Surface modification of valve metals using plasma electrolytic oxidation for antibacterial applications: A review

Easy and versatile cellulosic support inhibiting broad spectrum strains: synergy between photodynamic antimicrobial therapy and polymyxin B

Despite advances achieved in the health field over the last decade, infections caused by resistant bacterial strains are an increasingly important societal issue that needs to be addressed. New approaches have already been developed to overcome this problem. Photodynamic antimicrobial chemotherapy (PACT) could provide a promising alternative method to eradicate microbes. This approach has already inspired the development of innovative surfaces. Interesting results were achieved against Gram-positive bacteria, but it also appeared that Gram-negative strains, especially Pseudomonas aeruginosa, were less sensitive to PACT. However, materials coated with cationic porphyrins have already proven their wide-spectrum activity, but these materials were not suitable for industrial-scale production. The main aim of this work was the design of a large-scale evolutionary material based on PACT and antibiotic prophylaxis. Transparent regenerated cellulose has been simply impregnated with a usual cationic porphyrin (N-methylpyridyl) and an antimicrobial peptide (polymyxin B). In addition to its photophysical properties, this film exhibited a wide-spectrum bactericidal activity over 4 days despite daily application of fresh bacterial inoculums. The efficiency of PACT and polymyxin B combination could help to reduce the emergence of bacterial multi-resistant strains and we believe that this kind of material would provide an excellent opportunity to prevent bacterial contamination of bandages or packaging.

Investigation of In Vitro Cytocompatibility of Zinc-Containing Coatings Developed on Medical Magnesium Alloys

In a neutral solution, we investigated the effects of Na2[ZnEDTA] concentrations at 0, 6, 12, 18, and 24 g/L on surface morphology, chemical composition, degradation resistance, and in vitro cytocompatibility of micro-arc oxidation (MAO) coatings developed on WE43 (Mg-Y-Nd-Zr) magnesium alloys. The results show that the enhanced Na2[ZnEDTA] concentration increased the Zn amount but slightly decreased the degradation resistance of MAO-treated coatings. Among the zinc-containing MAO samples, the fabricated sample in the base solution added 6 g/L Na2[ZnEDTA] exhibits the smallest corrosion current density (6.84 × 10-7 A·cm-2), while the sample developed in the solution added 24 g/L Na2[ZnEDTA] and contains the highest Zn content (3.64 wt.%) but exhibits the largest corrosion current density (1.39 × 10-6 A·cm-2). Compared to untreated WE43 magnesium alloys, zinc-containing MAO samples promote initial cell adhesion and spreading and reveal enhanced cell viability. Coating degradation resistance plays a more important role in osseogenic ability than Zn content. Among the untreated WE43 magnesium alloys and the treated MAO samples, the sample developed in the base solution with 6 g/L Na2[ZnEDTA] reveals the highest ALP expression at 14 d. Our results indicate that the MAO samples formed in the solution with Na2[ZnEDTA] promoted degradation resistance and osseogenesis differentiation of the WE43 magnesium alloys, suggesting potential clinic applications.

Modification of titanium orthopedic implants with bioactive glass: a systematic review of in vivo and in vitro studies

Bioactive glasses (BGs) are ideal biomaterials in the field of bio-restoration due to their excellent biocompatibility. Titanium alloys are widely used as a bone graft substitute material because of their excellent corrosion resistance and mechanical properties; however, their biological inertness makes them prone to clinical failure. Surface modification of titanium alloys with bioactive glass can effectively combine the superior mechanical properties of the substrate with the biological properties of the coating material. In this review, the relevant articles published from 2013 to the present were searched in four databases, namely, Web of Science, PubMed, Embase, and Scopus, and after screening, 49 studies were included. We systematically reviewed the basic information and the study types of the included studies, which comprise in vitro experiments, animal tests, and clinical trials. In addition, we summarized the applied coating technologies, which include pulsed laser deposition (PLD), electrophoretic deposition, dip coating, and magnetron sputtering deposition. The superior biocompatibility of the materials in terms of cytotoxicity, cell activity, hemocompatibility, anti-inflammatory properties, bioactivity, and their good bioactivity in terms of osseointegration, osteogenesis, angiogenesis, and soft tissue adhesion are discussed. We also analyzed the advantages of the existing materials and the prospects for further research. Even though the current research status is not extensive enough, it is still believed that BG-coated Ti implants have great clinical application prospects.

Surface antibacterial properties enhanced through engineered textures and surface roughness: A review

The spread of bacteria through contaminated surfaces is a major issue in healthcare, food industry, and other economic sectors. The widespread use of antibiotics is not a sustainable solution in the long term due to the development of antibiotic resistance. Therefore, surfaces with antibacterial properties have the potential to be a disruptive approach to combat microbial contamination. Different methods and approaches have been studied to impart or enhance antibacterial properties on surfaces. The surface roughness and texture are inherent parameters that significantly impact the antibacterial properties of a surface. They are also directly related to the previously employed machining and treatment methods. This review article discusses the correlation between surface roughness and antibacterial properties is presented and discussed. It begins with an introduction to the concepts of surface roughness and texture, followed by a description of the most commonly utilized machining methods and surface. A thorough analysis of bacterial adhesion and growth is then presented. Finally, the most recent studies in this research area are comprehensively reviewed. The studies are sorted and classified based on the utilized machining and treatment methods, which are divided into mechanical processes, surface treatments and coatings. Through the systematic review and record of the recent advances, the authors aim to assist and promote further research in this very promising and extremely important direction, by providing a systematic review of recent advances.

