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Aellos F, Grauer JA, Harder KG, Dworan JS, Fabbri G, Cuevas PL, Yuan X, Liu B, Brunski JB, Helms JA. Dynamic analyses of a soft tissue-implant interface: Biological responses to immediate versus delayed dental implants. J Clin Periodontol 2024; 51:806-817. [PMID: 38708491 DOI: 10.1111/jcpe.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/16/2024] [Accepted: 03/10/2024] [Indexed: 05/07/2024]
Abstract
AIM To qualitatively and quantitatively evaluate the formation and maturation of peri-implant soft tissues around 'immediate' and 'delayed' implants. MATERIALS AND METHODS Miniaturized titanium implants were placed in either maxillary first molar (mxM1) fresh extraction sockets or healed mxM1 sites in mice. Peri-implant soft tissues were evaluated at multiple timepoints to assess the molecular mechanisms of attachment and the efficacy of the soft tissue as a barrier. A healthy junctional epithelium (JE) served as positive control. RESULTS No differences were observed in the rate of soft-tissue integration of immediate versus delayed implants; however, overall, mucosal integration took at least twice as long as osseointegration in this model. Qualitative assessment of Vimentin expression over the time course of soft-tissue integration indicated an initially disorganized peri-implant connective tissue envelope that gradually matured with time. Quantitative analyses showed significantly less total collagen in peri-implant connective tissues compared to connective tissue around teeth around implants. Quantitative analyses also showed a gradual increase in expression of hemidesmosomal attachment proteins in the peri-implant epithelium (PIE), which was accompanied by a significant inflammatory marker reduction. CONCLUSIONS Within the timeframe examined, quantitative analyses showed that connective tissue maturation never reached that observed around teeth. Hemidesmosomal attachment protein expression levels were also significantly reduced compared to those in an intact JE, although quantitative analyses indicated that macrophage density in the peri-implant environment was reduced over time, suggesting an improvement in PIE barrier functions. Perhaps most unexpectedly, maturation of the peri-implant soft tissues was a significantly slower process than osseointegration.
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Affiliation(s)
- Fabiana Aellos
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Joseph A Grauer
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kasidy G Harder
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julia S Dworan
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Department of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Giacomo Fabbri
- Private Practice, Ban Mancini Fabbri Dental Clinic, Cattolica, Italy
| | - Pedro L Cuevas
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Xue Yuan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Bo Liu
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - John B Brunski
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jill A Helms
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
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McCarthy ML, Ariizumi RM, Grajales AG, DeCicco J, Forsberg JA, Watson N, Burch RH, Highland KB. Pain Management in Staged Osseointegration Procedures: A Retrospective Study and Foundation for Future Optimization. Mil Med 2024:usae320. [PMID: 38907523 DOI: 10.1093/milmed/usae320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/13/2024] [Accepted: 06/10/2024] [Indexed: 06/24/2024] Open
Abstract
INTRODUCTION Osseointegration is an innovative procedure to attach an external prosthetic device directly to the skeleton. The technique has been shown to improve physical function and quality of life relative to conventional socket prosthetic devices. While much of the research in osseointegration has focused on functional outcomes, less is known regarding perioperative pain management. The purpose of this study was to describe perioperative and postoperative pain management approaches received by patients undergoing osseointegration procedures at a tertiary medical center. MATERIALS AND METHODS This retrospective study was determined to be exempt from Institutional Review Board review by the Walter Reed National Military Medical Center Department of Research Programs. Perioperative and postoperative pain management approaches received by 41 patients who underwent 76 staged osseointegration procedures from 2016 to 2021 at Walter Reed National Military Medical Center were described. RESULTS Pain management approaches included perioperative ketamine (51% stage I, 55% stage II), epidurals (76% stage I, 77% stage II) with a median of 3-4 days across stages, peripheral nerve catheters (27% stage I, 16% stage II), and/or single-shot peripheral nerve block (<10% across stages). The median morphine equivalent dose provided during surgery was 65 mg across both stages, with 56% and 54% of patients also requiring opioid medication in the post-anesthesia care unit. In 11 of 76 (15%) procedures, patients required an increase in the rate or concentration of epidural or peripheral nerve catheter infusion. In six (8%) unique recovery periods, patients experienced a dislodged catheter. In 27 of 76 (36%) unique recovery periods, patients experienced a significant increase in postoperative pain requiring acute pain service intervention in the form of catheter adjustment, intravenous pain medications, and/or the addition of intravenous patient-controlled analgesia. Adequate pain control was achieved with minimal epidural or peripheral nerve catheter trouble-shooting and a bolus for 24 patients (89% requiring intervention). Summed 24-hour pain scores (SPI24) did not vary across stages. SPI24 was positively correlated with opioid doses received. Patients with single, relative to multiple, limb amputations had similar SPI24 values (P > .05). CONCLUSIONS Variability in pain management requirements calls forth opportunities to optimize osseointegration analgesia care and future research. As osseointegration becomes more accessible, the need for optimizing pain management through patient-centered research becomes more salient.
