The mechanisms of passive dissolution of titanium in a model physiological environment

Biocompatibility of titanium from the viewpoint of its surface

Among metals, Ti and majority of its alloys exhibit excellent biocompatibility or tissue compatibility. Although their high corrosion resistance is a factor in the biocompatibility of Ti and Ti alloys, it is clear that other factors exist. In this review, the corrosion resistance and passive film of Ti are compared to those of other metallic biomaterials, and their band gap energies, E_gs, are compared to discuss the role of E_g in the reactivity with living tissues. From the perspective of the material's surface, it is possible to explain the excellent biocompatibility of Ti by considering the following factors: Ti ions are immediately stabilized not to show toxicity if it is released to body fluids; good balance of positive and negative charges by the dissociation of surface hydroxyl groups on the passive film; low electrostatic force of the passive film inducing a natural adsorption of proteins maintaining their natural conformation; strong property as n-type semiconductor; lower band gap energy of the passive film on Ti generating optimal reactivity; and calcium phosphate formation is caused by this reactivity. The results suggest that due to the passive oxide film, the optimal balance between high corrosion resistance and appropriate reactivity of Ti is the predominate solution for the excellent biocompatibility of Ti.

Mineralization of Titanium Surfaces: Biomimetic Implants

The surface modification by the formation of apatitic compounds, such as hydroxyapatite, improves biological fixation implants at an early stage after implantation. The structure, which is identical to mineral content of human bone, has the potential to be osteoinductive and/or osteoconductive materials. These calcium phosphates provoke the action of the cell signals that interact with the surface after implantation in order to quickly regenerate bone in contact with dental implants with mineral coating. A new generation of calcium phosphate coatings applied on the titanium surfaces of dental implants using laser, plasma-sprayed, laser-ablation, or electrochemical deposition processes produces that response. However, these modifications produce failures and bad responses in long-term behavior. Calcium phosphates films result in heterogeneous degradation due to the lack of crystallinity of the phosphates with a fast dissolution; conversely, the film presents cracks, which produce fractures in the coating. New thermochemical treatments have been developed to obtain biomimetic surfaces with calcium phosphate compounds that overcome the aforementioned problems. Among them, the chemical modification using biomineralization treatments has been extended to other materials, including composites, bioceramics, biopolymers, peptides, organic molecules, and other metallic materials, showing the potential for growing a calcium phosphate layer under biomimetic conditions.

Time Transient of Calcium and Phosphate Ion Adsorption by Rutile Crystal Facets in Hanks' Solution Characterized by XPS

For the elucidation of the mechanism of calcium phosphate formation on commercially pure titanium (CP Ti) in the human body, rutile TiO₂ single crystal plates with (001), (110), and (111) facets, namely, TiO₂(001), TiO₂(110), and TiO₂(111), and polycrystalline plates (TiO₂(poly)) were immersed in a simulated body fluid, Hanks' solution (Hanks), for 10⁰-10⁵ s, and the adsorption of calcium and phosphate ions was precisely characterized employing X-ray photoelectron spectroscopy (XPS). Previously published CP Ti data were used for comparison. Prior to immersion in Hanks, oxygen content was more than twice as high as that of titanium due to the existence of hydroxyl groups and water on the oxides. After immersion in Hanks, the composition and chemical state of the TiO₂ substrates remained unchanged. Among the electrolytes contained in Hanks, only calcium and phosphate ions were adsorbed by and incorporated onto TiO₂ surfaces. Adsorption of calcium ions onto rutile did not exhibit any systematic increase of calcium with immersion time except TiO₂(poly). Adsorption of phosphate ions was initially constant, followed by an increase with the logarithm of immersion time. The adsorption rate of phosphate ions decreased in the following order: TiO₂(001), TiO₂(poly), TiO₂(111), CP Ti, and TiO₂(110). The coordination number and band gap of each crystal facet of rutile is important for the adsorption and incorporation of phosphate ions. Regular calcium phosphate formation on CP Ti is possibly enabled by the surface oxide film, which consists chiefly of amorphous TiO₂. However, calcium phosphate formation kinetics on CP Ti differed from those on the TiO₂ crystalline phase. These findings may further the understanding of CP Ti hard tissue compatibility.

Titanium Dioxide Nanotube Arrays for Cardiovascular Stent Applications

Efficient stent implantation among others depends on avoiding the aggregation of platelets in the blood vessels and appropriate proliferation of endothelial cells and controlled proliferation of smooth muscle cells, which reduces the development of pathology, such as neointimal hyperplasia, thrombosis, and restenosis. The current article provides an elegant solution for prevention of platelet and smooth muscle cell adhesion and activation on stent surfaces while obtaining surface conditions to support the growth of human coronary artery endothelial cells. This was achieved by surface nanostructuring and chemical activation of the surface. Specific nanotopographies of titanium were obtained by electrochemical anodization, while appropriate chemical properties were attained by treatment of titanium oxide nanotubes by highly reactive oxygen plasma. Surface properties were studied by scanning electron microscopy, atomic force microscopy, and X-ray photoelectron spectroscopy. Wettability was evaluated by measuring the water contact angle. The influence of nanostructured morphology and plasma modification on in vitro biological response with human coronary artery endothelia and smooth muscle cells as well as whole blood was studied. Our results show that a combination of nanostructuring and plasma modification of the surfaces is an effective way to achieve desired biological responses necessary for implantable materials such as stents.

RETRACTED: In vitro corrosion resistance and in vivo osseointegration testing of new multifunctional beta-type quaternary TiMoZrTa alloys

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of authors. Due to communication issues between Professor dr. Lucia Carmen Trincă and Professor dr. Vizureanu Petrica and Assist. dr. Bălţatu Simona, the first author was not aware that the specimens processed by corrosion by Assoc. Professor dr. Daniel Mareci and evaluated in the aforementioned article would be included by Assistant dr. Bălţatu Simona in her PhD thesis that was defended in June 2017 and then in an international patent application (Indonesia) No: PI 2019006569, in November 2019. The authors understand and respect the intellectual property rights of the international (Indonesia) patent application holders no: PI 2019006569/2019 and thus request the retraction of the article.

