New oxidation treatment of NiTi shape memory alloys to obtain Ni-free surfaces and to improve biocompatibility

Influence of Low Temperature Plasma Oxidizing on the Bioactivity of NiTi Shape Memory Alloy for Medical Applications

The present study elucidates the impact of glow discharge oxidation within a low-temperature plasma environment on the bioactivity characteristics of an NiTi shape memory alloy. The properties of the produced surface layers, such as structure (TEM observations), surface morphology (SEM observations), chemical and phase composition (EDS and XRD measurements), wettability (optical gonimeter), and the biological response of osteoblasts and platelets to the oxidized surface compared with the NiTi alloy without a surface layer are presented. The presented surface modification of the NiTi shape memory alloy, achieved through oxidizing in a low-temperature plasma environment, led to the creation of a continuous surface layer composed of nanocrystalline titanium oxide TiO2 (rutile). The findings obtained from this study provide evidence that the oxidized layer augments the bioactivity of the shape memory alloy. This augmentation was substantiated through the spontaneous biomimetic deposition of apatite from a simulated body fluid (SBF) solution. Furthermore, the modified surface exhibited improved osteoblast proliferation, and enhanced platelet adhesion and activation. This proposed surface modification strategy holds promise as a prospective solution to enhance the biocompatibility and bioactivity of NiTi shape memory alloy intended for prolonged use in bone implant applications.

3D printing metal implants in orthopedic surgery: Methods, applications and future prospects

Background

Currently, metal implants are widely used in orthopedic surgeries, including fracture fixation, spinal fusion, joint replacement, and bone tumor defect repair. However, conventional implants are difficult to be customized according to the recipient's skeletal anatomy and defect characteristics, leading to difficulties in meeting the individual needs of patients. Additive manufacturing (AM) or three-dimensional (3D) printing technology, an advanced digital fabrication technique capable of producing components with complex and precise structures, offers opportunities for personalization.

Methods

We systematically reviewed the literature on 3D printing orthopedic metal implants over the past 10 years. Relevant animal, cellular, and clinical studies were searched in PubMed and Web of Science. In this paper, we introduce the 3D printing method and the characteristics of biometals and summarize the properties of 3D printing metal implants and their clinical applications in orthopedic surgery. On this basis, we discuss potential possibilities for further generalization and improvement.

Results

3D printing technology has facilitated the use of metal implants in different orthopedic procedures. By combining medical images from techniques such as CT and MRI, 3D printing technology allows the precise fabrication of complex metal implants based on the anatomy of the injured tissue. Such patient-specific implants not only reduce excessive mechanical strength and eliminate stress-shielding effects, but also improve biocompatibility and functionality, increase cell and nutrient permeability, and promote angiogenesis and bone growth. In addition, 3D printing technology has the advantages of low cost, fast manufacturing cycles, and high reproducibility, which can shorten patients' surgery and hospitalization time. Many clinical trials have been conducted using customized implants. However, the use of modeling software, the operation of printing equipment, the high demand for metal implant materials, and the lack of guidance from relevant laws and regulations have limited its further application.

Conclusions

There are advantages of 3D printing metal implants in orthopedic applications such as personalization, promotion of osseointegration, short production cycle, and high material utilization. With the continuous learning of modeling software by surgeons, the improvement of 3D printing technology, the development of metal materials that better meet clinical needs, and the improvement of laws and regulations, 3D printing metal implants can be applied to more orthopedic surgeries.

The translational potential of this paper

Precision, intelligence, and personalization are the future direction of orthopedics. It is reasonable to believe that 3D printing technology will be more deeply integrated with artificial intelligence, 4D printing, and big data to play a greater role in orthopedic metal implants and eventually become an important part of the digital economy. We aim to summarize the latest developments in 3D printing metal implants for engineers and surgeons to design implants that more closely mimic the morphology and function of native bone.

Effect of Stabilized Martensite on the Long-Term Performance of Superelastic NiTi Endodontic Files

One of the most used rotary files in endodontics is NiTi files due to their superelastic properties. This property means that this instrument has extraordinary flexion that can adapt to large angles inside the tooth canals. However, these files lose their superelasticity and fracture during use. The aim of this work is to determine the cause of fracture of the endodontic rotary files. For this purpose, 30 NiTi F6 SkyTaper^® files (Komet, Germany) were used. Their chemical composition was determined by X-ray microanalysis, and their microstructure was determined by optical microscopy. Successive drillings were carried out with artificial tooth molds at 30, 45, and 70°. These tests were carried out at a temperature of 37 °C with a constant load controlled by a high sensitivity dynamometer of 5.5 N, and every five cycles were lubricated with an aqueous solution of sodium hypochlorite. The cycles to fracture were determined, and the surfaces were observed by scanning electron microscopy. Transformation (austenite to martensite) and retransformation (martensite to austenite) temperatures and enthalpies were determined by Differential Scanning Calorimeter at different endodontic cycles. The results showed an original austenitic phase with a M_s temperature of 15 °C and A_f of 7 °C. Both temperatures increase with endodontic cycling, indicating that martensite forms at higher temperatures, and the temperature must be increased with cycling to retransform it to austenite. This fact indicates the stabilization of martensite with cycling, which is confirmed by the decrease in both transformation and retransformation enthalpies. The martensite is stabilized in the structure due to defects and does not retransform. This stabilized martensite has no superelasticity and, therefore, fractures prematurely. It has been possible to observe the stabilized martensite by studying the fractography, observing that the mechanism is by fatigue. The results showed that the files fracture earlier the greater the angle applied (for the tests at 70° at 280 s, at 45° at 385 s, and at 30° at 1200 s). As the angle increases, there is an increase in mechanical stress, and, therefore, the martensite stabilizes at lower cycles. To destabilize the martensite, a heat treatment can be carried out at 500 °C for 20 min, and the files recovers all its superelasticity.

