Induction plasma sprayed Sr and Mg doped nano hydroxyapatite coatings on Ti for bone implant

Ginger extract loaded Fe2O3/MgO-doped hydroxyapatite: Evaluation of biological properties for bone-tissue engineering

Since antiquity, the medicinal properties of naturally sourced biomolecules such as ginger (Zingiber officinale) extract are documented in the traditional Indian and Chinese medical systems. However, limited work is performed to assess the potential of ginger extracts for bone-tissue engineering. Our work demonstrates the direct incorporation of ginger extract on iron oxide-magnesium oxide (Fe2O3 and MgO) co-doped hydroxyapatite (HA) for enhancement in the biological properties. The addition of Fe2O3 and MgO co-doping system and ginger extract with HA increases the osteoblast viability up to ~ 1.4 times at day 11. The presence of ginger extract leads to up to ~ 9 times MG-63 cell viability reduction. The co-doping does not adversely affect the release of ginger extract from the graft surface in the biological medium at pH 7.4 for up to 28 days. Assessment of antibacterial efficacy according to the modified ISO 22196: 2011 standard method indicates that the combined effects of Fe2O3, MgO, and ginger extract lead to ~ 82 % more bacterial cell reduction, compared to the control HA against S. aureus. These ginger extract-loaded artificial bone grafts with enhanced biological properties may be utilized as a localized site-specific delivery vehicle for various bone tissue engineering applications.

Curcumin and Vitamin C dual release from Hydroxyapatite coated Ti6Al4V discs enhances in vitro biological properties

Titanium alloys are widely used as implant materials due to their biocompatibility and superior mechanical properties for high-load-bearing applications. However, one of the major challenges is their inferior bioactivity and osseoconductivity. Hydroxyapatite is widely used as an alternative material for bone implants due to its compositional similarity to natural bone. In this study, hydroxyapatite is coated on Ti6Al4V discs to enhance its bioactivity. The coated discs are drop-casted with curcumin in the lower layer and vitamin C in the upper layer. This study aims to evaluate the effects of this dual drug delivery system on osteoblast cell proliferation, inhibition of osteoclastogenesis, chemo-preventive and infection control properties. The coating strength obtained is 22 ± 2 MPa. The release from the dual delivery system shows a 1.5-fold increase in osteoblast cell viability, a 1.5-fold reduction in osteoclast cell differentiation, a 2-fold decrease in osteosarcoma growth. The release of curcumin demonstrates a 94% antibacterial efficacy, while the release of vitamin C exhibits an efficacy of 98.6% aganist Staphylococcus aureus. This multifunctional system can be used as a potential implant for load-bearing applications.

In vivo biocompatibility of SrO and MgO doped brushite cements

The addition of dopants in biomaterials has emerged as a critical regulator of bone formation and regeneration due to their imminent role in the biological process. The present work evaluated the role of strontium (Sr) and magnesium (Mg) dopants in brushite cement (BrC) on in vivo bone healing performance in a rabbit model. Pure, 1 wt% SrO (Sr-BrC), 1 wt% MgO (Mg-BrC), and a binary composition of 1.0 wt% SrO + 1.0 wt% MgO (Sr + Mg-BrC) BrCs were implanted into critical-sized tibial defects in rabbits for up to 4 months. The in vivo bone healing of three doped and pure BrC samples was examined and compared using sequential radiological examination, histological evaluations, and fluorochrome labeling studies. The results indicated excellent osseous tissue formation for Sr-BrC and Sr + Mg-BrC and moderate bone regeneration for Mg-BrC compared to pure BrC. Our findings indicated that adding small amounts of SrO, MgO, and binary dopants to the BrC can significantly influence new bone formation for bone tissue engineering.

Corrosion of Stirred Electrochemical Nano-Crystalline Hydroxyapatite (HA) Coatings on Ti6Al4V

Ti6Al4V substrates were electrochemically deposited with nano-crystalline hydroxyapatite (HA) from aqueous electrolytes. Cathodic HA coatings were obtained when the electrolyte was stirred using ultrasonic vibration. Two current densities of 20 mA/cm² and 50 mA/cm² were employed. Polarization and electrochemical impedance spectroscopy (EIS) were the techniques used to estimate the corrosion of coatings in simulated body fluid (SBF). The results indicate good corrosion resistance for the coating obtained at 50 mA/cm² from ultrasonic stirring of the electrolyte.

Bioactive Surface Modifications through Thermally Sprayed Hydroxyapatite Composite Coatings: A Review over Selective Reinforcements

Hydroxyapatite (HA) has been an excellent replacement for the natural bone in orthopedic applications, owing to its close resemblance; however, it is brittle and has low strength. Surface modification techniques...

3D porous PCL-PEG-PCL / strontium, magnesium and boron multi-doped hydroxyapatite composite scaffolds for bone tissue engineering

Bioceramic/polymer composite systems have gained importance in treating hard tissue damages using bone tissue engineering (BTE). In this context, it was aimed to develop 3D porous composite PCL-PEG-PCL scaffolds containing different amounts of B, Sr and Mg multi-doped HA that can provide bone regeneration in the bone defect area and to investigate the effect of both the amount of inorganic phase and the porosity on the mechanical and the biological properties. B-Sr-Mg multi-doped HA and PCL-PEG-PCL copolymer were successfully synthesized. PCL-PEG-PCL composite scaffolds containing different amounts of hydroxyapatite (HA) (10% and 20 wt%) were produced with the desired porosity (50% and 60%) by compression-molding and particulate leaching method. The porosity of the scaffolds was determined between 47% and 59%. HA/PCL-PEG-PCL composite scaffolds were subjected to a 3-week degradation test and showed negligible (0.2-0.5%) degradation. The water uptake percentage of the composite scaffolds with 60% porosity was the highest among all groups. Presence of HA in the scaffolds improved the water adsorption and the mechanical properties. Compressive strength of the scaffolds was between 9.32 and 24.27 MPa and 20% 2Sr0.5BHA scaffolds were found to have the maximum compressive strength. Compressive strength of 50% porous samples was higher than that of 60% porous samples. In the relative cell viability (%) test, the highest viability was observed on the scaffolds with HA and 2Sr0.5BHA. The specific ALP activity level of the cells on the scaffolds containing 2Sr0.5BHA was significantly higher (2.6 times) than that of the control group. The amount of porosity did not make a significant difference in cellular response. It was concluded that PCL-PEG-PCL composite scaffolds with 2Sr0.5BHA have the potential to be used in BTE.

