Surface potential change in bioactive titanium metal during the process of apatite formation in simulated body fluid

Rubbing-Assisted Approach for Fabricating Oriented Nanobiomaterials

The highly-oriented structures in biological tissues play an important role in determining the functions of the tissues. In order to artificially fabricate oriented nanostructures similar to biological tissues, it is necessary to understand the oriented mechanism and invent the techniques for controlling the oriented structure of nanobiomaterials. In this review, the oriented structures in biological tissues were reviewed and the techniques for producing highly-oriented nanobiomaterials by imitating the oriented organic/inorganic nanocomposite mechanism of the biological tissues were summarized. In particular, we introduce a fabrication technology for the highly-oriented structure of nanobiomaterials on the surface of a rubbed polyimide film that has physicochemical anisotropy in order to further form the highly-oriented organic/inorganic nanocomposite structures based on interface interaction. This is an effective technology to fabricate one-directional nanobiomaterials by a biomimetic process, indicating the potential for wide application in the biomedical field.

The response of bioactive titanium surfaces with different structure to UVC-irradiation to eliminate the negative effect on biological properties during aging time

The biological aging of titanium implants affects the service lifetime negatively in clinical applications, and UV irradiation is an applicable method to overcome the biological aging. This study investigated the changes in surface characteristics and biological properties of bioactive titanium surfaces with different structure and topography after UVC-irradiation. The bioactive titanium surfaces were prepared by anodizing (AO), sandblasting and acid-etching (SLA), acid-alkali etching (AA), alkali-heat etching (AH) methods. Samples were stored at dark for 7 weeks to simulate biological aging process and then irradiated by UVC for 2 hours. The results showed that the Ti-OH groups, which are crucial to enhance the biological properties, were easier to be generated on AO surfaces by UVC-irradiation, o owing to a mixture of anatase and rutile on surfaces. UVC-irradiation had the strongest effect on AO surfaces to enhance the bioactivity in bone-like apatite deposition and better biocompatibility in MSCs attachment and proliferation. Therefore, titanium surfaces with a mixture phase of anatase and rutile has the potential to effectively utilize the benefits of UVC-irradiation to overcome the negative effects of the biological aging and have a promising clinical application prospect.

Extracellular-Vesicle-Based Coatings Enhance Bioactivity of Titanium Implants-SurfEV

Extracellular vesicles (EVs) are nanoparticles released by cells that contain a multitude of biomolecules, which act synergistically to signal multiple cell types. EVs are ideal candidates for promoting tissue growth and regeneration. The tissue regenerative potential of EVs raises the tantalizing possibility that immobilizing EVs on implant surfaces could potentially generate highly bioactive and cell-instructive surfaces that would enhance implant integration into the body. Such surfaces could address a critical limitation of current implants, which do not promote bone tissue formation or bond bone. Here, we developed bioactive titanium surface coatings (SurfEV) using two types of EVs: secreted by decidual mesenchymal stem cells (DEVs) and isolated from fermented papaya fluid (PEVs). For each EV type, we determined the size, morphology, and molecular composition. High concentrations of DEVs enhanced cell proliferation, wound closure, and migration distance of osteoblasts. In contrast, the cell proliferation and wound closure decreased with increasing concentration of PEVs. DEVs enhanced Ca/P deposition on the titanium surface, which suggests improvement in bone bonding ability of the implant (i.e., osteointegration). EVs also increased production of Ca and P by osteoblasts and promoted the deposition of mineral phase, which suggests EVs play key roles in cell mineralization. We also found that DEVs stimulated the secretion of secondary EVs observed by the presence of protruding structures on the cell membrane. We concluded that, by functionalizing implant surfaces with specialized EVs, we will be able to enhance implant osteointegration by improving hydroxyapatite formation directly at the surface and potentially circumvent aseptic loosening of implants.

Characterization and evaluation of a femtosecond laser-induced osseointegration and an anti-inflammatory structure generated on a titanium alloy

Cell–material interactions during early osseointegration of the bone–implant interface are critical and involve crosstalk between osteoblasts and osteoclasts. The surface properties of titanium implants also play a critical role in cell–material interactions. In this study, femtosecond laser treatment and sandblasting were used to alter the surface morphology, roughness and wettability of a titanium alloy. Osteoblasts and osteoclasts were then cultured on the resulting titanium alloy disks. Four disk groups were tested: a polished titanium alloy (pTi) control; a hydrophilic micro-dislocation titanium alloy (sandblasted Ti (STi)); a hydrophobic nano-mastoid Ti alloy (femtosecond laser-treated Ti (FTi)); and a hydrophilic hierarchical hybrid micro-/nanostructured Ti alloy [femtosecond laser-treated and sandblasted Ti (FSTi)]. The titanium surface treated by the femtosecond laser and sandblasting showed higher biomineralization activity and lower cytotoxicity in simulated body fluid and lactate dehydrogenase assays. Compared to the control surface, the multifunctional titanium surface induced a better cellular response in terms of proliferation, differentiation, mineralization and collagen secretion. Further investigation of macrophage polarization revealed that increased anti-inflammatory factor secretion and decreased proinflammatory factor secretion occurred in the early response of macrophages. Based on the above results, the synergistic effect of the surface properties produced an excellent cellular response at the bone–implant interface, which was mainly reflected by the promotion of early ossteointegration and macrophage polarization.