Effect of oxidation at an elevated temperature on the evolution of phases, microstructure, and properties of the oxide films formed on the surface of TiZr

This study examined the evolution of the microstructure, microhardness, corrosion resistance, and selective leaching properties of oxide films formed on the surface of a Ti-50Zr (%) alloy during heat treatment at 600 °C for various time intervals. According to our experimental results, the growth and evolution of oxide films can be divided into three stages. In stage I (heat treatment for less than 2 min), ZrO₂ was first formed on the surface of the TiZr alloy, which slightly improved its corrosion resistance. In stage II (heat treatment for 2-10 min), the initially generated ZrO₂ is gradually transformed into ZrTiO₄ from the top to the bottom of the surface layer. The formation of ZrTiO₄ significantly improves the microhardness and corrosion resistance of the alloy. In stage III (heat treatment for more than 10 min), microcracks appeared and propagated on the surface of the ZrTiO₄ film, deteriorating the surface properties of the alloy. The ZrTiO₄ began to peel off after heat treatment for more than 60 min. The untreated and heat-treated TiZr alloys exhibited excellent selective leaching properties in Ringer's solution, whereas a trace amount of suspended ZrTiO₄ oxide particles formed in the solution after soaking the 60 min heat-treated TiZr alloy for 120 days. Surface modification of the TiZr alloy by generating an intact ZrTiO₄ oxide film effectively improved its microhardness and corrosion resistance; however, oxidation should be performed appropriately to obtain materials with optimal properties for biomedical applications.

Effect of Fluoride Content of Mouthwashes on the Metallic Ion Release in Different Orthodontics Archwires

Metal ion release studies were carried out on three of the most commonly used orthodontic wires in the clinic: austenitic stainless steel, Ti-Mo, and superelastic NiTi, using three mouthwashes with different fluoride concentrations: 130, 200, and 380 ppm. Immersions were carried out in these mouthwashes at 37 °C for 1, 4, 7, and 14 days, and the ions released were determined by inductively coupled plasma-mass spectrometry (ICP-MS). All wires were observed by scanning electron microscopy (SEM). The results showed a moderate ion release in the stainless steel wires, with nickel and chromium values of 500 and 1000 ppb in the worst conditions for the wires: concentrations of 380 ppm fluoride and 14 days of immersion. However, in the Ti-Mo and NiTi alloys, an abrupt change in release was observed when the samples were immersed in 380 ppm fluoride concentrations. Titanium releases in Ti-Mo wires reached 200,000 ppb, creating numerous pits on the surface. Under the same conditions, the release of Ni and Ti ions from the superelastic wires also exceeded 220,000 ppb and 180,000 ppb, respectively. This release of ions causes variations in the chemical composition of the wires, causing the appearance of martensite plates in the austenitic matrix after 4 days of immersion. This fact causes it to lose its superelastic properties at a temperature of 37 °C. In the case of immersion in 380 ppm mouthwashes for more than 7 days, rich-nickel precipitates can be seen. These embrittle the wire and lose all tooth-correcting properties. It should be noted that the release of Ni ions can cause hypersensitivity in patients, particularly women. The results indicate that the use of mouthwashes with a high content of fluoride should not be recommended with orthodontic archwires.

Additive Manufactured Magnesium-Based Scaffolds for Tissue Engineering

Additive manufacturing (AM) is an important technology that led to a high evolution in the manufacture of personalized implants adapted to the anatomical requirements of patients. Due to a worldwide graft shortage, synthetic scaffolds must be developed. Regarding this aspect, biodegradable materials such as magnesium and its alloys are a possible solution because the second surgery for implant removal is eliminated. Magnesium (Mg) exhibits mechanical properties, which are similar to human bone, biodegradability in human fluids, high biocompatibility, and increased ability to stimulate new bone formation. A current research trend consists of Mg-based scaffold design and manufacture using AM technologies. This review presents the importance of biodegradable implants in treating bone defects, the most used AM methods to produce Mg scaffolds based on powder metallurgy, AM-manufactured implants properties, and in vitro and in vivo analysis. Scaffold properties such as biodegradation, densification, mechanical properties, microstructure, and biocompatibility are presented with examples extracted from the recent literature. The challenges for AM-produced Mg implants by taking into account the available literature are also discussed.