Effects of vitamin C on osteoblast proliferation and osteosarcoma inhibition using plasma coated hydroxyapatite on titanium implants

Plasma-sprayed hydroxyapatite (HAp) coated titanium (Ti) implants are being extensively used in orthopedic surgeries and post-tumor resection to repair load-bearing segmental bone defects. In this study, vitamin C, an abundantly available natural biomolecule, is loaded onto plasma-sprayed HAp-coated commercially pure titanium (cpTi) surface to evaluate its chemopreventive and osteogenic properties, suggesting its clinical significance as an alternative or adjunct therapy in the treatment for osteosarcoma bone resection. Controlled release of vitamin C from HAp coated cpTi implant is assessed by in vitro drug release study, where Korsmeyer-Peppas model was applied to understand the release kinetics. After 21 days, the implants loaded with 400 and 800 μg of vitamin C showed a cumulative release of 62.7 and 74.1% in acidic microenvironment, whereas, 50.9% and 53.1% of total vitamin C release were observed by the implants loaded with 400 and 800 μg of vitamin C in physiological pH, respectively. To observe the effects of in vitro vitamin C release on osteosarcoma and osteoblast cellular activity, MG-63 (human osteosarcoma) and hFOB (human fetal osteoblast) cells were cultured on the surface of the implant and MTT cell viability assay and FESEM were carried out at 3 and 7 days of culture. Presence of high dosages 25 mM vitamin C shows a statistically significant (p≤0.05) decrease in osteosarcoma cell viability after 3 days, while both 5 mM and 25mM vitamin C reduced cellular viability by 2.5 folds (p≤0.05) compared to the control after 7 days. Interestingly, the presence of vitamin C showed no obvious signs of cytotoxicity towards osteoblast cell-line at day 3 and day 7, as confirmed by the MTT assay. Additionally, the FESEM images depict layers of hFOB cellular morphology on the surface of the implants, suggesting excellent cytocompatibility towards the osteoblast cells. These results suggest that vitamin C loaded HAp coated cpTi implant with improved osteogenic and chemopreventive properties can be considered as a promising reconstructive option to repair the post-tumor resection defects in osteosarcoma.

Recent advances in the design of cardiovascular materials for biomedical applications

Biomaterials dominate the field of cardiovascular therapeutics, a multitude of which have been used to repair and replace injured heart tissue. This field has evolved beyond the simple selection of compatible materials and now focuses on the rational design of controlled structures that integrate with the cardiovascular system. However, the compatibility of these materials with the blood presents a major limitation to their clinical application. In this context, surface modification strategies can enhance blood compatibility and several recent advances in this area have emerged. This review summarizes the recent applications of biomaterials in cardiovascular therapies, the improvements in their biocompatibility and the surface modification technologies that have the potential to improve clinical outcomes.

Biomimetic Coatings Obtained by Combinatorial Laser Technologies

The modification of implant devices with biocompatible coatings has become necessary as a consequence of premature loosening of prosthesis. This is caused mainly by chronic inflammation or allergies that are triggered by implant wear, production of abrasion particles, and/or release of metallic ions from the implantable device surface. Specific to the implant tissue destination, it could require coatings with specific features in order to provide optimal osseointegration. Pulsed laser deposition (PLD) became a well-known physical vapor deposition technology that has been successfully applied to a large variety of biocompatible inorganic coatings for biomedical prosthetic applications. Matrix assisted pulsed laser evaporation (MAPLE) is a PLD-derived technology used for depositions of thin organic material coatings. In an attempt to surpass solvent related difficulties, when different solvents are used for blending various organic materials, combinatorial MAPLE was proposed to grow thin hybrid coatings, assembled in a gradient of composition. We review herein the evolution of the laser technological process and capabilities of growing thin bio-coatings with emphasis on blended or multilayered biomimetic combinations. These can be used either as implant surfaces with enhanced bioactivity for accelerating orthopedic integration and tissue regeneration or combinatorial bio-platforms for cancer research.

Controlled Delivery of Curcumin and Vitamin K2 from Hydroxyapatite-Coated Titanium Implant for Enhanced in Vitro Chemoprevention, Osteogenesis, and in Vivo Osseointegration

Successful repair of critical-sized tumor-resection defects, especially in load-bearing bones, still remains a major challenge in clinical orthopedics. Titanium (Ti) implants have been increasingly used in the past few decades because of titanium's suitable mechanical properties and biocompatibility; however, it shows insufficient integration with the surrounding bone. In this study, the plasma spray technique is utilized to form homogeneous hydroxyapatite (HA) coating on the surface of the Ti implant to enhance osseointegration at the tissue-implant interface. These coated implants are loaded with curcumin and vitamin K2 to introduce chemopreventive and osteogenesis ability via controlled release of these biomolecules. The synergistic effect of these two biomolecules showed enhanced in vitro osteoblast (hFOB) cell attachment and proliferation for 11 days. Moreover, these biomolecules showed lower in vitro osteosarcoma (MG-63) cell proliferation after 3, 7, and 11 days. An in vivo study was carried out to evaluate the bone bonded zone in a rat distal femur model at an early wound healing stage of 5 days. Modified Masson Goldner staining of the tissue-implant section showed improved contact between tissue and implant in dual drug-loaded HA-coated Ti implants compared to control implants. This work presents a successful fabrication of a mechanically competent functional Ti implant with the advantages of enhanced in vitro osteoblast proliferation, osteosarcoma inhibition, and in vivo osseointegration, indicating the potential for load-bearing bone-defect repair after tumor resection.