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Affiliation(s)
- Margaret L McCarthy
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- Department of Anesthesiology, Uniformed Services University, Bethesda, MD 20814, USA
| | - Ren M Ariizumi
- Department of Anesthesiology, Uniformed Services University, Bethesda, MD 20814, USA
- Department of Anesthesia Services, Alexander T. Augusta Military Medical Center, Fort Belvoir, VA 22060, USA
| | - Ana G Grajales
- School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Joseph DeCicco
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Jonathan A Forsberg
- Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- Orthopaedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Nora Watson
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Robert H Burch
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- Department of Anesthesiology, Uniformed Services University, Bethesda, MD 20814, USA
| | - Krista B Highland
- Department of Anesthesiology, Uniformed Services University, Bethesda, MD 20814, USA
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Bujda M, Klíma K. Enhancing Guided Bone Regeneration with a Novel Carp Collagen Scaffold: Principles and Applications. J Funct Biomater 2024; 15:150. [PMID: 38921524 PMCID: PMC11205119 DOI: 10.3390/jfb15060150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Bone defects resulting from trauma, surgery, and congenital, infectious, or oncological diseases are a functional and aesthetic burden for patients. Bone regeneration is a demanding procedure, involving a spectrum of molecular processes and requiring the use of various scaffolds and substances, often yielding an unsatisfactory result. Recently, the new collagen sponge and its structural derivatives manufactured from European carp (Cyprinus carpio) were introduced and patented. Due to its fish origin, the novel scaffold poses no risk of allergic reactions or transfer of zoonoses and additionally shows superior biocompatibility, mechanical stability, adjustable degradation rate, and porosity. In this review, we focus on the basic principles of bone regeneration and describe the characteristics of an "ideal" bone scaffold focusing on guided bone regeneration. Moreover, we suggest several possible applications of this novel material in bone regeneration processes, thus opening new horizons for further research.
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Affiliation(s)
- Michele Bujda
- Department of Oral and Maxillofacial Surgery, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, 12108 Prague, Czech Republic
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4
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Piñera-Avellaneda D, Buxadera-Palomero J, Delint RC, Dalby MJ, Burgess KV, Ginebra MP, Rupérez E, Manero JM. Gallium and silver-doped titanium surfaces provide enhanced osteogenesis, reduce bone resorption and prevent bacterial infection in co-culture. Acta Biomater 2024; 180:154-170. [PMID: 38621600 DOI: 10.1016/j.actbio.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/17/2024]
Abstract
Bacterial infection remains a significant problem associated with orthopaedic surgeries leading to surgical site infection (SSI). This unmet medical need can become an even greater complication when surgery is due to malignant bone tumor. In the present study, we evaluated in vitro titanium (Ti) implants subjected to gallium (Ga) and silver (Ag)-doped thermochemical treatment as strategy to prevent SSI and improve osteointegration in bone defects caused by diseases such as osteoporosis, bone tumor, or bone metastasis. Firstly, as Ga has been reported to be an osteoinductive and anti-resorptive agent, its performance in the mixture was proved by studying human mesenchymal stem cells (hMSC) and pre-osteoclasts (RAW264.7) behaviour. Then, the antibacterial potential provided by Ag was assessed by resembling "The Race for the Surface" between hMSC and Pseudomonas aeruginosa in two co-culture methods. Moreover, the presence of quorum sensing molecules in the co-culture was evaluated. The results highlighted the suitability of the mixture to induce osteodifferentiation and reduce osteoclastogenesis in vitro. Furthermore, the GaAg surface promoted strong survival rate and retained osteoinduction potential of hMSCs even after bacterial inoculation. Therefore, GaAg-modified titanium may be an ideal candidate to repair bone defects caused by excessive bone resorption, in addition to preventing SSI. STATEMENT OF SIGNIFICANCE: This article provides important insights into titanium for fractures caused by osteoporosis or bone metastases with high incidence in surgical site infection (SSI) because in this situation bacterial infection can become a major disaster. In order to solve this unmet medical need, we propose a titanium implant modified with gallium and silver to improve osteointegration, reduce bone resorption and avoid bacterial infection. For that aim, we study osteoblast and osteoclast behavior with the main novelty focused on the antibacterial evaluation. In this work, we recreate "the race for the surface" in long-term experiments and study bacterial virulence factors (quorum sensing). Therefore, we believe that our article could be of great interest, providing a great impact on future orthopedic applications.
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Affiliation(s)
- David Piñera-Avellaneda
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain.
| | - Judit Buxadera-Palomero
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain
| | - Rosalia Cuahtecontzi Delint
- Centre for the Cellular Microenvironment, Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Matthew J Dalby
- Centre for the Cellular Microenvironment, Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Karl V Burgess
- EdinOmics, University of Edinburgh, Max Born Crescent, Edinburgh, EH9 3BF, UK
| | - Maria-Pau Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain; Institute for Bioengineering of Catalonia (IBEC), 08028, Barcelona, Spain
| | - Elisa Rupérez
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain
| | - José María Manero
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain
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5
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Shrivas S, Samaur H, Yadav V, Boda SK. Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration. ACS Biomater Sci Eng 2024; 10:1966-1987. [PMID: 38530973 DOI: 10.1021/acsbiomaterials.3c01555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
A holistic biointegration of percutaneous bone-anchored metallic prostheses with both hard and soft tissues dictates their longevity in the human body. While titanium (Ti) has nearly solved osseointegration, soft tissue integration of percutaneous metallic prostheses is a perennial problem. Unlike the firm soft tissue sealing in biological percutaneous structures (fingernails and teeth), foreign body response of the skin to titanium (Ti) leads to inflammation, epidermal downgrowth and inferior peri-implant soft tissue sealing. This review discusses various implant surface treatments/texturing and coatings for osseointegration, soft tissue integration, and against bacterial attachment. While surface microroughness by SLA (sandblasting with large grit and acid etched) and porous calcium phosphate (CaP) coatings improve Ti osseointegration, smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings encourage soft tissue attachment. However, the inferior peri-implant soft tissue sealing compared to natural teeth can lead to peri-implantitis. Toward this end, the application of smart multifunctional bioadhesives with strong adhesion to soft tissues, mechanical resilience, durability, antibacterial, and immunomodulatory properties for soft tissue attachment to metallic prostheses is proposed.