Osteogenic properties of bioactive sodium titanate/titanium oxide composite coating prepared by anodic oxidation in NaOH electrolyte

Our sodium titanate/titanium oxide coating has excellent osteogenic performance and has potential to be used as a bone repair material.

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

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

Development of a novel bioactive titanium membrane with alkali treatment for bone regeneration

This study evaluates a bioactive titanium membrane with alkali treatment for stimulating apatite formation and promoting bone regeneration. The titanium thin membranes were either treated with NaOH (alkali-group) or untreated (control). Each sample were incubated in simulated body fluid. Subsequently, the composition of the surface calcium deposition, its weight increase ratio, and optical absorbance were evaluated. Then, the bone defect was trephined on the rats calvaria and covered with each sample membrane or no membrane, and the bone tissue area ratio (BTA) and bone membrane contact ratio (BMC) were evaluated. The spherical crystalline precipitates formed in both groups. In the alkali-group after 21 days, the precipitates matured, forming apatite-like precipitates. The alkali-group showed higher Ca and P contents and weight increase ratios than the control. The alkali-group exhibited a higher BMC than the control in the central area. Thus, this novel membrane has high apatite-forming and bone regeneration abilities.

Characterization of the in Vitro Osteogenic Response to Submicron TiO2 Particles of Varying Structure and Crystallinity

Titanium oxide (TiO2) nano-/microparticles have been widely used in orthopedic and dental sciences because of their excellent mechanical properties, chemical stability, and ability to promote the osseointegration of implants. However, how the structure and crystallinity of TiO2 particles may affect their osteogenic activity remains elusive. Herein, we evaluated the osteogenic response to submicron amorphous, anatase, and rutile TiO2 particles with controlled size and morphology. First, the ability of TiO2 particles to precipitate apatite was assessed in an acellular medium by using a simulated body fluid (SBF). Three days after the addition to SBF, anatase and rutile TiO2 particles induced the precipitation of aggregates of nanoparticles with a platelike morphology, typical for biomimetic apatite. Conversely, amorphous TiO2 particles induced the precipitation of particles with poor Ca/P atomic ratio only after 14 days of exposure to SBF. Next, the osteogenic response to TiO2 particles was assessed in vitro by incubating MC3T3-E1 preosteoblasts with the particles. The viability and mineralization efficiency of osteoblastic cells were maintained in the presence of all the tested TiO2 particles despite the differences in the induction of apatite precipitation in SBF by TiO2 particles with different structures. Analysis of the particles' surface charge and of the proteins adsorbed onto the particles from the culture media suggested that all the tested TiO2 particles acquired a similar biological identity in the culture media. We posited that this phenomenon attenuated potential differences in osteoblast response to amorphous, anatase, and rutile particles. Our study provides an important insight into the complex relationship between the physicochemical properties and function of TiO2 particles and sheds light on their safe use in medicine.

Titanium Alloys for Dental Implants: A Review

The topic of titanium alloys for dental implants has been reviewed. The basis of the review was a search using PubMed, with the large number of references identified being reduced to a manageable number by concentrating on more recent articles and reports of biocompatibility and of implant durability. Implants made mainly from titanium have been used for the fabrication of dental implants since around 1981. The main alloys are so-called commercially pure titanium (cpTi) and Ti-6Al-4V, both of which give clinical success rates of up to 99% at 10 years. Both alloys are biocompatible in contact with bone and the gingival tissues, and are capable of undergoing osseointegration. Investigations of novel titanium alloys developed for orthopaedics show that they offer few advantages as dental implants. The main findings of this review are that the alloys cpTi and Ti-6Al-4V are highly satisfactory materials, and that there is little scope for improvement as far as dentistry is concerned. The conclusion is that these materials will continue to be used for dental implants well into the foreseeable future.

Comparative Study of Surface Modification Treatment for Porous Titanium

OBJECTIVES

This study was to investigate suitable surface treatment methods for porous titanium by ex vivo study of material properties and calcium phosphate deposition in simulated body fluid.

MATERIAL AND METHODS

Porous titanium with acid (H2SO4 and HCl mixed acid) or alkali (NaOH) treatment was prepared. The surfaces were observed, and the weight change ratio (after and before surface treatment) and compression strength were measured. To investigate the apatite formation ability, each sample was immersed in simulated body fluid (SBF). Surface observations were performed, and the weight change ratio (before/after immersing SBF) and calcification (by alizarin red staining) were measured.

RESULTS

The acid group showed a martensitic micro-scale rough structure and the weight and mechanical strength greatly decreased compared to the other groups. The alkali group exhibited a nano-scale roughness structure with similar weight and mechanical strength. Following immersion in SBF, an apatite-like crystal layer in the alkali group was observed. The weight of all samples increased. The change in weight of the samples in the alkali, acid, and control groups were significantly different, showing the following trend: alkali group (1.6%) > acid group (1.2%) > control group (0.8%). Calcium precipitation values were higher in the samples from alkali group than in those from the acid and control groups.

CONCLUSIONS

Alkali treatment was found to be a suitable surface modification method for porous titanium, resulting in good mechanical strength and apatite formation ability in simulated body fluid.

Enhanced bone regeneration capability of chitosan sponge coated with TiO2 nanoparticles

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Chitosan hybridized with titanium dioxide nanoparticles improves its bone regeneration capability.

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Nano titanium dioxide addition to the matrix of chitosan sponges was done successfully, as depicted from an even distribution of nano titanium dioxide on the surface of the sponges.