Substituted hydroxyapatite coatings of bone implants

Surface modification of orthopedic and dental implants has been demonstrated to be an effective strategy to accelerate bone healing at early implantation times. Among the different alternatives, coating implants with a layer of hydroxyapatite (HAp) is one of the most used techniques, due to its excellent biocompatibility and osteoconductive behavior. The composition and crystalline structure of HAp allow for numerous ionic substitutions that provide added value, such as antibiotic properties or osteoinduction. In this article, we will review and critically analyze the most important advances in the field of substituted hydroxyapatite coatings. In recent years substituted HAp coatings have been deposited not only on orthopedic prostheses and dental implants, but also on macroporous scaffolds, thus expanding their applications towards bone regeneration therapies. Besides, the capability of substituted HAps to immobilize proteins and growth factors by non-covalent interactions has opened new possibilities for preparing hybrid coatings that foster bone healing processes. Finally, the most important in vivo outcomes will be discussed to understand the prospects of substituted HAp coatings from a clinical point of view.

Porosity and Its Significance in Plasma-Sprayed Coatings

Porosity in plasma-sprayed coatings is vital for most engineering applications. Porosity has its merits and demerits depending on the functionality of the coating and the immediate working environment. Consequently, the formation mechanisms and development of porosity have been extensively explored to find out modes of controlling porosity in plasma-sprayed coatings. In this work, a comprehensive review of porosity on plasma-sprayed coatings is established. The formation and development of porosity on plasma-sprayed coatings are governed by set spraying parameters. Optimized set spraying parameters have been used to achieve the most favorable coatings with minimum defects. Even with the optimized set spraying parameters, defects like porosity still occur. Here, we discuss other ways that can be used to control porosity in plasma-sprayed coating with emphasis to atmospheric plasma-sprayed chromium oxide coatings. Techniques like multilayer coatings, nanostructured coatings, doping with rare earth elements, laser surface re-melting and a combination of the above methods have been suggested in adjusting porosity. The influences of porosity on microstructure, properties of plasma-sprayed coatings and the measurement methods of porosity have also been reviewed.

Mechanical and biological properties of ZnO, SiO2, and Ag2O doped plasma sprayed hydroxyapatite coating for orthopaedic and dental applications

In this study, we explored a ternary dopant system utilizing 0.25 wt% ZnO to induce osteogenesis, 0.5 wt% SiO₂ to induce angiogenesis, and 2.0 wt% Ag₂O to provide secondary infection control within a plasma assisted hydroxyapatite coating for orthopaedic or dental applications. The objective of this study was to understand the effects of ZnO, SiO₂, and Ag₂O dopants on the mechanical and biological properties of hydroxyapatite (HA) coatings on titanium (Ti). Coatings were deposited using a 30 kW plasma spray system equipped with a supersonic nozzle to produce above standard coating bond strengths of 24 ± 2 MPa on Ti6Al4V and 22 ± 1 MPa on commercially pure Ti substrates. Antibacterial properties were revealed in vitro against E. coli and S. aureus. The ternary dopant system was implanted in 18 male Sprague-Dawley rats with timepoints of 5 and 10 weeks. By week 5, ZnSiAg-HA produced 32% bone mineralization of 68% total bone formation compared to only 11% bone mineralization of 55% total bone formation in the undoped coating. This system can be employed for replacement surgeries and revision surgeries to reduce healing time and enhance osseointegration. STATEMENT OF SIGNIFICANCE: Total hip replacements increased 124% from 2000 to 2010 with an ever-increasing rate due to the rise in average life span and an escalation in surgeries for young patients. Replacement surgeries come with the risk of rejection, poor integration, and infection. This study incorporates biologically relevant metallic oxides of ZnO, SiO₂, and Ag₂O within a hydroxyapatite coating on titanium deposited using a radio frequency induction plasma spray. A ternary dopant system has not been explored in the current literature and little is known about these particular dopants in vivo. This proposed system can be employed for replacement surgeries to lower healing time and enhance osseointegration between implant and host tissue.

In Vitro Activity Assays of Sputtered HAp Coatings with SiC Addition in Various Simulated Biological Fluids

Considering the requirements of medical implantable devices, it is pointed out that biomaterials should play a more sophisticated, longer-term role in the customization and optimization of the material–tissue interface in order to ensure the best long-term clinical outcomes. The aim of this contribution was to assess the performance of silicon carbide–hydroxyapatite in various simulated biological fluids (Dulbecco’s modified Eagle’s medium (DMEM), simulated body fluid (SBF), and phosphate buffer solution (PBS)) through immersion assays for 21 days at 37 ± 0.5 °C and to evaluate the electrochemical behavior. The coatings were prepared on Ti6Al4V alloy substrates by magnetron sputtering method using two cathodes made of hydroxyapatite and silicon carbide (SiC). After immersion assays the coating’s surface was analyzed in terms of morphology, chemical and phase composition, and chemical bonds. According to the electrochemical behavior in the media investigated at 37 ± 0.5 °C, SiC addition inhibits the dissolution of the hydroxyapatite in DMEM acellular media. Furthermore, after adding SiC, the slow degradation of hydroxyapatite in PBS and SBF media as well as biomineralization in DMEM were observed.

