Comparison of bone-implant interface shear strength of hydroxyapatite-coated and alumina-coated metal implants

Biocompatibility and antibacterial properties of medical stainless steel and titanium modified by alumina and hafnia films prepared by atomic layer deposition

New methods for producing surfaces with suitable biocompatible properties are desirable due to increasing demands for biomedical devices. Stainless steel 316 L and cp- titanium specimens were coated with thin films of alumina and hafnia deposited using the atomic layer deposition method at two temperatures, 180 and 260 °C. The morphology of the films was analysed using scanning electron microscopy, and their surface energies were determined based on drop contact angle measurements. Biocompatibility assays performed using mesenchymal stem cells were evaluated by incubating the specimens and then exposing their extracts to the cells or directly seeding cells on the specimen surfaces. No detrimental effect was noticed for any of the specimens. Antibacterial properties were tested by directly incubating the specimens with the bacteria Staphylococcus aureus. Overall, our data show that all prepared films were biocompatible. Alumina films deposited on cp-titanium at 260 °C outperform the other prepared and tested surfaces regarding antiadhesive properties, which could be related to their low surface energy.

Accuracy of different electronic torque drivers: A comparative evaluation

PURPOSE

This study aims to evaluate the loosening torque on the implant fixture, and to assess the accuracy of difference electronic torque drivers.

MATERIALS AND METHODS

Three electronic torque drivers were used to measure the loosening torque on the implant system (AnyOne; MegaGen). The implant fixtures were divided among the 3 electronic torque driver types (W&H, SAESHIN, and NSK group) and 9 for each group. The screws were fastened at the implant fixture by three electronic torque drivers using the tightening torques recommended by the manufacturers of the drivers. After 10 minutes, the screws were again fastened at the implant fixture with equal torque. Then, the loosening torques were measured with an MGT12 torque gauge (MARK-10, Inc.). This measurement procedure was repeated 10 times under loosening torques of 15 Ncm, 25 Ncm, and 35 Ncm. In the statistical analysis, all values of loosening torque were analyzed with the one-way ANOVA and Kruskal-Wallis test (α=.05) for comparative evaluation.

RESULTS

There were significant inter-group differences at loosening torques of 15 Ncm and 25 Ncm (P<.05). The accuracy of the NSK driver was the highest, followed by SAESHIN and W&H. There was no significant difference between NSK and W&H at 35 Ncm (P>.05). The SAESHIN driver showed the closest loosening torque at 35 Ncm.

CONCLUSION

The most accurate loosening torques were SAESHIN at 35 Ncm, and NSK at 15 Ncm and 25 Ncm. Since the loosening torque may vary depending on the tightening torques and electronic torque drivers, periodic calibration of the electronic torque driver is recommended.

Bioactive Glass and Silicate-Based Ceramic Coatings on Metallic Implants: Open Challenge or Outdated Topic?

The overall success and long-term life of the medical implants are decisively based on the convenient osseointegration at the hosting tissue-implant interface. Therefore, various surface modifications and different coating approaches have been utilized to the implants to enhance the bone formation and speed up the interaction with the surrounding hosting tissues, thereby enabling the successful fixation of implants. In this review, we will briefly present the main metallic implants and discuss their biocompatibility and osseointegration ability depending on their chemical and mechanical properties. In addition, as the main goal of this review, we explore the main properties of bioactive glasses and silica-based ceramics that are used as coating materials for both orthopedic and dental implants. The current review provides an overview of these bioactive coatings, with a particular emphasis on deposition methods, coating adhesion to the substrates and apatite formation ability tested by immersion in Simulated Body Fluid (SBF). In vitro and in vivo performances in terms of biocompatibility, biodegradability and improved osseointegration are examined as well.