The race for the optimal antimicrobial surface: perspectives and challenges related to plasma electrolytic oxidation coating for titanium-based implants

Plasma electrolytic oxidation (PEO) is a low-cost, structurally reliable, and environmentally friendly surface modification method for orthopedic and dental implants. This technique is successful for the formation of porous, corrosion-resistant, and bioactive coatings, besides introducing antimicrobial compounds easily. Given the increase in implant-related infections, antimicrobial PEO-treated surfaces have been widely proposed to surmount this public health concern. This review comprehensively discusses antimicrobial implant surfaces currently produced by PEO in terms of their in vitro and in vivo microbiological and biological properties. We present a critical [part I] and evidence-based [part II] review about the plethora of antimicrobial PEO-treated surfaces. The mechanism of microbial accumulation on implanted devices and the principles of PEO technology to ensure antimicrobial functionalization by one- or multi-step processes are outlined. Our systematic literature search showed that particular focus has been placed on the metallic and semi-metallic elements incorporated into PEO surfaces to facilitate antimicrobial properties, which are often dose-dependent, without leading to cytotoxicity in vitro. Meanwhile, there are concerns over the biocompatibility of PEO and its long-term antimicrobial effects in animal models. We clearly highlight the importance of using clinically relevant infection models and in vivo long-term assessments to guarantee the rational design of antimicrobial PEO-treated surfaces to identify the 'finish line' in the race for antimicrobial implant surfaces.

Study on Enhancing the Corrosion Resistance and Photo-Thermal Antibacterial Properties of the Micro-Arc Oxidation Coating Fabricated on Medical Magnesium Alloy

Photo-thermal antibacterial properties have attracted much attention in the biomedical field because of their higher antibacterial efficiency. Through fabricating micro-arc oxidation coatings with different treating current densities set on a Mg-Zn-Ca alloy, the present study tried to systematically investigate and optimize the corrosion resistance and photo-thermal antibacterial properties of MAO coatings. The results indicated that different current densities had great influence on the corrosion resistance and photo-thermal property of the MAO coatings, and a current density at 30 A·dm–2 exhibited the best corrosion resistance, light absorption capacity at 808 nm, and photo-thermal capability, simultaneously with good antibacterial activity against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coil). This photo-thermal property of MAO coatings was probably related to the effect of current density on MgO content in the coating that could promote the separation of photo-generated electron carriers and hinder the recombination of photo-generated electron carriers and holes.

A Decade of Progress on MAO-Treated Tantalum Surfaces: Advances and Contributions for Biomedical Applications

Micro-structured coatings with functional properties have been investigated due to a wide range of applications. It is known that micro-structures can play an important role in surface interactions determining the materials’ performance. Amongst the other materials, there has been an increasing interest in tantalum oxide (Ta₂O₅). This attention is mainly due to its variety of properties: biocompatibility and bioactivity; high dielectric constant; good thermal and chemical stability; excellent corrosion and mechanical resistance. Moreover, there is a wide range of applications in which the properties can be fitted. Furthermore, according to the final application, these properties can be enhanced or tailored through surface micro-structures manipulation. Due to this purpose, over the past decade, Ta surface modification by micro-arc oxidation (MAO) has been investigated mostly for biomedical applications. Therefore, this review focuses on Ta surface functionalization using the MAO technique. A clear understanding of the micro-discharge phenomena and the formation mechanism of a Ta₂O₅ anodic coating by MAO is supplied. The Ta₂O₅ coating morphology, topography, chemistry, and structure are explored, establishing their correlation with the MAO parameters. Additionally, an understanding of Ta₂O₅’s biological, mechanical, and electrochemical properties is provided and reviewed.

Antimicrobial coating strategy to prevent orthopaedic device-related infections: recent advances and future perspectives

The rapid development of multidrug-resistant (MDR) bacteria and biofilm-related infections (BRIs) has urgently called for new strategies to combat severe orthopaedic device-related infections (ODRIs). Antimicrobial coating has emerged as a promising strategy in halting the incidence of ODRIs and treating ODRIs in long term. With the advancement of material science and biotechnology, numerous antimicrobial coatings have been reported in literature, showing superior antimicrobial and osteogenic functions. This review has specifically discussed the currently developed antimicrobial coatings in the perspective of drug release from the coating system, focusing on their realization of controlled and on demand antimicrobial agents release, as well as multi-functionality. Acknowledging the multidisciplinary nature of antimicrobial coating, the conceptual design, the deposition method and the therapeutic effect of the antimicrobial coatings have been described in detail and discussed critically. Particularly, the challenges and opportunities on the way toward the clinical translation of antimicrobial coatings have been highlighted.