Comparative effects of controlled release of sodium bicarbonate and doxorubicin on osteoblast and osteosarcoma cell viability

This study intends to analyze the effects of doxorubicin and sodium bicarbonate release with polycaprolactone (PCL) coating on calcium phosphate system which is a bone like material, on the cell viability and proliferation of osteosarcoma and osteoblast. Increased systematic pH concentrations locally by the release of sodium bicarbonate diminished acidosis and hence, alleviated malignancy. In our studies, we have shown that the same of dosage of doxorubicin inhibited both osteoblast and osteosarcoma cell attachment and viability whereas, sodium bicarbonate abated osteosarcoma cell proliferation. Sodium bicarbonate also inhibited osteoblast cell proliferation in the early time points, however, the cell viability increased after the initial burst release of the molecule. Polymer coating on calcium phosphate-based implants, as carriers of drug, can minimize chances of toxic effects of higher oral drug dosage in the body, and also help in delivering effective doses of drugs, locally to the target tissues, as compared to the oral drug delivery approach. A coating of PCL was thus incorporated to control the initial burst release of bicarbonate, which enhanced the osteoblast cell viability, but was capable of diminishing osteosarcoma cell proliferation. The novelty and clinical significance of this study lies in the understanding of unique delivery using encapsulated naturally occurring and more benign sodium bicarbonate, for usage after excision of the cancerous bone, without any adverse effects on normal bone cells.

Starch-Hydroxyapatite Composite Bone Scaffold Fabrication Utilizing a Slurry Extrusion-Based Solid Freeform Fabricator

Significant efforts have been made to treat bone disorders through the development of composite scaffolds utilizing calcium phosphate (CaP) through additive manufacturing techniques. However, the incorporation of natural polymers with CaP during 3D printing is difficult and remains a formidable challenge in bone and tissue engineering applications. The objective of this study is to understand the use of a natural polymer binder system in ceramic composite scaffolds using a ceramic slurry-based solid freeform fabricator (SFF). This was achieved through the utilization of naturally sourced gelatinized starch with hydroxyapatite (HA) ceramic in order to obtain high mechanical strength and enhanced biological properties of the green part without the need for cross-linking or post processing. The parametric effects of solids loading, polycaprolactone (PCL) polymer addition, and designed porosity on starch-HA composite scaffolds were assessed through mechanical strength, microstructure, and in vitro biocompatibility utilizing human osteoblast cells. It was hypothesized that starch incorporation would improve the mechanical strength of the scaffolds and increase proliferation of osteoblast cells in vitro. Starch loading was shown to improve mechanical strength from 4.07 ± 0.66 MPa to 10.35 ± 1.10 MPa, more closely resembling the mechanical strength of cancellous bone. Based on these results, a reinforcing mechanism of gelatinized starch based on interparticle and apatite crystal interlocking is proposed. Morphological characterization utilizing FESEM and MTT cell viability assay showed enhanced osteoblast cell proliferation in the presence of starch and PCL. Overall, the utilization of starch as a natural binder system in SFF scaffolds was found to improve both green strength and in vitro biocompatibility.

A New Highly Hydrophilic Electrochemical Implant Titanium Surface: A Histological and Biomechanical In Vivo Study

PURPOSE

The aim was to compare the osseointegration degree and secondary implant stability between implants with different surface treatments.

MATERIALS AND METHODS

A novel electrochemical treatment was applied to modify the sandblasted and acid-etched surface (SLA) to obtain the new hydrophilic Feeling (FEL) surface presenting a highly soluble and homogenous film made of calcium and phosphorus nanocrystals. Twenty 3.8 × 10-mm dynamix implants (Cortex) were inserted in sheep iliac crests. Sheep were killed after 2 months. Bone-to-implant contact percentage (%BIC) and biomechanical parameters, such as implant stability quotient (ISQ) and value of actual micromotion (VAM), were evaluated for each implants.

RESULTS

No implant failures were observed. Implants of test group showed %BIC value 30% higher in respect with control group (P = 0.001). No statistical differences were detected between the 2 groups in VAM and ISQ values.

CONCLUSION

Both surface treatments were highly osteoconductive because they were able to significantly increase the bone density onto implant surface in respect with that in which they were inserted (D4 bone density). The hydrophilic FEL surface demonstrated an increase of about 216% in BIC in respect with host bone density and an additional 30% more in respect with SLA surface. Faster osseointegration process is desirable in case of early implant loading protocol.

Effects of polycaprolactone on alendronate drug release from Mg-doped hydroxyapatite coating on titanium

The scientific objective of this study was to understand the influence of PCL coating on alendronate drug release kinetics in vitro. Our hypothesis was PCL coating would minimize burst release of alendronate from plasma sprayed Mg-doped hydroxyapatite (HA) coated commercially pure titanium (CpTi) samples. In the US alone, over 44 million women and men aged 50 and older are affected by osteoporosis which can lead to replacement and/or revision surgeries. Alendronate is a widely-used drug for treating osteoporosis and would be an ideal drug to be loaded and released from these replacement systems. Initial burst release is a common phenomenon for the most drug loaded devices. To modulate the release kinetics, a biodegradable polymer, polycaprolactone (PCL), coating with slow degradable kinetics was employed. Samples with 2 and 4 wt% PCL showed about 34% and 26% release of alendronate within the first 24 h, respectively, compared to 75% burst release without any PCL coating. With the addition of a PCL coating, a controlled release kinetics of alendronate was achieved from HA coated titanium implants, which can potentially impact millions of patients worldwide having compromised bone due to osteoporosis.

Separation and preconcentration of riboflavin from human plasma using polythionine coated magnetite/hydroxyapatite nanocomposite prior to analysis by surfactant-enhanced fluorimetry

The exploration of novel adsorption properties of conductive polymers based on hybridization with biocompatible nanomaterials receives an increasing interest. In this regard, hydroxyapatite (HA) bioceramic is of critical importance mainly owing to its facile synthesis, high surface area, economic and low toxicity in biological environments. In this work, we first prepared and characterized a magnetite/hydroxyapatite (Fe₃O₄/HA) nanocomposite using the bio-waste chicken eggshell via an attractive green way that involved low cost and irrespective of toxicity. Then, polythionine as a novel class of conductive polymers was in situ coated on the synthesized magnetic bioceramic for the separation and preconcentration of riboflavin (vitamin B₂) in human plasma before its fluorimetric determination. Considering the putative role of riboflavin in protecting against cancer and cardiovascular diseases, it is essential to evaluate this vitamin in biological fluids. The described method possesses a linear range of 0.75-262.5μgL^-1 (R²=0.9985) and a detection limit of 0.20μgL^-1 (signal-to-noise ratio of 3). The relative standard deviations (RSDs) for single-sorbent repeatability and sorbent-to-sorbent reproducibility were less than 4.0% and 7.6% (n=5), respectively. The respective enrichment factor and extraction recovery of the method found to be 35.7 and 98.4%. The analytical performance of method for riboflavin was characterized by good consistency of the results with those obtained by the enzyme-linked immunosorbent assay (ELISA) conventional method (p-value of <0.05). The optimized protocol intended for control determinations of riboflavin in human subjects and is addressed to clinical laboratories.