Off-Stoichiometric Reactions at the Cell-Substrate Biomolecular Interface of Biomaterials: In Situ and Ex Situ Monitoring of Cell Proliferation, Differentiation, and Bone Tissue Formation

The availability of osteoinductive biomaterials has encouraged new therapies in bone regeneration and has potentially triggered paradigmatic shifts in the development of new implants in orthopedics and dentistry. Among several available synthetic biomaterials, bioceramics have gained attention for their ability to induce mesenchymal cell differentiation and successive bone formation when implanted in the human body. However, there is currently a lack of understanding regarding the fundamental biochemical mechanisms by which these materials can induce bone formation. Phenomenological studies of retrievals have clarified the final effect of bone formation, but have left the chemical interactions at the cell-material interface uncharted. Accordingly, the knowledge of the intrinsic material properties relevant for osteoblastogenesis and osteoinduction remains incomplete. Here, we systematically monitored in vitro the chemistry of mesenchymal cell metabolism and the ionic exchanges during osteoblastogenesis on selected substrates through conventional biological assays as well as via in situ and ex situ spectroscopic techniques. Accordingly, the chemical behavior of different bioceramic substrates during their interactions with mesenchymal cells could be unfolded and compared with that of biomedical titanium alloy. Our goal was to clarify the cascade of chemical equations behind the biological processes that govern osteoblastogenic effects on different biomaterial substrates.

Titanium-Tissue Interface Reaction and Its Control With Surface Treatment

Titanium (Ti) and its alloys are widely used for medical and dental implant devices-artificial joints, bone fixators, spinal fixators, dental implant, etc. -because they show excellent corrosion resistance and good hard-tissue compatibility (bone formation and bone bonding ability). Osseointegration is the first requirement of the interface structure between titanium and bone tissue. This concept of osseointegration was immediately spread to dental-materials researchers worldwide to show the advantages of titanium as an implant material compared with other metals. Since the concept of osseointegration was developed, the cause of osseointegration has been actively investigated. The surface chemical state, adsorption characteristics of protein, and bone tissue formation process have also been evaluated. To accelerate osseointegration, roughened and porous surfaces are effective. HA and TiO2 coatings prepared by plasma spray and an electrochemical technique, as well as alkalinization of the surface, are also effective to improve hard-tissue compatibility. Various immobilization techniques for biofunctional molecules have been developed for bone formation and prevention of platelet and bacteria adhesion. These techniques make it possible to apply Ti to a scaffold of tissue engineering. The elucidation of the mechanism of the excellent biocompatibility of Ti can provide a shorter way to develop optimal surfaces. This review should enhance the understanding of the properties and biocompatibility of Ti and highlight the significance of surface treatment.

Enhanced Osseointegration of a Modified Titanium Implant with Bound Phospho-Threonine: A Preliminary In Vivo Study

Implant surface topography is a key factor in achieving osseointegration. l-Threonine can be chemically and stably bonded to titanium surfaces by phosphorylation. This study investigated the degree of in vivo osseointegration of an implant with a novel o-phospho-l-threonine (p-Thr)-binding surface. MC3T3-E1 cells were seeded on the p-Thr binding surface and machined surface disks, and initial cell attachment was evaluated. p-Thr-binding and machined surface implants were tested in vivo by implantation into the femurs of three male New Zealand white rabbits, and the osseointegration was assessed by measurement of removal torque (RT) and bone-implant contact (BIC) ratio. Initial cell attachment was greater for the p-Thr-binding than for the machined surface implant group (P < 0.05). In addition, RT and BIC values were higher for the p-Thr-binding surface than for the machined surface (P < 0.05). These results indicate that our implant with a p-Thr-binding surface can achieve enhanced osseointegration.

TiO2 Nanotubes on Ti Dental Implant. Part 1: Formation and Aging in Hank’s Solution

Self-organized TiO2 nanotube layer has been formed on titanium screws with complex geometry, which are used as dental implants. TiO2 nanotubes film was grown by potentiostatic anodizing in H3PO4 and HF aqueous solution. During anodizing, the titanium screws were mounted on a rotating apparatus to produce a uniform structure both on the peaks and on the valleys of the threads. X-ray diffraction (XRD), Scanning electron microscopy (SEM), Energy dispersive X-ray (EDX) and electrochemical characterization were used to evaluate the layer, chemical composition and electrochemical properties of the samples. Aging in Hank’s solution of both untreated and nanotubes covered screw, showed that: (i) samples are covered by an amorphous oxide layer, (ii) the nanotubes increases the corrosion resistance of the implant, and (iii) the presence of the nanotubes catalyses the formation of chemical compounds containing Ca and P.

Electrochemical characterization of MC3T3-E1 cells cultured on γTiAl and Ti-6Al-4V alloys

Electrochemical impedance spectroscopy (EIS) was used to study the behavior of MC3T3-E1 cells cultured in an αMEM+FBS solution on two Ti-based alloys (Ti-6Al-4V and γTiAl) for 4, 7 and 14 days. EIS measurements were carried out at an open-circuit potential in a 1 mHz to 100 kHz frequency range. Results indicate a general increase in impedance on the Ti alloy surfaces with cells as a function of time. Bode plots indicate changes corresponding to the passive oxide film, adsorption of proteins and cell tissue on surfaces with the passage of time. Normal cellular activity based on the polygonal morphology, with long and fine cytoplasmic prolongations of the cells on Ti-6Al-4V and γTiAl was observed from SEM images. Similarly, mineralization nodules corresponding to cell differentiation associated with the osseogenetic process were observed confirmed by Alizarin Red S staining. Immunofluorescence analysis to detect the presence of collagen Type I showed an increase in the segregation of collagen as a function of time. The impedance values obtained from EIS testing are indicative of the corrosion protection offered to the Ti alloy substrates by the cell layer. This study shows that γTiAl has better corrosion resistance than that of Ti-6Al-4V in the αMEM+FBS environment in the presence of MC3T3-E1 cells.