Formation of a ZnO nanorods-patterned coating with strong bactericidal capability and quantitative evaluation of the contribution of nanorods-derived puncture and ROS-derived killing

To endow Ti-based orthopedic implants with strong bactericidal activity, a ZnO nanorods-patterned coating (namely ZNR) was fabricated on Ti utilizing a catalyst- and template-free method of micro-arc oxidation (MAO) and hydrothermal treatment (HT). The coating comprises an outer layer of ZnO nanorods and a partially crystallized inner layer with nanocrystalline TiO₂ and Zn₂TiO₄ embedded amorphous matrix containing Ti, O and Zn. During HT, Zn²⁺ ions contained in amorphous matrix of the as-MAOed layer migrate to surface and react with OH⁻ in hydrothermal solution to form ZnO nuclei growing in length at expense of the migrated Zn²⁺. ZNR exhibits intense bactericidal activity against the adhered and planktonic S. aureus in vitro and in vivo. The crucial contributors to kill the adhered bacteria are ZnO nanorods derived mechano-penetration and released reactive oxygen species (ROS). Within 30 min of S. aureus incubation, ROS is the predominant bactericidal contributor with quantitative contribution value of ∼20%, which transforms into mechano-penetration with prolonging time to reach quantitative contribution value of ∼96% at 24 h. In addition, the bactericidal contributor against the planktonic bacteria of ZNR is relied on the released Zn²⁺. This work discloses an in-depth bactericidal mechanism of ZnO nanorods.

(1)

A templates and catalysts-free method is used to fabricate ZnO nanorods on Ti

(2)

ZnO nanorods-arrayed coating shows intense broad-spectrum bactericidal activity

(3)

Main bactericidal contributor of ZnO nanorods to adhered bacteria is mechano-puncture

(4)

Main bactericidal contributor of ZnO nanorods to planktonic bacteria is released Zn²⁺

Surface modification and antibacterial properties of superelastic Ti-Zr-based alloys for medical application

To date, significant progress has been achieved in the development of biomedical superelastic Ti-based alloys with high mechanical properties. In view of the high probability of implant-associated infection, an urgent task is to impart bactericidal properties to the material. Herein, advanced superelastic Ti-18Zr-15Nb alloys were surface-etched in a piranha solution, and then Ag nanoparticles were deposited on their surface using a polyol process. This led to the formation of a porous surface layer with a thickness of approximately 100 nm and pore size of less than 20 nm, filled with metallic Ag nanoparticles with an average size of 14 nm. The surface-modified samples showed superior antibacterial activity against E.coli cells. The enhanced bactericidal efficiency is explained by the combination of a higher rate of Ag⁺ ions release and direct contact of E.coli cells with Ag nanoparticles.

Zn-Doped CaP-Based Coatings on Ti–6Al–4V and Ti–6Al–7Nb Alloys Prepared by Magnetron Sputtering: Controllable Biodegradation, Bacteriostatic, and Osteogenic Activities

New TiNb-based alloys, such as Ti–6Al–7Nb, are currently being studied around the world as an alternative to other Ti alloys, e.g., instead of Ti–6Al–4V. We conducted a pilot study where thin (approximately 1.2 micron) CaP coatings containing low doses of Zn2+ (0.4–0.8 wt.%) were prepared by the radio frequency magnetron sputtering (RFMS) of Zn-hydroxyapatite (HA) target on Ti–6Al–4V and Ti–6Al–7Nb substrates and investigated their physicochemical properties, in vitro solubility, cytotoxicity, and antibacterial and osteogenic activities. The thickness of the obtained coatings was approximately 1.2–1.3 microns. Zn substitution did not result in roughness or structural or surface changes in the amorphous CaP coatings. The distributions of Ca, P, and Zn were homogeneous across the film thickness as shown by the EDX mapping of these elements. Zn doping of CaP coatings on both types of Ti-based alloys statistically influenced the results of the scratch-test. However, obtained values are satisfactory to use Zn-CaP coatings on biomedical implants. Increased Zn2+ release vs. tapered output of Ca and phosphate ions occurred during 5 weeks of an in vitro immersion test in 0.9% NaCl solution. Ti–6Al–7Nb alloy, unlike Ti–6Al–4V, promoted more linear biodegradation of CaP coatings in vitro. As a result, CaP-based surfaces on Ti–6Al–7Nb, compared with on Ti–6Al–4V alloy, augmented the total areas of Alizarin red staining in a 21-day culture of human adipose-derived mesenchymal stem cells in a statistically significant manner. Moreover, Zn–CaP coatings statistically reduced leukemic Jurkat T cell survival within 48 h of in vitro culture. Along with the higher solubility of the Zn–CaP surface, a greater reduction (4- to 5.5-fold) in Staphylococcus aureus growth was observed in vitro when 7-day extracts of the coatings were added into the microbial culture. Hence, Zn–CaP-coated Ti–6Al–7Nb alloy with controllable biodegradation as prepared by RFMS is a prospective material suitable for bone applications in cases where there is a risk of bacterial contamination with severe consequences, for example, in leukemic patients. Further research is needed to closely investigate the mechanical features and pathways of their solubility and antimicrobial, antitumor, and osteogenic activities.