Effects of MgO and SiO2 on Plasma-Sprayed Hydroxyapatite Coating: An in Vivo Study in Rat Distal Femoral Defects

Plasma-sprayed hydroxyapatite (HA)-coated titanium implants have been widely used in orthopedic applications due to their inheritance of an excellent mechanical property from titanium and great osteoconductivity from HA. However, the lack of osteoinductivity limits their further applications. In this study, 1 wt % MgO and 0.5 wt % SiO₂ were mixed with HA for making plasma-sprayed coatings on titanium implants. Plasma-sprayed HA- and MgO/SiO₂-HA-coated titanium implants showed adhesive bond strengths of 25.73 ± 1.92 and 23.44 ± 2.89 MPa, respectively. The presence of MgO and SiO₂ significantly increased the osteogenesis, osseointegration, and bone mineralization of HA-coated titanium implants by the evaluation of their histomorphology after 6, 10, and 14 weeks of implantation in rat distal femoral defects. Implant pushout tests also showed a shear modulus of 149.83 ± 3.69 MPa for MgO/SiO₂-HA-coated implants after 14 weeks of implantation, compared to 52.68 ± 10.41 MPa for uncoated implants and 83.92 ± 3.68 MPa for pure HA-coated implants; These are differences in the shear modulus of 96% and 56.4%, respectively. This study assesses for the first time the quality of the bone-implant interface of induction plasma-sprayed MgO and SiO₂ binary-doped HA coatings on load-bearing implants compared to bare titanium and pure HA coatings in a quantitative manner. Relating the osseointegration and interface shear modulus to the quality of implant fixation is critical to the advancement and implementation of HA-coated orthopedic implants.

Effects of Iron on Physical and Mechanical Properties, and Osteoblast Cell Interaction in β-Tricalcium Phosphate

Iron (Fe) is a vital element and its deficiency causes abnormal bone metabolism. We investigated the effects of Fe and its concentration in β-tricalcium phosphate (β-TCP) on physicomechanical properties and in vitro proliferation and differentiation of osteoblasts. Our results showed that Fe addition at concentrations of 0.5 wt.% (0.5 Fe-TCP) and 1.0 wt.% (1.0 Fe-TCP) inhibits the β-TCP to α-TCP phase transformation at sintering temperature of 1250 °C. Addition of 0.25 wt.% Fe (0.25 Fe-TCP) increased the compressive strength of β-TCP from 167.27 ± 16.2 to 227.10 ± 19.3 MPa. After 3 days of culture, surfaces of 0.5 Fe-TCP and 1.0 Fe-TCP samples were covered by osteoblast cells, compared to that of pure and 0.25 Fe-TCP. Cells grew to confluency on all Fe-doped samples after 7 days of culture and monolayer sheet-like cellular structure was found at 11 days. Optical cell density and alkaline phosphatase activity were significantly higher on Fe-doped samples and the highest values were found in 0.5 Fe-TCP samples. Our results show that Fe concentration had significant effect on physical and mechanical properties of TCP ceramics, and also on the in vitro osteoblast cellular interactions in TCP ceramics.

Influence of single and binary doping of strontium and lithium on in vivo biological properties of bioactive glass scaffolds

Effects of strontium and lithium ion doping on the biological properties of bioactive glass (BAG) porous scaffolds have been checked in vitro and in vivo. BAG scaffolds were prepared by conventional glass melting route and subsequently, scaffolds were produced by evaporation of fugitive pore formers. After thorough physico-chemical and in vitro cell characterization, scaffolds were used for pre-clinical study. Soft and hard tissue formation in a rabbit femoral defect model after 2 and 4 months, were assessed using different tools. Histological observations showed excellent osseous tissue formation in Sr and Li + Sr scaffolds and moderate bone regeneration in Li scaffolds. Fluorochrome labeling studies showed wide regions of new bone formation in Sr and Li + Sr doped samples as compared to Li doped samples. SEM revealed abundant collagenous network and minimal or no interfacial gap between bone and implant in Sr and Li + Sr doped samples compared to Li doped samples. Micro CT of Li + Sr samples showed highest degree of peripheral cancellous tissue formation on periphery and cortical tissues inside implanted samples and vascularity among four compositions. Our findings suggest that addition of Sr and/or Li alters physico-chemical properties of BAG and promotes early stage in vivo osseointegration and bone remodeling that may offer new insight in bone tissue engineering.

Bone demineralization with citric acid enhances adhesion and spreading of preosteoblasts

BACKGROUND

Previous studies have demonstrated that bone demineralization can improve consolidation in bone grafts. The biologic mechanisms underlying this phenomenon remain unclear.

METHODS

Twelve adult male guinea pigs were used in this experiment. Forty-five bone samples removed from the calvaria of nine animals were divided in groups (n = 9) according to the time of demineralization with citric acid (50%, pH 1): 15, 30, 90, and 180 seconds and non-demineralized samples (control). Preosteoblasts (MC3T3-E1) were cultured on the bone samples for 24, 48, and 72 hours (n = 3). Fifteen samples removed from the remaining three animals were analyzed by scanning electron microscopy/energy dispersive spectrometry (SEM/EDS) after demineralization (n = 3).