Effect of dissolution/precipitation on the residual stress redistribution of plasma-sprayed hydroxyapatite coating on titanium substrate in simulated body fluid (SBF)

The residual stress distributions in hydroxyapatite (HAp) coating with and without mixed hydroxyapatite/titanium (HAp/Ti) bond coating on commercially pure Titanium substrate (cp-Ti) were evaluated by Raman piezo-spectroscopy analysis. The Raman shifted position 962cm(-1), which is the symmetrical stretching of surrounded oxygen atoms with phosphorous atom ( [Formula: see text] ), was referred to analyses of stress dependency. The piezo-spectroscopic coefficient, which is a Raman shift value per stress (cm(-1)/GPa), was fitted from the result of four-points bending test of rectangular HAp bar and as-sprayed HAp on Zn plate. The calculated values were 3.89cm(-1)/GPa for the former and 7.11cm(-1)/GPa for the latter. By using these calibrations, the compressive residual stress in HAp coating with HAp/Ti bond coating (HA-B) has been found to be distributed in the range of -137MPa to -75MPa. For the heat-treated HAp coating (HA-B-HT) specimen, the compressive residual stresses placed in the range of -40--22MPa. The changes in the values of residual stress of the HAp coating after immersion in SBF were also evaluated. The residual stress in HA-WB specimens tend to change from compressive to tensile after 30 days immersion. The HA-B-HT specimens exhibited similar behavior and reached to zero stress after the immersion. The mechanism of the changes in residual stress would be the effect of stress redistribution around melted calcium phosphate particles to remained HAp splats.

Results at a minimum of 10 years of follow-up for AMS and PerFix HA-coated cementless total hip arthroplasty: impact of cross-linked polyethylene on implant longevity

PURPOSE

The purpose of this study was to report results at a minimum of 10 years for hydroxyapatite (HA) coating on the titanium arc-sprayed cementless total hip arthroplasty (THA) and to evaluate the impact of cross-linked polyethylene (XLPE) on implant longevity.

METHODS

A total of 131 consecutive primary THAs in 123 patients using an AMS acetabular cup and a PerFix HA stem were retrospectively reviewed. Conventional PE was used for 62 hips (CPE group) and cross-linked PE for 69 hips (XLPE group), with mean follow-up periods of 13 and 11.5 years, respectively. These patients were reviewed using the Japanese Orthopaedic Association (JOA) Hip Score and evaluated in terms of PE wear, osteolysis, and implant survival.

RESULTS

The JOA score improved from 42.6 to 83.9 points at the final follow-up. The mean wear rate of 0.12 mm/year in the CPE group was significantly greater than that of XLPE at 0.007 mm/year. In the CPE group, ten (16.1 %) and two (3.2 %) hips, respectively, underwent PE exchange due to severe wear and acetabular revision due to loosening associated with osteolysis. Three patients had revision in the XLPE group: one cup for aseptic loosening, one PE for recurrent dislocation, and one stem for neck fracture. No evident osteolysis was seen in the XLPE group. Kaplan-Meier survivorship with any revision as the end point shows that the 12-year survival rate was 97.7 % for cups, 93.8 % for PE liners, and 99.2 % for stems. Multivariate analysis revealed that the use of XLPE significantly reduced the risk of revision, with the odds ratio (OR) of 4.3.

CONCLUSIONS

AMS and PerFix HA components in this series show excellent implant fixation; however, high rates of PE wear and subsequent osteolysis were limiting factors in long-term success. Low wear rates with XLPE suggest improved implant longevity.

Influence of substrate metal alloy type on the properties of hydroxyapatite coatings deposited using a novel ambient temperature deposition technique