Bacteriostatic Poly Ethylene Glycol Plasma Coatings for Orthodontic Titanium Mini-Implants

Titanium mini-implants are used as anchorage for orthodontic tooth movements. However, these implants present problems due to the infection of surrounding tissues. The aim of this work was to obtain a polyethylene glycol (PEG) layer by plasma in order to achieve a bacteriostatic surface. Titanium surfaces were activated by argon plasma and, after, by PEG plasma with different powers (100, 150 and 200 W) for 30 and 60 min. The roughness was determined by white light interferometer microscopy and the wettability was determined by the contact angle technique. Surface chemical compositions were characterized by X-ray photoelectron spectroscopy (XPS) and cytocompatibility and cell adhesion studies were performed with fibroblast (hFFs) and osteoblast (SAOS-2) cells. Bacterial cultures with Spectrococcus Sanguinis and Lactobacillus Salivarius were performed, and bacterial colonization was determined. The results showed that plasma treatments do not affect the roughness. Plasma makes the surfaces more hydrophilic by decreasing the contact angles from 64.2° for titanium to 5.2° for argon-activated titanium, with values ranging from 12° to 25° for the different PEG treatments. The plasma has two effects: the cleaning of the surface and the formation of the PEG layer. The biocompatibility results were, for all cases, higher than 80%. The polymerization treatment with PEG reduced the adhesion of hFFs from 7000 to 6000 and, for SAOS-2, from 14,000 to 6500, for pure titanium and those treated with PEG, respectively. Bacterial adhesion was also reduced from 600 to 300 CFU/mm² for Spetrococcuns Sanguinis and from 10,000 to 900 CFU/mm² for Lactobacillus Salivarius. The best bacteriostatic treatment corresponded to PEG at 100 W and 30 s. As a consequence, the PEG coating would significantly prevent the formation of bacterial biofilm on the surface of titanium mini-implants.

Effect of Fluoride Content of Mouthwashes on Superelastic Properties of NiTi Orthodontic Archwires

The influence of sodium fluoride (NaF) concentration in mouthwashes on the properties of superelastic NiTi orthodontic wires has been studied. In this work, 55.8%Ni and 44.2%Ti (in weight) wires were introduced in commercial mouthwashes with different NaF contents (0, 130, 200 and 380 ppm). The release of Ni²⁺ and Ti⁴⁺ ions was by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) at 1, 4, 7 and 14 days. Superelastic orthodontic wires present at oral temperature the austenitic phase which is transformed into a plastic phase (martensite) by cooling. The temperatures at which this occurs are influenced by the chemical composition. The release of ions from the wire will produce variations in the temperatures and stresses of the stress-induced martensitic transformation. M_s, M_f, A_s, A_f were determined by Differential Scanning Calorimeter (DSC). The transformation stresses (austenite to stress induce martensite) were determined with a servo-hydraulic testing machine at 37 °C. The surfaces for the different times and mouthwash were observed by Scanning Electron Microscope (SEM). The release of Ni²⁺ in mouthwashes with 380 ppm NaF concentrations reaches 230,000 ppb in 14 days and for Ti⁴⁺ 175,000 ppb. When NaF concentrations are lower than 200 ppm the release of Ni and Ti ions is around 1500 ppb after 14 days. This variation in compositions leads to variations in M_s from 27 °C to 43.5 °C in the case of higher NaF concentration. The increasing immersion time and NaF concentrations produce a decrease of Ni in the wires, increasing M_s which exceed 37 °C with the loss of superelasticity. In the same way, the stresses (tooth position corrective) decrease from 270 MPa to 0 MPa due to the martensitic phase. The degradation can produce the growth of precipitates rich in Ti (Ti₂Ni). These results are of great interest in the orthodontic clinic in order to avoid the loss of the therapeutic properties of superelastic NiTi due to long immersion in fluoride mouthwashes.

Reduction in nickel content of the surface oxide layer on Ni-Ti alloy by electrolytic treatment

PURPOSE

Ni-Ti alloy has been increasingly applied to dental and medical devices, however, it contains nickel, which is known to have adverse effects on the human body. The purpose of this study was to form a nickel-free surface oxide layer on Ni-Ti alloy by electrolytic treatment for better biocompatibility.

METHODS

Ni-49.15Ti (mol%) alloy was used, and the electrolytic treatment was performed in the electrolytes under 50 V for 30 minutes. The electrolytes were composed of lactic acid, water, and glycerol with different compositions. Surface analysis and characterization of Ni-Ti alloy were carried out by means of X-ray photoelectron spectroscopy (XPS) and Auger electron spectroscopy (AES).

RESULTS

Results indicated that the outmost surface oxide layer was nickel-free when using an electrolyte comprising 7.1% lactic acid, 57.2% water, and 35.7% glycerol by volume. The composition of this nickel-free surface oxide layer was determined as TiO_1.92(OH)_1.35 ∙ 0.43H₂O by XPS, similar to that of unalloyed titanium. The thickness of this nickel-free layer was estimated at 6.4 nm by AES.

CONCLUSION

The nickel-free surface oxide layer produced on Ni-Ti alloy is considered to improve the biocompatibility of medical and dental devices having shape memory effect and/or super-elasticity.

Enhanced corrosion resistance, antibacterial properties, and biocompatibility by hierarchical hydroxyapatite/ciprofloxacin-calcium phosphate coating on nitrided NiTi alloy

Multi-functional hierarchical coatings are deposited on the nitrided NiTi alloy. The nitrided layer is first deposited by nitrogen plasma immersion ion implantation and a middle layer containing porous hydroxyapatite and ciprofloxacin (Cip) is produced before the top calcium phosphate coating is deposited by the sol-gel method. The thicknesses of the coating and nitrided intermediate layer are about 1.54 μm and 160 nm, respectively and Cip penetrates to a depth of about 530 nm. Calcium phosphate reduces surface defects resulting in a surface roughness of 17 ± 2 nm compared to 34 ± 5 nm of the porous hydroxyapatite coating. The corrosion resistance is improved due to reduced defects and localized corrosion as manifested by the decrease in the Ni²⁺ release rate by 11.6% from 0.0198 to 0.0175 mg L^-1 cm^-2. The bacterial resistance against E. coli is also improved by about 88 times on account of Cip release and good biocompatibility is confirmed by proliferation of MC3T3 cells. This multi-functional hierarchical coating has large potential in orthopedic and dental applications.