RESULTS

The number of preosteoblasts increased significantly with time in all groups. The bone surface area covered by these cells increased with time, except in the control group. Intragroup differences occurred between 24 and 72 hours (P < 0.05). Samples demineralized for 30 seconds showed greater area covered by preosteoblast cells than for the other times of demineralization in all periods of cell culture (P < 0.05) without a statistically significant difference compared with 15 seconds. SEM/EDS showed diminished content of calcium (Ca) after 15 seconds of demineralization, but the Ca content increased after 180 seconds of demineralization (P < 0.05). The phosphorus (P) amount increased significantly only after 30 seconds of demineralization (P < 0.5). The sulfur (S) content was increased in demineralized samples in relation to non-demineralized ones, reaching the highest level after 90 seconds, when the difference became significant in relation to all the other times of demineralization (P < 0.05). Magnesium (Mg) content did not differ significantly between demineralized and non-demineralized samples.

CONCLUSIONS

Bone surfaces demineralized for 30 seconds increased the spreading of preosteoblasts as well as the surface area covered by these cells. Bone demineralization deserves to be studied in periodontal and maxillofacial regenerative procedures.

Lithium-doped β-tricalcium phosphate: Effects on physical, mechanical and in vitro osteoblast cell-material interactions

In this work, we have investigated the effects of lithium (Li) dopant at different concentrations and sintering temperatures on the physical and mechanical properties of β-tricalcium phosphate (β-TCP). Our results showed that Li addition at concentrations of 0.65 and 1.0 wt % inhibits the β-TCP to α-TCP phase transformation. 0.15 wt % Li addition resulted in grain growth and extensive liquid phase was formed at higher concentrations. At 1150°C, compressive strength of β-TCP increased from 138.7 ± 19.9 MPa to 170.9 ± 29.8 MPa with the addition of 0.15 wt % Li. Addition of higher amounts of Li decreased the compressive strength and the lowest compressive strength of 99.8 ± 13.7 MPa was found in samples containing 1.0 wt % Li. After 3 days of culture, osteoblast cells grew to confluence on samples containing 0.65 and 1.0 wt % Li. Cells grew to confluence on all doped samples after 11 days of culture and optical cell density was 4-5 folds higher on 0.15 and 1.0 wt % Li-doped TCP samples. Our results show that both Li content and sintering temperature have significant influence toward physicochemical and mechanical properties of β-TCP which affects the osteoblast cell-materials interaction in Li-doped TCP scaffolds. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 391-399, 2017.

Phase stability and biological property evaluation of plasma sprayed hydroxyapatite coatings for orthopedic and dental applications

In this work we have investigated the effects of strontium (Sr) dopant on in vitro protein release kinetics and in vivo osteogenic properties of plasma sprayed hydroxyapatite (HA) coatings, along with their dissolution behavior. Plasma sprayed HA coatings are widely used in load-bearing implants. Apart from osseointegration, the new generation of HA coating is expected to deliver biomolecules and/or drugs that can induce osteoinduction. This paper reports the preparation of crystalline and amorphous HA coatings on commercially pure titanium (Cp-Ti) using inductively coupled radio frequency (RF) plasma spray, and their stability at different solution pH. Coatings prepared at 110 mm working distance from the nozzle showed an average Ca ion release of 18 and 90 ppm in neutral and acidic environments, respectively. Decreasing the working distance to 90 mm resulted in the formation of a coating with less crystalline HA and phases with higher solubility products, and consequently higher dissolution over 32 days. A 92% release of a model protein bovine serum albumin (BSA) in phosphate buffer with pH of 7.4 was measured for Sr-doped HA (Sr-HA) coating, while only a 72% release could be measured for pure HA coating. Distortion of BSA during adsorption on coatings revealed a strong interaction between the protein and the coating, with an increase in α-helix content. Osteoid formation was found on Sr-HA implants as early as 7 weeks post implantation compared to HA coated and uncoated Ti implants. After 12 weeks post implantation, osteoid new bone was formed on HA implants; whereas, bone mineralization started on Sr-HA samples. While no osteoid was formed on bare Ti surfaces, bone was completely mineralized on HA and Sr-HA coatings after 16 weeks post implantation. Our results show that both phase stability and chemistry can have a significant influence toward in vitro and in vivo response of HA coatings on Ti implants.

Nanotechnology in the Regeneration of Complex Tissues

Modern medicine faces a growing crisis as demand for organ transplantations continues to far outstrip supply. By stimulating the body’s own repair mechanisms, regenerative medicine aims to reduce demand for organs, while the closely related field of tissue engineering promises to deliver “off-the-self” organs grown from patients’ own stem cells to improve supply. To deliver on these promises, we must have reliable means of generating complex tissues. Thus far, the majority of successful tissue engineering approaches have relied on macroporous scaffolds to provide cells with both mechanical support and differentiative cues. In order to engineer complex tissues, greater attention must be paid to nanoscale cues present in a cell’s microenvironment. As the extracellular matrix is capable of driving complexity during development, it must be understood and reproduced in order to recapitulate complexity in engineered tissues. This review will summarize current progress in engineering complex tissue through the integration of nanocomposites and biomimetic scaffolds.

Advances in the surface modification techniques of bone-related implants for last 10 years

At the time of implanting bone-related implants into human body, a variety of biological responses to the material surface occur with respect to surface chemistry and physical state. The commonly used biomaterials (e.g. titanium and its alloy, Co-Cr alloy, stainless steel, polyetheretherketone, ultra-high molecular weight polyethylene and various calcium phosphates) have many drawbacks such as lack of biocompatibility and improper mechanical properties. As surface modification is very promising technology to overcome such problems, a variety of surface modification techniques have been being investigated. This review paper covers recent advances in surface modification techniques of bone-related materials including physicochemical coating, radiation grafting, plasma surface engineering, ion beam processing and surface patterning techniques. The contents are organized with different types of techniques to applicable materials, and typical examples are also described.