Bone response to surface-modified titanium implants: studies on the early tissue response to implants with different surface characteristics

In a series of experimental studies, the bone formation around systematically modified titanium implants is analyzed. In the present study, three different surface modifications were prepared and evaluated. Glow-discharge cleaning and oxidizing resulted in a highly stoichiometric TiO₂ surface, while a glow-discharge treatment in nitrogen gas resulted in implants with essentially a surface of titanium nitride, covered with a very thin titanium oxide. Finally, hydrogen peroxide treatment of implants resulted in an almost stoichiometric TiO₂, rich in hydroxyl groups on the surface. Machined commercially pure titanium implants served as controls. Scanning Auger Electron Spectroscopy, Scanning Electron Microscopy, and Atomic Force Microscopy revealed no significant differences in oxide thickness or surface roughness parameters, but differences in the surface chemical composition and apparent topography were observed. After surface preparation, the implants were inserted in cortical bone of rabbits and evaluated after 1, 3, and 6 weeks. Light microscopic evaluation of the tissue response showed that all implants were in contact with bone and had a large proportion of newly formed bone within the threads after 6 weeks. There were no morphological differences between the four groups. Our study shows that a high degree of bone contact and bone formation can be achieved with titanium implants of different surface composition and topography.

Nucleation and growth of apatite on an anatase layer irradiated with UV light under different environmental conditions

Implant surfaces must sometimes be modified to form strong bonds to host tissues. The method of depositing an anatase layer on chemically pure titanium by chemical oxidation with H(2)O(2) and subsequent calcination (CHT) is known to deposit apatite under physiological conditions; it thus exhibits bone-bonding ability. UV irradiation should affect the bonding ability because the CHT anatase layer would experience certain chemical modifications, such as a decrease or an increase in the number of Ti-OH and Ti-O(H)-Ti sites; these sites are considered active sites for apatite nucleation. When in vitro apatite deposition was examined, using Kokubo's simulated body fluid, UV irradiation in air reduced the apatite-forming ability of the CHT anatase layer, and UV irradiation on the samples in water enhanced the ability. These results were correlated to changes in the Ti-OH and Ti-O(H)-Ti sites, as determined by O 1s X-ray photoelectron spectroscopy. Analysis of the number and size of the semi-spherical apatite particles and their surface coverage led to a model: proper assembly of the Ti-OH and Ti-O(H)-Ti sites should only give rise to the induction of apatite nucleation, analogous to topotaxy effects.

In vivo evaluation of titanium oxide and hydroxyapatite as an artificial cornea skirt

Keratoprosthetic devices are subject to chronic inflammatory, pathological processes and the external environment that affect their stability and biocompatibility with the ocular surface and adjacent ocular tissues. We compared the corrosion resistance property and tissue-implant reaction of titanium oxide (TiO(2)) with hydroxyapatite (HA) in artificial tear fluid and a rabbit skin implantation model. The dissolution properties of the implant surfaces were evaluated with scanning electronic microscope (SEM) and atomic force microscope (AFM). Tissue inflammatory reactions were evaluated by Hematoxylin & Eosin staining, avidin biotin peroxidase complex (ABC) immunoassay and immunofluorescence. SEM and AFM images showed that there was less pitting corrosion on the surface of TiO(2) implants compared with HA. TiO(2) and HA exhibited a similar pattern of foreign body capsule formation and inflammatory cellular responses. The Collagen I/Collagen III ratio of the TiO(2) capsule was higher than that of the HA capsule. TiO(2) implants possess a high corrosion resistance property both in vitro and in vivo and the inflammatory cellular response to TiO(2) is similar to HA. With regards to corrosion resistance and inflammatory tissue responses, TiO(2) appears to be a promising material for keratoprosthetic skirt devices.

Cellular Response of Titanium and Its Alloys as Implants

The cellular response of osteocytes to commercially pure titanium (α) and its alloys (α + β and β) has been tested in a culture media, and the results have been supplemented by analyses from various techniques such as inductively coupled plasma atomic emission spectroscopic (ICP-AES) analysis, X-ray photoemission spectroscopy (XPS), scanning electron microscopy (SEM), metallography, and electrochemical measurements. These results have been correlated with respect to the presence of various alloying elements in these alloys to qualify them for human application. The newer β alloys have been examined for their potential use as implants. These results serve as a preliminary baseline to characterize the best alloy system for a comprehensive long-term investigation.

Detection of synthetic RGDS(PO3H2)PA peptide adsorption using a titanium surface plasmon resonance biosensor

The purpose of this study was to measure the time-dependent chemical interaction between synthetic RGDS(PO(3)H(2))PA (P-RGD) peptide and titanium surfaces using a titanium surface plasmon resonance (SPR) biosensor and to determine the degree of peptide immobilization on the surfaces. An SPR instrument for 'single-spot' analysis was used for nanometer-scale detection of biomolecular adsorption using a He-Ne laser light according to Knoll's method. The oxidized titanium surface was etched when exposed to H(3)PO(4) solutions with a pH of 2.0 or below. The amount of P-RGD adsorbed at pH 1.9 was approximately 3.6 times as much as that at pH 3.0 (P < 0.05). P-RGD naturally adsorbed on the oxidized titanium surface as a consequence of the bonding and dissociation mechanism of the phosphate functional group. Furthermore, the control of pH played a very important role in the interaction between P-RGD and the surface. These findings show that pH control may promote progressive binding of biomolecules with the phosphate functional group to the titanium surface.

