Fabrication and characterization of functionally graded nano-micro porous titanium surface by anodizing

Assessment of Inhibition of Biofilm Formation on Non-Thermal Plasma-Treated TiO2 Nanotubes

Peri-implantitis is an inflammatory disease similar to periodontitis, caused by biofilms formed on the surface of dental implants. This inflammation can spread to bone tissues and result in bone loss. Therefore, it is essential to inhibit the formation of biofilms on the surface of dental implants. Thus, this study examined the inhibition of biofilm formation by treating TiO₂ nanotubes with heat and plasma. Commercially pure titanium specimens were anodized to form TiO₂ nanotubes. Heat treatment was performed at 400 and 600 °C, and atmospheric pressure plasma was applied using a plasma generator (PGS-200, Expantech, Suwon, Republic of Korea). Contact angles, surface roughness, surface structure, crystal structure, and chemical compositions were measured to analyze the surface properties of the specimens. The inhibition of biofilm formation was assessed using two methods. The results of this study showed that the heat treatment of TiO₂ nanotubes at 400 °C inhibited the adhesion of Streptococcus mutans (S. mutans), associated with initial biofilm formation, and that heat treatment of TiO₂ nanotubes at 600 °C inhibited the adhesion of Porphyromonas gingivalis (P. gingivalis), which causes peri-implantitis. Applying plasma to the TiO₂ nanotubes heat-treated at 600 °C inhibited the adhesion of S. mutans and P. gingivalis.

Microbial Adhesion and Biofilm Formation on Bioactive Surfaces of Ti-35Nb-7Zr-5Ta Alloy Created by Anodization

This study evaluated the microbial colonization (adhesion and biofilm) on modified surfaces of a titanium alloy, Ti-35Nb-7Zr-5Ta, anodized with Ca and P or F ions, with and without silver deposition. The chemical composition, surface topography, roughness (Ra), and surface free energy were evaluated before and after the surface modifications (anodizing). Adhesion and biofilm formation on saliva-coated discs by primary colonizing species (Streptococcus sanguinis, Streptococcus gordonii, Actinomyces naeslundii) and a periodontal pathogen (Porphyromonasgingivalis) were assessed. The surfaces of titanium alloys were modified after anodizing with volcano-shaped micropores with Ca and P or nanosized with F, both with further silver deposition. There was an increase in the Ra values after micropores formation; CaP surfaces became more hydrophilic than other surfaces, showing the highest polar component. For adhesion, no difference was detected for S. gordonii on all surfaces, and some differences were observed for the other three species. No differences were found for biofilm formation per species on all surfaces. However, S. gordonii biofilm counts on distinct surfaces were lower than S. sanguinis, A. naeslundii, and P. gingivalis on some surfaces. Therefore, anodized Ti-35Nb-7Zr-5Ta affected microbial adhesion and subsequent biofilm, but silver deposition did not hinder the colonization of these microorganisms.

Enhancement of osseointegration by direct coating of rhBMP-2 on target-ion induced plasma sputtering treated SLA surface for dental application

