Effect of surface roughness of Ti, Zr, and TiZr on apatite precipitation from simulated body fluid

Development of Rapid Bioactivity-Expressed Zr-50Ti Alloys by Surface Treatment with Modified Simulated Body Fluid

Zr-50Ti alloys are promising biomaterials due to their excellent mechanical properties and low magnetic susceptibility. However, Zr-50Ti alloys do not inherently bond well with bone. This study aims to enhance the bioactivity and bonding strength of Zr-50Ti alloys for orthopedic implant materials. Initially, the surface of Zr-50Ti alloys was treated with a sulfuric acid solution to create a microporous structure, increasing surface roughness and area. Subsequently, low crystalline calcium phosphate (L-CaP) precipitation was controlled by adding Mg2+ and/or CO32- ions in modified simulated body fluid (m-SBF). The treated Zr-50Ti alloys were then subjected to cold isostatic pressing to force m-SBF into the micropores, followed by incubation to allow L-CaP formation. The apatite-forming process was tested in simulated body fluid (SBF). The results demonstrated that the incorporation of Mg2+ and/or CO32- ions enabled the L-CaP to cover the entire surface of Zr-50Ti alloys within only one day. After short-term soaking in SBF, the L-CaP layer, modulated by Mg2+ and/or CO32- ions, formed a uniform hydroxyapatite (HA) coating on the surface of the Zr-50Ti alloys, showing potential for optimized bone integration. After soaking in SBF for 14 days, the bonding strength between the apatite layer and alloy has the potential to meet the orthopedic application requirement of 22 MPa. This study demonstrates an effective method to enhance the bioactivity and bonding strength of Zr-50Ti alloys for orthopedic applications.

Enhancement of in vitro antibacterial activity and bioactivity of iodine-loaded titanium by micro-scale regulation using mixed-acid treatment

Postoperative infection and subsequent device loss are serious complications in the use of titanium dental implants and plates for jawbone reconstruction. We have previously reported that NaOH-CaCl2 -thermal-ICl3 -treated titanium (NaCaThIo) has a nano-scale surface and exhibits antibacterial activity against Staphylococcus aureus. The present study examined the surface properties of mixed-acid treated and then iodine-treated titanium (MA-NaCaThIo), and evaluated oral antibacterial activity and cytotoxicity compared with the results obtained with NaCaThIo. MA-NaCaThIo formed a surface layer with a nano-scale network structure having microscale irregularities, and both the thickness of the surface layer (1.49 ± 0.16 μm) and the average surface roughness (0.35 ± 0.03 μm) were significantly higher than those of NaCaThIo. Furthermore, MA-NaCaThIo maintained high hydrophilicity with a contact angle of 7.5 ± 1.7° even after 4 weeks, as well as improved apatite formation, iodine ion release, and antibacterial activity against Prevotella intermedia compared to NaCaThIo. Cell culture test revealed that MA-NaCaThIo exhibited no cytotoxicity against MG-63 and Vero cells, while increased cell proliferation, ALP activity and mineralization of MG-63 compared to NaCaThIo. This treated titanium is expected to be useful for the development of next-generation titanium devices having both bone-bonding and antibacterial properties.

Influence of laser intensity and BaTiO3 content on the surface properties of 3YSZ

Zirconia-based dental implants are in direct contact with living tissues and any improvements in their bioactivity and adhesion to the tissues are highly welcome. In this study, different ratios of barium titanate (BT) were added to 3 mol% yttria-stabilized zirconia (3YSZ) through conventional sintering. The laser-texturing technique was also conducted to improve the biological performance of 3YSZ ceramics. The composition and the surface of the prepared composites were characterized by X-ray diffraction and scanning electron microscopy (SEM), respectively. The roughness and surface wettability of the composites were also measured. Furthermore, MC3T3-E1 pre-osteoblast cells were used for the in vitro experiments. Cell viability was evaluated using a commercial resazurin-based method. Morphology and cellular adhesion were observed using SEM. Based on the results, the laser texturing and the barium titanate content influenced the surface characteristics of the prepared composites. The laser-textured 3YSZ/7 mol% BT composites showed a lower water contact angle compared to the other samples, which indicated superior surface hydrophilicity. The cell viability and cell adhesion of 3YSZ/BT composites increased with the rise in the barium titanate content and laser power. An elongated cell morphology and apatite nucleation were also observed by the BT content. Overall, the laser-treated 3YSZ/5 and 7 mol% BT composites may be promising candidates in hard tissue repair due to their good cell response.

Zirconia Facts and Perspectives for Biomaterials in Dental Implantology

Dental implantology has witnessed remarkable advancements in recent years, and zirconia has emerged as a prominent biomaterial for dental implant applications. This review explores the multifaceted aspects of zirconia, focusing on its properties, processing methods, biocompatibility, mechanical performance, and clinical applications. Over the past few decades, the most popular choice of material for dental implantology has been titanium which has been found to have the highest success rate of implant treatment. However, recently, it has been observed that zirconia might replace titanium and eventually emerge as one of the gold-standard materials of dental implants. Analysis of biomechanical sciences and biomaterial sciences provides an opportunity for the refinement of design and material notions for surgical implants. However, the most important aspect and prime concern is how tissue at the implant site responds to biomechanical disturbances caused by foreign materials. The literature revealed that zirconia has certain characteristics that make it an excellent material for implants, including biocompatibility and osseointegration which depicts positive soft tissue response with low plaque affinity as well as aesthetics owing to light transmission and color. Additionally, this review discusses the current challenges and prospects of zirconia in dental implantology as well as aims to provide dental professionals and researchers with a comprehensive understanding of zirconia's potential as a biomaterial in dental implantology. The present overview of available literature intends to highlight and explore the biological characteristics of zirconia for applications in dental implantology. However, research is urgently required to fill in gaps over time for clinical assessments of all zirconia implants, consequently, the implementation of hybrid systems (a titanium screw with a zirconia collar) has recently been suggested.

