Bone-bonding behavior under load-bearing conditions of an alumina ceramic implant incorporating beads coated with glass-ceramic containing apatite and wollastonite

Ability of zirconia double coated with titanium and hydroxyapatite to bond to bone under load-bearing conditions

As a preclinical study, we evaluated the ability of hydroxyapatite and titanium on zirconia (HTOZ) to bond to bone under load-bearing conditions in animal experiments. HTOZ, HA, and Ti on Co-Cr alloy (HTOC) and Ti on Co-Cr alloy (TOC) were implanted into the weight-bearing portion of the femoral condyles of nine beagle dogs. Femurs were extracted 4, 12, and 52 weeks after implantation and examined mechanically by pullout testing, and histologically by toluidine blue staining, SEM, and calculation of the affinity index. The interfacial shear strengths (mean+/-SD) of the HTOZ, HTOC, and TOC groups were 4.42+/-0.453, 3.90+/-0.903, and 4.08+/-0.790 MPa at 4 weeks; 6.82+/-2.64, 6.00+/-1.88, and 6.63+/-1.63 MPa at 12 weeks; and 13.98+/-1.94, 11.95+/-1.51, and 10.78+/-0.83 MPa at 52 weeks. There were no significant differences in the interfacial shear strengths between the three groups at any time. Affinity indices (mean+/-SD) obtained from SEM images of the HTOZ, HTOC, and TOC groups were 49.6+/-6.52%, 43.3+/-10.43%, and 23.7+/-3.95% at 4 weeks; 55.0+/-6.72%, 51.5+/-3.07%, and 28.6+/-4.09% at 12 weeks; and 59.1+/-6.73%, 63.0+/-6.40%, and 34.3+/-6.72% at 52 weeks. HA-coated implants (HTOZ, HTOC) had significantly higher affinity indices than non-HA-coated implants (TOC) at all times. HTOZ has the ability to bond to bone equivalent to HTOC and TOC. HTOZ is an excellent material for components of cementless joint prostheses.

Osseointegration of alumina with a bioactive coating under load-bearing and unloaded conditions

The aim of the study was to evaluate the osseointegration of Al(2)O(3) coated with a bioactive glass ceramic (BioveritI), in a load-bearing implant model in sheep in comparison to uncoated Al(2)O(3) and to a minimally loaded situation. Both types of implants were inserted into the proximal tibia (load-bearing model) and in a drill hole defect into the tibia diaphysis (minimally loaded model). Under load-bearing conditions, the coating resulted in significantly higher interfacial shear strength and a high amount of mineralized bone in direct contact to the implant surface. In contrast, the uncoated Al(2)O(3) was surrounded by a thick connective tissue layer corresponding to low interfacial shear strength. In the minimally loaded model, however, there was rather a tendency of lower interfacial shear strength in the case of the coated implants. This finding corresponds to the histological results, which showed mineralized bone in the interface of uncoated Al(2)O(3), whereas in the case of the coated implants a thin layer of osteoid was observed. It was suggested that the osseointegration of Al(2)O(3) could be improved by the coating under load-bearing conditions, under which uncoated Al(2)O(3) ceramics cannot directly bind to bone.

Initial in vitro interaction of osteoblasts with nano-porous alumina

In the present study we have used a characterised primary human cell culture model to investigate cellular interactions with nano-porous alumina. This material, prepared by anodisation, is being developed as a coating on titanium alloy implants. The structure of the alumina, as determined by X-ray diffraction and transmission electron microscopy, was amorphous. When studying cell/material interactions we used both biochemical and morphological parameters. Cell viability, proliferation and phenotype were assessed by measurement of redox reactions in the cells, cellular DNA, tritiated thymidine ([3H]-TdR) incorporation and alkaline phosphatase (ALP) production. Results showed a normal osteoblastic growth pattern with increasing cell numbers during the first 2 weeks. A peak in cell proliferation was seen on day 3, after which cell growth decreased, followed by an increase in ALP production, thus indicating that the osteoblastic phenotype was retained on the alumina. Cell adhesion was observed, the osteoblast-like cells having a flattened morphology with filipodia attached to the pores of the material. SDS-PAGE and western blot measurements showed that the nano-porous alumina was able to adsorb fibronectin. Trace amounts of aluminium ions were measured in the surrounding medium, but no adverse effect on cell activity was observed.

Adhesion of bioactive glass coating to Ti6A14V oral implant

Bioactive glass (BAG) is a bioactive material with a high potential as implant material. Reactive plasma spraying produces an economically feasible BAG-coating for Ti6A14V oral implants. This coating is only functional if it adheres well to the metal substrate and if it is strong enough to transfer all loads. To examine these two properties an appropriate mechanical adhesion test, the moment test, is developed. This test quantifies under a realistic loading condition the corresponding functional adhesion strength to be >84 MPa in tensile. To get a qualitative insight in the BAG-coating behavior during loading the mechanical test was combined with finite element analysis, acoustic emission and microscopic analysis. These analyses showed that the coating withstands without any damage an externally generated tensile stress of 47 MPa. Not only the initial adhesion is determining for the implant quality, but more important is the coating functionality after reaction of the BAG. Adhesion testing after two months of in vitro reaction in a simulated body fluid showed that coating adhesion strength decreased with 10%, but the implant system was still adequate for load-bearing applications.