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Affiliation(s)
- Sangeeta Shrivas
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Harshita Samaur
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Vinod Yadav
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Sunil Kumar Boda
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
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6
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Li P, Dai J, Li Y, Alexander D, Čapek J, Geis-Gerstorfer J, Wan G, Han J, Yu Z, Li A. Zinc based biodegradable metals for bone repair and regeneration: Bioactivity and molecular mechanisms. Mater Today Bio 2024; 25:100932. [PMID: 38298560 PMCID: PMC10826336 DOI: 10.1016/j.mtbio.2023.100932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/12/2023] [Accepted: 12/25/2023] [Indexed: 02/02/2024] Open
Abstract
Bone fractures and critical-size bone defects are significant public health issues, and clinical treatment outcomes are closely related to the intrinsic properties of the utilized implant materials. Zinc (Zn)-based biodegradable metals (BMs) have emerged as promising bioactive materials because of their exceptional biocompatibility, appropriate mechanical properties, and controllable biodegradation. This review summarizes the state of the art in terms of Zn-based metals for bone repair and regeneration, focusing on bridging the gap between biological mechanism and required bioactivity. The molecular mechanism underlying the release of Zn ions from Zn-based BMs in the improvement of bone repair and regeneration is elucidated. By integrating clinical considerations and the specific bioactivity required for implant materials, this review summarizes the current research status of Zn-based internal fixation materials for promoting fracture healing, Zn-based scaffolds for regenerating critical-size bone defects, and Zn-based barrier membranes for reconstituting alveolar bone defects. Considering the significant progress made in the research on Zn-based BMs for potential clinical applications, the challenges and promising research directions are proposed and discussed.
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Affiliation(s)
- Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China
- School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
- Department of Prosthodontics, School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Jingtao Dai
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China
| | - Yageng Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Dorothea Alexander
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Osianderstrasse 2-8, Tübingen 72076, Germany
| | - Jaroslav Čapek
- FZU – the Institute of Physics, Czech Academy of Sciences, Na Slovance 1999/2, Prague 8, 18200, Czech Republic
| | - Jürgen Geis-Gerstorfer
- Section Medical Materials Science and Technology, University Hospital Tübingen, Osianderstrasse 2-8, Tübingen 72076, Germany
| | - Guojiang Wan
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China
| | - Jianmin Han
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhentao Yu
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road 366, Guangzhou 510280, China
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7
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Deng T, Liu Q, Li Y, Zhu X, Long Y, Liu B, Pang J, Zhao L. PCAT-1' s role in wound healing impairment: Mitochondrial dysfunction and bone marrow stem cell differentiation inhibition via PKM2/β-catenin pathway and its impact on implant osseo-integration. Int Wound J 2024; 21:e14589. [PMID: 38135901 PMCID: PMC10961899 DOI: 10.1111/iwj.14589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
This study focused on unravelling the role of PCAT-1 in wound-healing process, particularly its impact on regenerative and osteogenic abilities of mesenchymal stem cells (MSCs). We delved into how PCAT-1 regulates mitochondrial oxidative phosphorylation (OXPHOS) and interacts with pivotal molecular pathways, especially β-catenin and PKM2, using human bone marrow-derived MSCs. MSCs were cultured under specific conditions and PCAT-1 expression was modified through transfection. We thoroughly assessed several critical parameters: MSC proliferation, mitochondrial functionality, ATP production and expression of wound healing and osteogenic differentiation markers. Further, we evaluated alkaline phosphatase (ALP) activity and mineral deposition, essential for bone healing. Our findings revealed that overexpressing PCAT-1 significantly reduced MSC proliferation, hampered mitochondrial performance and lowered ATP levels, suggesting the clear inhibitory effect of PCAT-1 on these vital wound-healing processes. Additionally, PCAT-1 overexpression notably decreased ALP activity and calcium accumulation in MSCs, crucial for effective bone regeneration. This overexpression also led to the reduction in osteogenic marker expression, indicating suppression of osteogenic differentiation, essential in wound-healing scenarios. Moreover, our study uncovered a direct interaction between PCAT-1 and the PKM2/β-catenin pathway, where PCAT-1 overexpression intensified PKM2 activity while inhibiting β-catenin, thereby adversely affecting osteogenesis. This research thus highlights PCAT-1's significant role in impairing wound healing, offering insights into the molecular mechanisms that may guide future therapeutic strategies for enhancing wound repair and bone regeneration.
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Affiliation(s)
- Tianzheng Deng
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
| | - Qian Liu
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
| | - Ying Li
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
| | - Xiaoru Zhu
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
| | - Yunjing Long
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
| | - Bing Liu
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
| | - Jianliang Pang
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
| | - Lingzhou Zhao
- Department of StomatologyAirforce Medical Center PLA, Air Force Medical UniversityBeijingChina
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8
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Gallab M, Le PTM, Shintani SA, Takadama H, Ito M, Kitagaki H, Matsushita T, Honda S, Okuzu Y, Fujibayashi S, Yamaguchi S. Mechanical, bioactive, and long-lasting antibacterial properties of a Ti scaffold with gradient pores releasing iodine ions. BIOMATERIALS ADVANCES 2024; 158:213781. [PMID: 38335763 DOI: 10.1016/j.bioadv.2024.213781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/30/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
The ideal bone implant would effectively prevent aseptic as well as septic loosening by minimizing stress shielding, maximizing bone ingrowth, and preventing implant-associated infections. Here, a novel gradient-pore-size titanium scaffold was designed and manufactured to address these requirements. The scaffold features a larger pore size (900 μm) on the top surface, gradually decreasing to small sizes (600 μm to 300 μm) towards the center, creating a gradient structure. To enhance its functionality, the additively manufactured scaffolds were biofunctionalized using simple chemical and heat treatments so as to incorporate calcium and iodine ions throughout the surface. This unique combination of varying pore sizes with a biofunctional surface provides highly desirable mechanical properties, bioactivity, and notably, long-lasting antibacterial activity. The target mechanical aspects, including low elastic modulus, high compression, compression-shear, and fatigue strength, were effectively achieved. Furthermore, the biofunctional surface exhibits remarkable in vitro bioactivity and potent antibacterial activity, even under conditions specifically altered to be favorable for bacterial growth. More importantly, the integration of small pores alongside larger ones ensures a sustained high release of iodine, resulting in antimicrobial activity that persisted for over three months, with full eradication of the bacteria. Taken together, this gradient structure exhibits obvious superiority in combining most of the desired properties, making it an ideal candidate for orthopedic and dental implant applications.