Electrochemical behaviour of titanium in ammine and stannous fluoride and chlorhexidine 0.2 percent mouthwashes

Titanium (Ti) is widely used in dentistry. Fluorides at acid pH could destabilize Ti oxide and make it susceptible to corrosion. The behaviour of IV grade machined Ti disks in 5 electrolytic solutions: Fusayama artificial saliva (Fas), ammine fluoride-stannous fluoride (Am-SnF2), 0.2 percent Chlorexidine (CHX) 0.20 percent, Fas with 20 percent Am-SnF2, and Fas with 20 percent CHX, was evaluated. Open circuit potential Ecorr was determined by immersing Ti disks for 24 hours in an electrochemical cell containing the solutions, potential changes were measured until a stable value was obtained. Examination by Scanning Electronic Microscope and Energy Dispersive X-ray Analysis were then performed. One way ANOVA analysis showed a significant difference of Ecorr values regarding the 5 solutions (p less than 0.001). The highest values were observed for Fas (-37.6 mV), intermediate for Am-SnF2 (-81mV) and lowest for CHX (-87.6mV). SEM analysis of disks after polarization curve in CHX showed a marked localized corrosion, while the other solutions showed no considerable corrosive action on Ti surface. When considering corrosive potential range in oral cavity, Ti had an excellent behaviour on both antiseptics evaluated. The results obtained in this study will enable us to recommend the use of Am-SnF2 mouthwash for patients with dental implants.

Dental implant systems

Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s) in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities.

Monitoring TiO2 Nanotubes Elaboration Condition, a Way for Obtaining Various Characteristics of Nanostructures

In this paper the elaboration and characterization of TiO2 nanotubes as a function of anodizing conditions are studied taking into consideration electrolyte composition and voltage. The obtained results show that the nanotubes dimensions and surface features depend on elaboration conditions. The technique of surface characteristics investigation (2D and 3 D images) was atomic force microscopy which permitted roughness and porosity evaluation.

Histological Biocompatibility of a Stainless Steel Miniature Glaucoma Drainage Device in Humans: A Case Report

The purpose of this study was to evaluate the histological biocompatibility of a stainless steel miniature glaucoma drainage device. Twenty-four months before death due to heart failure, this seventy-three-year-old female patient underwent filtration surgery for primary open-angle glaucoma uncontrolled in the right eye. The device was implanted at the limbus under a scleral flap. For histopathological evaluation, two corneoscleral specimens were embedded in methacrylate blocks sectioned to a thickness of 50 microns, polished and stained with periodic acid schiff. Some sections included a longitudinal cross-section of the implant. At the interface between the spur and the flange of the device and the cornea, there was a small shoulder of fibrous tissue. A thin, fibrous capsule covered the remainder of the body of the device up to the distal tip. No inflammatory cells occurred within the fibrous capsule. No material or blockage was noted within the lumen. Our results support the biological inertness of the device.

Chemical interaction between titanium implant surface and amino acids

The purpose of this study was to investigate the chemical interaction between titanium implant surface and amino acids. Pure titanium disks were pretreated with 10 N HCl and ultrapure water at room temperature for 30 minutes each. Disks were then modified with one of the three amino acids--L-aspartic acid, L-serine, or L-threonine--at 37 degrees C for 12 hours. Modification with oxalic acid was used as a control. By means of X-ray photoelectron spectroscopy (XPS), amino acid powders and the modified surfaces without or with ultrasonic water rinsing were chemically analyzed. It was revealed that the N 1s peak which originated from amino acids was not or hardly detected in the wide scan spectra of amino acid-modified surfaces. Moreover, the COO- peak which originated from oxalic acid could hardly be detected in the narrow scan spectrum of the C is region of oxalic acid-modified surface with ultrasonic water rinsing. Based on the results of this study, it was concluded that amino acids could not chemically bond to the titanium surface.

Electrochemical characterization of albumin protein on Ti-6AL-4V alloy immersed in a simulated plasma solution

The effect of oxygen and albumin on the electrochemical behavior of a Ti-6Al-4V alloy immersed in a simulated inorganic plasma (SIP) solution was studied with a rotating-cylindrical electrode configuration to focus on the surface/electrolyte reactions. Potentiokinetic scans and electrochemical impedance spectroscopy have been used to characterize the interface by determining the passive current density and capacitance. For the polarization scans, an albumin addition of 37.7 mg/cm(3) to the SIP solution (oxygenated and unoxygenated) decreased the passive current density, indicating a lowering of the corrosive rate. The surface capacitance for the Ti-6Al-4V alloy immersed in a SIP solution averaged 13 microF/cm(2), which transformed after albumin addition (37.7 mg/cm(3)) from a potential independent behavior to the capacitance ranging from 23 to 6 microF/cm(2) with increasing potentials from -800 to 1500 mV(SCE), respectively, indicative of albumin adsorption. Within the same potential range and albumin addition to oxygenated solutions, the capacitances expanded slightly with a similar decreasing trend from 31 to 6 microF/cm(2), although the capacitance depicts an interaction between the hydrated passive film and the adsorbed albumin from -550 to 500 mV(SCE) in which the capacitance plateaued at 15 microF/cm(2). The hydrated porous oxide film results from the porous rutile layer reacting with H(2)O(2) formed as an intermediary component of oxygen reduction at the Ti-6Al-4V surface. The passive film-albumin interaction would affect the processing of titanium alloys in their surface preparation for biocompatibility, as well as determining the reactivity of titanium alloys to proteins.