Surface Oxygen Vacancies of Rutile Nanorods Accelerate Biomineralization

Titanium dioxide (TiO₂) materials have been widely used in biomedical applications of bone tissue engineering. However, the mechanism underlying the induced biomineralization onto the TiO₂ surface still remains elusive. In this study, we demonstrated that the surface oxygen vacancy defects of rutile nanorods could be gradually eliminated by the regularly used annealing treatment, which restrained the heterogeneous nucleation of hydroxyapatite (HA) onto rutile nanorods in simulated body fluids (SBFs). Moreover, we also observed that the surface oxygen vacancies upregulated the mineralization of human mesenchymal stromal cells (hMSCs) on rutile TiO₂ nanorod substrates. This work therefore emphasized the importance of subtle changes of surface oxygen vacancy defective features of oxidic biomaterials during the regularly used annealing treatment on their bioactive performances and provided new insights into the fundamental understanding of interactions of materials with the biological environment.

Effect of simulated body fluid formulation on orthopedic device apatite-forming ability assessment

Integration of native bone into orthopedic devices is a key factor in long-term implant success. The material-tissue interface is generally accepted to consist of a hydroxyapatite layer so bioactive materials that can spontaneously generate this hydroxyapatite layer after implantation may improve patient outcomes. Per the ISO 22317:2014 standard, "Implants for surgery - In vitro evaluation for apatite-forming ability of implant materials," bioactivity performance statements can be assessed by soaking the material in simulated body fluid (SBF) and evaluating the surface for the formation of a hydroxyapatite layer; however, variations in test methods may alter hydroxyapatite formation and result in false-positive assessments. The goal of this study was to identify the effect of SBF formulation on bioactivity assessment. Bioglass® (45S5 and S53P4) and non-bioactive Ti-6Al-4V were exposed to SBF formulations varying in calcium ion and phosphate concentrations as well as supporting ion concentrations. Scanning electron microscopy and X-ray powder diffraction evaluation of the resulting hydroxyapatite layers revealed that SBF enriched with double or quadruple the calcium and phosphate ion concentrations increased hydroxyapatite crystal size and quantity compared to the standard formulation and can induce hydroxyapatite crystallization on surfaces traditionally considered non-bioactive. Altering concentrations of other ions, for example, bicarbonate, changed hydroxyapatite induction time, quantity, and morphology. For studies evaluating the apatite-forming ability of a material to support bioactivity performance statements, test method parameters must be adequately described and controlled. It is unclear if apatite formation after exposure to any of the SBF formulations is representative of an in vivo biological response. The ISO 23317 standard test method should be further developed to provide additional guidance on apatite characterization and interpretation of the results.

Effect of oxidation at an elevated temperature on the evolution of phases, microstructure, and properties of the oxide films formed on the surface of TiZr

This study examined the evolution of the microstructure, microhardness, corrosion resistance, and selective leaching properties of oxide films formed on the surface of a Ti-50Zr (%) alloy during heat treatment at 600 °C for various time intervals. According to our experimental results, the growth and evolution of oxide films can be divided into three stages. In stage I (heat treatment for less than 2 min), ZrO₂ was first formed on the surface of the TiZr alloy, which slightly improved its corrosion resistance. In stage II (heat treatment for 2-10 min), the initially generated ZrO₂ is gradually transformed into ZrTiO₄ from the top to the bottom of the surface layer. The formation of ZrTiO₄ significantly improves the microhardness and corrosion resistance of the alloy. In stage III (heat treatment for more than 10 min), microcracks appeared and propagated on the surface of the ZrTiO₄ film, deteriorating the surface properties of the alloy. The ZrTiO₄ began to peel off after heat treatment for more than 60 min. The untreated and heat-treated TiZr alloys exhibited excellent selective leaching properties in Ringer's solution, whereas a trace amount of suspended ZrTiO₄ oxide particles formed in the solution after soaking the 60 min heat-treated TiZr alloy for 120 days. Surface modification of the TiZr alloy by generating an intact ZrTiO₄ oxide film effectively improved its microhardness and corrosion resistance; however, oxidation should be performed appropriately to obtain materials with optimal properties for biomedical applications.

Antibacterial and Proliferative Effects of NaOH-Coated Titanium, Zirconia, and Ceramic-Reinforced PEEK Dental Composites on Bone Marrow Mesenchymal Stem Cells

Several metallic and polymer-based implants have been fabricated for orthopedic applications. For instance, titanium (Ti), zirconia (Zr), and polyetheretherketone (PEEK) are employed due to their excellent biocompatibility properties. Hence, the present study aimed to compare the functional and biological properties of these three biomaterials with surface modification. For this purpose, Ti, Zr, and ceramic-reinforced PEEK (CrPEEK) were coated with NaOH and tested for the biological response. Our results showed that the surface modification of these biomaterials significantly improved the water contact, protein adhesion, and bioactivity compared with uncoated samples. Among the NaOH-coated biomaterials, Ti and CrPEEK showed higher protein absorption than Zr. However, the mineral binding ability was higher in CrPEEK than in the other two biomaterials. Although the coating improved the functional properties, NaOH coating did not influence the antibacterial effect against E. coli and S. aureus in these biomaterials. Similar to the antibacterial effects, the NaOH coating did not contribute any significant changes in cell proliferation and cell loading, and CrPEEK showed better biocompatibility among the biomaterials. Therefore, this study concluded that the surface modification of biomaterials could potentially improve the functional properties but not the antibacterial and biocompatibility, and CrPEEK could be an alternative material to Ti and Zr with desirable qualities in orthopedic applications.

Bioactive Silicon Nitride Implant Surfaces with Maintained Antibacterial Properties

Silicon nitride (Si3N4) is a promising biomaterial, currently used in spinal fusion implants. Such implants should result in high vertebral union rates without major complications. However, pseudarthrosis remains an important complication that could lead to a need for implant replacement. Making silicon nitride implants more bioactive could lead to higher fusion rates, and reduce the incidence of pseudarthrosis. In this study, it was hypothesized that creating a highly negatively charged Si3N4 surface would enhance its bioactivity without affecting the antibacterial nature of the material. To this end, samples were thermally, chemically, and thermochemically treated. Apatite formation was examined for a 21-day immersion period as an in-vitro estimate of bioactivity. Staphylococcus aureus bacteria were inoculated on the surface of the samples, and their viability was investigated. It was found that the thermochemically and chemically treated samples exhibited enhanced bioactivity, as demonstrated by the increased spontaneous formation of apatite on their surface. All modified samples showed a reduction in the bacterial population; however, no statistically significant differences were noticed between groups. This study successfully demonstrated a simple method to improve the in vitro bioactivity of Si3N4 implants while maintaining the bacteriostatic properties.