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Affiliation(s)
- Mahmoud Gallab
- Biomedical Sciences Department, Chubu University, Kasugai, Aichi 487-0027, Japan; Faculty of Engineering, Minia University, Minia 61111, Egypt.
| | - Phuc Thi Minh Le
- Biomedical Sciences Department, Chubu University, Kasugai, Aichi 487-0027, Japan; Institute of Biotechnology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Ha Noi, Viet Nam
| | - Seine A Shintani
- Biomedical Sciences Department, Chubu University, Kasugai, Aichi 487-0027, Japan
| | - Hiroaki Takadama
- Biomedical Sciences Department, Chubu University, Kasugai, Aichi 487-0027, Japan
| | - Morihiro Ito
- Biomedical Sciences Department, Chubu University, Kasugai, Aichi 487-0027, Japan
| | - Hisashi Kitagaki
- Osaka Yakin Kogyo Co., Ltd., Zuiko 4-4-28, Higashi Yodogawa-ku, Osaka City, Osaka 533-0005, Japan
| | - Tomiharu Matsushita
- Biomedical Sciences Department, Chubu University, Kasugai, Aichi 487-0027, Japan
| | - Shintaro Honda
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Kyoto 606-8501, Japan
| | - Yaichiro Okuzu
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Kyoto 606-8501, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Kyoto 606-8501, Japan
| | - Seiji Yamaguchi
- Biomedical Sciences Department, Chubu University, Kasugai, Aichi 487-0027, Japan.
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9
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Evans AR, Tetsworth K, Quinnan S, Wixted JJ. Transcutaneous osseointegration for amputees. OTA Int 2024; 7:e326. [PMID: 38487401 PMCID: PMC10936159 DOI: 10.1097/oi9.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 03/17/2024]
Abstract
Transcutaneous osseointegration for amputees (TOFA) is an evolving technology that has the potential to revolutionize the interface between the amputee and their prosthesis, showing potential at many levels of amputation. While no amputation is without its challenges, TOFA requires a highly specialized prosthesis and a multidisciplinary team that includes specialized surgeons, physical therapists, wound care teams, and social workers who guide the amputee through surgery, postoperative rehabilitation, and the chronic wound care that goes into maintaining the prosthesis. The infrastructure required to facilitate care pathways that lead to reliable, successful outcomes are unique in each health care setting, including those in advanced health care systems such as the United States and Australia. This article details the emerging evidence supporting the use of this prosthetic interface design and many of the challenges that providers face when establishing programs to offer this type of care in the United States.
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Affiliation(s)
- Andrew R. Evans
- Orthopedic Trauma Service, Department of Orthopedics, The Warren Alpert School of Medicine, Brown University/Rhode Island Hospital, Providence, RI
| | - Kevin Tetsworth
- Trauma & Limb Reconstruction Unit, Department of Orthopaedics, Royal Brisbane Hospital, Herston, Australia
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10
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Valamvanos TF, Dereka X, Katifelis H, Gazouli M, Lagopati N. Recent Advances in Scaffolds for Guided Bone Regeneration. Biomimetics (Basel) 2024; 9:153. [PMID: 38534838 DOI: 10.3390/biomimetics9030153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
The rehabilitation of alveolar bone defects of moderate to severe size is often challenging. Currently, the therapeutic approaches used include, among others, the guided bone regeneration technique combined with various bone grafts. Although these techniques are widely applied, several limitations and complications have been reported such as morbidity, suboptimal graft/membrane resorption rate, low structural integrity, and dimensional stability. Thus, the development of biomimetic scaffolds with tailor-made characteristics that can modulate cell and tissue interaction may be a promising tool. This article presents a critical consideration in scaffold's design and development while also providing information on various fabrication methods of these nanosystems. Their utilization as delivery systems will also be mentioned.
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Affiliation(s)
- Theodoros-Filippos Valamvanos
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Xanthippi Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Hector Katifelis
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Gazouli
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- School of Science and Technology, Hellenic Open University, 26335 Patra, Greece
| | - Nefeli Lagopati
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Greece Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece
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11
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Ailaney N, Barra MF, Schloemann DT, Thirukumaran CP, Kaplan NB. Short-Term (6 Months or Less) Pain in Cemented versus Cementless Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. J Arthroplasty 2024:S0883-5403(24)00134-7. [PMID: 38387768 DOI: 10.1016/j.arth.2024.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Cementless total knee arthroplasty (TKA) has increased in popularity to potentially improve survivorship. Radiostereometric studies demonstrate increased component migration during the first 3 to 6 months in cementless constructs, generating concern for increased postoperative pain during early osseointegration. The purpose of this study was to evaluate short-term (≤ 6 months) pain and function in cemented versus cementless TKA. We hypothesized that cementless TKA patients report increased pain during the short-term (≤ 6 months) postoperative period. METHODS The MEDLINE, EMBASE, CINAHL, and Cochrane Libraries were searched for studies evaluating short-term (≤ 6 months) outcomes of cemented versus cementless primary TKA. Studies involving hybrid fixation were excluded. A meta-analysis was performed using standardized mean difference for primary outcomes (early postoperative pain) and weighted mean difference (WMD) for secondary outcomes (early postoperative function). RESULTS There were eleven studies included. There was no significant difference in acute postoperative pain between cemented and cementless TKA within 6 months of index TKA (standardized mean difference 0.08 in favor of cemented TKA; P = .10). Early postoperative forgotten joint scores (WMD 0.81; P = .81) and knee injury and osteoarthritis outcome scores for joint replacement (WMD 0.80 in favor of cemented TKA; P = .14) were also similar between groups. CONCLUSIONS There is no difference in short-term (≤ 6 months) pain or early function between patients receiving cemented and cementless TKA. This suggests that surgeons may utilize cementless TKA without fear of increased pain due to micromotion within 6 months of index arthroplasty. However, additional studies with uniform assessment methods are needed to further inform differences in short-term pain and early functional outcomes between cemented and cementless TKA.