Amorphous-Crystalline Calcium Phosphate Coating Promotes In Vitro Growth of Tumor-Derived Jurkat T Cells Activated by Anti-CD2/CD3/CD28 Antibodies

A modern trend in traumatology, orthopedics, and implantology is the development of materials and coatings with an amorphous-crystalline structure that exhibits excellent biocopatibility. The structure and physico-chemical and biological properties of calcium phosphate (CaP) coatings deposited on Ti plates using the micro-arc oxidation (MAO) method under different voltages (200, 250, and 300 V) were studied. Amorphous, nanocrystalline, and microcrystalline statesof CaHPO4 and β-Ca2P2O7 were observed in the coatings using TEM and XRD. The increase in MAO voltage resulted in augmentation of the surface roughness Ra from 2.5 to 6.5 µm, mass from 10 to 25 mg, thickness from 50 to 105 µm, and Ca/P ratio from 0.3 to 0.6. The electrical potential (EP) of the CaP coatings changed from -456 to -535 mV, while the zeta potential (ZP) decreased from -53 to -40 mV following an increase in the values of the MAO voltage. Numerous correlations of physical and chemical indices of CaP coatings were estimated. A decrease in the ZP magnitudes of CaP coatings deposited at 200-250 V was strongly associated with elevated hTERT expression in tumor-derived Jurkat T cells preliminarily activated with anti-CD2/CD3/CD28 antibodies and then contacted in vitro with CaP-coated samples for 14 days. In turn, in vitro survival of CD4+ subsets was enhanced, with proinflammatory cytokine secretion of activated Jurkat T cells. Thus, the applied MAO voltage allowed the regulation of the physicochemical properties of amorphous-crystalline CaP-coatings on Ti substrates to a certain extent. This method may be used as a technological mechanism to trigger the behavior of cells through contact with micro-arc CaP coatings. The possible role of negative ZP and Ca2+ as effectors of the biological effects of amorphous-crystalline CaP coatings is discussed. Micro-arc CaP coatings should be carefully tested to determine their suitability for use in patients with chronic lymphoid malignancies.

Plasma Electrolytic Oxidation (PEO) Process-Processing, Properties, and Applications

Plasma electrolytic oxidation (PEO) is a novel surface treatment process to produce thick, dense metal oxide coatings, especially on light metals, primarily to improve their wear and corrosion resistance. The coating manufactured from the PEO process is relatively superior to normal anodic oxidation. It is widely employed in the fields of mechanical, petrochemical, and biomedical industries, to name a few. Several investigations have been carried out to study the coating performance developed through the PEO process in the past. This review attempts to summarize and explain some of the fundamental aspects of the PEO process, mechanism of coating formation, the processing conditions that impact the process, the main characteristics of the process, the microstructures evolved in the coating, the mechanical and tribological properties of the coating, and the influence of environmental conditions on the coating process. Recently, the PEO process has also been employed to produce nanocomposite coatings by incorporating nanoparticles in the electrolyte. This review also narrates some of the recent developments in the field of nanocomposite coatings with examples and their applications. Additionally, some of the applications of the PEO coatings have been demonstrated. Moreover, the significance of the PEO process, its current trends, and its scope of future work are highlighted.

Zinc- and strontium- co-incorporated nanorods on titanium surfaces with favorable material property, osteogenesis, and enhanced antibacterial activity

Early infection and peri-implantitis after implant restoration are major reasons for dental implant failure. Implant-associated infections are majorly attributed to biofilm formation. In this study, co-incorporated zinc- (Zn-) and strontium- (Sr-) nanorod coating on sandblasted and acid-etched (SLA) titanium (SLA-Zn/Sr) was fabricated by hydrothermal synthesis. It was aimed at promoting osteogenesis while inhibiting biofilm formation. The nanorod-like particles (φ 30-50 nm) were found to be evenly formed on SLA-Zn/Sr (Zn: 1.49 ± 0.16 wt%; Sr: 21.69 ± 2.74 wt%) that was composed of well-crystallized ZnTiO₃ and SrTiO₃ phases. With a sufficient interface bonding strength (42.00 ± 3.00 MPa), SLA-Zn/Sr enhanced the corrosion resistance property of titanium. Besides, SLA-Zn/Sr promoted the cellular initial adhesion, proliferation and osteogenic differentiation of rBMSCs in vitro while inhibiting the adhesion of Staphylococcus aureus and Porphyromonas gingivalis . In addition, through down-regulating icaA gene expression, this novel surface reduced the secretion of polysaccharide intercellular adhesion (reduced by 87.9% compared to SLActive) to suppress the S. aureus biofilm formation. We, therefore, propose a new chemical modification on titanium for multifunctional implant material development. Due to the Zn/Sr co-doping in coating, material properties, early osteogenic effect and antibacterial ability of titanium can be simultaneously enhanced, which has the potential to be applied in dental implantation in the future.