Polydopamine treatment of chitosan nanofibers for the conception of osteoinductive scaffolds for bone reconstruction

We report the influence of treatment time of electrospun chitosan nanofibers (CHT NFs) in dopamine hydrochloride bath (2 mg.mL^-1 in 10 mM Tris buffer, pH 8.5) on the extent of the polydopamine (pDA) coating on NFs surface. The reaction was characterized by FTIR and SEM analysis and the cytocompatibility of the scaffolds toward MT3C3-E1 cells was assessed. Biomimetic deposition of hydroxyapatite (HA) in 1.5xSBF batch was investigated by SEM-EDS and XRD. Samples treated in dopamine bath during 2 h promoted the structural stability of NFs in PBS, provided optimal cytocompatibility and induced the in vitro biomineralization from 6 days in 1.5xSBF. The XRD and SEM-EDS investigations confirmed formation of spherical-shaped particles composed of apatitic phase. Finally, this study shows that these NFs-pDA scaffolds prepared in the optimal experimental conditions defined here are promising candidates for application as osteoinductive scaffolds for bone regeneration applied to orthopedic and dental applications.

Surface properties and biocompatibility of sandblasted and acid-etched titanium-zirconium binary alloys with various compositions

Ti-Zr alloys have been investigated as an alternative to commercially pure Ti (c.p.Ti). According to our previous studies on the mechanical properties of Ti-Zr alloys, a Zr proportion in the range of 30-50 mol% has competitive advantages over Ti-10Zr and c.p.Ti. The aim of this study is to evaluate the biological response to Ti-Zr alloys with different compositions and their surface characteristics. Alloy surfaces are modified by sandblasting and sulfuric acid etching. As a result, similar surface structures are observed for c.p.Ti, Ti-10Zr, and Ti-30Zr, whereas Ti-50Zr does not form a micro-rough structure by the same treatment process. No significant difference is found in the viability of cells on c.p.Ti, Ti-10Zr, and Ti-30Zr, whereas lower cell attachment levels are detected on Ti-50Zr. In summary, Ti-30Zr reliably forms a micro-rough structure, which provides one evidence for its application in a new dental implant material.

Reactivity of Titanium Dental Implant Surfaces in Simulated Body Fluid

Osseointegration of titanium (Ti) implants in bone is crucial for dental implant treatment. Bacterial challenge possibly leading to peri-implantitis threatens long-term success. For the improvement of osseointegration, an understanding of materials and tissue intervention is needed. This in vitro study analyzed changes of different implant surfaces exposed to simulated body fluid (SBF). Implants were analyzed by scanning electron microscopy/X-ray photoelectron spectroscopy. Supernatants (SNs) were assessed using inductively coupled plasma-mass spectrometry (ICP-MS). Additional calcium (Ca) and phosphate (P) crystals developed (Hank's buffered salt solution (HBSS)) on implants with layered surfaces. ICP of SN demonstrated a decreased Ca/P ratio. After incubation with human serum (HS), layers appeared flattened containing <1% Ca/P. The etched/machined implants showed the formation of a surface transformation layer or coating consisting of crystalline Ca/P precipitations and a decrease in the Ca/P ratio in the supernatant. Incubation in HS induced noncrystalline coverage, and increased Ti/Ca/P was detected in supernatants. HBSS induced crystals on surfaces of modified implants and crystalline covers on nonmodified implants containing Ca/P. The serum did not show the development of HA-like structures but showed dissolving effects. Titanium surfaces show completely altered behavior when incubated in serum-containing SBF.

Compositional dependence of the apatite formation ability of Ti-Zr alloys designed for hard tissue reconstruction

Ti-Zr alloys are expected to be novel biomaterials with low stress shielding owing to their lower Young's moduli than pure Ti. The drawback of metallic biomaterials is that their bone-bonding abilities are relatively low. NaOH and heat treatments have been performed to provide Ti-50Zr with apatite-forming ability in the body environment, which is essential for bone bonding. However, the systematic compositional dependence of apatite formation has not been revealed. In the present study, NaOH treatment of Ti-Zr alloys with various compositions and bone-bonding abilities was assessed in vitro by apatite formation in simulated body fluid (SBF). The corrosion current density in NaOH aqueous solution and the amount of Na incorporated into the surface tended to decrease with increasing Zr content. The apatite-forming ability of the treated alloy significantly decreased when the Zr content was ≥60 atom%. This phenomenon is attributed to the (1) low OH content on the surface, (2) low Na incorporation into the treated alloy surface, which enhances apatite formation, and (3) low ability of P adsorption to the Ti-Zr alloy in SBF following Ca adsorption to trigger apatite nucleation. Although the adhesion of the titanate/zirconate layer formed on the surfaces to the substrates increased as Zr content increased, the adhesion between the apatite and the substrate was still low.

The Use of Simulated Body Fluid (SBF) for Assessing Materials Bioactivity in the Context of Tissue Engineering: Review and Challenges

Some special implantable materials are defined as “bioactive” if they can bond to living bone, forming a tight and chemically-stable interface. This property, which is inherent to some glass compositions, or can be induced by applying appropriate surface treatments on otherwise bio-inert metals, can be evaluated in vitro by immersion studies in simulated body fluid (SBF), mimicking the composition of human plasma. As a result, apatite coating may form on the material surface, and the presence of this bone-like “biomimetic skin” is considered predictive of bone-bonding ability in vivo. This review article summarizes the story and evolution of in vitro bioactivity testing methods using SBF, highlighting the influence of testing parameters (e.g., formulation and circulation of the solution) and material-related parameters (e.g., composition, geometry, texture). Suggestions for future methodological refinements are also provided at the end of the paper.