Owing to the excellent bioactive properties of recombinant human bone morphogenetic proteins (rhBMPs), dentistry considers them as a fascinating adjuvant alternative for enhancing bone regeneration and bone-to-implant junction in the early implantation stages. However, stable loading and delivery efficiency of rhBMPs on the implant surfaces involve major concerns because of the harsh wearing condition under load during implantation. In this study, to achieve successful rhBMP-2 delivery, a nanoporous surface structure is introduced on the sandblasting with large grit and acid-etching (SLA)-treated titanium (Ti) surface via the tantalum (Ta) target-ion induced plasma sputtering (TIPS) technique. Unlike oxidation-induced surface nanoporous fabrications on a Ti surface, TIPS-treated surfaces provide excellent structural unity of the nanoporous structure with the substrate due to their etching-based fabrication mechanism. SLA/TIPS-treated Ti exhibits distinct nanoporous structures on the microscale surface geometry and better hydrophilicity compared with SLA-treated Ti. A sufficiently empty nanoporous surface structure combined with the hydrophilic property of SLA/TIPS-treated Ti facilitates the formation of a thick and uniform coating layer of rhBMP-2 on the surface without any macro- and microcoagulation. Compared with the SLA-treated Ti surface, the amount of coated rhBMP-2 increases up to 63% on the SLA/TIPS-treated Ti surface. As a result, the in vitro pre-osteoblast cell response of the SLA/TIPS-treated Ti surface, especially cell adhesion and differentiation behaviors, improves remarkably. A bone-regenerating direct comparison between the rhBMP-2-coated SLA-treated and SLA/TIPS-treated Ti is conducted on a defective dog mandible model. After 8 weeks of implantation surgery, SLA/TIPS-treated Ti with rhBMP-2 exhibits a better degree of contact area for the implanted bone, which mineralizes new bones around the implant. Quantitative results of bone-in-contact ratio and new bone volume also show significantly higher values for the SLA/TIPS-treated Ti with the rhBMP-2 specimen. These results confirm that an SLA/TIPS-treated surface is a suitable rhBMP-2 carrier for a dental implant to achieve early and strong osseointegration of Ti dental implants.

Biomedical applications of nano-titania in theranostics and photodynamic therapy

Titanium dioxide (TiO₂) is one of the most abundantly used nanomaterials for human life. It is used in sunscreen, photovoltaic devices, biomedical applications and as a food additive and environmental scavenger.

Nanotechnology for treating osteoporotic vertebral fractures

Osteoporosis is a serious public health problem affecting hundreds of millions of aged people worldwide, with severe consequences including vertebral fractures that are associated with significant morbidity and mortality. To augment or treat osteoporotic vertebral fractures, a number of surgical approaches including minimally invasive vertebroplasty and kyphoplasty have been developed. However, these approaches face problems and difficulties with efficacy and long-term stability. Recent advances and progress in nanotechnology are opening up new opportunities to improve the surgical procedures for treating osteoporotic vertebral fractures. This article reviews the improvements enabled by new nanomaterials and focuses on new injectable biomaterials like bone cements and surgical instruments for treating vertebral fractures. This article also provides an introduction to osteoporotic vertebral fractures and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. In addition, perspectives on future trends with injectable bone cements and surgical instruments enhanced by nanotechnology are provided.

RGD peptide immobilized on TiO2 nanotubes for increased bone marrow stromal cells adhesion and osteogenic gene expression

Recently, TiO(2) nanotube layers are widely used in orthopedics and dental applications because of their good promotion effect on bone cells. Furthermore, peptide sequences such as arginine-glycine-aspartic acid are used to modify Ti implant for binding to cell surface integrins through motif. In this study, a cellular adhesive peptide of arginine-glycine-aspartic acid-cysteine (RGDC) was immobilized onto anodized TiO(2) nanotubes on Ti to examine its in vitro responses on rat bone marrow stromal cells (BMSCs). Materials were characterized by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy techniques. High-resolution C1s scans suggested the presence of RGDC on the surface and SEM images confirmed the nanotubes were not destroyed after modification. BMSCs adhesion and osteogenic gene expression were detected in TiO(2) nanotube layers with and without RGDC modification by fluorescence microscopy, confocal laser scanning microscopy, SEM, and realtime polymerase chain reaction (Real-time PCR). Results showed that the TiO(2) nanotube layers immobilized with RGDC increased BMSCs adhesion compared to nonfunctionalized nanotubes after 4 h of cultivation. Furthermore, the osteogenic gene expression of BMSCs was dramatically enhanced on the TiO(2) nanotube layers immobilized with RGDC (10 mM) compared to the TiO(2) nanotube layers immobilized with RGDC (1 mM) and non-functionalized anodized Ti. Our results from in vitro study provided evidence that Ti anodized to possess nanotubes and then further functionalized with RGDC should be further studied for the design of better biomedical implant surfaces.