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Affiliation(s)
- Nikhil Ailaney
- Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Matthew F Barra
- Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Derek T Schloemann
- Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Caroline P Thirukumaran
- Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Nathan B Kaplan
- Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, New York
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12
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Aoyagi H, Okada M, Yanagimoto H, Matsumoto T. Investigation on bacterial capture and antibacterial properties of acid-treated Ti surface. Dent Mater 2024; 40:318-326. [PMID: 38042700 DOI: 10.1016/j.dental.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVES Utilizing Ti and Ti alloys as dental materials established a huge spurt in the field of dentistry. Since implantation is an invasive procedure that involves tissue penetration, infection control is mandatory for increasing the success rate of the implant treatment. In this study, we aimed to assess the impact of the surface physicochemical properties of acid-treated Ti on microorganisms specifically bacteria. METHODS After investigating the surface morphology and characteristics of acid-treated and untreated Ti sheets, we evaluated their potential to capture Escherichia coli (E. coli.) as well as the latter's survival on the surface of both types of sheets. Finally, we assessed the efficiency of the antibacterial properties exhibited by Ti against the oral microflora. RESULTS SEM images revealed surface roughening of the acid-treated Ti represented by significantly irregular shape. Moreover, the acid-treated Ti exhibited remarkable hydrophobicity. A quantitative evaluation confirmed that acid-treated Ti has higher bacterial capture and antibacterial properties than untreated Ti. Further experiments showed similar effects of both types of Ti not only on E. coli but also on oral microflora. SIGNIFICANCE Results suggest that acid treatment of Ti surface is a potent technique for enhancing the antibacterial properties of Ti-derived materials.
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Affiliation(s)
- Haruyuki Aoyagi
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Masahiro Okada
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Hiroaki Yanagimoto
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takuya Matsumoto
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan.
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13
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Wang Z, Zhao Y, Bai H, Chang F, Yang X, Wang X, Liu J, Wu M, Lin Q, Wang J, Liu H. Bioactive prosthesis interface compositing variable-stiffness hydrogels regulates stem cells fates to facilitate osseointegration through mechanotransduction. Int J Biol Macromol 2024; 259:129073. [PMID: 38184033 DOI: 10.1016/j.ijbiomac.2023.129073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/02/2023] [Accepted: 12/25/2023] [Indexed: 01/08/2024]
Abstract
Fluid hydrogel is proper to be incorporated with rigid porous prosthesis interface, acting as a soft carrier to support cells and therapeutic factors, to enhance osseointegration. In the previous study, we innovatively utilized self-healing supramolecular hydrogel as 3D cell culture platform to incorporate with 3D printed porous titanium alloy scaffold, constructing a novel bioactive interface. However, the concrete relationship and mechanism of hydrogel stiffness influencing cellular behaviors of bone marrow mesenchymal stem cells (BMSCs) within the interface are still inconclusive. Herein, we synthesized a series of supramolecular hydrogels with variable stiffness as extracellular matrix (ECM) to enhance the osseointegration of 3D printed prosthesis interface. BMSCs exposed to stiff hydrogel received massive environmental mechanical stimulations, subsequently transducing biophysical cues into biochemical signal through mechanotransduction process. The mRNA-sequencing analysis revealed that the activated FAK-MAPK pathway played significant roles in promoting osteogenic differentiation, thus contributing to a strong osseointegration. Our work preliminarily demonstrated the relationship of ECM stiffness and osteogenic differentiation trend of BMSCs, and optimized stiffness of hydrogel within a certain range benefitting for osteogenic differentiation and prosthesis interface osseointegration, providing a valuable insight into the development of orthopaedic implants equipped with osteogenic mechanotransduction ability.
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Affiliation(s)
- Zhonghan Wang
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - Yue Zhao
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun 130012, PR China
| | - Haotian Bai
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - Fei Chang
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - Xiaoyu Yang
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - Xianggang Wang
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - Jiaqi Liu
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - Minfei Wu
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - Quan Lin
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun 130012, PR China
| | - Jincheng Wang
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China
| | - He Liu
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, PR China; Orthopaedic Research Institute of Jilin Province, Changchun 130041, PR China.
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14
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Romero-Gavilán F, García-Arnáez I, Cerqueira A, Arias-Mainer C, Azkargorta M, Elortza F, Izquierdo R, Gurruchaga M, Goñi I, Suay J. Using osteogenic medium in the in vitro evaluation of bone biomaterials: Artefacts due to a synergistic effect. Biochimie 2024; 216:24-33. [PMID: 37716498 DOI: 10.1016/j.biochi.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/01/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023]
Abstract
In vitro tests using bone cells to evaluate the osteogenic potential of biomaterials usually employ the osteogenic medium (OM). The lack of correlation frequently reported between in vitro and in vivo studies in bone biomaterials, makes necessary the evaluation of the impact of osteogenic supplements on these results. This study analysed the proteomic profiles of human osteoblasts (HOb) cultured in the media with and without osteogenic agents (ascorbic acid and β-glycerol phosphate). The cells were incubated for 1 and 7 days, on their own or in contact with Ti. The comparative Perseus analysis identified 2544 proteins whose expression was affected by osteogenic agents. We observed that the OM strongly alters protein expression profiles with a complex impact on multiple pathways associated with adhesion, immunity, oxidative stress, coagulation, angiogenesis and osteogenesis. OM-triggered changes in the HOb intracellular energy production mechanisms, with key roles in osteoblast maturation. HOb cultured with and without Ti showed enrichment in the skeletal system development function due to the OM. However, differentially expressed proteins with key regenerative functions were associated with a synergistic effect of OM and Ti. This synergy, caused by the Ti-OM interaction, could complicate the interpretation of in vitro results, highlighting the need to analyse this phenomenon in biomaterial testing.
