseous healing properties in the native bone of the posterior maxilla, under immediate loading conditions, when compared with the MA surface.

CLINICAL RELEVANCE

Under immediate loading conditions in the human posterior maxilla, the nanostructured calcium-incorporated surface has led to better histologic and histomorphometric results than the machined surface; therefore, the clinical use of implants with nanostructured calcium-incorporated surface may be beneficial in the posterior maxilla, under immediate loading protocol.

Biomechanical cell regulatory networks as complex adaptive systems in relation to cancer

Physiological structure and function of cells are maintained by ongoing complex dynamic adaptive processes in the intracellular molecular pathways controlling the overall profile of gene expression, and by genes in cellular gene regulatory circuits. Cytogenetic mutations and non-genetic factors such as chronic inflammation or repetitive trauma, intrinsic mechanical stresses within extracellular matrix may induce redirection of gene regulatory circuits with abnormal reactivation of embryonic developmental programmes which can now drive cell transformation and cancer initiation, and later cancer progression and metastasis. Some of the non-genetic factors that may also favour cancerization are dysregulation in epithelial-mesenchymal interactions, in cell-to-cell communication, in extracellular matrix turnover, in extracellular matrix-to-cell interactions and in mechanotransduction pathways. Persistent increase in extracellular matrix stiffness, for whatever reason, has been shown to play an important role in cell transformation, and later in cancer cell invasion. In this article we review certain cell regulatory networks driving carcinogenesis, focussing on the role of mechanical stresses modulating structure and function of cells and their extracellular matrices.

Adhesion and differentiation of Saos-2 osteoblast-like cells on chromium-doped diamond-like carbon coatings

Diamond-like carbon (DLC) thin films are promising for use in coating orthopaedic, dental and cardiovascular implants. The problem of DLC layers lies in their weak layer adhesion to metal implants. Chromium is used as a dopant for improving the adhesion of DLC films. Cr-DLC layers were prepared by a hybrid technology, using a combination of pulsed laser deposition (PLD) from a graphite target and magnetron sputtering. Depending on the deposition conditions, the concentration of Cr in the DLC layers moved from zero to 10.0 at.%. The effect of DLC layers with 0.0, 0.9, 1.8, 7.3, 7.7 and 10.0 at.% Cr content on the adhesion and osteogenic differentiation of human osteoblast-like Saos-2 cells was assessed in vitro. The DLC samples that contained 7.7 and 10.0 at.% of Cr supported cell spreading on day 1 after seeding. On day three after seeding, the most apparent vinculin-containing focal adhesion plaques were also found on samples with higher concentrations of chromium. On the other hand, the expression of type I collagen and alkaline phosphatase at the mRNA and protein level was the highest on Cr-DLC samples with a lower concentration of Cr (0-1.8 at.%). We can conclude that higher concentrations of chromium supported cell adhesion; however DLC and DLC doped with a lower concentration of chromium supported osteogenic cell differentiation.

Recombinant mussel proximal thread matrix protein promotes osteoblast cell adhesion and proliferation

Background

von Willebrand factor (VWF) is a key load bearing domain for mamalian cell adhesion by binding various macromolecular ligands in extracellular matrix such as, collagens, elastin, and glycosaminoglycans. Interestingly, vWF like domains are also commonly found in load bearing systems of marine organisms such as in underwater adhesive of mussel and sea star, and nacre of marine abalone, and play a critical load bearing function. Recently, Proximal Thread Matrix Protein1 (PTMP1) in mussel composed of two vWF type A like domains has characterized and it is known to bind both mussel collagens and mammalian collagens.

Results

Here, we cloned and mass produced a recombinant PTMP1 from E. coli system after switching all the minor codons to the major codons of E. coli. Recombinant PTMP1 has an ability to enhance mouse osteoblast cell adhesion, spreading, and cell proliferation. In addition, PTMP1 showed vWF-like properties as promoting collagen expression as well as binding to collagen type I, subsequently enhanced cell viability. Consequently, we found that recombinant PTMP1 acts as a vWF domain by mediating cell adhesion, spreading, proliferation, and formation of actin cytoskeleton.

Conclusions

This study suggests that both mammalian cell adhesion and marine underwater adhesion exploits a strong vWF-collagen interaction for successful wet adhesion. In addition, vWF like domains containing proteins including PTMP1 have a great potential for tissue engineering and the development of biomedical adhesives as a component for extra-cellular matrix.