Effects of new machinable ceramic on behavior of rat bone cells cultured in vitro

The behavior of cultured rat bone cells growing on modified polyethylene terephthalate (mPET), glass, and machinable ceramic substrates containing enstatite (MgO, SiO2) and glass (CaO-P2O5-Al2O3) was studied. Cell attachment was measured directly on the substrates using an image analysis system. Electron microscopy observations and the MTT test revealed that cells are able to spread and proliferate on the material surface, keeping a healthy ultrastructure on all materials tested in the present study. After having colonized the surface of the materials, as shown by immunocytochemistry, the cells synthesize an osteoid-like matrix composed of osteocalcin, type I collagen, and fibronectin fibrils. The titration of alkaline phosphatase activity showed that the cells grown on the ceramic exhibit a greater osteogenic activity than those grown on controls (glass and mPET). This osteogenic activity results in a mineralization of the extracellular matrix in cultures on ceramic or plastic whereas only few calcium phosphate crystallite traces were revealed by Von Kossa staining on glass. Enstatite constitutes, therefore, an environment compatible with in vitro bone cell life.

Alumina powder/Bis-GMA composite: effect of filler content on mechanical properties and osteoconductivity

Three composites consisting of alumina powder dispersed in a bisphenol-a-glycidyl methacrylate (Bis-GMA) matrix were prepared and evaluated to assess the effect of alumina powder content on the mechanical properties and osteoconductivity of the composite. The alumina powder composites (APC) consisted of alumina powder (AL-P) as the inorganic filler dispersed in a Bis-GMA matrix that was solidified by a radical polymerization process. Prior to polymerization the AL-P was mixed with the monomers in proportions of 50%, 70%, and 80% by weight (APC50, APC70, and APC80). A fused silica-glass-filled composite containing 70% glass by weight (SGC70) was used as a control. The compressive and bending strengths, the elastic modulus in bending, and the bending strain of the composites increased as the AL-P content increased. We also evaluated the composites in vivo by implanting them into the medullary canals of rat tibiae. To compare the osteoconductivity of the composites, an affinity index was calculated for each composite; the affinity index equals the length of a bone in direct apposition to the composite and is expressed as a percentage of the total length of the composite surface. Microradiographic examination for periods of up to 26 weeks after implantation revealed that APC50, APC70, and APC80 all exhibited excellent osteoconductivity and made direct contact with the bone with no interposed soft tissues. However, the higher the AL-P content of the composite, the higher the osteoconductivity, especially at 4 weeks after the operation. Moreover, the amount of bone directly apposed to the composite surface increased with time. In contrast, little bone formation was seen on the surface of SGC70, even after 26 weeks. Observation by scanning electron microscope-energy dispersive X-ray microanalysis demonstrated that bone made direct contact with the APC surface through a layer containing calcium, phosphorus, and alumina powder. These results suggest that APC shows promise as a basis for developing mechanically strong and highly osteoconductive composites.

Ultrastructure of the interface between alumina bead composite and bone

We developed a composite (ABC) consisting of alumina bead powder as an inorganic filler and bisphenol-a-glycidyl dimethacrylate (Bis-GMA)-based resin as an organic matrix. Alumina bead powder was manufactured by fusing crushed alpha-alumina powder and quenching it. The beads took a spherical form 3 microm in average diameter. The proportion of filler in the composites was 70% w/w. The composite was implanted into rat tibiae and cured in situ. Specimens were prepared 1, 2, 4, and 8 weeks after the operation and observed by transmission electron microscopy. The results were compared with those of a bone composite made of alpha-alumina powder (alpha-ALC). In ABC-implanted tibiae, the uncured surface layer of Bis-GMA-based resin was completely filled with newly formed bonelike tissue 2 weeks after implantation. The alumina bead fillers were surrounded by and in contact with bonelike tissue. No intervening soft tissue was seen. In alpha-ALC-implanted tibiae, a gap was always observed between the alpha-ALC and the bonelike tissue. These results indicate that the ABC has osteoconductivity, although the precise mechanism is still unclear.