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Affiliation(s)
- Francisco Romero-Gavilán
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain.
| | - Iñaki García-Arnáez
- Department of Polymers and Advanced Materials: Physics, Chemistry and Technology, Universidad del País Vasco, P. M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Andreia Cerqueira
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Carlos Arias-Mainer
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Mikel Azkargorta
- Proteomics Platform, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), CIBERehd, Bizkaia Science and Technology Park, 48160, Derio, Spain
| | - Félix Elortza
- Proteomics Platform, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), CIBERehd, Bizkaia Science and Technology Park, 48160, Derio, Spain
| | - Raúl Izquierdo
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Mariló Gurruchaga
- Department of Polymers and Advanced Materials: Physics, Chemistry and Technology, Universidad del País Vasco, P. M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Isabel Goñi
- Department of Polymers and Advanced Materials: Physics, Chemistry and Technology, Universidad del País Vasco, P. M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Julio Suay
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
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15
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Leelasukseree R, Chouyratchakarn W, Phutiyothin C, Pikwong F, Srisopar O, Baipaywad P, Udomsom S, Mongkolpathumrat P, Supanchart C, Kumphune S. Recombinant human secretory leukocyte protease inhibitor (rhSLPI) coated titanium enhanced human osteoblast adhesion and differentiation. Sci Rep 2023; 13:23013. [PMID: 38155270 PMCID: PMC10754898 DOI: 10.1038/s41598-023-50565-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023] Open
Abstract
Osseointegration is vital to success in orthopedic and dental reconstructions with implanted materials. The bone matrix or cells-particularly osteoblasts-are required to achieve functional contact on the implant surface. Osteoblast induction is therefore essential for osteogenesis to occur. Enhancement of osteoblast adhesion, proliferation, and differentiation, particularly by implant surface modifications, have been found challenging to develop. Secretory Leukocyte Protease Inhibitor (SLPI), a cation ionic protein with anti-inflammatory and anti-bacterial activities, showed activation in osteoblast proliferation and differentiation. However, the effects of coating recombinant human (rh) SLPI on a titanium alloy surface on human osteoblast adhesion, proliferation, and differentiation has never been investigated. In this study, titanium alloys (Ti-6Al-4V) were coated with rhSLPI, while human osteoblast adhesion, proliferation, differentiation, actin cytoskeletal organization, and gene expressions involved in cell adhesion and differentiation were investigated. The results indicate that coating titanium with 10-100 µg/ml rhSLPI enhanced the physical properties of the Ti surface and enhanced human osteoblast (hFOB 1.19) cell adhesion, activated actin dynamic, enhanced adhesive forces, upregulated integrins α1, α2, and α5, enhanced cell proliferation, mineralization, alkaline phosphatase activity, and upregulated ALP, OCN, and Runx2. This is the first study to demonstrate that coating SLPI on titanium surfaces enhances osseointegration and could be a candidate molecule for surface modification in medical implants.
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Affiliation(s)
- Radchanon Leelasukseree
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Wannapat Chouyratchakarn
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Chayanisa Phutiyothin
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Faprathan Pikwong
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Onnicha Srisopar
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Phornsawat Baipaywad
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Suruk Udomsom
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Podsawee Mongkolpathumrat
- Cardio-Thoracic Technology Program, Chulabhorn International College of Medicine (CICM), Cooperative Learning Center, Thammasat University (Rangsit Center), Piyachart 2, 99 Moo 18 Klong Luang, Rangsit, Pathumthani, 12120, Thailand
| | - Chayarop Supanchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sarawut Kumphune
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand.
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand.
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16
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Zhou Z, Jiang W, Yan J, Liu H, Ren M, Li Y, Liu Z, Yao X, Li T, Ma N, Chen B, Guan W, Yang M. Trichostatin A enhances the titanium rods osseointegration in osteoporotic rats by the inhibition of oxidative stress through activating the AKT/Nrf2 pathway. Sci Rep 2023; 13:22967. [PMID: 38151509 PMCID: PMC10752907 DOI: 10.1038/s41598-023-50108-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/15/2023] [Indexed: 12/29/2023] Open
Abstract
The use of titanium implants as fixed supports following fractures in patients with OP can often result in sterile loosening and poor osseointegration. Oxidative stress has been shown to play a particularly important role in this process. While TSA has been reported to facilitate in vivo osteogenesis, the underlying mechanisms remain to be clarified. It also remains unclear whether TSA can improve the osseointegration of titanium implants. This study investigated whether TSA could enhance the osseointegration of titanium rods by activating AKT/Nrf2 pathway signaling, thereby suppressing oxidative stress. MC3T3-E1 cells treated with CCCP to induce oxidative stress served as an in vitro model, while an OVX-induced OP rat model was employed for in vivo analysis of titanium rod implantation. In vitro, TSA treatment of CCCP-treated MC3T3-E1 cells resulted in the upregulation of osteogenic proteins together with increased AKT, total Nrf2, nuclear Nrf2, HO-1, and NQO1 expression, enhanced mitochondrial functionality, and decreased oxidative damage. Notably, the PI3K/AKT inhibitor LY294002 reversed these effects. In vivo, TSA effectively enhanced the microstructural characteristics of distal femur trabecular bone, increased BMSCs mineralization capacity, promoted bone formation, and improved the binding of titanium implants to the surrounding tissue. Finally, our results showed that TSA could reverse oxidative stress-induced cell damage while promoting bone healing and improving titanium rods' osseointegration through AKT/Nrf2 pathway activation.