Antibacterial Titanium Implants Biofunctionalized by Plasma Electrolytic Oxidation with Silver, Zinc, and Copper: A Systematic Review

Patients receiving orthopedic implants are at risk of implant-associated infections (IAI). A growing number of antibiotic-resistant bacteria threaten to hamper the treatment of IAI. The focus has, therefore, shifted towards the development of implants with intrinsic antibacterial activity to prevent the occurrence of infection. The use of Ag, Cu, and Zn has gained momentum as these elements display strong antibacterial behavior and target a wide spectrum of bacteria. In order to incorporate these elements into the surface of titanium-based bone implants, plasma electrolytic oxidation (PEO) has been widely investigated as a single-step process that can biofunctionalize these (highly porous) implant surfaces. Here, we present a systematic review of the studies published between 2009 until 2020 on the biomaterial properties, antibacterial behavior, and biocompatibility of titanium implants biofunctionalized by PEO using Ag, Cu, and Zn. We observed that 100% of surfaces bearing Ag (Ag-surfaces), 93% of surfaces bearing Cu (Cu-surfaces), 73% of surfaces bearing Zn (Zn-surfaces), and 100% of surfaces combining Ag, Cu, and Zn resulted in a significant (i.e., >50%) reduction of bacterial load, while 13% of Ag-surfaces, 10% of Cu-surfaces, and none of Zn or combined Ag, Cu, and Zn surfaces reported cytotoxicity against osteoblasts, stem cells, and immune cells. A majority of the studies investigated the antibacterial activity against S. aureus. Important areas for future research include the biofunctionalization of additively manufactured porous implants and surfaces combining Ag, Cu, and Zn. Furthermore, the antibacterial activity of such implants should be determined in assays focused on prevention, rather than the treatment of IAIs. These implants should be tested using appropriate in vivo bone infection models capable of assessing whether titanium implants biofunctionalized by PEO with Ag, Cu, and Zn can contribute to protect patients against IAI.

Use of Plasma Technologies for Antibacterial Surface Properties of Metals

Bacterial infections of medical devices present severe problems connected with long-term antibiotic treatment, implant failure, and high hospital costs. Therefore, there are enormous demands for innovative techniques which would improve the surface properties of implantable materials. Plasma technologies present one of the compelling ways to improve metal's antibacterial activity; plasma treatment can significantly alter metal surfaces' physicochemical properties, such as surface chemistry, roughness, wettability, surface charge, and crystallinity, which all play an important role in the biological response of medical materials. Herein, the most common plasma treatment techniques like plasma spraying, plasma immersion ion implantation, plasma vapor deposition, and plasma electrolytic oxidation as well as novel approaches based on gaseous plasma treatment of surfaces are gathered and presented. The latest results of different surface modification approaches and their influence on metals' antibacterial surface properties are presented and critically discussed. The mechanisms involved in bactericidal effects of plasma-treated surfaces are discussed and novel results of surface modification of metal materials by highly reactive oxygen plasma are presented.

Plasma-activated interfaces for biomedical engineering

As an important phenomenon to monitor disease development, cell signaling usually takes place at the interface between organisms/cells or between organisms/cells and abiotic materials. Therefore, finding a strategy to build the specific biomedical interfaces will help regulate information transmission and produce better therapeutic results to benefit patients. In the past decades, plasmas containing energetic and active species have been employed to construct various interfaces to meet biomedical demands such as bacteria inactivation, tissue regeneration, cancer therapy, and so on. Based on the potent functions of plasma modified surfaces, this mini-review is aimed to summarize the state-of-art plasma-activated interfaces and provide guidance to researchers to select the proper plasma and processing conditions to design and prepare interfaces with the optimal biological and related functions. After a brief introduction, plasma-activated interfaces are described and categorized according to different criteria including direct plasma-cells interfaces and indirect plasma-material-cells interfaces and recent research activities on the application of plasma-activated interfaces are described. The authors hope that this mini-review will spur interdisciplinary research efforts in this important area and expedite associated clinical applications.

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The Interfaces between organisms/cells and abiotic materials are crucial for cell signaling.

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Plasmas containing energetic and active species are potent tool to construct biomedical interfaces.

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The objective here is to summarize recent plasma-activated interfaces to spur interdisciplinary efforts for clinical applications.

Gene Expression Regulation and Secretory Activity of Mesenchymal Stem Cells upon In Vitro Contact with Microarc Calcium Phosphate Coating

The manufacture of biomaterial surfaces with desired physical and chemical properties that can directly induce osteogenic differentiation without the need for biochemical additives is an excellent strategy for controlling the behavior of mesenchymal stem cells (MSCs) in vivo. We studied the cellular and molecular reactions of MSCs to samples with a double-sided calcium phosphate (CaP) coating and an average roughness index (Ra) of 2.4-4.6 µm. The study aimed to evaluate the effect of a three-dimensional matrix on the relative mRNA expression levels of genes associated with the differentiation and maturation of MSCs toward osteogenesis (RUNX2, BMP2, BMP6, BGLAP, and ALPL) under conditions of distant interaction in vitro. Correlations were revealed between the mRNA expression of some osteogenic and cytokine/chemokine genes and the secretion of cytokines and chemokines that may potentiate the differentiation of cells into osteoblasts, which indicates the formation of humoral components of the extracellular matrix and the creation of conditions supporting the establishment of hematopoietic niches.