Parametric evaluation of electrical discharge coatings on nickel-titanium shape memory alloy in deionized water

Nickel-titanium shape memory alloy (NiTi) has a unique capacity to restore its initial shape after deformation, which is highly applicable to orthopaedic implantations, especially for the minimization of invasive surgeries. The high nickel content of this alloy can lead to unfavourable effects on the human body upon dissolution; thus, a reliable barrier of coatings on the NiTi surface is required to alleviate the nickel migration and increase its biocompatibility. In this paper, analyses of a titanium oxide layer development on NiTi surface using electrical discharge coating (EDC) process is presented. The recast layer thickness, crater sizes, and surface roughness were characterized based on five parameters; polarity, discharge duration, pulse interval, peak current, and gap voltage. The results show that the discharge duration is the most significant parameter to influence all responses, followed by peak current. The surface characteristics of the EDC substrate is depending on the crater formations and is highly correlated with the discharge energy intensity. As a result, appropriate parametric conditions of the electrical discharge coating process can enhance the NiTi surface for future medical applications, without compromising the shape memory effect.

New Bactericide Orthodonthic Archwire: NiTi with Silver Nanoparticles

A potential new bactericide treatment for NiTi orthodontic archwires based in the electrodeposition of silver nanoparticles on the surface was studied. Twenty-five archwires were treated by electrodeposition, obtaining nanoparticles of silver embedded on the archwire surface. These were evaluated in order to investigate the possible changes on the superelastic characteristics (critical temperatures and stresses), the nickel ion release, and the bacteria culture behavior. The chemical composition was analyzed by Energy Dispersive X-Ray Spectroscopy-microanalysis; the singular temperatures of the martensitic transformation were obtained by a flow calorimeter. Induced martensitic transformation stresses were obtained by mechanical testing apparatus. Nickel ion release was analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) equipment using artificial saliva solution at 37 °C. Bacterial tests were studied with the most used oral bacterial strains: Streptococcus sanguinis and Lactobacillus salivarius. NiTi samples were immersed in bacterial suspensions for 2 h at 37 °C. Adhered bacteria were separated and seeded on agar plates: Tood-Hewitt (TH) and Man-Rogosa-Sharpe (MRS) for S. sanguinis and for L.salivarius, respectively. These were then incubated at 37 °C for 1 day and the colonies were analyzed. The results showed that the transformation temperatures and the critical stresses have not statistically significant differences. Likewise, nickel ion release at different immersion times in saliva at 37 °C does not present changes between the original and treated with silver nanoparticles archwires. Bacteria culture results showed that the reduction of the bacteria due to the presence to the nanoparticles of silver is higher than 90%. Consequently, the new treatment with nanoparticles of silver could be a good candidate as bactericidic orthodontic archwire.

Ion Release and Surface Characterization of Nanostructured Nitinol during Long-Term Testing

The corrosion resistance of nanostructured nitinol (NiTi) was investigated using long-term tests in solutions simulating physiological fluids at static conditions, reflecting the material structure and metal concentration in the solutions. Mechanical polishing reduced the ion release by a factor of two to three, whereas annealing deteriorated the corrosion resistance. The depassivation and repassivation of nitinol surfaces were considered. We found that nanostructured nitinol might increase the corrosion leaching of titanium into solutions, although the nickel release decreased. Metal dissolution did not occur in the alkaline environment or artificial plasma. A Ni-free surface with a protective 25 nm-thick titanium oxide film resulted from soaking mechanically treated samples of the NiTi wire in a saline solution for two years under static conditions. Hence, the medical application of nanostructured NiTi, such as for the production of medical devices and implants such as stents, shows potential compared with microstructured NiTi.

Advanced biomaterials for repairing and reconstruction of mandibular defects

Mandibles are the largest and strongest bone in the human face and are often severely compromised by mandibular defects, compromising the quality of life of patients. Mandibular defects may result from trauma, inflammatory disease and benign or malignant tumours. The reconstruction of mandibular defect has been a research hotspot in oral and maxillofacial surgery. Although the principles and techniques of mandibular reconstruction have made great progress in recent years, the development of biomedical materials is still facing technical bottleneck, and new materials directly affect technological breakthroughs in this field. This paper reviews the current status of research and application of various biomaterials in mandibular defects and systematically elaborates different allogeneic biomaterial-based approaches. It is expected that various biomaterials, in combination with new technologies such as digital navigation and 3D printing, could be tuned to build new types of scaffold with more precise structure and components, addressing needs of surgery and post-reconstruction. With the illustration and systematization of different solutions, aims to inspire the development of reconstruction biomaterials.

