Osseointegration of atmospheric plasma-sprayed titanium implants: Influence of the native oxide layer

Emerging factors affecting peri-implant bone metabolism

Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.

Biomedical Applications of Titanium Alloys: A Comprehensive Review

Titanium alloys have emerged as the most successful metallic material to ever be applied in the field of biomedical engineering. This comprehensive review covers the history of titanium in medicine, the properties of titanium and its alloys, the production technologies used to produce biomedical implants, and the most common uses for titanium and its alloys, ranging from orthopedic implants to dental prosthetics and cardiovascular devices. At the core of this success lies the combination of machinability, mechanical strength, biocompatibility, and corrosion resistance. This unique combination of useful traits has positioned titanium alloys as an indispensable material for biomedical engineering applications, enabling safer, more durable, and more efficient treatments for patients affected by various kinds of pathologies. This review takes an in-depth journey into the inherent properties that define titanium alloys and which of them are advantageous for biomedical use. It explores their production techniques and the fabrication methodologies that are utilized to machine them into their final shape. The biomedical applications of titanium alloys are then categorized and described in detail, focusing on which specific advantages titanium alloys are present when compared to other materials. This review not only captures the current state of the art, but also explores the future possibilities and limitations of titanium alloys applied in the biomedical field.

Study on the effect of surface characteristics of short-pulse laser patterned titanium alloy on cell proliferation and osteogenic differentiation

Concise, low-cost preparation of titanium alloy implants with high cell proliferation and osteogenic differentiation is urgently needed. Nanosecond laser ablation of titanium alloy has the advantages of short processing time, less pollution, and non-contact. In this research, we adopt a nanosecond UV laser to process the closed groove and cross groove titanium alloys with length to width ratio of 1:1, 2.5:1, 4:1, and 6:1. The surface morphology, surface roughness, phase, element distribution, surface chemistry, and wettability were characterized. The effect of the patterned surface's properties on the adhesion, proliferation, and osteogenic differentiation of stem cells was studied. The results show the laser-ablated lattice structure's surface energy can increase rapidly in the natural environment. The cell adhesion of stem cells on a lattice structure with low roughness and high surface energy is optimal. The element concentration at the ablated edges is higher than at the bottom under Marangoni and surface tension. Stem cells preferentially adhere to the ablated edges with high roughness, element concentration, and hardness. Cell differentiation is chiefly affected by patterning structure. On the surface of the boss structure with a length to width ratio of 2.5:1, the proportion of cell length to diameter is about 2.5, and the cell area is greater. The osteogenic differentiation of cells is the highest on the surface.

Surface Modified Techniques and Emerging Functional Coating of Dental Implants

Dental implants are widely used in the field of oral restoration, but there are still problems leading to implant failures in clinical application, such as failed osseointegration, marginal bone resorption, and peri-implantitis, which restrict the success rate of dental implants and patient satisfaction. Poor osseointegration and bacterial infection are the most essential reasons resulting in implant failure. To improve the clinical outcomes of implants, many scholars devoted to modifying the surface of implants, especially to preparing different physical and chemical modifications to improve the osseointegration between alveolar bone and implant surface. Besides, the bioactive-coatings to promote the adhesion and colonization of ossteointegration-related proteins and cells also aim to improve the osseointegration. Meanwhile, improving the anti-bacterial performance of the implant surface can obstruct the adhesion and activity of bacteria, avoiding the occurrence of inflammation related to implants. Therefore, this review comprehensively investigates and summarizes the modifying or coating methods of implant surfaces, and analyzes the ossteointegration ability and anti-bacterial characteristics of emerging functional coatings in published references.