Zn- or Cu-containing CaP-Based Coatings Formed by Micro-Arc Oxidation on Titanium and Ti-40Nb Alloy: Part II-Wettability and Biological Performance

This work describes the wettability and biological performance of Zn- and Cu-containing CaP-based coatings prepared by micro-arc oxidation on pure titanium (Ti) and novel Ti-40Nb alloy. Good hydrophilic properties of all the coatings were demonstrated by the low contact angles with liquids, not exceeding 45°. An increase in the applied voltage led to an increase of the coating roughness and porosity, thereby reducing the contact angles to 6° with water and to 17° with glycerol. The free surface energy of 75 ± 3 mJ/m² for all the coatings were determined. Polar component was calculated as the main component of surface energy, caused by the presence of strong polar PO₄³⁻ and OH⁻ bonds. In vitro studies showed that low Cu and Zn amounts (~0.4 at.%) in the coatings promoted high motility of human adipose-derived multipotent mesenchymal stromal cells (hAMMSC) on the implant/cell interface and subsequent cell ability to differentiate into osteoblasts. In vivo study demonstrated 100% ectopic bone formation only on the surface of the CaP coating on Ti. The Zn- and Cu-containing CaP coatings on both substrates and the CaP coating on the Ti-40Nb alloy slightly decreased the incidence of ectopic osteogenesis down to 67%. The MAO coatings showed antibacterial efficacy against Staphylococcus aureus and can be arranged as follows: Zn-CaP/Ti > Cu-CaP/TiNb, Zn-CaP/TiNb > Cu-CaP/Ti.

Metal Ions Supported Porous Coatings by Using AC Plasma Electrolytic Oxidation Processing

Coatings enriched with zinc and copper as well as calcium or magnesium, fabricated on titanium substrate by Plasma Electrolytic Oxidation (PEO) under AC conditions (two cathodic voltages, i.e., -35 or -135 V, and anodic voltage of +400 V), were investigated. In all experiments, the electrolytes were based on concentrated orthophosphoric acid (85 wt%) and zinc, copper, calcium and/or magnesium nitrates. It was found that the introduced calcium and magnesium were in the ranges 5.0-5.4 at% and 5.6-6.5 at%, respectively, while the zinc and copper amounts were in the range of 0.3-0.6 at%. Additionally, it was noted that the metals of the block S (Ca and Mg) could be incorporated into the structure about 13 times more than metals of the transition group (Zn and Cu). The incorporated metals (from the electrolyte) into the top-layer of PEO phosphate coatings were on their first (Cu⁺) or second (Cu²⁺, Ca²⁺ and Mg²⁺) oxidation states. The crystalline phases (TiO and Ti₃O) were detected only in coatings fabricated at cathodic voltage of -135 V. It has also been pointed that fabricated porous calcium-phosphate coatings enriched with biocompatible magnesium as well as with antibacterial zinc and copper are dedicated mainly to medical applications. However, their use for other applications (e.g., catalysis and photocatalysis) after additional functionalizations is not excluded.

Effect of the Porosity, Roughness, Wettability, and Charge of Micro-Arc Coatings on the Efficiency of Doxorubicin Delivery and Suppression of Cancer Cells

Porous calcium phosphate coatings were formed by the micro-arc oxidation method on the surface of titanium for the loading and controlled release of the anticancer drug doxorubicin. The coatings’ morphology and microstructure were examined by scanning electron microscopy. The phase composition was determined with the help of X-ray diffraction analysis. Studies of the hydrophilic properties of the coatings and their zeta potential were carried out. Data on the kinetics of doxorubicin adsorption-desorption were obtained. In addition, the effect of calcium phosphate coatings impregnated with doxorubicin on the viability of the Neuro-2a cell line was revealed. The coating formed at low voltages of 200–250 V contained a greater number of branched communicating pores, and therefore they were able to adsorb a greater amount of doxorubicin. The surface charge also contributes to the process of the adsorption-desorption of doxorubicin, but this effect is not fully understood and further studies are required to identify it.

Synthesis of bioactive glass-based coating by plasma electrolytic oxidation: Untangling a new deposition pathway toward titanium implant surfaces

HYPOTHESIS

Although bioactive glass (BG) particle coatings were previously developed by different methods, poor particle adhesion to surfaces and reduced biological effects because of glass crystallization have limited their biomedical applications. To overcome this problem, we have untangled, for the first time, plasma electrolytic oxidation (PEO) as a new pathway for the synthesis of bioactive glass-based coating (PEO-BG) on titanium (Ti) materials.

EXPERIMENTS

Electrolyte solution with bioactive elements (Na₂SiO₃-5H₂O, C₄H₆O₄Ca, NaNO₃, and C₃H₇Na₂O₆P) was used as a precursor source to obtain a 45S5 bioglass-like composition on a Ti surface by PEO. Subsequently, the PEO-BG coating was investigated with respect to its surface, mechanical, tribological, electrochemical, microbiological, and biological properties, compared with those of machined and sandblasted/acid-etched control surfaces.

FINDINGS

PEO treatment produced a coating with complex surface topography, Ti crystalline phases, superhydrophilic status, chemical composition, and oxide layer similar to that of 45S5-BG (~45.0Si, 24.5 Ca, 24.5Na, 6.0P w/v%). PEO-BG enhanced Ti mechanical and tribological properties with higher corrosion resistance. Furthermore, PEO-BG had a positive influence in polymicrobial biofilms, by reducing pathogenic bacterial associated with biofilm-related infections. PEO-BG also showed higher adsorption of blood plasma proteins without cytotoxic effects on human cells, and thus may be considered a promising biocompatible approach for biomedical implants.