Hydroxyapatite (HA) coatings are applied widely to enhance the level of osteointegration onto orthopedic implants. Atmospheric plasma spray (APS) is typically used for the deposition of these coatings; however, HA crystalline changes regularly occur during this high-thermal process. This article reports on the evaluation of a novel low-temperature (<47°C) HA deposition technique, called CoBlast, for the application of crystalline HA coatings. To-date, reports on the CoBlast technique have been limited to titanium alloy substrates. This study addresses the suitability of the CoBlast technique for the deposition of HA coatings on a number of alternative metal alloys utilized in the fabrication of orthopedic devices. In addition to titanium grade 5, both cobalt chromium and stainless steel 316 were investigated. In this study, HA coatings were deposited using both the CoBlast and the plasma sprayed techniques, and the resultant HA coating and substrate properties were evaluated and compared. The CoBlast-deposited HA coatings were found to present similar surface morphologies, interfacial properties, and composition irrespective of the substrate alloy type. Coating thickness however displayed some variation with the substrate alloy, ranging from 2.0 to 3.0 μm. This perhaps is associated with the electronegativity of the metal alloys. The APS-treated samples exhibited evidence of both coating, and significantly, substrate phase alterations for two metal alloys; titanium grade 5 and cobalt chrome. Conversely, the CoBlast-processed samples exhibited no phase changes in the substrates after depositions. The APS alterations were attributed to the brief, but high-intensity temperatures experienced during processing.

Failure behavior of plasma-sprayed HAp coating on commercially pure titanium substrate in simulated body fluid (SBF) under bending load

Four point bending tests with acoustic emission (AE) monitoring were conducted for evaluating failure behavior of the plasma-sprayed hydroxyapatite (HAp) top coat on commercially pure titanium (cp-Ti) plate with and without mixed HAp/Ti bond coat. Effect of immersion in simulated body fluid (SBF) on failure behavior of the coated specimen was also investigated by immersing the specimen in SBF. The AE patterns obtained from the bending test of the HAp coating specimens after a week immersion in SBF clearly showed the earlier stage of delamination and spallation of the coating layer compared to those without immersion in SBF. It was also found that the bond coating improved failure resistance of the HAp coating specimen compared to that without the bond coat. Four point bend fatigue tests under ambient and SBF environments were also conducted with AE monitoring during the entire fatigue test for investigating the influence of SBF environment on fatigue failure behavior of the HAp coating specimen with the mixed HAp/Ti bond coat. The specimens tested at a stress amplitude of 120 MPa under both ambient and SBF environments could survive up to 10⁷ cycles without spallation of HAp coating layer. The specimens tested under SBF environment and those tested under ambient environment after immersion in SBF showed shorter fatigue life compared to those tested under ambient environment without SBF immersion. Micro-cracks nucleated in the coating layer in the early stage of fatigue life and then propagated into the cp-Ti substrate in the intermediate stage, which unstably propagated to failure in the final stage. It was found from the XRD analysis that the dissolution of the co-existing phases and the precipitation of the HAp phase were taken place during immersion in SBF. During this process, the co-existing phases disappeared from the coating layer and the HAp phase fully occupied the coating layer. The degradation of bending strength and fatigue life of the HAp coating specimens tested under SBF environment would be induced by dissolution of the co-existing phases from the coating layer during immersion in SBF.

Comparison between the SBF Response of Hydroxyapatite Coatings Deposited Using both a Plasma-Spray and a Novel Co-Incident Micro-Blasting Technique

This paper reports on the response of hydroxyapatite (HA) coatings, fabricated using two deposition technologies, to immersion in simulated body fluid (SBF). The deposition methods used were: plasma spray, a commercial standard, and CoBlast, a novel low temperature microblast technique. In the case of the latter, HA coatings are deposited by simultaneous blasting HA and abrasive powders concentrically at a metallic substrate, resulting in a thin layer of HA (approx. 2.5 µm thick). Groups of the CoBlast and plasma spray HA coatings were immersed in 7 ml of SBF solution for 1, 2, 4, 7, 14 and 28 days, and were subsequently removed and examined for any alterations caused by the SBF solution. It was noted from this study that the CoBlast HA coatings appeared to undergo a two step calcium phosphate recrystallisation process; initial homogenous nucleation and subsequent heterogeneous nucleation. Conversely recrystallisation on the plasma spray coatings appeared to proceed largely through a heterogeneous nucleation process. Two factors that may influence the differences in HA recrystallisation is the presence of amorphous HA resulting in rapid dissolution, and/or the significantly lower surface area (roughness) offered to the SBF solution by the CoBlast coatings. The interpretation of recrystallisation mechanisms from this preliminary study is limited however by the differences in coating morphology and thickness (27 versus 2 µm) for the plasma spray and CoBlast HA coatings respectively.