Superelasticity Evaluation of the Biocompatible Ti-17Nb-6Ta Alloy

Recently, studying the shape memory effect of the biocompatible Ti alloys takes much attention in the biomedical and healthcare applications. This study concerns about characterizing the superelasticity of the new biocompatible Ti-17Nb-6Ta (TNT) alloy. Microstructure of TNT was observed using optical and confocal microscopes. The alloy consists of two phases: β (predominant phase) and α″ martensite phase. The influence of cold rolling deformation on the microstructure was illustrated in which the martensitic-induced transformation appeared by cold rolling. The alloy is ductile as only the fracture dimples appeared in its fracture surface. Multicyclic loading and deloading tensile testing was applied to TNT specimens (flat and wire shapes) in order to evaluate the superelasticity. A superelastic strain as high as 3.5% was recorded for this TNT alloy. Therefore, TNT alloy has high potential for many biomedical and healthcare applications.

Biomedical Porous Shape Memory Alloys for Hard-Tissue Replacement Materials

Porous shape memory alloys (SMAs), including NiTi and Ni-free Ti-based alloys, are unusual materials for hard-tissue replacements because of their unique superelasticity (SE), good biocompatibility, and low elastic modulus. However, the Ni ion releasing for porous NiTi SMAs in physiological conditions and relatively low SE for porous Ni-free SMAs have delayed their clinic applications as implantable materials. The present article reviews recent research progresses on porous NiTi and Ni-free SMAs for hard-tissue replacements, focusing on two specific topics: (i) synthesis of porous SMAs with optimal porous structure, microstructure, mechanical, and biological properties; and, (ii) surface modifications that are designed to create bio-inert or bio-active surfaces with low Ni releasing and high biocompatibility for porous NiTi SMAs. With the advances of preparation technique, the porous SMAs can be tailored to satisfied porous structure with porosity ranging from 30% to 85% and different pore sizes. In addition, they can exhibit an elastic modulus of 0.4⁻15 GPa and SE of more than 2.5%, as well as good cell and tissue biocompatibility. As a result, porous SMAs had already been used in maxillofacial repairing, teeth root replacement, and cervical and lumbar vertebral implantation. Based on current research progresses, possible future directions are discussed for "property-pore structure" relationship and surface modification investigations, which could lead to optimized porous biomedical SMAs. We believe that porous SMAs with optimal porous structure and a bioactive surface layer are the most competitive candidate for short-term and long-term hard-tissue replacement materials.

Mechanism of fracture of NiTi superelastic endodontic rotary instruments

The aim is to investigate the premature catastrophic fracture produced for different periods during clinical endodontic treatment of two brands of NiTi endodontic rotary instruments. 3 samples as-received, 6 samples used with patients for 2 and 7 h and 5 samples fractured were studied for each brand of endodontic NiTi rotary instruments. Transformation temperatures (M_s, M_f, A_s and A_f) and enthalpies of transformation were determined by calorimetry. Critical stresses until fracture (σ^β→SIM, σ^SIM→β) were obtained using an electromechanical testing machine. The samples were also visualized by Scanning Electron Microscopy. Calorimetric studies have shown an increase of the M_s and A_s transformation temperatures with time of use as well as a decrease of their stress transformations. Moreover, reverse transformation enthalpies decreased along the time. The enthalpies of transformation decreased because martensitic plates were anchored, which prevented their transformation to austenite; thus losing its superelastic effect. The stabilisation of the martensitic plates induced the collapse of the structure and so the main cause for the fracture. The heat treatment proposed has been increased the life in service of NiTi superelastic endodontic instruments recovering theirs superelastic effect.

Development of Biomimetic NiTi Alloy: Influence of Thermo-Chemical Treatment on the Physical, Mechanical and Biological Behavior

A bioactive layer, free of nickel, has been performed for its greater acceptability and reliability in clinical applications for NiTi shape memory alloys. In the first step, a safe barrier against Ni release has been produced on the surface by means of a thicker rutile/anastase protective layer free of nickel. In the second step, a sodium alkaline titanate hydrogel, which has the ability to induce apatite formation, has been performed from oxidized surface. An improvement of host tissue–implant integration has been achieved in terms of Ni ions release and the bioactivity of the treated NiTi alloys has been corroborated with both in vitro and in vivo studies. The transformation temperatures (A_s, A_f, M_s, and M_f), as well as the critical stresses (σ^β⇔M), have been slightly changed due to this surface modification. Consequently, this fact must be taken into account in order to design new surface modification on NiTi implants.

Controlled in vivo swimming of a swarm of bacteria-like microrobotic flagella

In vivo imaging and actuation of a swarm of magnetic helical microswimmers by external magnetic fields (less than 10 mT) in deep tissue is demonstrated for the first time. This constitutes a major milestone in the field, yielding a generation of micrometer-scale transporters with numerous applications in biomedicine including synthetic biology, assisted fertilization, and drug/gene delivery.

In vitro evaluation of biocompatibility of Ti-Mo-Sn-Zr superelastic alloy

Shape memory alloys (SMAs) including superelastic alloys have unique properties such as shape memory and superelasticity, thus they are recognized as very useful biomaterials. These properties are very advantageous for medical use, and actually the SMA wires have been widely used in medical field. However, biocompatibility of nickel-titanium (Ni-Ti) alloy, which is the only practical SMA at present, has been questioned because of its high nickel content. The aim of this study was to evaluate the biocompatibility of a newly developed Ni-free Ti-based SMA for medical use. The newly developed SMA made of Ti-Mo-Sn-Zr system was processed into a disk of 15.1 mm in diameter. Pure titanium of the same shape was prepared as control. All the disk surfaces were polished using emery papers, #120, #400, and #600. Scanning electron microscopy and a 3D optics profiler were used to evaluate the surface of the materials. In vitro evaluations included colony examination for evaluation of the cell cytotoxicity, DNA quantification for the cell proliferation, Alamar blue assay for metabolic activity, FDA staining for the live cell imaging, and cell cycle analysis, using Chinese hamster fibroblastic V-79 cells and mouse osteoblastic MC3T3-E1 cells. In colony examination and DNA quantification, there was no significant difference between the Ti-Mo-Sn-Zr and the pure titanium. In FDA staining, cultured cells on the Ti-Mo-Sn-Zr alloy showed the same biocompatibility as those on the pure titanium. The present results suggest that the newly developed Ti-Mo-Sn-Zr alloy showed the high biocompatibility comparable to pure titanium and can be used as efficient biomaterial for medical use.