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Chitosan – nanoTiO₂ scaffold results in significantly improved sponge robustness, biomineralization, and bone regeneration capability, as indicated by DMP1 and OCN gene upregulation in chitosan-50% nanoTiO₂ sample.

Chitosan has been a popular option for tissue engineering, however exhibits limited function for bone regeneration due to its low mechanical robustness and non-osteogenic inductivity. Here we hybridized chitosan with TiO₂ nanoparticles to improve its bone regeneration capability. Morphology and crystallographic analysis showed that TiO₂ nanoparticles in anatase-type were distributed evenly on the surface of the chitosan sponges. Degradation test showed a significant effect of TiO₂ nanoparticles addition in retaining its integrity. Biomineralization assay using simulated body fluid showed apatite formation in sponges surface as denoted by PO⁴⁻ band observed in FTIR results. qPCR analysis supported chitosan - TiO₂ sponges in bone regeneration capability as indicated by DMP1 and OCN gene upregulation in TiO₂ treated group. Finally, cytotoxicity analysis supported the fact that TiO₂ nanoparticles added sponges were proved to be biocompatible. Results suggest that chitosan-50% TiO₂ nanoparticles sponges could be a potential novel scaffold for bone tissue engineering.

Simulated body fluid and the novel bioactive materials derived from it

Professor Larry Hench first reported that certain glasses are able to spontaneously bond to living bone in 1970. This discovery stimulated research into new kinds of bone-bonding materials. However, there were no guiding principles for this purpose, and many animals were sacrificed in the effort to establish them. The present authors proposed in 1991 that the bone-bonding capacity of a material could be evaluated by examining apatite formation on its surface in an acellular simulated body fluid (SBF), without the need of performing any animal experiments. Various kinds of novel bone-bonding bioactive materials based on Ti metal and its alloys with a number of different functions have been developed using SBF. Some of these have entered clinical use as important bone-repairing materials. Without the method of SBF evaluation, these novel materials would not have been developed. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 968-977, 2019.

Role of calcium ions in defining the bioactivity of surface modified Ti metal

Nano-structured hydrogen titanate and sodium hydrogen titanate layers were formed when Ti metal was treated with H₂O₂ and NaOH solutions, respectively. The chemically treated Ti metals upon subsequent treatment with Ca(NO₃)₂ and CaCl₂ solutions, resulted in incorporation of Ca²⁺ ions into the nano-structured titanate layer. Thus formed nano-structured titanate layers containing Ca²⁺ ions when subjected to heat treatment, forms anatase and calcium titanate-rutile phases, respectively. In vitro apatite-forming ability in simulated body fluid (SBF) was positive for H₂O₂-Ca and heat-treated Ti metal in contrast to NaOH-Ca and heat treatment. Formation of anatase phase together with Ca²⁺ ion release into SBF was found to be the key driving force for such a high bioactivity of Ca²⁺ containing H₂O₂ treated Ti metal on contrary to NaOH and heat treatment. This study provides a new insight into the factors accelerating the bioactivity of Ti metals during various chemical and thermal treatments, which further aid and abet to design dental and orthopaedic implants with high bone-bonding ability.

Bioactive pedicle screws prepared by chemical and heat treatments improved biocompatibility and bone-bonding ability in canine lumbar spines

Background

Titanium (Ti)-6Al-4V alloy, which is widely used in spinal instrumentation with a pedicle screw (PS) system. However, significant clinical problems, including loosening and back-out of PSs, persist. During the last decade, a novel technology that produces bioactive Ti from chemical and heat treatments has been reported that induces the spontaneous formation of a hydroxyapatite (HA) layer on the surface of Ti materials. The purpose of this study was to study the effect of bioactivation of Ti-6Al-4V PSs on the ability of HA formation in vitro and its biocompatibility and bone-bonding ability in vivo.

Methods

Ti-6V-4Al alloy PSs were prepared and bioactivated by NaOH-CaCl₂-heat-water treatments. The HA-forming ability of bioactive PSs in simulated body fluid (SBF) was evaluated by field emission scanning electron microscopy (FE-SEM) and energy dispersive X-ray analysis (EDX). Six 11-month-old female beagle dogs were used for the in vivo study. Bioactive and control (without bioactivation) PSs were left and right randomly placed from L1 to L6. One and three months after surgery, lumbar spines were removed for biomechanical and histological analyses.

Results

In vitro: The surface analysis of bioactive PSs by FE-SEM and EDX showed substantial HA deposits over the entire surface. In vivo: The mean extraction torque was significantly higher for bioactive PSs compared to controls PSs (P<0.01); there was no significant difference in pull-out strength between control and bioactive PSs. Histologically, the contact area between bone tissue and screw surface showed no significant trend to be greater in bioactive PSs compared to control PSs (P = 0.06).

Conclusions

Bioactive PSs prepared by chemical and heat treatments formed layers of HA on the surface of screws in vitro that improved biocompatibility and bonding ability with bone in vivo. Bioactive PSs may reduce screw loosening to overcome the obstacles confronted in spinal instrumentation surgery.