Mesoporous silica pellets as bifunctional bone drug delivery system for cefazolin

For decades, bone drug delivery systems dedicated for osteomyelitis treatment have been investigated as bifunctional materials that exhibit prolonged drug release and mineralization potential. Herein, composite-type pellets based on cefazolin-loaded amino-modified mesoporous silica SBA-15 and microwave-assisted hydroxyapatite were investigated as potential bone drug delivery system in vitro. Pellets were obtained by granulation, extrusion and spheronization methods in laboratory scale and studied in terms of physical properties, drug release, mineralization potential, antimicrobial activity and cytotoxicity towards human osteoblasts. The obtained pellets were characterized for hardness and friability which indicated the pellets durability during further investigations. Prolonged (5-day) release of cefazolin from pellets was observed. The pellets exhibited mineralization potential in simulated body fluid, i.e., a continuous layer of bone-like apatite was formed on the surface of pellets after 28 days of incubation. An antimicrobial assay of pellets revealed an antibacterial effect against Staphylococcus aureus strain during 6 days. No cytotoxic effects of pellets towards human osteoblasts were observed. The obtained results proved that proposed pellets appear to have potential applications as bone drug delivery systems.

The Trends of TiZr Alloy Research as a Viable Alternative for Ti and Ti16 Zr Roxolid Dental Implants

Despite many discussions about Ti versus Zr, Ti remains the golden standard for dental implants. With the extended use of implants, their rejection in peri-implantitis due to material properties is going to be an important part of oral health problems. Extended use of implants leading to a statistical increase in implant rejection associated with peri-implantitis raises concerns in selecting better implant materials. In this context, starting in the last decade, investigation and use of TiZr alloys as alternatives for Ti in oral dentistry became increasingly more viable. Based on existing new results for Ti16Zr (Roxolid) implants and Ti50Zr alloy behaviour in oral environments, this paper presents the trends of research concerning the electrochemical stability, mechanical, and biological properties of this alloy with treated and untreated surfaces. The surface treatments were mostly performed by anodizing the alloy in various conditions as a non-sophisticated and cheap procedure, leading to nanostructures such as nanopores and nanotubes. The drug loading and release from nanostructured Ti50Zr as an important perspective in oral implant applications is discussed and promoted as well.

Mechanistic studies of biomineralisation on silver incorporated anatase TiO2

Here we report silver incorporated anatase TiO₂ developed on Ti metal by H₂O₂-AgNO₃ and heat treatment to have faster biomineralisation or apatite-forming ability in simulated body fluid (SBF). Apatite-forming ability has been investigated concerning heat treatment temperatures ranges, 400-800 °C and duration of soaking period in SBF. The apatite formation showed an increasing trend with increase in the heat treatment temperatures up to 600 °C and beyond that the Ti metal lost this ability. XRD as wells as Raman results of such chemical and heat-treated Ti metal at different temperatures further correlates the apatite nucleation directly in relation with that of anatase to rutile TiO₂ formation. Further, a time dependent apatite mineralisation study by XPS revealed simultaneous calcium and phosphate deposition at the early stage of soaking in SBF. Therefore, the apatite nucleation in the present chemically treated Ti metal depends on the crystalline phase of TiO₂ formed by H₂O₂ and heat treatment along with Ag⁺ ion release.

Magnesium matrix nanocomposites for orthopedic applications: A review from mechanical, corrosion, and biological perspectives

Magnesium (Mg) and some of its alloys have attracted extensive interests for biomedical applications as they exhibit biodegradability and low elastic modulus that is closer to natural bones than the currently used metallic implant materials such as titanium (Ti) and its alloys, stainless steels, and cobalt-chromium (Co-Cr) alloys. However, the rapid degradation of Mg alloys and loss of their mechanical integrity before sufficient bone healing impede their clinical application. Our literature review shows that magnesium matrix nanocomposites (MMNCs) reinforced with nanoparticles possess enhanced strength, high corrosion resistance, and good biocompatibility. This article provides a detailed analysis of the effects of nanoparticle reinforcements on the mechanical properties, corrosion behavior, and biocompatibility of MMNCs as promising biodegradable implant materials. The governing equations to quantitatively predict the mechanical properties and underlying synergistic strengthening mechanisms in MMNCs are elucidated. The potential, recent advances, challenges and future research directions in relation to nanoparticles reinforced MMNCs are highlighted. STATEMENT OF SIGNIFICANCE: Critically reviewing magnesium metal matrix nanocomposites (MMNCs) for the biomedical application. Clear definitions of strengthening mechanisms using reinforcement particle in the magnesium matrix, as there were controversial in governing equations of strengthening parameters. Providing better understanding of the effect of particle size, volume fraction, interfacial bonding, and uniform dispersion of reinforcement particles on MMNCs.

Electrophoretic deposition of Bioactive glass - Chitosan nanocomposite coatings on Ti-6Al-4V for orthopedic applications

Chitosan-Bioactive glass (CS-BG) nanocomposite coatings were developed on the Ti-6Al-4 V alloy to investigate the effect of the BG content on the adhesion strength, bioactivity, bio-corrosion, wettability and roughness. For this purpose, BG nanoparticles were synthesized using a sol-gel process. Three nanocomposite coatings with different concentrations of BG (0.5, 1 and 1.5 g/L) were fabricated through cathodic electrophoretic deposition (EPD). The surface morphology and composition of the coatings revealed the formation of compact coatings with a uniform distribution of BG nanoparticles. Increasing the BG content enhanced the deposition rate of CS-BG nanocomposite coatings and raised the coating thickness. Moreover, the CS-BG coating containing 1.5 g/L BG showed the best corrosion performance owing to the more uniform distribution of BG nanoparticles and its higher thickness. Also, increasing the BG concentration improved the adhesion strength, raised the roughness, and promoted wettability. Further, in-vitro bioactivity evaluation of the coated and uncoated specimens in SBF revealed that the formation of bone-like apatite was significantly encouraged on the surface of CS-BG coatings, as compared to the Ti-6Al-4 V uncoated sample. So, the apatite-forming ability of the coatings was improved by increasing the BG content. For in vitro investigation, osteoblast-like cell line MG63 were cultured on Ti-6Al-4 V substrate coated with CS-BG and cellular behavior was evaluated. Results demonstrated good cell attachment with no significant levels of cytotoxicity during 5 days of culture. Therefore, the electrophoretic deposition of the CS-1.5 g/L BG coating could successfully enhance the adhesion strength, bioactivity, corrosion and cellular performance of the substrate.