The influence of residual stress on the shear strength between the bone and plasma-sprayed hydroxyapatite coating

Plasma-sprayed HA coating (HAC) 50 and 200 microm thick on Ti6Al4V cylinders was transcortically implanted in the femora of canines. Push-out testing of implant-bone interfaces showed that the HAC coating exhibited higher shear strength at 50 microm coating than 200 microm one. The plasma-sprayed HACs were exhibited compressive residual stresses and the thicker HAC exhibited higher residual stress than that of the thinner HAC. Due to the structure for 50 and 200 microm implants were the same, meaning similar cohesive strength of the lamellar splats. And, there was no difference in the physiological environment; hence the difference of the shear strength for the 50 and 200 microm-HAC implants could best be attributed to the compressive residual stress existed in the HA coating.

Hydroxyapatite-Electroplated cp–Titanium Implant and Its Bone Integration Potentiality: An In Vivo Study

PURPOSE

This study was designed to precipitate hydroxyapatite coating on the surface of commercially pure titanium (cpTi) implants using an electroplating technique. After characterization of the hydroxyapatite coating, the bone-implant interface and bone integration of both cpTi and hydroxyapatite-coated implants were assessed.

MATERIALS

Twenty implants were divided equally into 2 main groups (n = 10). Ten cpTi implants were utilized as received, while the others were hydroxyapatite coated and then sterilized. The implants of both groups were inserted in the tibiae of New Zealand rabbits. The purity and crystallinity of the hydroxyapatite coat were characterized using x-ray diffraction. A scanning electron microscope examined the grain morphology. Profilometer evaluated the surface texture before and after sterilization. Histological examination using a scanning electron microscope was performed to qualify osseointegration of the regenerated bone and measure the gap distance at the bone-implant interface.

RESULTS

Pure crystalline hydroxyapatite precipitate of thickness (range 69-78 microm) and rough surface (2.7 +/- 0.2 microm) compared to smooth cpTi (1.3 +/- 0.5 microm). The gamma-radiation sterilization resulted in finer grains and insignificant smoother surface. Histological examination of the cpTi implant exhibited less bone regeneration with few and less dense bone trabeculae, and gap distance was significantly high (1.29 +/- 0.51 microm). Meanwhile, the hydroxyapatite-coated implant showed a recognizable amount of bone regeneration with more and denser bone trabeculae, and gap distance ranged from 0 to 1.32 microm.

CONCLUSIONS

The employed technique provided a thin and uniform pure crystalline hydroxyapatite coating. The characterization of the precipitated film is promising for clinically successful long-term bone fixation.

CaTiO(3) coating on titanium for biomaterial application--optimum thickness and tissue response

The objectives of this study were to determine the optimum thickness of a CaTiO(3) film for biomaterial applications and to investigate the biocompatibility and bone formation of titanium with a CaTiO(3) film. First, CaTiO(3) films of 10, 20, 30, and 50 nm in thickness were deposited on titanium substrates using radiofrequency magnetron sputtering followed by annealing at 873 K in air for 7.2 ks. The optimum thickness of the CaTiO(3) film for bone formation was determined by comparison with its performance regarding calcium phosphate formation in Hanks' balanced saline solution (HBSS). Regarding calcium phosphate formation, the performance of the specimen with a 50-nm-thick CaTiO(3) film was superior to those of specimens with other thicknesses. A titanium prism with a CaTiO(3) film of 50-nm in thickness was surgically inserted in both soft and hard rat tissues. The biocompatibility of CaTiO(3)-deposited titanium and bone formation on it was investigated by histological observations. A slight inflammatory reaction was observed around the titanium with the 50-nm-thick CaTiO(3) film, while no severe response, such as degeneration and necrosis, was observed in either soft or hard rat tissue. New bone formation on the titanium plate with the CaTiO(3) film was more active than that without the film. The 50-nm-thick CaTiO(3) film has biocompatibility and can facilitate new bone formation in vivo, and, consequently, it is an excellent surface modification method for biomaterial applications.