Structural effects of phosphate groups on apatite formation in a copolymer modified with Ca2+ in a simulated body fluid

Organic-inorganic composites are novel bone substitutes that can ameliorate the mismatch of Young's moduli between natural bone and implanted ceramics. Phosphate groups contribute to the formation of apatite in a simulated body fluid (SBF) and the adhesion of osteoblast-like cells. Therefore, modification of a polymer with these functional groups is expected to enhance the ability of the organic-inorganic composite to bond with bone. Two phosphate groups have been used, phosphonic acid (-C-PO₃H₂) and phosphoric acid (-O-PO₃H₂). However, the effects of structural differences between these phosphate groups have not been clarified. In this study, the apatite formation of copolymers modified with Ca²⁺ and either -C-PO₃H₂ or -O-PO₃H₂ was examined. The mechanism of apatite formation is discussed based on analytical and computational approaches. The copolymers containing -O-PO₃H₂, but not those containing -C-PO₃H₂, formed apatite in the SBF, although both released similar amounts of Ca²⁺ into the SBF. Adsorption of HPO₄ ^2- from -O-PO₃H₂ in the SBF following Ca²⁺ adsorption was confirmed by zeta-potential measurement and X-ray photoelectron spectroscopy. The measurement of the complex formation constant revealed that the -O-PO₃ ^2-Ca²⁺ complex was thermodynamically unstable enough to convert into CaHPO₄, which was not the case with -C-PO₃ ^2-Ca²⁺. The formation of CaHPO₄-based clusters was found to be a key factor for apatite nucleation. In conclusion, this study revealed that modification with -O-PO₃H₂ was more effective for enhancing apatite formation compared with -C-PO₃H₂.

Development of hafnium metal and titanium-hafnium alloys having apatite-forming ability by chemical surface modification

Hafnium (Hf) has attracted considerable attention as a component of biomedical titanium (Ti) alloys with low Young's moduli and/or shape-memory functionalities, because its cytotoxicity is as low as that of Ti. The drawback of metals is that their bone-bonding ability is generally low. It is known that apatite formation in the body is a prerequisite for bone-bonding. Although several chemical treatments have been proposed for preparing Ti for bone-bonding, there have been no similar investigations for Hf. In the present study, NaOH- and heat-treatments were applied to pure Hf and Ti-Hf alloys and their bone-bonding ability was assessed in vitro with the use of simulated body fluid (SBF). After NaOH- and heat-treatments, anatase formed on alloys with low Hf content (20-40% (atom%) Hf); mixtures of sodium titanate and hafnium titanate formed on alloys with similar Ti and Hf content (60% Hf); and hafnium oxide formed on alloys with high Hf content (80% Hf and pure Hf). Precipitates of apatite were observed on all the metals in SBF, except for the alloy with 60% Hf. We speculated that the hafnium titanate formed on this alloy had a low apatite-forming ability owing to its high negative surface charge, which inhibited P adsorption. The apatite-forming abilities of the Ti-Hf alloys strongly depended on their Hf content. The present results indicate that Hf-based materials have good potential for bone-bonding. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2519-2523, 2018.

Effect of metallographic structure and machining process on the apatite-forming ability of sodium hydroxide- and heat-treated titanium

Although titanium (Ti) is clinically used for hard tissue reconstruction, it has low bone-bonding ability, i.e. bioactivity. Materials able to deposit apatite on their surfaces within the body is considered to exhibit bioactivity. Effects of the metallographic structure and machining process of Ti on its apatite-forming ability remains unclear. In this study, Ti substrates subjected to various preheating and machining processes were then subjected to NaOH and heat treatments. The apatite-forming abilities of resulting Ti were examined in simulated body fluid (SBF). Preheating of the Ti decreased its reactivity with NaOH solution. When quenched or annealed Ti was subjected to NaOH and heat treatments, the induction period for apatite formation in SBF slightly increased. This was attributed to a decrease in sodium titanate and increase in rutile on the Ti surface after the treatments. Substrates subjected to wire-electrical-discharge machining did not form apatite. This was attributed to the inhibition of PO43- adsorption on their surfaces following Ca2+ adsorption, which is an essential process for apatite nucleation. Contamination of Ti surface by components of the brass wire used in the machining contributed to the inhibition. The bioactivity of surface-modified Ti was therefore significantly affected by its thermal treatment and machining process.

Two-in-One Biointerfaces-Antimicrobial and Bioactive Nanoporous Gallium Titanate Layers for Titanium Implants

The inhibitory effect of gallium (Ga) ions on bone resorption and their superior microbial activity are attractive and sought-after features for the vast majority of implantable devices, in particular for implants used for hard tissue. In our work, for the first time, Ga ions were successfully incorporated into the surface of titanium metal (Ti) by simple and cost-effective chemical and heat treatments. Ti samples were initially treated in NaOH solution to produce a nanostructured sodium hydrogen titanate layer approximately 1 μm thick. When the metal was subsequently soaked in a mixed solution of CaCl₂ and GaCl₃, its Na ions were replaced with Ca and Ga ions in a Ga/Ca ratio range of 0.09 to 2.33. 8.0% of the Ga ions were incorporated into the metal surface when the metal was soaked in a single solution of GaCl₃ after the NaOH treatment. The metal was then heat-treated at 600 °C to form Ga-containing calcium titanate (Ga–CT) or gallium titanate (GT), anatase and rutile on its surface. The metal with Ga–CT formed bone-like apatite in a simulated body fluid (SBF) within 3 days, but released only 0.23 ppm of the Ga ions in a phosphate-buffered saline (PBS) over a period of 14 days. In contrast, Ti with GT did not form apatite in SBF, but released 2.96 ppm of Ga ions in PBS. Subsequent soaking in hot water at 80 °C dramatically enhanced apatite formation of the metal by increasing the release of Ga ions up to 3.75 ppm. The treated metal exhibited very high antibacterial activity against multidrug resistant Acinetobacter baumannii (MRAB12). Unlike other antimicrobial coating on titanium implants, Ga–CT and GT interfaces were shown to have a unique combination of antimicrobial and bioactive properties. Such dual activity is essential for the next generation of orthopaedic and dental implants. The goal of combining both functions without inducing cytotoxicity is a major advance and has far reaching translational perspectives. This unique dual-function biointerfaces will inhibit bone resorption and show antimicrobial activity through the release of Ga ions, while tight bonding to the bone will be achieved through the apatite formed on the surface.