Titanium surfaces with nanostructures influence on osteoblasts proliferation: a systematic review

Objectives

Nanothechnology found to be increasingly implemented in implantology sphere over the recent years and it shows encouraging effect in this field. The aim of present review is to compare, based on the recent evidence, the influence of various nanostructure surface modifications of titanium for implants, on osteoblasts proliferation.

Material and Methods

A literature review of English articles was conducted by using MEDLINE database restricted to 2009 - 2014 and constructed according PRISMA guidelines. Search terms included “Titanium implant”, “Titanium surface with nanostructure”, “Osteoblast”. Additional studies were identified in bibliographies. Only in vitro and/or in vivo studies on nano structured implant surfaces plus control sample, with specific evaluation method for osteoblasts proliferation and at least one Ti sample with nanostructure, were included in the review.

Results

32 studies with 122 groups of examined samples were selected for present review. Each study conducted in vitro experiment, two studies conducted additional in vivo experiments. All studies were dispensed by type of surface modification into two major groups; “Direct ablative titanium implant surface nano-modifications” with 19 studies and ”Nanocomposite additive implant surface modifications” with 13 studies. Overall 24 studies reporting on positive effect of nanostructured surface, 2 studies found no significant advantage and 6 studies reported on negative effect compared to other structure scales.

Conclusions

From examination of selected articles we can notice marked advantage in implementation of various nanostructures onto implant surface. Yet for discovering the ultimate implant surface nanostructure, further comparable investigations of Ti surface nanostructures need to be done.

Micro-Raman spectroscopy shows how the coating process affects the characteristics of hydroxylapatite

The diversity in the structural and chemical state of apatites allows implant manufacturers to fine-tune implant properties. This requires suitable manufacturing processes and characterization tools to adjust the amorphous phase and hydroxyl content from the source hydroxylapatite. Hydroxylapatite was processed by high-velocity oxy-fuel spraying, plasma spraying and flame spraying, and primarily analyzed by Raman spectroscopy. Investigation of rounded splats, the building blocks of thermal spray coatings, allowed correlation between the visual identity of the splat surface and the Raman spectra. Splats were heat-treated to crystallize any remaining amorphous phase. The ν1 PO4 stretching peak at 950-970 cm(-1) displayed the crystalline order, but the hydroxyl peak at 3572 cm(-1) followed the degree of dehydroxylation. Hydroxyl loss was greatest for flame-sprayed particles, which create the longest residence time for the melted particle. Higher-frequency hydroxyl peaks in flame- and plasma-sprayed splats indicated a lower structural order for the recrystallized hydroxylapatite within the splats. Crystallization at 700 °C has shown potential for revealing hydroxyl ions previously trapped in amorphous calcium phosphate. This work compares Fourier transform infrared and Raman spectroscopy to measure the hydroxyl content in rapidly solidified apatites and shows that Raman spectroscopy is more suitable.

Sr-containing hydroxyapatite: morphologies of HA crystals and bioactivity on osteoblast cells

A series of Sr-substituted hydroxyapatites (HA), of general formula Ca(10-x)Srx(PO4)6(OH)2, where x=2 and 4, were synthesized by solid state methods and characterized extensively. The reactivity of these materials in cell culture medium was evaluated, and the behavior towards MG-63 osteoblast cells (in terms of cytotoxicity and proliferation assays) was studied. Future in vivo studies will give further insights into the behavior of the materials. A paper by Lagergren et al. (1975), concerning Sr-substituted HA prepared by a solid state method, reports that the presence of Sr in the apatite composition strongly influences the apatite diffraction patterns. Zeglinsky et al. (2012) investigated Sr-substituted HA by ab initio methods and Rietveld analyses and reported changes in the HA unit cell volume and shape due to the Sr addition. To further clarify the role played by the addition of Sr on the physico-chemical properties of these materials we prepared Sr-substituted HA compositions by a solid state method, using different reagents, thermal treatments and a multi-technique approach. Our results indicated that the introduction of Sr at the levels considered here does influence the structure of HA. There is also evidence of a decrease in the crystallinity degree of the materials upon Sr addition. The introduction of increasing amounts of Sr into the HA composition causes a decrease in the specific surface area and an enrichment of Sr-apatite phase at the surface of the samples. Bioactivity tests show that the presence of Sr causes changes in particle size and/or morphology during soaking in MEM solution; on the contrary the morphology of pure HA does not change after 14 days of reaction. The presence of Sr, as Sr-substituted HA and SrCl2, in cultures of human MG-63 osteoblasts did not produce any cytotoxic effect. In fact, Sr-substituted HA increased the proliferation of osteoblast cells and enhanced cell differentiation: Sr in HA has a positive effect on MG-63 cells. In contrast, Sr ions alone, at the concentrations released by Sr-HA (1.21-3.24 ppm), influenced neither cell proliferation nor differentiation. Thus the positive effects of Sr in Sr-HA materials are probably due to the co-action of other ions such as Ca and P.

Mechanical and In Vitro Biocompatibility of Brushite Cement Modified by Polyethylene Glycol

Brushite (dicalcium phosphate dihydrate, DCPD) cement, owing to its high solubility in physiological condition and ability to guide new bone formation, is widely used to treat bone defects. In the present study, we have evaluated the effects of poly ethylene glycol (PEG) addition on the setting time, compressive strength and in vitro biocompatibility of brushite cement. The brushite cements were prepared by mixing β-tricalcium phosphate [β-TCP, Ca(3)(PO(4))(2)] and monocalcium phosphate monohydrate [MCPM, Ca(H(2)PO(4))(2). H(2)O]. PEG was introduced at 2.0 and 5.0 wt% with the liquid. Introduction of PEG resulted in marginal increase in both initial and final setting time; however, significantly affected the compressive strength. Effects of PEG incorporation on in vitro biocompatibility of brushite cements were studied by using human fetal osteoblast cells (hFOB) cells. Field emission scanning electron microscope (FESEM) images and immunohistochemical analysis indicated that pure and PEG incorporated brushite cement facilitates cell adhesion, proliferation and differentiation. Fewer cells expressed vinculin protein with increased PEG content in the cement. Cell proliferation was found to decrease with increased PEG concentration while the cell differentiation increased with PEG content. Our results provide a better understanding of in vitro biocompatibility of PEG added brushite cements that can be used to customize the cement compositions based on application need.