The effect of heating rate on the surface chemistry of NiTi

The impact of the heating rate on the Ni content at the surface of the oxide layer of biomedical NiTi is explored. Heat treatment emulating common shape-setting procedures was performed by means of conventional and inductive heating for similar annealing time and temperature, applying various heating rates from ~0.25 K s(-1) to 250 K s(-1). A glow discharge optical emission spectroscopy method was established and employed to evaluate concentration profiles of Ni, Ti and O in the near-surface region at high resolution. The Ni content at the surface of the differently treated samples varies significantly, with maximum surface Ni concentrations of ~20 at.% at the lowest and ~1.5 at.% at the highest heating rate, i.e. the total amount of Ni contained in the surface region of the oxide layer decreases by >15 times. Consequently, the heating rate is a determinant for the biomedical characteristics of NiTi, especially since Ni available at the surface of the oxide layer may affect the hemocompatibility and be released promptly after surgical application of a respective implant. Furthermore, apparently contradictory results presented in the literature reporting surface Ni concentrations of ~3 at.% to >20 at.% after heat treatment are consistently explained considering the ascertained effect of the heating rate.

Mesenchymal stem cell proliferation and differentiation on load-bearing trabecular Nitinol scaffolds

Bone tissue regeneration in load-bearing regions of the body requires high-strength porous scaffolds capable of supporting angiogenesis and osteogenesis. 70% porous Nitinol (NiTi) scaffolds with a regular 3-D architecture resembling trabecular bone were produced from Ni foams using an original reactive vapor infiltration technique. The "trabecular Nitinol" scaffolds possessed a high compressive strength of 79 MPa and high permeability of 6.9×10(-6) cm2. The scaffolds were further modified to produce a near Ni-free surface layer and evaluated in terms of Ni ion release and human mesenchymal stem cell (hMSC) proliferation (AlamarBlue), differentiation (alkaline phosphatase activity, ALP) and mineralization (Alizarin Red S staining). Scanning electron microscopy was employed to qualitatively corroborate the results. hMSCs were able to adhere and proliferate on both as-produced and surface-modified trabecular NiTi scaffolds, to acquire an osteoblastic phenotype and produce a mineralized extracellular matrix. Both ALP activity and mineralization were increased on porous scaffolds compared to control polystyrene plates. Experiments in a model coculture system of microvascular endothelial cells and hMSCs demonstrated the formation of prevascular structures in trabecular NiTi scaffolds. These data suggest that load-bearing trabecular Nitinol scaffolds could be effective in regenerating damaged or lost bone tissue.

Effect of temperature on the orthodontic clinical applications of NiTi closed-coil springs

NiTi spring coils were used to obtain large deformation under a constant force. The device consists on a NiTi coil spring, superelastic at body temperature, in order to have a stress plateau during the austenitic retransformation during the unloading. The temperature variations induced changes in the spring force. Objectives: The aim of this study is to investigate the effect of the temperature variations in the spring forces and corrosion behaviour simulating the ingestion hot/cold drinks and food. Study Design: The springs were subjected to a tensile force using universal testing machine MTS-Adamel (100 N load cell). All tests were performed in artificial saliva maintained at different temperatures. The corrosion tests were performed according to the ISO-standard 10993-15:2000. Results: The increase in temperature of 18oC induced an increase in the spring force of 30%. However, when the temperature returns to 37oC the distraction force recovers near the initial level. After cooling down the spring to 15oC, the force decreased by 46%. This investigation show as the temperature increase, the corrosion potential shifts towards negative values and the corrosion density is rising. Conclusions: The changes of the temperatures do not modify the superelastic behaviour of the NiTi closed-coil springs. The corrosion potential of NiTi in artificial saliva is decreasing by the rise of the temperatures.

Key words:Superelasticity, NiTi, springs, orthodontic, coils, recovery, temperature.

Friction coefficients and wear rates of different orthodontic archwires in artificial saliva

The aim of this paper is to analyze the influence of the nature of the orthodontic archwires on the friction coefficient and wear rate against materials used commonly as brackets (Ti-6Al-4V and 316L Stainless Steel). The materials selected as orthodontic archwires were ASI304 stainless steel, NiTi, Ti, TiMo and NiTiCu. The array archwire's materials selected presented very similar roughness but different hardness. Materials were chosen from lower and higher hardness degrees than that of the brackets. Wear tests were carried out at in artificial saliva at 37 °C. Results show a linear relationship between the hardness of the materials and the friction coefficients. The material that showed lower wear rate was the ASI304 stainless steel. To prevent wear, the wire and the brackets have high hardness values and in the same order of magnitude.