Ultraviolet Functionalization Improved Bone Integration on Titanium Surfaces by Fluorescent Analysis in Rabbit Calvarium

This study evaluated the effect of ultraviolet functionalization (UV) on bone integration ability in rabbit model, using epifluorescence microscopy. Each of 12 rabbits (n = 6) received randomly four titanium domes prepared with or without ultraviolet for 48 hours (UVC, λ = 250 ± 20 nm; Philips, Tokyo, Japan): (1) turned surface (T), (2) turned surface with UV (T-UV), (3) sandblasted (120 μm aluminum oxide) and etched by 18% hydrochloric acid and 49% sulphuric acid at 60°C for 30 min (SLA) and (4) SLA surface with UV (SLA-UV). Fluorochrome bone labels were marked by oxytetracycline at 25 mg/kg on 13th days and 14th days and calcein at 5 mg/kg on 3th days and 4th days before euthanization. The study samples were sacrified at 2 weeks and 4 weeks. The undecalcified specimens were prepared. The newly formed total bone of cross-sectional area (TB, %), the mineralized trabecular bone of cross-sectional area (MB, %), and the new bone and dome contact (BDC, %) were measured and analyzed by fluorescence microscope and Image Pro Express 6.0. The data of MB and TB showed new bone regeneration was increased in all groups, but no signs of difference were found. However, the means BDC of UV treatment on turned surface at 4 weeks, the UV treated on SLA surface at 2 weeks and 4 weeks were statistically significantly higher than the control group (P &lt; .05). Within the limitations of the study, it can be concluded that ultraviolet functionalization on the titanium surface could enhance the new bone tissues and titanium surface integration.

Carbon Nanotubes and Graphene as Nanoreinforcements in Metallic Biomaterials: a Review

Current challenges in existing metallic biomaterials encourage undertaking research in the development of novel materials for biomedical applications. This paper critically reviews the potential of carbon nanotubes (CNT) and graphene as nanoreinforcements in metallic biomaterials for bone tissue engineering. Unique and remarkable mechanical, electrical, and biological properties of these carbon nanomaterials allow their use as secondary-phase reinforcements in monolithic biomaterials. The nanoscale dimensions and extraordinarily large surface areas of CNT and graphene make them suitable materials for purposeful reaction with living organisms. However, the cytocompatibility of CNT and graphene is still a controversial issue that impedes advances in utilizing these promising materials in clinical orthopedic applications. The interaction of CNT and graphene with biological systems including proteins, nucleic acids, and human cells is critically reviewed to assess their cytocompatibity in vitro and in vivo. It is revealed that composites reinforced with CNT and graphene show enhanced adhesion of osteoblast cells, which subsequently promotes bone tissue formation in vivo. This potential is expected to pave the way for developing ground-breaking technologies in regenerative medicine and bone tissue engineering. In addition, current progress and future research directions are highlighted for the development of CNT and graphene reinforced implants for bone tissue engineering.

Improved in situ seeding of 3D printed scaffolds using cell-releasing hydrogels

The design of tissue engineered scaffolds based on polymerized high internal phase emulsions (polyHIPEs) has emerged as a promising bone grafting strategy. We previously reported the ability to 3D print emulsion inks to better mimic the structure and mechanical properties of native bone while precisely matching defect geometry. In the current study, redox-initiated hydrogel carriers were investigated for in situ delivery of human mesenchymal stem cells (hMSCs) utilizing the biodegradable macromer, poly(ethylene glycol)-dithiothreitol. Hydrogel carrier properties including network formation time, sol-gel fraction, and swelling ratio were modulated to achieve rapid cure without external stimuli and a target cell-release period of 5-7 days. These in situ carriers enabled improved distribution of hMSCs in 3D printed polyHIPE grafts over standard suspension seeding. Additionally, carrier-loaded polyHIPEs supported sustained cell viability and osteogenic differentiation of hMSCs post-release. In summary, these findings demonstrate the potential of this in situ curing hydrogel carrier to enhance the cell distribution and retention of hMSCs in bone grafts. Although initially focused on improving bone regeneration, the ability to encapsulate cells in a hydrogel carrier without relying on external stimuli that can be attenuated in large grafts or tissues is expected to have a wide range of applications in tissue engineering.

Transformation of the surface compositions of titanium during alkali and heat treatment at different vacuum degrees

The AH method at different vacuum degrees had a significant influence on the surface composition, structure, wettability, bioactivity and other properties of titanium.

3D printing of hybrid biomaterials for bone tissue engineering: Calcium-polyphosphate microparticles encapsulated by polycaprolactone

Here we describe the formulation of a morphogenetically active bio-ink consisting of amorphous microparticles (MP) prepared from Ca²⁺ and the physiological inorganic polymer, polyphosphate (polyP). Those MP had been fortified by mixing with poly-ε-caprolactone (PCL) to allow 3D-bioprinting. The resulting granular PCL/Ca-polyP-MP hybrid material, liquefied by short-time heating to 100 °C, was used for the 3D-printing of tissue-like scaffolds formed by strands with a thickness of 400 µm and a stacked architecture leaving ≈0.5 mm²-sized open holes enabling cell migration. The printed composite scaffold turned out to combine suitable biomechanical properties (Young's modulus of 1.60 ± 0.1 GPa; Martens hardness of 153 ± 28 MPa), matching those of cortical and trabecular bone, with morphogenetic activity. This scaffold was capable of attracting and promoting the growth of human bone-related SaOS-2 cells as demonstrated by staining for cell viability (Calcein AM), cell density (DRAQ5) and SEM studies. Furthermore, the hybrid material was demonstrated to upregulate the steady-state-expression of the cell migration-inducing chemokine SDF-1α. EDX analysis and FTIR measurements revealed the presence of hydroxyapatite in the mineral deposits formed on the scaffold surface. Based on the results we conclude that granular PCL/Ca-polyP-MP hybrid material is suitable for the fabrication of bioprintable scaffold which comprises not only biomechanical stability but also morphogenetic potential.