Plasma Electrolytic Oxidation as a Feasible Surface Treatment for Biomedical Applications: an in vivo study

OBJECTIVES

In this in vivo animal study, we evaluated the effect of plasma electrolytic oxidation (PEO) coating on the topographic and biological parameters of implants installed in rats with induced osteoporosis and low-quality bones.

MATERIALS AND METHODS

In total 44 Wistar rats (Rattus novergicus), 6 months old, were submitted to ovariectomy (OXV group) and dummy surgery (SHAM group). After 90 days, the ELISA test was performed and the ovariectomy effectiveness was confirmed. In each tibial metaphysis, an implant with PEO coating containing Ca²⁺ and P⁵⁺ molecules were installed, and the other tibia received an implant with SLA acid etching and blasting (AC) (control surface). After 42 days, 16 rats from each group were euthanized, their tibias were removed for histological and immunohistochemical analysis (OPG, RANKL, OC and TRAP), as well as reverse torque biomechanics. Data were submitted to One-way ANOVA or Kruskal-Wallis tests, followed by a Tukey post-test; P < 0.05. Histological analyses showed higher bone neoformation values among the members of the PEO group, SHAM and OVX groups. Immunohistochemical analysis demonstrated equilibrium in all groups when comparing surfaces for TRAP, OC and RANKL (P > 0.05), whereas OPG showed higher PEO labeling in the OVX group (P < 0.05). Biomechanical analysis showed higher reverse torque values (N.cm) for PEO, irrespective of whether they were OVX or SHAM groups (P < 0.05).

CONCLUSION

The results indicated that the PEO texturing method favored bone formation and showed higher bone maturation levels during later periods in osteoporotic rats.

ROS induced bactericidal activity of amorphous Zn-doped titanium oxide coatings and enhanced osseointegration in bacteria-infected rat tibias

Titanium-based endosseous implants with high antibacterial and osseointegration activities are extremely required in clinics. To achieve this line, herein the doped coatings with three kinds of Zn doses were micro-arc oxidized (MAOed) on Ti. They were examined to reveal a bilayered structure, in which the outer layer consisted completely of the amorphism comprising elements of Ti, O and Zn with Zn doped in the form of weaken Zn-O bonds, and the underlying layer was partially crystallized with nanocrystalline TiO₂ and Zn₂TiO₄ to embed an amorphous matrix. While the Zn doped doses of the surface amorphous layers increased with elevating the MAOed voltages, the weaken Zn-O bonds in the amorphism were identified to act as both the contributor of Zn²⁺ controllable release and the generator of reactive oxide species (ROS) on the coatings. The enhanced HO• and O₂^-• formation on the elevated voltage MAOed coatings caused serious break of the cell walls and plasma membranes of S. aureus. In parallel, the enhanced Zn²⁺ release and extracellular H₂O₂ formation led to the enhanced intracellular ROS level of S. aureus, further aggravating the damage of plasma membrane, resulting in bacteria death. On contrary to the overdose of Zn doped coating, the moderate doses of Zn doped coatings did not induce additional intracellular ROS and attenuate viability and proliferation of osteoblasts in vitro, and promoted osseointegration in both S. aureus-uninfected and infected rat tibias, which ascribed to the strong antibacterial activity and un-attenuated cell function of the coatings in the infected case. STATEMENT OF SIGNIFICANCE: (1) The Zn-doped coatings revealed a bilayered structure of the surface layer comprising the Ti, O and Zn constructed amorphism with Zn in the form of weaken Zn-O bonds, and the underlying layer comprising nanocrystalline TiO₂ and Zn₂TiO₄ to embed amorphous matrix. (2) The weaken Zn-O bonds in the amorphism were identified to act as both the contributor of Zn²⁺ controllable release and the generator of ROS on the coatings. (3) The enhanced Zn²⁺ release and ROS formation on the coatings killed S. aureus by inducing serious break of their cell walls and plasma membranes. This effect in combination of un-attenuated osteoblast proliferation endowed the moderate Zn doped coatings with enhanced osseointegration in S. aureus-infected rat tibias.

Modification of titanium surface via Ag-, Sr- and Si-containing micro-arc calcium phosphate coating

The current research is devoted to the study of the modification of the titanium implants by the micro-arc oxidation with bioactive calcium phosphate coatings containing Ag or Sr and Si elements. The coatings' microstructure, phase composition, morphology, physicochemical and biological properties were examined by scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD). Ag-containing and Sr-Si-incorporated coatings were formed in alkaline and acid electrolytes, respectively. The formation of the coatings occurred at different ranges of the applied voltages, which led to the significant difference in the coatings properties. The trace elements Ag, Sr and Si participated intensively in the plasma-chemical reactions of the micro-arc coatings formation. Ag-containing coatings demonstrated strong antibacterial effect against Staphylococcus aureus AТСС 6538-P. MTT in vitro test with 3T3-L1 fibroblasts showed no cytotoxicity appearance on Sr-Si-incorporated coatings.