Calcium phosphate formation on titanium by low-voltage electrolytic treatments

Electrochemical treatments are expected to be effective for the coating of calcium phosphate ceramics to a titanium substrate. In the present study, two types of chronoamperometry with a step potential and a cyclic wave potential at low voltage (up to 2.0 V) and low current density were performed in Hanks' solution to modify the surface characteristics of titanium. Titanium oxide film formed by self-passivation, that formed as reconstructed film during electrochemical treatments, and a calcium phosphate layer precipitated through treatments were characterised by X-ray photoelectron spectroscopy. The thickness and compositions of the surface films and layers were quantified from the XPS results. Calcium phosphate formation during immersion in Hanks' solution for 1.0 Ms was evaluated by scanning electron microscopy with energy-dispersive X-ray spectrometry. The results confirmed that the electrolytic treatments in this study were effective to accelerate calcium phosphate formation on titanium in Hanks' solution in spite of their lower voltage than conventional methods. The results also suggested that the hydroxyl group in the surface oxide film might contribute to the formation of calcium phosphate. This technique is a promising process for the treatment of thin titanium materials.

Surface analysis and biocorrosion properties of nanostructured surface sol–gel coatings on Ti6Al4V titanium alloy implants

Surfaces of biocompatible alloys used as implants play a significant role in their osseointegration. Surface sol-gel processing (SSP), a variant of the bulk sol-gel technique, is a relatively new process to prepare bioreactive nanostructured titanium oxide for thin film coatings. The surface topography, roughness, and composition of sol-gel processed Ti6Al4V titanium alloy coatings was investigated by atomic force microscopy (AFM) and X-ray electron spectroscopy (XPS). This was correlated with corrosion properties, adhesive strength, and bioreactivity in simulated body fluids (SBF). Electroimpedance spectroscopy (EIS) and polarization studies indicated similar advantageous corrosion properties between sol-gel coated and uncoated Ti6Al4V, which was attributed to the stable TiO2 composition, topography, and adhesive strength of the sol-gel coating. In addition, inductive coupled plasma (ICP) and scanning electron microscopy with energy dispersive spectrometry (SEM-EDS) analysis of substrates immersed in SBF revealed higher deposition of calcium and phosphate and low release rates of alloying elements from the sol-gel modified alloys. The equivalent corrosion behavior and the definite increase in nucleation of calcium apatite indicate the potential of the sol-gel coating for enhanced bioimplant applications.

Effect of passivation and surface modification on the dissolution behavior and nano-surface characteristics of Ti-6Al-4V in Hank/EDTA solution

The aim of the present study was to investigate the effects of passivation treatment (34% nitric acid passivation, 400 ( composite function)C heated in air, and aged in 100 ( composite function)C de-ionized water) and surface modification (2 hr and 8 hr vacuum-brazed treatments) on the ion dissolution and nano-surface characteristics of Ti-6Al-4V exposed in Hank's solution with 8.0 mM ethylene diamine tetra-acetic acid (EDTA) at 37 ( composite function)C. The results indicated that the original nano-surface characteristics and microstructure would influence the ion dissolution but not change the capability of the Ca and P adsorption upon immersion. Of the three passivated treatments, 400 ( composite function)C thermal treatment for both 2 hr brazed Ti-6Al-4V (B2) and 8 hr brazed Ti-6Al-4V (B8) exhibits a substantial reduction in the constituent release compared to the acid passivated and water aged treatment, because the thicker thickness and rutile structure of surface oxide could provide the better dissolution resistance for 400 ( composite function)C-treated specimens. Moreover, the reduced Ti(2)Cu and increased alpha -titanium structure in B8 specimen could also improve ion dissolution resistance in comparison with B2 specimen. After soaking in Hank/EDTA solution, the adsorbed non-elemental Ca and P for all groups of specimens were observed by XPS analysis, and the AES depth-profile analysis indicate that the oxide films of all groups of specimens thicken with the longer immersion periods. The increasing oxide thickness may be the factor in the improved dissolution resistance at the longer immersion periods. The relation between lower dissolution rate and thicker oxide films were observed for all groups of specimens. The results suggest that the dissolution kinetics was governed by the metal ion transport through the oxide film in this study.

Ligand density characterization of peptide-modified biomaterials

A simple fluorescence based characterization method was developed to assess ligand density on peptide-modified biomaterials. The method exploits the exquisite sensitivity of proteolysis for the purpose of liberating a fluorescently labeled probe fragment from an immobilized peptide. The released fragment can then be detected in solution using high-throughput fluorometry. In silico screening tools identified the enzyme chymotrypsin as a promising candidate for releasing a detectable probe fragment from the fluorescently labeled peptide, Ac-CGGNGEPRGDTYRAYK(FITC)GG-NH(2). After chymotrypsin digestion of the peptide in solution was first characterized using mass spectrometry and HPLC, a basic enzyme mediated release protocol was developed and implemented to generate peptide-binding isotherms on various peptide-modified biomaterials. The new method is sensitive, has good signal-to-noise ratio (S/N), and is easily standardized. Furthermore, the technique can be applied independent of material chemistry and geometry, making it a suitable alternative to radiolabeling for a wide range of biomaterial applications.