STATEMENT OF SIGNIFICANCE

In present-day regenerative engineering efforts, biomaterial- and cell-based strategies are proposed that meet the required functional and spatial characteristics and variations, especially in the transition regions between soft (cartilage, tendon or ligament) and hard (bone) tissues. In a biomimetic approach we succeeded to fabricate amorphous Ca-polyP nanoparticles/microparticles which are highly biocompatible. Together with polycaprolactone (PCL), polyP can be bio-printed. This hybrid material attracts the cells, as documented optically as well as by a gene-expression studies. Since PCL is already a FDA-approved organic and inert polymer and polyP a physiological biologically active component this new bio-hybrid material has the potential to restore physiological functions, including bone remodelling and regeneration if used as implant.

Bioactivity and biocompatibility of hydroxyapatite-based bioceramic coatings on zirconium by plasma electrolytic oxidation

In the present work, hydroxyapatite (HAP)-based plasma electrolytic oxide (PEO) coatings were produced on zirconium at different current densities in a solution containing calcium acetate and β-calcium glycerophosphate by a single step. The phase structure, surface morphology, functional groups, thickness and roughness of the coatings were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), eddy current method and surface profilometer, respectively. The phases of cubic-zirconia, calcium zirconate and HAP were detected by XRD. The amount of HAP and calcium zirconate increased with increasing current density. The surface of the coatings was very porous and rough. Moreover, bioactivity and biocompatibility of the coatings were analyzed in vitro immersion simulated body fluid (SBF) and MTT (3-(4,5-dimethyl thiazol-2yl)-2,5-diphenyl tetrazolium bromide) assay, hemolysis assay and bacterial formation. The apatite-forming ability of the coatings was evaluated after immersion in SBF up to 28days. After immersion, the bioactivity of HAP-based coatings on zirconium was greater than the ones of uncoated zirconium and zirconium oxide-based surface. The bioactivity of PEO surface on zirconium was significantly improved under SBF conditions. The bacterial adhesion of the coatings decreased with increasing current density. The bacterial adhesion of the coating produced at 0.370A/cm² was minimum compared to uncoated zirconium coated at 0.260 and 0.292A/cm². The hemocompatibility of HAP-based surfaces was improved by PEO. The cell attachment and proliferation of the PEO coatings were better than the one of uncoated zirconium according to MTT assay results.

Osteoanabolic Implant Materials for Orthopedic Treatment

Osteoporosis is becoming more prevalent due to the aging demographics of many populations. Osteoporotic bone is more prone to fracture than normal bone, and current orthopedic implant materials are not ideal for the osteoporotic cases. A newly developed strontium phosphate (SrPO4 ) coating is reported herein, and applied to Ti-29Nb-13Ta-4.6Zr (wt%), TNTZ, an implant material with a comparative Young's modulus to that of natural bone. The SrPO4 coating is anticipated to modulate the activity of osteoblast (OB) and osteoclast (OC) cells, in order to promote bone formation. TNTZ, a material with excellent biocompatibility and high bioinertness is pretreated in a concentrated alkaline solution under hydrothermal conditions, followed by a hydrothermal coating growth process to achieve complete SrPO4 surface coverage with high bonding strength. Owing to the release of Sr ions from the SrPO4 coating and its unique surface topography, OB cells demonstrate increased proliferation and differentiation, while the cellular responses of OC are suppressed, compared to the control case, i.e., bare TNTZ. This TNTZ implant with a near physiologic Young's modulus and a functional SrPO4 coating provides a new direction in the design and manufacture of implantable devices used in the management of orthopedic conditions in osteoporotic individuals.

The Controllable Growth of Stereo Reticular Hydroxyapatite Structure on Femtosecond Lasers Micro-Patterned Titanium Surface

The controllable deposition of hydroxyapatite (HA) on femtosecond lasers micro-patterned Titanium (Ti) plates was studied in simulated body fluid (SBF). Energy Dispersive Spectrometer analysis and X-ray Diffraction (XRD) analysis show that the hydroxyapatite deposites on the pattened titanium surface in 1.5 SBF and SEM studies show three growth modes of HA (homogeneous hydroxyapatite layer, needle-like structure, and plate-like structure) deposited at different spots of the Ti plate surface. This stereo reticular structure of hydroxyapatite could be regarded as promising candidate material for metal implantation.

Spark anodization of titanium-zirconium alloy: surface characterization and bioactivity assessment

Titanium (Ti) and its alloys have been popularly used as implant biomaterial for decades. Recently, titanium-zirconium (TiZr) alloy has been developed as an alternative implant material with improved strength in load bearing areas. Surface modification is one of the key factors to alter the surface properties to hasten osseointegration. Spark anodic oxidation (anodization) is one such method that is reported to enhance the bone formation around implants. This study aims to anodize TiZr and study its surface characteristics and cytocompatibility by cell culture experiments using osteoblast-like cells. Titanium (Ti) and TiZr discs were anodized in an electrolyte containing DL-α-glycerophosphate and calcium acetate (CA) at 300 V. The surface characteristics were analyzed by scanning electron microscopy, electron dispersive spectroscopy, X-ray diffraction (XRD), atomic force microscopy and goniometry. Using osteoblast-like cells viability, proliferation, differentiation and mineralization was assessed. The anodized surfaces demonstrated increased oxygen, entrapped calcium and phosphorous from the electrolyte used. XRD analysis confirmed the presence of anatase in the oxide layer. Average roughness increased and there was a significant decrease in contact angle (P < 0.01) following anodization. The anodized TiZr (aTiZr) surfaces were more nano-porous compared to anodized Ti (aTi). No significant difference was found in the viability of cells, but after 24 h the total number of cells was significantly higher (P < 0.01). Proliferation, alkaline phosphatase activity and calcium deposits were significantly higher on anodized surfaces compared to machined surfaces (P < 0.05, ANOVA). Anodization of TiZr resulted in a more nanoporous and hydrophilic surface than aTi, and osteoblast biocompatibility appeared comparable to aTi.