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Affiliation(s)
- Zhi Zhou
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Wenkai Jiang
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Junjie Yan
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Hedong Liu
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Maoxian Ren
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Yang Li
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Zhiyi Liu
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Xuewei Yao
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Tianlin Li
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Nengfeng Ma
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Bing Chen
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Wengang Guan
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China
| | - Min Yang
- Department of Traumatology and Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, People's Republic of China.
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17
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Wang B, Guo Y, Xu J, Zeng F, Ren T, Guo W. Efficacy of bone defect therapy involving various surface treatments of titanium alloy implants: an in vivo and in vitro study. Sci Rep 2023; 13:20116. [PMID: 37978333 PMCID: PMC10656537 DOI: 10.1038/s41598-023-47495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
Multiple surface treatment methods for titanium alloy prostheses, widely used in orthopedics, are available; however, these can affect bone integration and regeneration efficiency. In this study, through cell and animal experiments, we devised seven bone implant categories of Ti6Al4V based on surface preparation and post-processing technology (polishing, grit-blasting, fine titanium spraying, coarse titanium spraying, electron beam melting [EBM] printing, selective laser melting [SLM] printing, and post-processed SLM printing) and imaged each microscopic surface structure with a scanning electron microscope (SEM). Mechanical testing revealed excessive post-processing damaged the mechanical properties of the implants. In vitro, human bone marrow mesenchymal stem cells (hBMSCs) were cultured with implants, and the morphology of the cells adhering to the implant surface was observed using SEM and confocal laser scanning microscopy. Cell Counting Kit-8 (CCK-8) semi-quantitatively determined cell activity, indirectly reflecting the proliferation of hBMSCs. Alizarin red and alkaline phosphatase experiments assessed osteogenic differentiation. In vivo, experiments utilized the New Zealand rabbit femoral condyle bone defect model to assess bone regeneration and integration using micro-computed tomography, Van Giesen staining, and Masson staining. We found that 3D-printed implants with regular pore structures were more conducive to hBMSC osteogenic differentiation, while the presence of metal powder on NPT-SLM-printed implants hindered such differentiation. The post-treatment SLM scaffold surface may have some residual semi-melted powder; however, these powder residues have no significant effect on cell activity and differentiation. Surface treatment (grit-blasting and titanium spraying) of planar structures can enhance hBMSC adhesion but does not necessarily promote their differentiation. The framework structure of 3D printing may affect the osteogenic differentiation of hBMSCs, and for SLM-printed implants, excessive pursuit of a "powderless" state will damage the mechanical properties of the implant.
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Affiliation(s)
- Boyang Wang
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, People's Republic of China
| | - Yu Guo
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, People's Republic of China
| | - Jiuhui Xu
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, People's Republic of China
| | - Fanwei Zeng
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, People's Republic of China
| | - Tingting Ren
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, People's Republic of China
| | - Wei Guo
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, People's Republic of China.
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18
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Alavi SE, Gholami M, Shahmabadi HE, Reher P. Resorbable GBR Scaffolds in Oral and Maxillofacial Tissue Engineering: Design, Fabrication, and Applications. J Clin Med 2023; 12:6962. [PMID: 38002577 PMCID: PMC10672220 DOI: 10.3390/jcm12226962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
Guided bone regeneration (GBR) is a promising technique in bone tissue engineering that aims to replace lost or injured bone using resorbable scaffolds. The promotion of osteoblast adhesion, migration, and proliferation is greatly aided by GBR materials, and surface changes are critical in imitating the natural bone structure to improve cellular responses. Moreover, the interactions between bioresponsive scaffolds, growth factors (GFs), immune cells, and stromal progenitor cells are essential in promoting bone regeneration. This literature review comprehensively discusses various aspects of resorbable scaffolds in bone tissue engineering, encompassing scaffold design, materials, fabrication techniques, and advanced manufacturing methods, including three-dimensional printing. In addition, this review explores surface modifications to replicate native bone structures and their impact on cellular responses. Moreover, the mechanisms of bone regeneration are described, providing information on how immune cells, GFs, and bioresponsive scaffolds orchestrate tissue healing. Practical applications in clinical settings are presented to underscore the importance of these principles in promoting tissue integration, healing, and regeneration. Furthermore, this literature review delves into emerging areas of metamaterials and artificial intelligence applications in tissue engineering and regenerative medicine. These interdisciplinary approaches hold immense promise for furthering bone tissue engineering and improving therapeutic outcomes, leading to enhanced patient well-being. The potential of combining material science, advanced manufacturing, and cellular biology is showcased as a pathway to advance bone tissue engineering, addressing a variety of clinical needs and challenges. By providing this comprehensive narrative, a detailed, up-to-date account of resorbable scaffolds' role in bone tissue engineering and their transformative potential is offered.
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Affiliation(s)
- Seyed Ebrahim Alavi
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
| | - Max Gholami
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
| | - Hasan Ebrahimi Shahmabadi
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan 7717933777, Iran;
| | - Peter Reher
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
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19
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Choi SR, Kwon JW, Suk KS, Kim HS, Moon SH, Park SY, Lee BH. The Clinical Use of Osteobiologic and Metallic Biomaterials in Orthopedic Surgery: The Present and the Future. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16103633. [PMID: 37241260 DOI: 10.3390/ma16103633] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023]
Abstract
As the area and range of surgical treatments in the orthopedic field have expanded, the development of biomaterials used for these treatments has also advanced. Biomaterials have osteobiologic properties, including osteogenicity, osteoconduction, and osteoinduction. Natural polymers, synthetic polymers, ceramics, and allograft-based substitutes can all be classified as biomaterials. Metallic implants are first-generation biomaterials that continue to be used and are constantly evolving. Metallic implants can be made from pure metals, such as cobalt, nickel, iron, or titanium, or from alloys, such as stainless steel, cobalt-based alloys, or titanium-based alloys. This review describes the fundamental characteristics of metals and biomaterials used in the orthopedic field and new developments in nanotechnology and 3D-printing technology. This overview discusses the biomaterials that clinicians commonly use. A complementary relationship between doctors and biomaterial scientists is likely to be necessary in the future.