Quantitative evaluation of the fibrin clot extension on different implant surfaces: an in vitro study

The aim of the present study was a quantitative evaluation of the in vitro fibrin clot extension on different implant surfaces. Forty-five disk-shaped commercially pure Grade 2 titanium samples with three different surface topographies (machined, DPS, and Plus) were used in the present study. For the quantitative evaluation of the fibrin clot, 30 specimens were used (10 per group); human whole blood was employed. Venous blood was drawn from three healthy adult volunteers, and 0.2 mL were immediately dropped onto the surface of each specimen. Contact time was 5 min at room temperature; then the samples were rinsed with saline solution and fixed in a buffered solution of glutaraldehyde and paraformaldehyde. Samples were washed again with buffer and dehydrated in an ascending alcohol series. Specimens belonging to all groups were observed under SEM at a magnification of 1000x. From each sample, 50 random micrographs were collected in .tif format with an N x M 1024 x 768 grid of pixels. Quantitative analysis of fibrin clot extension showed the following results: in machined samples fibrin clot extension was 345987.2 +/- 63747.7 pixels(2) (mean +/- SD), in DPS samples fibrin clot extension was 375930.9 +/- 54726.86 pixels(2) (mean +/- SD), and in Plus samples, fibrin clot extension was 612333.6 +/- 46268.42 pixels(2) (mean +/- SD). With ANOVA it was possible to find that there were significant differences among the groups. The Tukey test revealed that the extension of the fibrin clot of Plus samples was statistically higher compared to both machined and DPS samples. The results of this in vitro study indicate that there is a correlation between implant surface morphology and fibrin clot extension. Improvement in surface microtexture complexity seems to determine the formation of a more extensive and three dimensionally complex fibrin scaffold. Further investigations are necessary to explain in more detail the mechanisms that regulate the fibrin clot formation on different implant surfaces.

Microstructures and bond strengths of plasma-sprayed hydroxyapatite coatings on porous titanium substrates

Hydroxyapatite (HA) coating was carried out by plasma spraying on bulk Ti substrates and porous Ti substrates having a Young's modulus similar to that of human bone. The microstructures and bond strengths of HA coatings were investigated in this study. The HA coatings with thickness of 200-250 microm were free from cracks at interfaces between the coating and Ti substrates. XRD analysis revealed that the HA powder used for plasma spraying had a highly crystallized apatite structure, while the HA coating contained several phases other than HA. The bond strength between the HA coating and the Ti substrates evaluated by standard bonding test (ASTM C633-01) were strongly affected by the failure behavior of the HA coating. A mechanism to explain the failure is discussed in terms of surface roughness of the plasma-sprayed HA coatings on the bulk and porous Ti substrates.

Comparison of metal release from various metallic biomaterials in vitro

To investigate the metal release of each base and alloying elements in vitro, SUS316L stainless steel, Co-Cr-Mo casting alloy, commercially pure Ti grade 2, and Ti-6Al-4V, V-free Ti-6Al-7Nb and Ti-15Zr-4Nb-4Ta alloys were immersed in various solutions, namely, alpha-medium, PBS(-), calf serum, 0.9% NaCl, artificial saliva, 1.2 mass% L-cysteine, 1 mass% lactic acid and 0.01 mass% HCl for 7d. The difference in the quantity of Co released from the Co-Cr-Mo casting alloy was relatively small in all the solutions. The quantities of Ti released into alpha-medium, PBS(-), calf serum, 0.9% NaCl and artificial saliva were much lower than those released into 1.2% L-cysteine, 1% lactic acid and 0.01% HCl. The quantity of Fe released from SUS316L stainless steel decreased linearly with increasing pH. On the other hand, the quantity of Ti released from Ti materials increased with decreasing pH, and it markedly attenuated at pHs of approximately 4 and higher. The quantity of Ni released from stainless steel gradually decreased with increasing pH. The quantities of Al released from the Ti-6Al-4V and Ti-6Al-7Nb alloys gradually decreased with increasing pH. A small V release was observed in calf serum, PBS(-), artificial saliva, 1% lactic acid, 1.2% l-cysteine and 0.01% HCl. The quantity of Ti released from the Ti-15Zr-4Nb-4Ta alloy was smaller than those released from the Ti-6Al-4V and Ti-6Al-7Nb alloys in all the solutions. In particular, it was approximately 30% or smaller in 1% lactic acid, 1.2% L-cysteine and 0.01% HCl. The quantity of (Zr + Nb + Ta) released was also considerably lower than that of (Al + Nb) or (Al + V) released. Therefore, the Ti-15Zr-4Nb-4Ta alloy with its low metal release in vitro is considered advantageous for long-term implants.

Comparison of metal concentrations in rat tibia tissues with various metallic implants

To compare metal concentrations in tibia tissues with various metallic implants, SUS316L stainless steel, Co-Cr-Mo casting alloy, and Ti-6Al-4V and V-free Ti-15Zr-4Nb-4Ta alloys were implanted into the rat tibia for up to 48 weeks. After the implant was removed from the tibia by decalcification, the tibia tissues near the implant were lyophilized. Then the concentrations of metals in the tibia tissues by microwave acid digestion were determined by inductively coupled plasma-mass spectrometry. Fe concentrations were determined by graphite-furnace atomic absorption spectrometry. The Fe concentration in the tibia tissues with the SUS316L implant was relatively high, and it rapidly increased up to 12 weeks and then decreased thereafter. On the other hand, the Co concentration in the tibia tissues with the Co-Cr-Mo implant was lower, and it increased up to 24 weeks and slightly decreased at 48 weeks. The Ni concentration in the tibia tissues with the SUS316L implant increased up to 6 weeks and then gradually decreased thereafter. The Cr concentration tended to be higher than the Co concentration. This Cr concentration linearly increased up to 12 weeks and then decreased toward 48 weeks in the tibia tissues with the SUS316L or Co-Cr-Mo implant. Minute quantities of Ti, Al and V in the tibia tissues with the Ti-6Al-4V implant were found. The Ti concentration in the tibia tissues with the Ti-15Zr-4Nb-4Ta implant was lower than that in the tibia tissues with the Ti-6Al-4V implant. The Zr, Nb and Ta concentrations were also very low. The Ti-15Zr-4Nb-4Ta alloy with its low metal release in vivo is considered advantageous for long-term implants.