Extension of hydrophilicity stability by reactive plasma treatment and wet storage on TiO2 nanotube surfaces for biomedical implant applications

Micro and nanoscale changes allow the optimization of physico-chemical properties of titanium implant surfaces. Recently UV and plasma treatments have allowed surface hydrophilicity to take increased prominence; however, this beneficial effect is short-lived. The aim of this study is to investigate methodologies post-anodizing treatment to generate and maintain high surface hydrophilicity along with high biocompatibility. Anodized surfaces were characterized regarding physical-chemical properties. Then, surface wettability with nanomorphology was evaluated at different times and with distinct post-treatments: as deposited, with a reactive plasma and UV-light post-treatment, stored in air or deionized (DI) water. Adhesion, alkaline phosphatase (ALP) activity and bone cell viability tests were executed after the incremental treatments. The anodizing process generated a surface with TiO2 nanotubes morphology and micro-roughness. Plasma-treated surfaces resulted in the most hydrophilic samples and this property was maintained for a longer period when those were stored in DI water (angle variation of 7° to 12° in 21 days). Furthermore, plasma post-treatment changed the titanium surface crystalline phase from amorphous to anatase. Anodized surfaces modified by reactive plasma and stored in DI water suggest better hydrophilicity stability, biocompatibility, ALP activity and achievement of crystalline phase alteration, indicating future potential use on biomedical implants.

[Advances in titanium dental implant surface modification]

Titanium dental implants have wide clinical application due to their many advantages, including comfort, aesthetics, lack of damage to adjacent teeth, and significant clinical effects. However, the failure of osseointegration, bone resorption, and peri-implantitis limits their application. Physical-chemical and bioactive coatings on the surface of titanium implants could improve the successful rate of dental implants and meet the clinical application requirements. This paper reviews the characteristics of surface modification of titanium implants from the aspects of physics, chemistry, and biology. Results provide information for research and clinical application of dental implant materials.

A bone preservation protocol that enables evaluation of osseointegration of implants with micro- and nanotextured surfaces

Development of surface treatments has enabled secure attachment of dental implants in less than 1 month. Consequently, it is necessary to characterize accurately the osseointegration of the implant surface in the region of the bone-implant contact (BIC). We developed a method for sample preparation that preserves both bone and BIC to permit analysis of the contact interface. We prepared eight nanotextured implants and implanted them in rabbit tibias. After healing for 30 days, outcomes were analyzed using both our bone preservation protocol and routine decalcification followed by preparation of histological sections stained by hematoxylin and eosin (H & E). Pull-out tests for implant osseointegration were performed after healing. Non-implanted samples of rabbit mandible were used as a control for assessing organic and mineralized bone characteristics and bone structure. Our bone preservation protocol enabled evaluation of many of the same bone characteristics as histological sections stained with H & E. Our protocol enables analysis of implant samples, implant surfaces and osseointegration without risk of BIC damage.

Atmospheric Plasma Deposition of Methacrylate Layers Containing Catechol/Quinone Groups: An Alternative to Polydopamine Bioconjugation for Biomedical Applications

Bioconjugation of enzymes on coatings based on polydopamine (PDA) layers is an appealing approach to control biological responses on biomedical implant surfaces. As alternative to PDA wet deposition, a fast, solvent-free, and dynamic deposition approach based on atmospheric-pressure plasma dielectric barrier discharge process is considered to deposit on metallic surfaces acrylic-based interlayers containing highly chemically reactive catechol/quinone groups. A biomimetic approach based on covalent immobilization of Dispersin B, an enzyme with antibiofilm properties, shows the bioconjugation potential of the novel plasma polymer layers. The excellent antibiofilm activity against Staphylococcus epidermidis is comparable to the PDA-based layers prepared by wet chemical methods with slow deposition rates. A study of preosteoblastic MG-63 human cell line viability and adhesion properties on plasma polymer layers demonstrates early interaction required for biomedical applications.

Modification of a SLA titanium surface with calcium-containing nanosheets and its effects on osteoblast behavior

The aim of this study was to present a procedure to prepare a calcium-containing nanosheets-modified sandblasted and acid etched (SLA) titanium surface and explore its effects on osteoblast behavior.