Mechanical, antibacterial, and biocompatibility mechanism of PVD grown silver-tantalum-oxide-based nanostructured thin film on stainless steel 316L for surgical applications

Surgical site infection associated with surgical instruments has always been a factor in delaying post-operative recovery of patients. The evolution in surface modification of surgical instruments can be a potential choice to overcome the nosocomial infection mainly caused by bacterial populations such as Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. A study was, therefore, conducted characterising the morphology, hydrophobicity, adhesion strength, phase, Nano-hardness, surface chemistry, antimicrobial and biocompatibility of SS 316L steel deposited with a Nano-composite layer of Silver (Ag) and Tantalum oxide (Ta₂O₅) using physical vapour deposition magnetron sputtering. The adhesion strength of Ag/AgTa₂O₅ coating on SS 316L and treated at 250-850 °C of thermal treatment was evaluated using micro-scratch. The Ag/Ag-Ta₂O₅-400 °C was shown a 154% improvement in adhesion strength on SS 316L when compared with as-sputtered layer or Ag/Ag-Ta₂O₅-250, 550, 700 and 850 °C. The FESEM, XPS, and XRD indicated the segregation of Ag on the surface of SS 316L after the crystallization. Wettability and Nano-indentation tests demonstrated an increase in hydrophobicity (77.3 ± 0.3°) and Nano-hardness (1.12 ± 0.43 GPa) when compared with as-sputtered layer, after the 400 °C of thermal treatment. The antibacterial performance on Ag/Ag-Ta₂O₅-400 °C indicated a significant zone of inhibition to Staphylococcus aureus (A-axis: 16.33 ± 0.58 mm; B-axis: 25.67 ± 0.58 mm, p < 0.01) and Escherichia coli (A-axis: 16.33 ± 1.15 mm; B-axis: 26.00 ± 0.00 mm, p < 0.01) when compared with SS 316L or Ag/Ag-Ta₂O₅-700 °C, which showed no inhibition. The biocompatibility tests on Ag/Ag-Ta₂O₅-400 °C demonstrated an excellent in cell attachment, F-actin protein expression and proliferation/viability of bone marrow derived mesenchymal stromal on day 14 when compared with uncoated or Ag/Ag-Ta₂O₅-700 °C. This study shows that the Ag segregation process, hydrophobicity, adhesion strength, crystallization, and hardness progressively improved after the annealing up to 400 °C.

A Novel Self-Adaptive Control Method for Plasma Electrolytic Oxidation Processing of Aluminum Alloys

Plasma electrolytic oxidation processing is a novel promising surface modification approach for various materials. However, its large-scale application is still restricted, mainly due to the problem of high energy consumption of the plasma electrolytic oxidation processing. In order to solve this problem, a novel intelligent self-adaptive control technology based on real-time active diagnostics and on the precision adjustment of the process parameters was developed. Both the electrical characteristics of the plasma electrolytic oxidation process and the microstructure of the coating were investigated. During the plasma electrolytic oxidation process, the discharges are maintained in the soft-sparking regime and the coating exhibits a good uniformity and compactness. A total specific energy consumption of 1.8 kW h m^-2 μm^-1 was achieved by using such self-adaptive plasma electrolytic oxidation processing on pre-anodized 6061 aluminum alloy samples.

Switchable Dual-Function and Bioresponsive Materials to Control Bacterial Infections

The colonization of undesired bacteria on the surface of devices used in biomedical and clinical applications has become a persistent problem. Different types of single-function (cell resistance or bactericidal) bioresponsive materials have been developed to cope with this problem. Even though these materials meet the basic requirements of many biomedical and clinical applications, dual-function (cell resistance and biocidal) bioresponsive materials with superior design and function could be better suited for these applications. The past few years have witnessed the emergence of a new class of dual-function materials that can reversibly switch between cell-resistance and biocidal functions in response to external stimuli. These materials are finding increased applications in biomedical devices, tissue engineering, and drug-delivery systems. This review highlights the recent advances in design, structure, and fabrication of dual-function bioresponsive materials and discusses translational challenges and future prospects for research involving these materials.

The Emerging Role of Gas Plasma in Oncotherapy

Atmospheric pressure gas plasmas are emerging as a promising treatment in cancer that can supplement the existing set of treatment modalities and, when combined with other therapies, enhance their selectivity and efficacy against resistant cancers. With further optimisation in production and administration of plasma treatment, plasma-enabled therapy has a strong potential to mature as a tool for selectively curing highly resistant solid tumours. Although intense preclinical studies have been conducted to exploit the unique traits of plasma as an oncotherapy, few clinical studies are underway. This review identifies types of cancers and patient groups that most likely benefit from plasma oncotherapy, to introduce clinical practitioners to plasma therapy and accelerate the speed of translating plasma for cancer control in clinics.

Potential antibacterial mechanism of silver nanoparticles and the optimization of orthopedic implants by advanced modification technologies

Infection, as a common postoperative complication of orthopedic surgery, is the main reason leading to implant failure. Silver nanoparticles (AgNPs) are considered as a promising antibacterial agent and always used to modify orthopedic implants to prevent infection. To optimize the implants in a reasonable manner, it is critical for us to know the specific antibacterial mechanism, which is still unclear. In this review, we analyzed the potential antibacterial mechanisms of AgNPs, and the influences of AgNPs on osteogenic-related cells, including cellular adhesion, proliferation, and differentiation, were also discussed. In addition, methods to enhance biocompatibility of AgNPs as well as advanced implants modifications technologies were also summarized.