On the microstructure of biocomposites sintered from Ti, HA and bioactive glass

Sintering reactions and fine structures of the biocomposites prepared from powder mixtures of titanium ( alpha -Ti), hydroxyapatite (HA) and bioactive glass (BG) (SiO2-CaO-P2O5-B2O3-MgO-TiO2-CaF2) were investigated by X-ray diffraction and transmission electron microscopy. The results showed that complex reactions among the starting materials mainly depended on the initial Ti/HA ratios as well as the sintering temperatures. And the reaction could be expressed by the following illustrative equation: Ti+Ca10(PO4)6(OH)2-->CaTiO3+CaO+TixPy+(Ti2O)+(Ca4P2O9)+H2O.

Attachment and proliferation of neonatal rat calvarial osteoblasts on Ti6Al4V: effect of surface chemistries of the alloy

This study examined the cell attachment and proliferation of neonatal rat calvarial osteoblasts on Ti6Al4V alloy as affected by the surface modifications. The modifications could alter simultaneously the surface chemistries of the alloy (elemental difference of Ti, Al, V, Cu and Ni about 300-600mum thick examined by EDS) as well as the XPS nano-surface characteristics of oxides on the metal surface (chemistries of oxides, amphoteric OH group adsorbed on oxides, and oxide thickness). Three materials including two from modifications and a control were examined. It is argued that a slight change of the nano-surface characteristics of oxides as a result of the modifications neither alters the in vitro capability of Ca and P ion adsorption nor affects the metal ion dissolution behavior of the alloy. This implies that any influence on the cytocompatibility of the materials should only be correlated to the effect of surface chemistries of the alloy and the associated metal ion dissolution behavior of the alloy. The experimental results suggest that the cell response of neonatal rat calvarial osteoblasts on the Ti6Al4V alloy should neither be affected by the variation of surface chemistries of the alloy in a range studied.

Apatite deposition on thermally and anodically oxidized titanium surfaces in a simulated body fluid

By application of a special specimen set-up, thermally oxidized titanium specimen pairs were found able to deposit apatite on the contact surfaces after soaking for 7 days in the simulated body fluid (SBF) of Kokubo's recipe. The specimens oxidized at 400 degrees C and 500 degrees C showed the highest ability of apatite deposition. Both increase and decrease in oxidation temperature from this range caused the apatite deposition ability to decrease. The specimen without treatment failed to deposit any apatite. Specimens anodically oxidized in electrolytes of H(3)PO(4), H(2)SO(4) and acetic acid exhibited very low ability of apatite deposition. Furthermore, the specimen thermally oxidized at 400 degrees C was even able to help the surfaces of PTFE and silicone deposit apatite in the PTFE-Ti and silicone-Ti pairs. This in vitro experimental results indicated that the difference in apatite deposition among various titanium oxides does exist and can be distinguished by applying the present specimen set-up. The mechanism of the apatite deposition on the contact surfaces was discussed in relation to the passive dissolution of titanium in SBF. The release of titanium hydroxide and OH(-) ions from the titanium surfaces and their accumulation inside the confined space between the two contact surfaces were suggested to be responsible for the apatite deposition.

Spinal implant debris-induced osteolysis

STUDY DESIGN

Generally, implant-induced osteolysis is a manifestation of an adverse cellular response to phagocytosable particulate wear and corrosion debris. Initially termed "cement disease," particle-induced loosening was recognized by Charnley in the early 1960s. Despite the plethora of information gained over the last 40 years on the basic science of periprosthetic bone loss, much remains unanswered. The effect of unintended debris resulting from wear and corrosion (e.g., micromotion between the interconnection mechanisms in spinal implants) remains a clinical concern. The current study highlights what is known of particle-induced osteolysis and how the presence of spinal implant particulate debris deleteriously influences osseointegration of posterolateral bone graft or disrupts an established posterolateral fusion mass. Tissue explant, animal, and cell culture studies have revealed the complexity of cellular reactivity involved in aseptic particle-induced osteolysis.

OBJECTIVES

The objectives of this study are twofold: 1) to highlight the dominant cellular participants in total joint arthroplasty particle induced osteolysis, which are purportedly the macrophage, osteoblast, fibroblast, and osteoclast and several of the dominant chemical mediators have been identified as well, which include prostaglandin E2, tumor necrosis factor-alpha, interleukin-1, and interleukin-6; and 2) to demonstrate the potential deleterious effects of spinal implant debris using animal models and analysis of soft tissue surrounding spinal implants in symptomatic patients.

METHODS

There are a growing number of proinflammatory and anti-inflammatory cytokines, prostenoids, and enzymes that have been shown to play important roles in the pathology of particle-induced osteolysis. Reports that aseptic granulomatous inflammation typical of that associated with corrosion debris appear to correlate with the complexity of the implant. Titanium particulate material was used to induce effects in 34 New Zealand White rabbits where analysis included serological quantification of systemic cytokines. Postmortem microradiographic, immunocytochemical, and histopathologic assessment of the intertransverse fusion mass quantified the extent of osteolysis, local proinflammatory cytokines, osteoclasts and inflammatory infiltrates. Clinical analysis of 12 patients more than 0.4 years after spinal implants (mean 4.03, range 0.4 to 11 years) presented with late operative site pain.

RESULTS

Currently the etiology of this inflammation around spinal implants resembles particle-induced osteolysis around joint arthroplasties where there typically is a self-perpetuating fibroinflammatory zone adjacent to the implant, where macrophage exhaustion, reactive oxygen intermediates, and pro-inflammatory cytokines affect a host of local cell types and induce a widening zone of soft tissue damage and inflammation. Animal model analysis indicated increased levels of local inflammatory cytokines typically associated with osteolysis-tumor necrosis factor-alpha. Osteoclast cell counts and regions of osteolytic resorption lacunas were higher in the titanium-treated versus autograft-alone groups (P < 0.05), and the extent of cellular apoptosis was markedly higher in the titanium-treated sites at both time intervals. Electron microscopy indicated definitive evidence of phagocytized titanium particles and foci of local, chronic inflammatory changes in the titanium-treated sites.