Nanostructural characteristics, mechanical properties, and osteoblast response of spark plasma sintered hydroxyapatite

This study aimed to fabricate bulk nanostructured hydroxyapatite (HA) pellets with improved properties using spark plasma sintering (SPS) for orthopedic applications. Spray-dried nanostructured HA (nSD-HA) powders were consolidated using the rapid SPS processing. The SPS processed nSD-HA was characterized using Raman spectroscopy and field emission scanning electron microscopy (FESEM). Mechanical properties of the consolidates were also evaluated through indentation approach. The nanostructures ( approximately 80 nm in grain size) of the starting powders were successfully retained after the SPS processing operated at 950 degrees C with <15 min holding time. The SPS consolidated nSD-HA showed promising mechanical properties, approximately 118 GPa for Young's modulus, and up to 2.22 MPa m(0.5) for fracture toughness. SPS holding time showed minor influence on the phases of the pellets. Furthermore, the spheroidized nanostructured HA retained the HA structure after the SPS consolidation. Preliminary cytotoxicity and cell attachment studies were also carried out using a human osteoblast cell line hFOB 1.19. Enhanced cell attachment and proliferation on the nanostructured pellets were revealed. The presence of the nanostructures accounts mainly for the enhanced mechanical properties and promoted proliferation of the osteoblast cells. This study suggests that the SPS technique is an appropriate process for fabrication of bulk nSD-HA from nanostructured powder.

The effect of three different calcium phosphate implant coatings on bone deposition and coating resorption: a long-term histological study in sheep

The present study investigated the hypothesis that hydroxyapatite (HA), tricalcium phosphate (TCP), and a HA-gel coated on endosseous titanium (Ti) implants by spark discharging (SD) and dip coating would achieve predictable osseointegration without evident bioresorption of the coatings on the long term. A costal sheep model was used for the implantation of the HA/SD, HA/TCP/SD, and HA-gel/SD specimens, which were retrieved 6 and 12 months following implantation. HA and Ti coatings on implants obtained by conventional plasma spraying (HA/PS, Ti/PS) were used as controls. Microscopy showed that osseointegration was achieved from all types of implants. No evidence for bioresorption of the HA/SD, HA/TCP/SD, and HA-gel/SD coatings was present but cohesive failure with disruption of the coating/implant interface was seen. A statistical analysis of the histomorphometrical data showed no time-dependent effect, however. HA/PS coatings achieved significantly higher bone-implant contact (BIC) percentages of the total implant surface (toBIC) than the other types of coatings (P=0.01). If the BIC percentages were traced separately for implant portions placed into cortical and cancellous bone (coBIC and caBIC, respectively), detailed analysis showed that the caBIC values of HA-gel/SD and HA/PS coatings were significantly higher than that of the other types of coatings (P=0.01). CaBIC values were highly correlated with toBIC values (P<0.001). The present study showed that the preparation techniques used produced thin, dense, and unresorbable coatings that achieved osseointegration. Compared with the control coatings, however, only HA-gel/SD coating can be recommended from the investigated preparation techniques for a future clinical use if a better coating cohesion is achieved.

Fixation to the canine bone of artificial implant with new surface structure

Screw and laser (SL) column by making screw threads and forming small holes using laser irradiation on the base metal and conventional beads coating (BC) columns were embedded into the shaft of canine femurs, and compared the implant fixation to the host bone. The interfacial strength in SL columns was almost equivalent as BC columns, and bone-column contact rate was higher than BC columns significantly at twelve weeks after implantation. The newly devised SL surface had almost equivalent bone fixation strength comparable to the conventional BC surface. Also, this surface should provide a useful porous surface for use in artificial joints since there is no risk of surface structure detachment.