Preparation and characterization of shape memory polymer scaffolds via solvent casting/particulate leaching

PURPOSE

Porous Shape Memory Polymers (SMPs) are ideal candidates for the fabrication of defect fillers, able to support tissue regeneration via minimally invasive approaches. In this regard, control of pore size, shape and interconnection is required to achieve adequate nutrient transport and cell ingrowth. Here, we assessed the feasibility of the preparation of SMP porous structures and characterized their chemico-physical properties and in vitro cell response.

METHODS

SMP scaffolds were obtained via solvent casting/particulate leaching of gelatin microspheres, prepared via oil/water emulsion. A solution of commercial polyether-urethane (MM-4520, Mitsubishi Heavy Industries) was cast on compacted microspheres and leached-off after polymer solvent evaporation. The obtained structures were characterized in terms of morphology (SEM and micro-CT), thermo-mechanical properties (DMTA), shape recovery behavior in compression mode, and in vitro cytocompatibility (MG63 Osteoblast-like cell line).

RESULTS

The fabrication process enabled easy control of scaffold morphology, pore size, and pore shape by varying the gelatin microsphere morphology. Homogeneous spherical and interconnected pores have been achieved together with the preservation of shape memory ability, with recovery rate up to 90%. Regardless of pore dimensions, MG63 cells were observed adhering and spreading onto the inner surface of the scaffolds obtained for up to seven days of static in vitro tests.

CONCLUSIONS

A new class of SMP porous structures has been obtained and tested in vitro: according to these preliminary results reported, SMP scaffolds can be further exploited in the design of a new class of implantable devices.

PIIID-formed (Ti, O)/Ti, (Ti, N)/Ti and (Ti, O, N)/Ti coatings on NiTi shape memory alloy for medical applications

(Ti, O)/Ti, (Ti, N)/Ti and (Ti, O, N)/Ti composite coatings were fabricated on NiTi shape memory alloy via plasma immersion ion implantation and deposition (PIIID). Surface morphology of samples was investigated using atomic force microscopy (AFM) and scanning electron microscopy (SEM). Cross-sectional morphology indicated that the PIIID-formed coatings were dense and uniform. X-ray diffraction (XRD) was used to characterize the phase composition of samples. X-ray photoelectron spectroscopy (XPS) results showed that the surface of coated NiTi SMA samples was Ni-free. Nanoindentation measurements and pin-on-disc tests were carried out to evaluate mechanical properties and wear resistance of coated NiTi SMA, respectively. For the in vitro biological assessment of the composite coatings in terms of cell morphology and cell viability, osteoblast-like SaOS-2 cells and breast cancer MCF-7 cells were cultured on NiTi SMA samples, respectively. SaOS-2 cells attached and spread better on coated NiTi SMA. Viability of MCF-7 cells showed that the PIIID-formed composite coatings were noncytotoxic and coated samples were more biocompatible than uncoated samples.

Reduction of Ni release and improvement of the friction behaviour of NiTi orthodontic archwires by oxidation treatments

This work studies NiTi orthodontic archwires that have been treated using a new oxidation treatment for obtaining Ni-free surfaces. The titanium oxide on the surface significantly improves corrosion resistance and decreases nickel ion release, while barely affecting transformation temperatures. This oxidation treatment avoids the allergic reactions or toxicity in the surrounding tissues produced by the chemical degradation of the NiTi. In the other hand, the lack of low friction coefficient for the NiTi superelastic archwires makes difficult the optimal use of these materials in Orthodontic applications. In this study, the decrease of this friction coefficient has been achieved by means of oxidation treatment. Transformation temperatures, friction coefficient and ion release have been determined.

Polymeric coating of surface modified nitinol stent with POSS-nanocomposite polymer

Stent angioplasty is a successful treatment for arterial occlusion, particularly in coronary artery disease. The clinical communities were enthusiastic about the use of drug-eluting stents; however, these stents have a tendency to be a contributory factor towards late stage thrombosis, leading to mortality in a significant number of patients per year. This work presents an innovative approach in self-expanding coronary stents preparation. We developed a new nanocomposite polymer based on polyhedral oligomeric silsesquioxanes (POSS) and poly(carbonate-urea)urethane (PCU), which is an antithrombogenic and a non-biodegradable polymer with in situ endothelialization properties. The aim of this work is to coat a NiTi stent alloy with POSS-PCU. In prolonged applications in the human body, the corrosion of the NiTi alloy can result in the release of deleterious ions which leads to unwanted biological reactions. Coating the nitinol (NiTi) surface with POSS-PCU can enhance surface resistance and improve biocompatibility. Electrohydrodynamic spraying was used as the polymer deposition process and thus a few experiments were carried out to compare this process with casting. Prior to deposition the NiTi has been surface modified. The peel strength of the deposit was studied before and after degradation of the coating. It is shown that the surface modification enhances the peel strength by 300%. It is also indicated how the adhesion strength of the POSS-PCU coating changes post-exposure to physiological solutions comprised of hydrolytic, oxidative, peroxidative and biological media. This part of the study shows that the modified NiTi presents far greater resistance to decay in peel strength compared to the non-modified NiTi.