CLINICAL CASES

11 of 12 clinical cases demonstrated elevated tumor necrosis factor-alpha levels and an increased osteoclastic response in the vicinity of wear debris caused by dry frictional wear particles of titanium or stainless steel. Resection of the wear debris and surrounding fibroinflammatory zone resolved clinical symptoms in all 12 cases.

CONCLUSIONS

More basic science and clinical research is needed to develop novel strategies for gaining knowledge, and developing effective evaluation and treatment of patients with implant debris related osteolysis. Titanium debris simulating that produced by spinal implants introduced at the level of a spinal arthrodesis elicits an inflammatory cytokine mediated particulate-induced response through increased expression of intracellular TNF-alpha, increased osteoclastic activity and cellular apoptosis. This study highlighted the association between spinal implants particulate wear debris and increased potential for osteolysis. Aseptic osteolysis is among the primary reasons for failure of orthopedic implants. Increased awareness of this destructive process is becoming more important with the growing popularity of total disc arthroplasty and highly modular spinal implants.

Biocompatibility of the Ex-PRESS miniature glaucoma drainage implant

PURPOSE

Based on lessons learned from earlier attempts, a novel miniature glaucoma implant, Ex-PRESS, was developed in 1998. The current study summarizes the histopathologic evaluation of this device implanted in the eyes of rabbits.

METHODS

The device was implanted into the anterior chamber at the corneoscleral junction in 1 eye each of 8 white New Zealand rabbits, while the contralateral eye served as control. Three and 6 months after implantation, the rabbits were killed and their eyes were enucleated and processed histologically, leaving the device in situ when sectioning.

RESULTS

Three and 6 months postoperatively, the local tissue reaction typically consisted of an enveloping, thin, mature, fibrotic capsule (thickness <0.04 mm), devoid of inflammatory cells. This capsule surrounded approximately 25% of the implant surface area present in the sections. The lumina of the devices were devoid of inflammatory exudates or other obstructions in all specimens examined, suggesting free flow of fluid.

CONCLUSIONS

The implantation of the Ex-PRESS miniature glaucoma shunt resulted in minimal capsular reaction. Considering the high reactivity of the rabbit eye, it is possible that this implant will induce a smaller cellular inflammatory reaction in the human eye.

Acid pretreatment of titanium implants

The purpose of this study was to evaluate the effectiveness of several methods of cleaning titanium surfaces as pretreatment for surface modifications by analyzing the chemical interaction of three acids, such as Na(2)S(2)O(8),H(2)SO(4) and HCl, followed by rinsing with acetone or ultrapure water. Chemical evaluation, using X-ray photoelectron spectroscopy (XPS), and mechanical evaluation, using nanoindentation, were employed. XPS revealed that an untreated Ti surface consisted of carbon- and nitrogen-containing contaminant and titanium oxide layer on metallic titanium substrate. The method involving the combination of 10 N HCl and acetone was the most effective of all the methods investigated. Such a combination most effectively reduced values of contamination parameters C/Ti and N/Ti, as well as the intensity of the titanium oxide component in Ti 2p spectra. Chlorine was barely detected from the surface treated with HCl in any concentration. Sulfur from the residual S(2)O(8)(2-) or SO(4)(2-), however, was detected from the samples treated with either Na(2)S(2)O(8) or H(2)SO(4). The S/Ti values depended on concentration of the acidic solution. In addition, nanoindentation measurements revealed that Young's modulus of the surface treated with 0.1-10 N HCl was not significantly different from that of an untreated surface (p > 0.05). Consequently, the HCl/acetone treatment is proposed as an excellent decontamination method for the surface preparation process of Ti.

Bioactive calcium phosphate invert glass-ceramic coating on beta-type Ti-29Nb-13Ta-4.6Zr alloy

A fine, strong coating consisting of a bioactive calcium phosphate invert glass-ceramic can be prepared easily by reaction of the glassy phase with an oxide layer formed on a new beta-type titanium alloy, Ti-29Nb-13Ta-4.6Zr, when the metal, on which the mother glass powders with a composition of 60CaO-30P(2)O(5)-7Na(2)O-3TiO(2) in mol% are placed, is heated at 800 degrees C in air. A compositionally gradient layer is developed on the titanium alloy during the heating. Tensile bonding strength of the coating to the metal is significantly higher than those of the coatings to conventional metals such as Ti-6Al-4V alloy or pure titanium. The oxidized layer on Ti-29Nb-13Ta-4.6Zr alloy is relatively thinner than that on Ti-6Al-4V alloy even with heat treatment in air; large tensile stresses are not generated in the layer.

Peptide-modified p(AAm-co-EG/AAc) IPNs grafted to bulk titanium modulate osteoblast behavior in vitro

Interpenetrating polymer networks (IPNs) of poly(acrylamide-co-ethylene glycol/acrylic acid) (p(AAm-co-EG/AAc) applied to model surfaces prevent protein adsorption and cell adhesion. Subsequently, IPN surfaces functionalized with the RGD cell-binding domain from rat bone sialoprotein (BSP) modulated bone cell adhesion, proliferation, and matrix mineralization. The objective of this study was to utilize the same biomimetic modification strategy to produce functionally similar p(AAm-co-EG/AAc) IPNs on clinically relevant titanium surfaces. Contact angle goniometry and X-ray photoelectron spectroscopy (XPS) data were consistent with the presence of the intended surface modifications. Cellular response was gauged by challenging the surfaces with primary rat calvarial osteoblast (RCO) surfaces in serum-containing media. IPN modified titanium and negative control (RGE-IPN) surfaces inhibit cell adhesion and proliferation, while RGD-modified IPNs on titanium supported osteoblast attachment and spreading. Furthermore, the latter surfaces supported significant mineralization despite exhibiting lower levels of proliferation than positive control surfaces. These results suggest that with the appropriate optimization, this approach may be practical for surface engineering of osseous implants.