Overcoming the biological aging of titanium using a wet storage method after ultraviolet treatment

We evaluated whether the biological activity of the surface of titanium, when stored in an aqueous solution after ultraviolet (UV) treatment, is comparable to that of the surface immediately after UV treatment. We subjected Grade IV titanium discs with machined surfaces to UV radiation for 15 min and then tested them immediately and after storage for 28 days, with and without distilled H₂O (dH₂O). We evaluated the surface characteristics using surface profiling, contact angle analysis, X-ray photoelectron spectroscopy, and in terms of the surface zeta-potential. We determined the level of biological activity by analysing albumin adsorption, MC3T3-E1 and human mesenchymal cell adhesion and cytoskeleton development, as well as the production of intracellular reactive oxygen species between groups. The surface characteristics produced by the UV irradiation were maintained in dH₂O for 28 days. We found that titanium stored in dH₂O for 28 days after UV treatment exhibited enhanced protein adsorption, cell attachment, and cytoskeleton development. Titanium stored in dH₂O for 28 days after UV irradiation exhibited a lower level of oxidative stress, comparable to that of the titanium immediately after UV treatment. UV treatment combined with wet storage can be used as a means of overcoming the biological aging of titanium.

Development of a SiYAlON glaze for improved osteoconductivity of implantable medical devices

The application of bioactive coatings onto orthopaedic appliances is commonly performed to compensate for the otherwise bioinert nature of medical devices and to improve their osseointegration. Calcium phosphates, hydroxyapatite (HAp), and bioglasses are commercially available for this purpose. Until recently, few other inorganic compounds have been identified with similar biofunctionality. However, silicon nitride (Si₃ N₄ ) has emerged as a new orthopaedic material whose unique surface chemistry also enhances osteoconductivity. Recent research has confirmed that its minority intergranular phase, consisting of silicon yttrium aluminum oxynitride (SiYAlON), is principally responsible for this improvement. As a result, it was hypothesized that SiYAlON itself might serve as an effective osteoconductive coating or glaze for medical devices. To test this hypothesis, a process inspired by traditional ceramic whiteware glazing was developed. A slurry containing ingredients similar to the intergranular SiYAlON composition was applied to a Si₃ N₄ surface, which was then subjected to a heat treatment to form a glaze. Various analytical tools were employed to assess its chemistry and morphology. It was found that the glaze was comprised predominately of Y₅ Si₃ O₁₂ N, a compound commonly referred to as N-apatite, which is isostructural to native HAp. Subsequent exposure of the glazed surface to acellular simulated body fluid led to increased deposition of biomimetic HAp-like crystals, while exposure to Saos-2 osteosarcoma cells in vitro resulted in greater HAp deposition relative to control samples. The observation that SiYAlON exhibits enhanced osteoconductivity portends its potential as a therapeutic aid in bone and tissue repair. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1084-1096, 2018.

Novel bioactive materials developed by simulated body fluid evaluation: Surface-modified Ti metal and its alloys

Until the discovery of the bone-bonding activity of Bioglass by Hench et al. in the early 1970s, it had not been demonstrated that a synthetic material could bond to living bone without eliciting a foreign body reaction. Since then, various kinds of materials based on calcium phosphate, such as sintered hydroxyapatite and β-tricalcium phosphate have also been shown to bond to living bone. Until the discovery of the bone-bonding activity of Ti metal formed with a sodium titanate surface layer by the present authors in 1996, it had not been shown that a metallic material could bond to living bone. Since then, various kinds of surface-modified Ti metal and its alloys have been found to bond to living bone. Until the discovery of the osteoinduction of porous hydroxyapatite by Yamasaki in 1990, it was unknown whether a synthetic material could induce bone formation even in muscle tissue. Since then, various kinds of porous calcium phosphate ceramics have been shown to induce osteoinduction. Until the discovery of osteoinduction induced by a porous Ti metal formed with a titanium oxide surface layer by Fujibayashi et al. in 2004, it had been unclear whether porous metals would be able to induce osteoinduction. These novel bioactive materials have been developed by systematic research into the apatite formation that occurs on surface-modified Ti metal and its related materials in an acellular simulated body fluid (SBF) having ion concentrations almost equal to those of human blood plasma. Some of the novel bioactive materials based on Ti metal are already in clinical use or clinical trials, such as artificial hip joints and spinal fusion devices. In the present paper, we review how these novel bioactive materials based on Ti metal have been developed based on an evaluation of apatite formation in SBF. Without the SBF evaluation, these novel bioactive materials would most likely never have been developed.