Bone cell-materials interactions and Ni ion release of anodized equiatomic NiTi alloy

A laser processed NiTi alloy was anodized for different times in H(2)SO(4) electrolyte with varying pH to create biocompatible surfaces with low Ni ion release as well as bioactive surfaces to enhance biocompatibility and bone cell-material interactions. The anodized surfaces were assessed for their in vitro cell-material interactions using human fetal osteoblast (hFOB) cells for 3, 7 and 11 days, and Ni ion release up to 8 weeks in simulated body fluids. The results were correlated with the surface morphologies of anodized surfaces characterized using field-emission scanning electron microscopy (FESEM). The results show that anodization creates a surface with nano/micro-roughness depending on the anodization conditions. The hydrophilicity of the NiTi surface was found to improve after anodization, as shown by the lower contact angles in cell medium, which dropped from 32° to <5°. The improved wettability of anodized surfaces is further corroborated by their high surface energy, comparable with that of commercially pure Ti. Relatively high surface energies, especially the polar component, and nano/micro surface features of anodized surfaces significantly increased the number of living cells and their adherence and growth on these surfaces. Finally, a significant drop in Ni ion release from 268±11 to 136±15 ppb was observed for NiTi surfaces after anodization. This work indicates that anodization of a NiTi alloy has a positive influence on the surface energy and surface morphology, which in turn improves bone cell-material interactions and reduces Ni ion release in vitro.

Chemico-physical modifications induced by plasma and ozone sterilizations on shape memory polyurethane foams

Thermally activated shape memory polyurethane foams are promising materials for minimally invasive surgical procedures. Understanding their physical and chemical properties, in vitro response and effects of sterilization is mandatory when evaluating their potential as biomaterials. In this work, we report on the characterization of two Cold Hibernated Elastic Memory (CHEM) foams before and after two novel low-temperature sterilization techniques (plasma and ozone). Foams have different transition temperatures (T(trans)), as determined by Tandelta peaks in DMA tests, that depend on their chemical composition: both foams possess excellent shape recovery ability (Recovery Rate up to 99%) in conventional shape recovery tests. Plasma sterilization (Sterrad sterilization system) resulted in a slight increase of open porosity, but no effects on bulk chemical and thermo-mechanical properties were observed. Ozone sterilization had a stronger effect on foams morphology, both in terms of an evident rupture of pore walls and surface oxidation. These modifications affected both thermomechanical and shape recovery behavior. Furthermore, plasma sterilized foams cytocompatibility was investigated with L929 fibroblast cell line in vitro, showing a good adhesion and proliferation, as confirmed by SEM observation and Alamar blue assay. The obtained results contribute to define the role of shape memory foams as biomaterials and open novel questions on the role of sterilization technique effects on cellular solids.

Metallic Scaffolds for Bone Regeneration

Bone tissue engineering is an emerging interdisciplinary field in Science, combining expertise in medicine, material science and biomechanics. Hard tissue engineering research is focused mainly in two areas, osteo and dental clinical applications. There is a lot of exciting research being performed worldwide in developing novel scaffolds for tissue engineering. Although, nowadays the majority of the research effort is in the development of scaffolds for non-load bearing applications, primarily using soft natural or synthetic polymers or natural scaffolds for soft tissue engineering; metallic scaffolds aimed for hard tissue engineering have been also the subject of in vitro and in vivo research and industrial development. In this article, descriptions of the different manufacturing technologies available to fabricate metallic scaffolds and a compilation of the reported biocompatibility of the currently developed metallic scaffolds have been performed. Finally, we highlight the positive aspects and the remaining problems that will drive future research in metallic constructs aimed for the reconstruction and repair of bone.

The electrochemical characteristics of native Nitinol surfaces

The present study explored the avenues for the improvement of native Nitinol surfaces for implantation obtained using traditional procedures such as mechanical polishing, chemical etching, electropolishing and heat treatments for a better understanding of their electrochemical behavior and associated surface stability, conductivity, reactivity and biological responses. The corrosion resistance (cyclic potential polarization, open circuit potential and polarization resistance) of Nitinol disc and wire samples were evaluated for various surface states in strain-free and strained wire conditions. The surface response to tension strain was studied in situ. Surface chemistry and structure were explored using XPS and Auger spectroscopy and photoelectrochemical methods, respectively. It was found that the polarization resistance of the Nitinol surfaces varied in a range from 100 kOmega to 10 MOmega cm(2) and the open circuit potentials from -440 mV to -55 mV. The surfaces prepared in chemical solutions showed consistent corrosion resistance in strain-free and strained states, but mechanically polished and heat treated samples were prone to pitting. Nitinol surface oxides are semiconductors with the band gaps of either 3.0 eV (rutile) or 3.4 eV (amorphous). The conductivity of semiconducting Nitinol surfaces relevant to their biological performances is discussed in terms of oxide stoichiometry and variable Ni content. Such biological characteristics of Nitinol surfaces as Ni release, fibrinogen adsorption and platelets behavior are re-examined based on the analysis of the results of the present study.

Microstructure of surface and subsurface layers of a Ni-Ti shape memory microwire

The microstructure of a 55 microm diameter, cold-worked Ni-Ti microwire is investigated by different transmission electron microscopy techniques. The surface consists of a few hundred nanometer thick oxide layer composed of TiO and TiO2 with a small fraction of inhomogeneously distributed Ni. The interior of the wire has a core-shell structure with primarily B2 grains in the 1 microm thick shell, and heavily twinned B19' martensite in the core. This core-shell structure can be explained by a concentration gradient of the alloying elements resulting in a structure separation due to the strong temperature dependence of the martensitic start temperature. Moreover, in between the B2 part of the metallic core-shell and the oxide layer, a Ni3Ti interfacial layer is detected.