Bioactive titanate layers formed on titanium and its alloys by simple chemical and heat treatments

To reveal general principles for obtaining bone-bonding bioactive metallic titanium, Ti metal was heat-treated after exposure to a solution with different pH. The material formed an apatite layer at its surface in simulated body fluid when heat-treated after exposure to a strong acid or alkali solution, because it formed a positively charged titanium oxide and negatively charged sodium titanate film on its surface, respectively. Such treated these Ti metals tightly bonded to living bone. Porous Ti metal heat-treated after exposure to an acidic solution exhibited not only osteoconductive, but also osteoinductive behavior. Porous Ti metal exposed to an alkaline solution also exhibits osteoconductivity as well as osteoinductivity, if it was subsequently subjected to acid and heat treatments. These acid and heat treatments were not effective for most Ti-based alloys. However, even those alloys exhibited apatite formation when they were subjected to acid and heat treatment after a NaOH treatment, since the alloying elements were removed from the surface by the latter. The NaOH and heat treatments were also not effective for Ti-Zr-Nb-Ta alloys. These alloys displayed apatite formation when subjected to CaCl₂ treatment after NaOH treatment, forming Ca-deficient calcium titanate at their surfaces after subsequent heat and hot water treatments. The bioactive Ti metal subjected to NaOH and heat treatments has been clinically used as an artificial hip joint material in Japan since 2007. A porous Ti metal subjected to NaOH, HCl and heat treatments has successfully undergone clinical trials as a spinal fusion device.

The influence of titania-zirconia-zirconium titanate nanotube characteristics on osteoblast cell adhesion

Studies of biomaterial surfaces and their influence on cell behavior provide insights concerning the design of surface physicochemical and topography properties of implant materials. Fabrication of biocompatible metal oxide nanotubes on metallic biomaterials, especially titanium alloys such as Ti50Zr via anodization, alters the surface chemistry as well as surface topography of the alloy. In this study, four groups of TiO2-ZrO2-ZrTiO4 nanotubes that exhibit diverse nanoscale dimensional characteristics (i.e. inner diameter Di, outer diameter Do and wall thicknesses Wt) were fabricated via anodization. The nanotubes were annealed and characterized using scanning electron microscopy and 3-D profilometry. The potential applied during anodization influenced the oxidation rate of titanium and zirconium, thereby resulting in different nanoscale characteristics for the nanotubes. The different oxidation and dissolution rates both led to changes in the surface roughness parameters. The in vitro cell response to the nanotubes with different nanoscale dimensional characteristics was assessed using osteoblast cells (SaOS2). The results of the MTS assay indicated that the nanotubes with inner diameter (Di)≈40nm exhibited the highest percentage of cell adhesion of 41.0%. This result can be compared to (i) 25.9% cell adhesion at Di≈59nm, (ii) 33.1% at Di≈64nm, and (iii) 33.5% at Di≈82nm. The nanotubes with Di≈59nm exhibited the greatest roughness parameter of Sa (mean roughness), leading to the lowest ability to interlock with SaOS2 cells.

Synthesis of bioactive β-TCP coatings with tailored physico-chemical properties on zirconia bioceramics

The objective of this work was to develop a synthesis procedure for the deposition of β-TCP coatings with tailored physico-chemical properties on zirconia bioceramics. The synthesis procedure involved two steps: (i) a rapid wet-chemical deposition of a biomimetic CaP coating and (ii) a subsequent post-deposition processing of the biomimetic CaP coating, which included a heat treatment between 800 and 1200 °C, followed by a short sonication in a water bath. By regulating the heating temperature the topography of the β-TCP coatings could be controlled. The average surface roughness (Ra) ranged from 42 nm for the coating that was heated at 900 °C (TCP-900) to 630 nm for the TCP-1200 coating. Moreover, the heating temperature also affected the dissolution rate of the coatings in a physiological solution, their protein-adsorption capacity and their bioactivity in a simulated body fluid.

Electronic properties of anodized TiO2 electrodes and the effect on in vitro response

For dental implants, improved osseointegration is obtained by modifying the surface roughness as well as oxide morphology and composition. A combination of different effects contributes to enhanced performance, but with surface roughness as the dominant factor. To single out the effect of oxide conductivity on biological response, oxide films with similar thickness and surface roughness but different electronic properties were formed using galvanostatic anodization. Three different current densities were used, 2.4, 4.8, and 11.9 mA cm(-2) , which resulted in growth rates ranging from 0.2 to 2.5 V s(-1) . The electronic properties were evaluated using cyclic voltammetry and impedance spectroscopy, while the biological response was studied by cell activity and apatite formation. The number of charge carrier in the oxide film close to the oxide/solution interface decreased from 5.8 × 10(-19) to 3.2 × 10(-19) cm(-2) with increasing growth rate, that is, the conductivity decreased correspondingly. Cell response of the different surfaces was tested in vitro using human osteoblast-like cells (MG-63). The results clearly show decreased osteoblast proliferation and adhesion but higher mineralization activity for the oxide with lower conductivity at the oxide/solution interface. The apatite-forming ability was examined by immersion in simulated body fluid. At short times the apatite coverage was ∼26% for the anodized surfaces, significantly larger than for the reference with only 3% coverage. After 1 week of immersion the apatite coverage ranged from 73 to 56% and a slight differentiation between the anodized surfaces was obtained with less apatite formation on the surface with lower conductivity, in line with the cell culture results.

Size tuning of Ag-decorated TiO₂ nanotube arrays for improved bactericidal capacity of orthopedic implants

Surface modification of orthopedic implants using titanium dioxide nanotubes and silver nanoparticles (SNs) is a promising approach to prevent bacteria adhesion, biofilm formation, and implant infection. Herein, we utilized a straightforward and all-solution process to prepare silver-decorated TiO2 nanotube arrays with surface density of 10(3) to 10(4) per µm(2). With controlling the synthesis conditions, hexagonal closed-packed nanotubes with opening diameter of 30-100 nm that are decorated with SNs with varying sizes (12-40 nm) were prepared. Various analytical techniques were utilized to characterize the size, morphology, distribution, valance state, surface roughness, and composition of the prepared antibacterial films. The bactericidal capacity of the films were studied on Escherichia coli (E. coli) by drop-test method and correlated with the size and percentage of Ag as well as the surface density of TiO2 nanotube arrays. Synergetic effect of TiO2 nanotubes and SNs on the antibacterial activity of the composite films is shown. The bactericidal capacity is found to depend on the size characteristics of the Ag-TiO2 coating. The highest antibacterial activity is obtained for TiO2 nanotubes with opening diameter of about 100 nm and SNs with an average size of 20 nm. MTT assay using osteoblast MG63 cells was performed to examine the cell viability. We suggest that release rate of the silver ions is an important factor controlling the antibacterial activity. Additionally, the size dependency of the bactericidal capacity implies that electrical coupling between silver and TiO2 nanotubes and improved hydrophobicity of the coating might influence the bacterial behavior of the hybrid nanostructures.