Decreased Staphylococcus aureus biofilm growth on anodized nanotubular titanium and the effect of electrical stimulation

Infection is a major problem in orthopedics leading to implant failure. It is a challenging task to treat orthopedic implant infection, which may lead to implant replacement and, in severe cases, may result in amputation and mortality. Infection poses an even further risk as bacteria are beginning to develop resistance against commonly used antibiotics. Therefore, in this research a combination of various approaches was used to fight implant infection without resorting to the use of antibiotics. Specifically, conventional titanium was altered through a process of anodization and electrical stimulation to reduce Staphylococcus aureus growth. It was shown that when a 15-30 V electrical stimulation was coupled with anodized nanotubular titanium a significant decrease in S. aureus biofilm formation was observed, compared with non-anodized and non-electrically stimulated titanium after 2 days culture. The decrease in biofilm formation observed here was explained by the presence of fluorine on the surfaces of anodized nanotubular titanium. Thus, coupling the positive influences of anodization and electrical stimulation could be a promising way to fight titanium-based orthopedic device-related infections.

Anodized 20 nm diameter nanotubular titanium for improved bladder stent applications

Materials currently used for bladder applications often suffer from incomplete coverage by urothelial cells (cells that line the interior of the bladder and ureter) which leads to the continuous exposure of the underlying materials aggravating an immune response. In particular, a ureteral (or sometimes called an ureteric or bladder) stent is a thin tube inserted into the ureter to prevent or treat obstruction of urine flow from the kidney. The main complications with ureteral stents are infection and blockage by encrustation, which can be avoided by promoting the formation of a monolayer of urothelial cells on the surface of the stent. Nanotechnology (or the use of nanomaterials) may aid in urothelialization of bladder stents since nanomaterials have been shown to have unique surface energetics to promote the adsorption of proteins important for urothelial cell adhesion and proliferation. Since many bladder stents are composed of titanium, this study investigated the attachment and spreading of human urothelial cells on different nanotextured titanium surfaces. An inexpensive and effective scaled up anodization process was used to create equally distributed nanotubular surfaces of different diameter sizes from 20-80 nm on titanium with lengths approximately 500 nm. Results showed that compared to untreated titanium stents and 80 nm diameter nanotubular titanium, 20 nm diameter nanotubular titanium stents enhanced human urothelial cell adhesion and growth up to 3 days in culture. In this manner, this study suggests that titanium anodized to possess nanotubular surface features should be further explored for bladder stent applications.

Anodic oxidized nanotubular titanium implants enhance bone morphogenetic protein-2 delivery

Implant failure has been attributed to loosening of an implant from the host bone possibly due to poor osseointegration. One promising strategy for improving osseointegration is to develop a functional implant surface that promotes osteoblast differentiation. In this study, a titanium (Ti) surface was functionalized by an anodic oxidation process and was loaded with recombinant human bone morphogenetic protein-2 (rhBMP-2). The following four groups of Ti surfaces were prepared: machined (M), anodized machined (MA), resorbable blast medium (RBM), and anodized RBM (RBMA). The surfaces were characterized by scanning electron microscopy and contact angle measurements. The results showed that a Ti oxide layer (TiO(2)) was observed in the anodized surfaces in the form of nanotubes, approximately 100 nm in diameter and 500 nm in length. The hydrophilic properties of the anodized surfaces were significantly improved. The adsorbed rhBMP-2 loaded on the nonanodized surfaces and lyophilized showed spherical particle morphology. However, the adsorbed rhBMP-2 showed a dispersed pattern over the anodized surfaces. The velocity of the rhBMP-2 released from the surfaces was measured to determine if the anodized surface can improve in delivery efficiency. The results showed that the release velocity of the rhBMP-2 from the anodized surfaces was sustained when compared with that of the nonanodized surfaces. In addition, the rhBMP-2 released from the surface was found to be bioactive according to the alkaline phosphatase activity and the level of calcium mineral deposition. These results suggest that the TiO(2) nanotubular structure formed by anodizing is a promising configuration for sustained rhBMP-2 delivery.