STATEMENT OF SIGNIFICANCE

On the basis of systematic study of apatite formation on a material in a simulated body fluid, various kinds of novel bioactive materials possessing not only bone-bonding activity and but also various other functions such as bone growth promotion, antibacterial activity and osteoinduction have been developed. Some of them are already successfully applied to clinical applications or trials for artificial hip joints and spinal fusion devices. It is shown in the present paper how these novel bioactive materials have been developed.

Apatite-forming ability of vinylphosphonic acid-based copolymer in simulated body fluid: effects of phosphate group content

Phosphate groups on materials surfaces are known to contribute to apatite formation upon exposure of the materials in simulated body fluid and improved affinity of the materials for osteoblast-like cells. Typically, polymers containing phosphate groups are organic matrices consisting of apatite-polymer composites prepared by biomimetic process using simulated body fluid. Ca(2+) incorporation into the polymer accelerates apatite formation in simulated body fluid owing because of increase in the supersaturation degree, with respect to apatite in simulated body fluid, owing to Ca(2+) release from the polymer. However, the effects of phosphate content on the Ca(2+) release and apatite-forming abilities of copolymers in simulated body fluid are rather elusive. In this study, a phosphate-containing copolymer prepared from vinylphosphonic acid, 2-hydroxyethyl methacrylate, and triethylene glycol dimethacrylate was examined. The release of Ca(2+) in Tris-NaCl buffer and simulated body fluid increased as the additive amount of vinylphosphonic acid increased. However, apatite formation was suppressed as the phosphate groups content increased despite the enhanced release of Ca(2+) from the polymer. This phenomenon was reflected by changes in the surface zeta potential. Thus, it was concluded that the apatite-forming ability of vinylphosphonic acid-2-hydroxyethyl methacrylate-triethylene glycol dimethacrylate copolymer treated with CaCl2 solution was governed by surface state rather than Ca(2+) release in simulated body fluid.

Time-dependent effects of ultraviolet and nonthermal atmospheric pressure plasma on the biological activity of titanium

Here, we evaluated time-dependent changes in the effects of ultraviolet (UV) and nonthermal atmospheric pressure plasma (NTAPPJ) on the biological activity of titanium compared with that of untreated titanium. Grade IV machined surface titanium discs (12-mm diameter) were used immediately and stored up to 28 days after 15-min UV or 10-min NTAPPJ treatment. Changes of surface characteristics over time were evaluated using scanning electron microscopy, surface profiling, contact angle analysis, X-ray photoelectron spectroscopy, and surface zeta-potential. Changes in biological activity over time were as determined by analysing bovine serum albumin adsorption, MC3T3-E1 early adhesion and morphometry, and alkaline phosphatase (ALP) activity between groups. We found no differences in the effects of treatment on titanium between UV or NTAPPJ over time; both treatments resulted in changes from negatively charged hydrophobic (bioinert) to positively charged hydrophilic (bioactive) surfaces, allowing enhancement of albumin adsorption, osteoblastic cell attachment, and cytoskeleton development. Although this effect may not be prolonged for promotion of cell adhesion until 4 weeks, the effects were sufficient to maintain ALP activity after 7 days of incubation. This positive effect of UV and NTAPPJ treatment can enhance the biological activity of titanium over time.

Biofilm formation of periodontal pathogens on hydroxyapatite surfaces: Implications for periodontium damage

Biofilm formation of periodontal pathogens on teeth surfaces promotes the progression of periodontal disease. Hence, understanding the mechanisms of bacterial attachment to the dental surfaces may inform strategies for the maintenance of oral health. Although hydroxyapatite (HA) is a major calcium phosphate component of teeth, effect of biofilm formation on HA surfaces remains poorly characterized. In this study, biofilm-forming abilities by the periodontal pathogens Aggregatibacter actinomycetemcomitans Y4 and Porphyromonas gingivalis 381 were investigated on dense and porous HAs that represent enamel and dentin surfaces, respectively. These experiments showed greater biofilm formation on porous HA, but differing attachment profiles and effects of the two pathogens. Specifically, while the detachment of A. actinomycetemcomitans Y4 biofilm was observed, P. gingivalis 381 biofilm increased with time. Moreover, observations of HA morphology following formation of A. actinomycetemcomitans Y4 biofilm revealed gaps between particles, whereas no significant changes were observed in the presence of P. gingivalis 381. Finally, comparisons of calcium leakage showed only slight differences between bacterial species and HA types and may be masked by bacterial calcium uptake. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2873-2880, 2016.

New Ti-Alloys and Surface Modifications to Improve the Mechanical Properties and the Biological Response to Orthopedic and Dental Implants: A Review

Titanium implants are widely used in the orthopedic and dentistry fields for many decades, for joint arthroplasties, spinal and maxillofacial reconstructions, and dental prostheses. However, despite the quite satisfactory survival rates failures still exist. New Ti-alloys and surface treatments have been developed, in an attempt to overcome those failures. This review provides information about new Ti-alloys that provide better mechanical properties to the implants, such as superelasticity, mechanical strength, and corrosion resistance. Furthermore, in vitro and in vivo studies, which investigate the biocompatibility and cytotoxicity of these new biomaterials, are introduced. In addition, data regarding the bioactivity of new surface treatments and surface topographies on Ti-implants is provided. The aim of this paper is to discuss the current trends, advantages, and disadvantages of new titanium-based biomaterials, fabricated to enhance the quality of life of many patients around the world.