Comparison of plasma-sprayed hydroxyapatite coatings and zirconia-reinforced hydroxyapatite composite coatings:In vivo study

The clinical use of plasma-sprayed hydroxyapatite (HA) coatings on metal implants has been widely adopted because the HA coating can achieve the firmly and directly biological fixation with the surrounding bone tissue. However, the long-term mechanical properties of HA coatings has been concern for the long-term clinical application. Previous research showed that the concept of adding ZrO2 as second phase to HA significantly increased the bonding strength of plasma-sprayed composite material. The present work aimed to explore the biological properties, including the histological responses and shear strength, between the plasma-sprayed HA and HA/ZrO2 coating, using the transcortical implant model in the femora of canines. After 6 and 12 weeks of implantation, the HA coating revealed the direct bone-to-coating contact by the backscattered electron images (BEIs) of scanning electron microscope (SEM), but the osseointegration was not observed at the surface of HA/ZrO2 coating. For new bone healing index (NBHI) and apposition index (AI), the values for HA implants were significantly higher than that for HA/ZrO2 coatings throughout all implant periods. After push-out test, the shear strength of HA-coated implants were statistically higher than HA/ZrO2 coated implants at 6- and 12-week implantation, and the failure mode of HA/ZrO2 coating was observed at the coating-bone interface by SEM. The results indicate that the firm fixation between bone and HA/ZrO2 has not been achieved even after 12-week implantation. Consequently, the addition of ZrO2 could improve the mechanical properties of coatings, while the biocompatibility was influenced by the different material characteristics of HA/ZrO2 coating compared to HA coatings.

Mechanical properties and Young's modulus of plasma-sprayed hydroxyapatite coating on Ti substrate in simulated body fluid

This study evaluated the Young's modulus, residual stress and strain, bonding strength, and microstructure of the plasma-sprayed hydroxyapatite coating (HAC) on Ti6Al4V substrate with and without immersion in Hank's balanced salt solution (HBSS). The purpose was to explore the possible correlation of HAC durability and mechanical properties of the coating. The results show that the residual stress and strain, Young's modulus, and bonding strength of the HAC after immersion in HBSS are substantially decreased. The decayed Young's modulus and mechanical properties of HACs are accounted for by the degraded interlamellar or cohesive bonding in the coating due to the increased porosity after immersion that weakens the bonding strength of coating and substrate system. The biologic implications of the research are discussed in detail. This study contributes to the arguments that the method to alleviate the dissolution of HAC will increase the bonding strength of the coating system after immersion, which together with the controlled residual stress and strain in the coating might promote the long-term stability of the HA-coated implant.

Comparison of hydroxyapatite and hydroxyapatite tricalcium-phosphate coatings

This study compared the effects of hydroxyapatite (HA) coating and biphasic HA/tricalcium-phosphate (HA/TCP) coating on the osseointegration of grit-blasted titanium-alloy implants. Each coated implant was compared with uncoated grit-blasted implants as well. The implants were press-fit into the medullary canal of rabbit femora, and their osseointegration was evaluated 3 to 24 weeks after surgery. The coated implants had significantly (P<.05) greater new bone ongrowth than the uncoated implants (HA, 56.1 +/- 3.1%; HA/TCP, 53.8 +/- 2.6%; uncoated, 32.2 +/- 1.4% of the implant perimeter, 12 weeks). Unmineralized tissue (cartilage and osteoid) was seen on the uncoated implants but never on the coated implants. The coated implants had significantly (P<.05) greater interfacial shear strength than the uncoated implants (HA, 4.1 +/- 0.4 MPa; HA/TCP, 4.8 +/- 0.5 MPa; uncoated, 2.6 +/- 0.2 MPa, 12 weeks). There was no difference between HA and HA/TCP coating in regard to new bone growth or interfacial shear strength. These data show a comparable enhancement effect of HA and HA/TCP coatings on the osseointegration of titanium-alloy implants.