The effects of different wavelength UV photofunctionalization on micro-arc oxidized titanium

Many challenges exist in improving early osseointegration, one of the most critical factors in the long-term clinical success of dental implants. Recently, ultraviolet (UV) light-mediated photofunctionalization of titanium as a new potential surface treatment has aroused great interest. This study examines the bioactivity of titanium surfaces treated with UV light of different wavelengths and the underlying associated mechanism. Micro-arc oxidation (MAO) titanium samples were pretreated with UVA light (peak wavelength of 360 nm) or UVC light (peak wavelength of 250 nm) for up to 24 h. UVC treatment promoted the attachment, spread, proliferation and differentiation of MG-63 osteoblast-like cells on the titanium surface, as well as the capacity for apatite formation in simulated body fluid (SBF). These biological influences were not observed after UVA treatment, apart from a weaker effect on apatite formation. The enhanced bioactivity was substantially correlated with the amount of Ti-OH groups, which play an important role in improving the hydrophilicity, along with the removal of hydrocarbons on the titanium surface. Our results showed that both UVA and UVC irradiation altered the chemical properties of the titanium surface without sacrificing its excellent physical characteristics, suggesting that this technology has extensive potential applications and merits further investigation.

Electronic Properties of TiO2 Nanoparticles Films and the Effect on Apatite-Forming Ability

Nanoparticle-covered electrodes have altered properties as compared to conventional electrodes with same chemical composition. The changes originate from the large surface area and enhanced conduction. To test the mineralization capacity of such materials, TiO2 nanoparticles were deposited on titanium and gold substrates. The electrochemical properties were investigated using cyclic voltammetry and impedance spectroscopy while the mineralization was tested by immersion in simulated body fluid. Two types of nucleation and growth behaviours were observed. For smooth nanoparticle surfaces, the initial nucleation is fast with the formation of few small nuclei of hydroxyapatite. With time, an amorphous 2D film develops with a Ca/P ratio close to 1.5. For the rougher surfaces, the nucleation is delayed but once it starts, thick layers are formed. Also the electronic properties of the oxides were shown to be important. Both density of states (DOS) in the bandgap of TiO2 and the active area were determined. The maximum in DOS was found to correlate with the donor density (N d ) and the active surface area. The results clearly show that a rough surface with high conductivity is beneficial for formation of thick apatite layers, while the nanoparticle covered electrodes show early nucleation but limited apatite formation.

Calcium phosphate-mediated gene delivery using simulated body fluid (SBF)

The present study aimed at developing a new approach in gene delivery of calcium phosphate nanoparticles through simulated body fluid (CaP-SBF). The physicochemical and biological characteristics of the CaP-SBF nanoparticles were compared with those made in pure water (CaP-water) via a similar procedure. The CaP-SBF and CaP-water solutions were then adjusted to two different pH values of 7.4 and 8.0, mixed with plasmid DNA (pDNA), and added in varying amounts to human embryonic kidney (HEK 293T) cells. The transfection efficiency and cell viability were studied in vitro by reporter gene (luciferase and Enhanced Green Fluorescent Protein) expression and the resazurin reduction assay, respectively, 24 and 48 h after the incubation with the nanoparticles. Our results indicated considerably high in vitro transfection efficiency for CaP-SBF/DNA complexes at physiological pH (7.4) with high amounts of CaP. Additionally, the SBF solution exhibited the ability to reduce the rapid growth of CaP particles over time, leading to higher transfection efficiency of CaP-SBF/DNA complexes than those made in water (CaP-water/DNA).

A Review of Titanium Zirconium (TiZr) Alloys for Use in Endosseous Dental Implants

Dental implants made from binary titanium-zirconium (TiZr) alloys have shown promise as a high strength, yet biocompatible alternative to pure titanium, particularly for applications requiring small diameter implants. The aim of this review is to summarize existing literature reporting on the use of binary TiZr alloys for endosseous dental implant applications as tested in vitro, in animals and clinically. And furthermore to show that TiZr is “at least as good as” pure titanium in terms of biocompatibility and osseointergration. From the twelve papers that met the inclusion criteria, the current literature confirms that TiZr alloys produce small diameter implants with a strength up to 40% higher than conventional, cold-worked, grade IV titanium implants, and with a corrosion resistance and biocompatibility that is at least as good as pure titanium. The surface structure of TiZr is compatible with established surface treatments proven to aid in the osseointegration of titanium implants. Furthermore, binary TiZr alloys have been shown to achieve good osseointegration and high success rates both in animal and in clinical studies.

The influence of surface energy of titanium-zirconium alloy on osteoblast cell functions in vitro

The success of an implant used for bone regeneration and repair is determined by the events that take place at the cell-material interface. An understanding of these interactions in vitro gives insights into the formulation of ideal conditions for their effective functioning in vivo. Thus, it is not only important to understand the physico-chemical properties of the materials but, also necessary to assess the cellular responses to them to determine their long-term stability and efficacy as implants. In the present study, we have compared the physico-chemical and biological properties of titanium (Ti) and two Ti-based alloys, namely: Ti- Zirconium (TiZr) and Ti-Niobium (TiNb). The morphology, chemical analysis, surface roughness, and contact angle measurements of the alloys were assessed by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), profilometer, and contact angle goniometer, respectively whereas the biological properties of the materials were evaluated by measuring the adhesion, proliferation, and differentiation of MC3T3-E1 osteoblast cells on the surfaces of these alloys. Our results indicate that the biological properties of osteoblasts were better on TiZr surface than on TiNb surface. Furthermore, the surface energy and substrate composition influenced the superior biological activity of the TiZr alloy.