Comparison study of biomimetic strontium-doped calcium phosphate coatings by electrochemical deposition and air plasma spray: morphology, composition and bioactive performance

In this study, strontium-doped calcium phosphate coatings were deposited by electrochemical deposition and plasma spray under different process parameters to achieve various coating morphologies. The coating composition was investigated by energy dispersive X-ray spectroscopy and X-ray diffraction. The surface morphologies of the coatings were studied through scanning electron microscopy while the cytocompatibility and bioactivity of the strontium-doped calcium phosphate coatings were evaluated using bone cell culture using MC3T3-E1 osteoblast-like cells. The addition of strontium leads to enhanced proliferation suggesting the possible benefits of strontium incorporation in calcium phosphate coatings. The morphology and composition of deposited coatings showed a strong influence on the growth of cells.

Fluorescence microscopic analysis of bone osseointegration of strontium-substituted hydroxyapatite implants

The purpose of this study was to analyze the effect of strontium-substituted hydroxyapatite (Sr-HA) on bone osseointegration of the implants using fluorescence microscopy. We allocated 20 implants to two groups: Sr-HA group and HA group. Electrochemically deposited HA and Sr-HA coatings were applied onto the implants separately. All the implants were inserted into femur bone of rabbits. Oxytetracycline hydrochloride, alizarin-complexon, and calcein green were respectively administered 7, 28, and 46 d after the implantation. After eight weeks, femurs were retrieved and prepared for the fluorescence microscopy observation. We analyzed the bone mineral apposition rates (MARs), bone area ratios (BARs), and bone to implant contact (BIC) of the two groups. Fluorescence microscopic observation showed that all groups exhibited extensive early peri-implant bone formation. The MAR of the Sr-HA group was greater than that for pure HA from 7 to 28 d after implantation, but no significant difference was found at later stage. And the BIC showed difference at 7 and 28 d compared with pure HA. We concluded that Sr-HA coating can improve the bone osseointegration of the implant in the early stage compared with the HA coating.

Antibacterial and biological characteristics of silver containing and strontium doped plasma sprayed hydroxyapatite coatings

Infection in primary total joint prostheses is estimated to occur in up to 3% of all surgery. As a measure to improve the antimicrobial properties of implant materials silver (Ag) was incorporated into plasma sprayed hydroxyapatite (HA) coatings. To offset potential cytotoxic effects of Ag in the coatings strontium (Sr) was also added as a binary dopant. HA powder was doped with 2.0 wt.% Ag(2)O, 1.0 wt.% SrO and was then heat treated at 800 °C. Titanium substrates were coated using a 30 kW plasma spray system equipped with a supersonic nozzle. X-ray diffraction confirmed the phase purity and high crystallinity of the coatings. Samples were evaluated for mechanical stability by adhesive bond strength testing. The results show that the addition of dopants did not affect the overall bond strength of the coatings. The antibacterial efficacies of the coatings were tested against Pseudomonas aeruginosa. Samples that contained the Ag(2)O dopant were found to be highly effective against bacterial colonization. In vitro cell-material interactions using human fetal osteoblast cells were characterized by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay for cell viability, field emission scanning electron microscopy for cell morphology and confocal imaging for the important differentiation marker alkaline phosphatase (ALP). Our results showed evidence of cytotoxic effects of the Ag-HA coatings, characterized by poor cellular morphology and cell death and nearly complete loss of functional ALP activity. The addition of SrO to the Ag-HA coatings was able to effectively offset these negative effects and improve performance compared with pure HA-coated samples.

Mechanical, in vitro antimicrobial, and biological properties of plasma-sprayed silver-doped hydroxyapatite coating

Implant-related infection is one of the key concerns in total joint hip arthroplasties. To reduce bacterial adhesion, we used silver (Ag)/silver oxide (Ag(2)O) doping in plasma sprayed hydroxyapatite (HA) coating on titanium substrate. HA powder was doped with 2.0, 4.0, and 6.0 wt % Ag, heat-treated at 800 °C and used for plasma spray coating using a 30 kW plasma spray system, equipped with supersonic nozzle. Application of supersonic plasma nozzle significantly reduced phase decomposition and amorphous phase formation in the HA coatings as evident by X-ray diffraction (XRD) study and Fourier transformed infrared spectroscopic (FTIR) analysis. Adhesive bond strength of more than 15 MPa ensured the mechanical integrity of the coatings. Resistance against bacterial adhesion of the coatings was determined by challenging them against Pseudomonas aeruginosa (PAO1). Live/dead staining of the adherent bacteria on the coating surfaces indicated a significant reduction in bacterial adhesion due to the presence of Ag. In vitro cell-material interactions and alkaline phosphatase (ALP) protein expressions were evaluated by culturing human fetal osteoblast cells (hFOB). Our results suggest that the plasma-sprayed HA coatings doped with an optimum amount of Ag can have excellent antimicrobial property without altering mechanical property of the Ag-doped HA coatings.

MgO-doped tantalum coating on Ti: microstructural study and biocompatibility evaluation

Pure and MgO incorporated Ta coatings were prepared on Cp-Ti substrate using laser engineered net shaping (LENS), which resulted in diffuse coating-substrate interface. MgO was found along the Ta grain boundaries in the Ta matrix that increased the coating hardness from 185 ± 2.7 HV to 794 ± 93 HV. In vitro biocompatibility study showed excellent early cellular attachment and later stage proliferation in MgO incorporated coatings. The results indicated that although Ta coatings had higher biocompatibility than Ti, it could further be improved by incorporating MgO in the coating, while simultaneously improving the mechanical properties.