Material fundamentals and clinical performance of plasma-sprayed hydroxyapatite coatings: a review

The clinical use of plasma-sprayed hydroxyapatite (HA) coatings on metal implants has aroused as many controversies as interests over the last decade. Although faster and stronger fixation and more bone growth have been revealed, the performance of HA-coated implants has been doubted. This article will initially address the fundamentals of the material selection, design, and processing of the HA coating and show how the coating microstructure and properties can be a good predictor of the expected behavior in the body. Further discussion will clarify the major concerns with the clinical use of HA coatings and introduce a comprehensive review concerning the outcomes experienced with respect to clinical practice over the past 5 years. A reflection on the results indicates that HA coatings can promote earlier and stronger fixation but exhibit a durability that can be related to the coating quality. Specific relationships between coating quality and clinical performance are being established as characterization methods disclose more information about the coating.

Three-dimensional printing and porous metallic surfaces: a new orthopedic application

As-cast, porous surfaced CoCr implants were tested for bone interfacial shear strength in a canine transcortical model. Three-dimensional printing (3DP) was used to create complex molds with a dimensional resolution of 175 microm. 3DP is a solid freeform fabrication technique that can generate ceramic pieces by printing binder onto a bed of ceramic powder. A printhead is rastered across the powder, building a monolithic mold, layer by layer. Using these 3DP molds, surfaces can be textured "as-cast," eliminating the need for additional processing as with commercially available sintered beads or wire mesh surfaces. Three experimental textures were fabricated, each consisting of a surface layer and deep layer with distinct individual porosities. The surface layer ranged from a porosity of 38% (Surface Y) to 67% (Surface Z), whereas the deep layer ranged from 39% (Surface Z) to 63% (Surface Y). An intermediate texture was fabricated that consisted of 43% porosity in both surface and deep layers (Surface X). Control surfaces were commercial sintered beaded coatings with a nominal porosity of 37%. A well-documented canine transcortical implant model was utilized to evaluate these experimental surfaces. In this model, five cylindrical implants were placed in transverse bicortical defects in each femur of purpose bred coonhounds. A Latin Square technique was used to randomize the experimental implants left to right and proximal to distal within a given animal and among animals. Each experimental site was paired with a porous coated control site located at the same level in the contralateral limb. Thus, for each of the three time periods (6, 12, and 26 weeks) five dogs were utilized, yielding a total of 24 experimental sites and 24 matched pair control sites. At each time period, mechanical push-out tests were used to evaluate interfacial shear strength. Other specimens were subjected to histomorphometric analysis. Macrotexture Z, with the highest surface porosity, failed at a significantly higher shear stress (p = 0.05) than the porous coated controls at 26 weeks. It is postulated that an increased volume of ingrown bone, resulting from a combination of high surface porosity and a high percentage of ingrowth, was responsible for the observed improvement in strength. Macrotextures X and Y also had significantly greater bone ingrowth than the controls (p = 0.05 at 26 weeks), and displayed, on average, greater interfacial shear strengths than controls, although they were not statistically significant.

Preparation, characterization, and in vitro release of ibuprofen from AI2O3/PLA/PMMA composites

The preparation, characterization, and in vitro release of Ibuprofen from Al2O3, poly(L-lactic acid) (PLLA), and polymethylmethacrylate (PMMA) composites are described. The release process of the anti-inflammatory drug after the immersion of composites in a buffered solution is analyzed. The rate of Ibuprofen release is related to the crystalline or amorphous form of the drug. The presence of a ceramic component, alpha-Al2O3, and a biodegradable polymer, PLLA, facilitates both Ibuprofen crystallization and drug release. In addition, these composite systems modulate the release of the stereoisomers R(-) and S(+) of the drug.