Bone-bonding behavior of alumina bead composite

Previously we developed an alumina bead composite (ABC) consisting of alumina bead powder (AL-P) and bisphenol-alpha-glycidyl methacrylate (Bis-GMA)-based resin and reported its excellent osteoconductivity in rat tibiae. In the present study, are evaluated histologically and mechanically the effect of alumina crystallinity on the osteoconductivity and bone-bonding strength of the composite. AL-P was manufactured by fusing crushed alpha-alumina powder and quenching it. The AL-P was composed mainly of amorphous and delta-crystal phases of alumina. Its average particle size was 3.5 microm, and it took a spherical form. Another composite (alpha ALC), filled with pure alpha-alumina powder (alpha AL-P), was used as a referential material. The proportion of powder added to each composite was 70% w/w. Mechanical testing of ABC and alpha ALC indicated that they would be strong enough for use under weight-bearing conditions. The affinity indices for ABC, determined using male Wistar rat tibiae, were significantly higher than those for alpha ALC (p < 0.0001) up to 8 weeks. Composite plates (15 x 10 x 2 mm) that had an uncured surface layer on one side were made in situ in a rectangular mold. One of the plates was implanted into the proximal metaphysis of the tibia of a male Japanese white rabbit, and the failure load was measured by a detaching test 10 weeks after implantation. The failure loads for ABC on its uncured surface [1.91+/-1.23 kgf (n = 8)] were significantly higher than those for alpha ALC on its uncured surface [0.35+/-0.33 kgf (n = 8); (p < 0.0001)], and they also were significantly higher than those for ABC on the other (cured surface) side (p < 0.0001). Histological examinations using rabbit tibiae revealed bone ingrowth into the composite only on the uncured surface of ABC. This study revealed that the amorphous phase of alumina and formation of an uncured surface layer are needed for the osteoconductive and bone-bonding ability of ABC. ABC shows promise as a basis for the development of a highly osteoconductive and mechanically strong biomaterial.

Materials characteristics of uncoated/ceramic-coated implant materials

In this paper, the biocompatibility of dental implant materials is discussed in the context of both the mechanical characteristics of the materials and the type of surface presented to the surrounding tissues. The proper functioning of the implant depends on whether it possesses the strength necessary to withstand loading within the expected range, with other properties such as elongation being of importance in some instances. A suitable modulus of elasticity may be of major importance in situations when optimum load transmission from the implant into the surrounding bone is key to the successful functioning of the device. Dental implants present a wide range of surfaces to the surrounding tissues based on surface composition, texture, charge energy, and cleanliness (sterility). Metallic implants are characterized by protective oxide layers, but ion release is still common with these materials, and is a function of passivation state, composition, and corrosion potential. An effective surface treatment for titanium appears to be passivation or anodization in a suitable solution prior to implantation. Inert ceramic surfaces exhibit minimal ion release, but are similar to metals in that they do not form a high energy bond to the surrounding bone. Some of the newly developed dental implant alloys such as titanium alloys, which contain zirconium and niobium, and high-strength ceramics such as zirconia may offer some advantages (such as lower modulus of elasticity) over the conventional materials. Calcium phosphate ceramic coatings are commonly used to convert metallic surfaces into a more bioactive state and typically cause faster bone apposition. There is a wide range of ceramic coatings containing calcium and phosphorus, with the primary difference in many of these materials being in the rate of ion release. Although their long-term success rate is unknown, the calcium phosphate surfaces seem to have a higher potential for attachment of osteoinductive agents than do uncoated titanium and other more inert implant materials.

Direct bone formation on alumina bead composite

We have developed a composite (designated ABC), consisting of alumina bead powder as an inorganic filler and bisphenol-alpha-glycidyl methacrylate (Bis-GMA)-based resin as an organic matrix, which allows direct bone formation on its surface in vivo. Alumina bead powder was manufactured by fusing crushed alpha-alumina powder and quenching it. The beads took spherical form 3 microns in average size. According to powder X-ray diffraction and Fourier transform infrared spectroscopy, the alumina bead powder was composed of amorphous and delta-crystal phases of alumina in its main crystal structure. Fused-quenched silica glass-filled composite (SGC) was used as a control. The proportion of filler added to the composites was 70% w/w. Mechanical testing of the ABC indicated that it would be strong enough for use under weight-bearing conditions. No apatite formation was detected on the surfaces of either composite after soaking in simulated body fluid for 28 days in vitro. Histological examination of rat tibiae for up to 8 weeks revealed that ABC bonded to bone directly via a layer of calcium, phosphorus, and alumina with no interposed soft-tissue layer. Moreover, the amount of bone directly apposed to the ABC surface increased with time, whereas with SGC there was poor direct bone formation even at 8 weeks. The precise mechanism of direct bone formation on ABC is as yet unknown but it is possible that changes in the crystallinity of alumina, which is known to be highly biocompatible, contribute to its excellent osteoconductivity in vivo. Although bioactive materials such as Bioglass or apatite and wollastonite-containing glass-ceramic have previously been reported to form bone-like apatite on their surfaces under acellular conditions via simple chemical reactions, ABC does not have such characteristics, and presenting favorable conditions for osteoconduction and tissue calcification may lead to direct bone formation on its surface in vivo.