Influence of strontium ions incorporated into nanosheet-pore topographical titanium substrates on osteogenic differentiation of mesenchymal stem cells in vitro and on osseointegration in vivo

Strontium ions incorporation and nanosheet-pore topography of titanium substrates synergistically improve the osteogensis of MSCs and osseointegration in vivo.

Growth of Novel Ceramic Layers on Metals via Chemical and Heat Treatments for Inducing Various Biological Functions

The present authors' systematic studies on growth of novel ceramic layers on Ti metal and its alloys by chemical and heat treatments for inducing bone-bonding bioactivity and some other biological functions are reviewed. Ti metal formed an apatite on its surface in a simulated body fluid, when heat-treated after exposure to strong acid solutions to form rutile surface layer, or to strong alkali solutions to form sodium titanate surface layer. Both types of Ti metal tightly bonded to the living bone. The alkali and heat treatment was applied to the surface Ti metal of an artificial hip joint and successfully used in the clinic since 2007. The acid and heat treatments was applied to porous Ti metal to induce osteoconductivity as well as osteoinductivity. The resulting product was successfully used in clinical trials for spinal fusion devices. For the Ti-based alloys, the alkali and heat treatment was little modified to form calcium titanate surface layer. Bone-growth promoting Mg, Sr, and Zn ions as well as the antibacterial Ag ion were successfully incorporated into the calcium titanate layer.

Precipitation of Calcium Phosphates in the Presence of Collagen Type I on Four Different Bioactive Titanium Surfaces: an in Vitro Study

OBJECTIVES

To compare the properties of calcium phosphate precipitation on four different bioactive surface preparations and one control surface in the simulated body fluid model with added collagen type I.

MATERIAL AND METHODS

Blasted titanium discs were treated with four different surface modifications, alkali and heat, sodium fluoride, anodic oxidation and hydroxyapatite coating. The discs were divided into five groups where one group, the blasted, served as control. The discs were immersed in simulated body fluid and collagen for 24 h, 3 days, 1 week and 2 weeks and then analysed by optical interferometry, scanning electron microscopy/energy dispersive X-ray analysis and X-ray photoelectron spectroscopy.

RESULTS

All surfaces show small precipitates after 3 days which with longer immersion times increase. After 2 weeks the surfaces were completely covered with precipitates, and Ca/P ratios were approximately 1.3, independently on surface preparation. The fluoridated discs showed significantly (P ≤ 0.05) higher degree of CaP after one week of immersion as compared to the other surface preparations. The collagen type I content increased with time, as reflected by increased nitrogen content.

CONCLUSIONS

The results from this study indicate that a fluoridated titanium surface may favour precipitation of calcium phosphate in the presence of collagen type I, as compared to the other surface treatments of the present study.

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

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

Controllably local gene delivery mediated by polyelectrolyte multilayer films assembled from gene-loaded nanopolymersomes and hyaluronic acid

To explore a spatiotemporally controllable gene delivery system with high efficiency and safety, polyelectrolyte multilayer (PEM) films were constructed on titanium or quartz substrates via layer-by-layer self-assembly technique by using plasmid deoxyribonucleic acid-loaded lipopolysaccharide–amine nanopolymersomes (pNPs) as polycations and hyaluronic acid (HA) as polyanions. pNPs were chosen because they have high transfection efficiency (>95%) in mesenchymal stem cells (MSCs) and induce significant angiogenesis in zebrafish in conventional bolus transfection. The assembly process of PEM films was confirmed by analyses of quartz crystal microbalance with dissipation, X-ray photoelectron spectroscopy, infrared, contact angle, and zeta potential along with atomic force microscopy observation. Quartz crystal microbalance with dissipation analysis reveals that this film grows in an exponential mode, pNPs are the main contributor to the film mass, and the film mass can be modulated in a relatively wide range (1.0–29 μg/cm²) by adjusting the deposition layer number. Atomic force microscopy observation shows that the assembly leads to the formation of a patterned film with three-dimensional tree-like nanostructure, where the branches are composed of beaded chains (pNP beads are strung on HA molecular chains), and the incorporated pNPs keep structure intact. In vitro release experiment shows that plasmid deoxyribonucleic acid can be gradually released from films over 14 days, and the released plasmid deoxyribonucleic acid exists in a complex form. In vitro cell experiments demonstrate that PEM films can enhance the adhesion and proliferation of MSCs and efficiently transfect MSCs in situ in vitro for at least 4 days. Our results suggest that a (pNPs/HA)_n system can mediate efficient transfection in stem cells in a spatially and temporally controllable pattern, highlighting its huge potential in local gene therapy.

Chemical and Heat Treatments for Inducing Bone-Bonding Ability of Ti-6Al-4V Pedicle Screw

Pedicle screw (PS) system using Ti-6Al-4V PSs became popular in spinal instrumentation system. However, they sometimes case loosening and back-out from bone because of their poor bone-bonding ability. In the present study, Ti-6Al-4V alloy was subjected to the acid-heat or calcium-heat treatments that are effective for inducing high capacities of apatite formation and bone bonding on pure Ti. When the alloy was subjected to the acid-heat treatment, a surface layer composed of rutile and anatase TiO2 enriched with Al and V was produced. Thus the treated alloy was neutrally charged and did not form apatite in a simulated body fluid (SBF) even after 3 day. In contrast, when the alloy was subjected to the Ca-heat treatment, a surface layer composed of calcium titanate, anatase and rutile free from Al and V was produced. The treated alloy formed apatite in SBF within 3 days. When the Ti-6Al-4V PSs subjected to the Ca-heat treatment was implanted into vertebra of beagle dogs, they showed higher bone-bonding ability as well as bone contact area than those without the treatment. This kind of bioactive Ti-6Al-4V PSs might be useful for spinal instrumentation since they could prevent loosening and back-out from bone.