Hydroxyapatite-coating on titanium arc sprayed titanium implants

We developed a new titanium spray technique using an inert gas shielded arc spray (titanium arc spray). Hydroxyapatite (HA)-coating can be applied to the implant without any surface pore obstruction after the rough surface is made by this technique. Scanning electron microscopy (SEM) of various porous implant surfaces after HA-coating revealed that the bead and fiber metal-coated implants had either a pore obstruction or an uneven HA-coating. On the other hand, the titanium arc sprayed implant demonstrated an even HA-coating all the way to the bottom of the surface pore. In the first set of animal experiments (Exp. 1), the interfacial shear strength to bone of four kinds of cylindrical Ti-6A1-4V (Ti) implants were compared using a canine transcortical push-out model 4 and 12 weeks after implantation. The implant surfaces were roughened by titanium arc spray (group A-C) and sand blasting (group D) to four different degrees (roughness average, Ra = group A: 56.1, B: 44.9, C: 28.3, D: 3.7 microns). The interfacial shear strength increased in a surface roughness-dependent manner at both time periods. However, the roughest implants (group A) showed some failed regions in the sprayed layers after pushout test. In the second set of animal experiments (Exp. 2), four kinds of Ti implants; HA-coated smooth Ti (sHA) with Ra of 3.4 microns, bead-coated Ti (Beads), titanium arc sprayed Ti (Ti-spray) with Ra of 38.1 microns and HA-coated Ti-spray (HA + Ti-spray) with Ra of 28.3 microns were compared using the same model as that in Exp. 1. The interfacial shear strength of HA + Ti-spray was significantly greater than that of sHA and Beads at both time periods, and that of Ti-spray at 4 weeks. Although a histological examination revealed that HA-coating enhanced bone ingrowth, sHA showed the lowest shear strength at both time periods. SEM after pushout test showed that sHA consistently demonstrated some regional failure at the HA-implant substrate interface. HA + Ti-spray had many failed regions either at the HA-bone interface or within the bone tissue rather than at the HA-implant substrate interface. These results suggested that the HA-coated smooth surfaced implants had a mechanical weakness at the HA-substrate interface. Therefore, HA should be coated on the rough surfaced implants to avoid a detachment of the HA-coating layer from the substrate and thus obtain a mechanical anchoring strength to bone. HA-coating on this new type of surface morphology may thus lead to a solution to the problems of conventional HA-coated and porous-coated implants.

Dental materials: 1995 literature review

This critical review of the published literature on dental materials for the year 1995 has been compiled by the Dental Materials Panel of the United Kingdom. It continues the series of annual reviews started in 1973 and published in the Journal of Dentistry. Emphasis has been placed upon publications which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, resin composites, dentine bonding, dental amalgam, endodontic materials, casting alloys, investment materials, resin-bonded bridges and ceramo-metallic restorations, all ceramic restorations, denture base and soft lining materials, impression materials, dental implants, orthodontic materials and biomechanics). Three hundred and thirty articles published in 68 titles have been reviewed.

HRTEM study of biological crystal growth mechanisms in the vicinity of implanted synthetic hydroxyapatite crystals

Calcium phosphates are widely used as biomaterials. Ultrastructural assessments are of the utmost importance in our understanding of interfacial phenomena. The aim of this study was to learn more about the newly formed crystal growth mechanisms. The interfaces between implanted synthetic hydroxyapatite crystals (HAS) and newly formed crystallites were thoroughly examined on a molecular level. The bone-grafting material (HAS) was implanted into two adult patients, and small biopsies were recovered 6 months after implantation. The raw biomaterial was analyzed by x-ray diffraction and high-resolution transmission electron microscopy (HRTEM). Six months after their implantation, the HAS aggregates were surrounded by a mineralized bone matrix. Tiny crystallites also filled the spaces between the HAS crystals within the aggregates. These newly formed crystallites growing at the surfaces of the implanted HAS crystals appeared to be apatitic. The crystallographic investigations of the nucleation and growing mechanisms of the newly formed crystallites were performed by HRTEM in association with computer simulation and mathematical processing of digitized images. A relationship was noted between the orientation axes of crystallites growing nearby and the zone axes of the implanted HAS, thus strongly suggesting a guiding or substratum role of the HAS particles.