Controlled release of strontium ions from a bioactive Ti metal with a Ca-enriched surface layer

A nanostructured sodium hydrogen titanate layer ∼1μm in thickness was initially produced on the surface of titanium metal (Ti) by soaking in NaOH solution. When the metal was subsequently soaked in a mixed solution of CaCl2 and SrCl2, its Na ions were replaced with Ca and Sr ions in an Sr/Ca ratio in the range 0.18-1.62. The metal was then heat-treated at 600°C to form strontium-containing calcium titanate (SrCT) and rutile on its surface. The treated metal did not form apatite in a simulated body fluid (SBF) even after 7days. When the metal formed with SrCT was subsequently soaked in water at 80°C, the treated metal formed bone-like apatite on its surface within 1day in SBF since the Ca ions were partially replaced with H3O(+) ions. However, it released only 0.06ppm of Sr ions even after 7days in phosphate-buffered saline. When the metal was soaked after the heat treatment in 1M SrCl2 solution instead of water, the treated metal released 0.92ppm of Sr ions within 7days while maintaining its apatite-forming ability. The Ti formed with this kind of bioactive SrCT layer on its surface is expected to be highly useful for orthopedic and dental implants, since it should be able to promote bone growth by releasing Sr ions and tightly bond to the bone through the apatite formed on its surface.

Fabrication and characterization of porous Ti-7.5Mo alloy scaffolds for biomedical applications

Porous titanium and titanium alloys are promising scaffolds for bone tissue engineering, since they have the potential to provide new bone tissue ingrowth abilities and low elastic modulus to match that of natural bone. In the present study, porous Ti-7.5Mo alloy scaffolds with various porosities from 30 to 75 % were successfully prepared through a space-holder sintering method. The yield strength and elastic modulus of a Ti-7.5Mo scaffold with a porosity of 50 % are 127 MPa and 4.2 GPa, respectively, being relatively comparable to the reported mechanical properties of natural bone. In addition, the porous Ti-7.5Mo alloy exhibited improved apatite-forming abilities after pretreatment (with NaOH or NaOH + water) and subsequent immersion in simulated body fluid (SBF) at 37 °C. After soaking in an SBF solution for 21 days, a dense apatite layer covered the inner and outer surfaces of the pretreated porous Ti-7.5Mo substrates, thereby providing favorable bioactive conditions for bone bonding and growth. The preliminary cell culturing result revealed that the porous Ti-7.5Mo alloy supported cell attachment.

Effect of Ca contamination on apatite formation in a Ti metal subjected to NaOH and heat treatments

It has long been known that titanium (Ti) metal bonds to living bone through an apatite layer formed on its surface in the living body after it had previously been subjected to NaOH and heat treatments and as a result had formed sodium titanate on its surface. These treatments were applied to a porous Ti metal layer on a total hip joint and the resultant joint has been in clinical use since 2007. It has been also demonstrated that the apatite formation on the treated Ti metal in the living body also occurred in an acelullar simulated body fluid (SBF) with ion concentrations nearly equal to those of the human blood plasma, and hence bone-bonding ability of the treated Ti metal can be evaluated using SBF in vitro. However, it was recently found that certain Ti metals subjected to the same NaOH and heat treatments display apatite formation in SBF which is decreased with the increasing volume of the NaOH solution used in some cases. This indicates that bone-bonding ability of the treated Ti metal varies with the volume of the NaOH solution used. In the present study, this phenomenon was systematically investigated using commercial NaOH reagents and is considered in terms of the structure and composition of the surface layers of the treated Ti metals. It was found that a larger amount of the calcium contamination in the NaOH reagent is concentrated on the surface of the Ti metal during the NaOH treatment with an increasing volume of the NaOH solution, and that this inhibited apatite formation on the Ti metal in SBF by suppressing Na ion release from the sodium titanate into the surrounding fluid. Even a Ca contamination level of 0.0005 % of the NaOH reagent was sufficient to inhibit apatite formation. On the other hand, another NaOH reagent with a nominal purity of just 97 % did not exhibit any such inhibition, since it contained almost no Ca contamination. This indicates that NaOH reagent must be carefully selected for obtaining reliable bone-bonding implants of Ti metal by the NaOH and heat treatments.

Formation of a bioactive calcium titanate layer on gum metal by chemical treatment

The so-called gum metal with the composition Ti-36Nb-2Ta-3Zr-0.3O is free from cytotoxic elements and exhibits a low elastic modulus as well as high mechanical strength. In the present study, it was shown that this alloy exhibited a high capacity for apatite formation in a simulated body fluid when subjected to 1 M NaOH treatment, 100 mM CaCl(2) treatment, heat treatment at 700°C, and then hot water treatment. The high apatite formation was attributed to the CaTi(2)O(5) which was precipitated on its surface, and found to be maintained even in a humid environment over a long period. The treated surface exhibited high scratch resistance, which is likely to be useful in clinical applications. The surface treatment had little effect on the unique mechanical properties described above. These results show that gum metal subjected to the present surface treatments exhibits a high potential for bone-bonding, which will be useful in orthopedic and dental implants.