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Affiliation(s)
- Sung-Ryul Choi
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Ji-Won Kwon
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Kyung-Soo Suk
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Hak-Sun Kim
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seong-Hwan Moon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Si-Young Park
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Byung Ho Lee
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
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Jafarpour Mahalleh A, Mesgarzadeh AH, Jarolmasjed S, Soltani Somee A, Khordadmehr M, Rezaei Y, Maleki Dizaj S, Shahi S. Extracorporeal Shock Wave Therapy as a Helpful Method for Rapid Osseointegration of Dental Implants: Animal Study. Biomimetics (Basel) 2023; 8:biomimetics8020137. [PMID: 37092389 PMCID: PMC10123648 DOI: 10.3390/biomimetics8020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/19/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
The aim of this study was to assess the multi-phasic use of extracorporeal shock wave therapy (ESWT) as an adjuvant treatment to accelerate the osseointegration of titanium dental implants. Initially, twelve titanium mini-screws were inserted in femur bones of six New Zealand rabbits in three groups; the one-time treated group, the three-time treated group, and the control group (without ESWT). Then, 1800 focused shockwaves with an energy flux density of 0.3 mJ/mm2 in every phase were used. Fourteen days after the last phase of ESWT, the animals were sacrificed to assess the osseointegration of screws via micro-computed tomography scan (micro-CT scan), biomechanical pull-out test, and histopathological analysis. Pull-out and histopathology analysis showed that the ESWT significantly increased bone regeneration and osseointegration around the implants compared to the control group (p < 0.05). Moreover, the pull-out test confirmed that the three-time treated screws needed more force to pull the bone out compared to the other two groups (p < 0.05). The mean bone volume fraction between the control group, the one-time treated group, and the three-time treatment group were not statistically significant (p > 0.05) according to the micro-CT scan results. Based on our results, ESWT can be suggested as a non-invasive and cost-effective adjuvant for osseointegration of dental implants. However, more in vivo studies and clinical trials are needed for validation of this finding.
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Piñera-Avellaneda D, Buxadera-Palomero J, Ginebra MP, Calero JA, Manero JM, Rupérez E. Surface competition between osteoblasts and bacteria on silver-doped bioactive titanium implant. BIOMATERIALS ADVANCES 2023; 146:213311. [PMID: 36709627 DOI: 10.1016/j.bioadv.2023.213311] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
The rapid integration in the bone tissue and the prevention of bacterial infection are key for the success of the implant. In this regard, a silver (Ag)-doped thermochemical treatment that generate an Ag-doped calcium titanate layer on titanium (Ti) implants was previously developed by our group to improve the bone-bonding ability and provide antibacterial activity. In the present study, the biological and antibacterial potential of this coating has been further studied. In order to prove that the Ag-doped layer has an antibacterial effect with no detrimental effect on the bone cells, the behavior of osteoblast-like cells in terms of cell adhesion, morphology, proliferation and differentiation was evaluated, and the biofilm inhibition capacity was assessed. Moreover, the competition by the surface between cell and bacteria was carried out in two different co-culture methods. Finally, the treatment was applied to porous Ti implants to study in vivo osteointegration. The results show that the incorporation of Ag inhibits the biofilm formation and has no effect on the performance of osteoblast-like cells. Therefore, it can be concluded that the Ag-doped surface is capable of preventing bone bacterial infection and providing suitable osseointegration.
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Affiliation(s)
- David Piñera-Avellaneda
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain.
| | - Judit Buxadera-Palomero
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain
| | - María-Pau Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain; Institute for Bioengineering of Catalonia (IBEC), 08028 Barcelona, Spain
| | - José A Calero
- AMES GROUP, 08980 Sant Feliu de Llobregat, Barcelona, Spain
| | - José María Manero
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain
| | - Elisa Rupérez
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Technical University of Catalonia (UPC), Barcelona East School of Engineering (EEBE), 08019 Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, EEBE, 08019 Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034 Barcelona, Spain
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Hoellwarth JS, Tetsworth K, Akhtar MA, Al Muderis M. Transcutaneous Osseointegration for Amputees: What Is It, How Did It Evolve, and What May Develop? CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00376-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Gomes-Ferreira PHS, Frigério PB, de Moura J, Duarte ND, de Oliveira D, Deering J, Grandfield K, Okamoto R. Evaluation of Vitamin D isolated or Associated with Teriparatide in Peri-Implant Bone Repair in Tibia of Orchiectomized Rats. BIOLOGY 2023; 12:biology12020228. [PMID: 36829506 PMCID: PMC9952949 DOI: 10.3390/biology12020228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
(1) Background: The objective of this study was to evaluate the morphometry of peri-implant bone tissue in orchiectomized rats, treated with vitamin D isolated or associated with teriparatide. (2) Methods: 24 rats were divided into 4 groups: ORQ-orchiectomy, without drug treatment, ORQ+D-orchiectomy, treated with vitamin D, ORQTERI-orchiectomy, treated with teriparatide and ORQTERI+D-orchiectomy, treated with teriparatide + vitamin D. Each animal received an implant in the tibial metaphysis. Euthanasia occurred 60 days after implant surgery. Computed microtomography (micro-CT) was performed to evaluate the parameters of volume and percentage of bone volume (BV, BV/TV), trabecular thickness (Tb.Th), number and separation of trabeculae (Tb.N, Tb.Sp) and percentage of total porosity (Po-tot). Data were subjected to 1-way ANOVA and Tukey post-test, with a significance level of 5%. (3) Results: For the parameters BV, BV/TV, Tb.Th, the ORQTERI+D group showed the highest values in relation to the other groups and for Po-tot, the lowest values were for ORQTERI+D. For Tb.Sp and Tb.N, there was no statistically significant difference when comparing intragroup results (p > 0.05). (4) Conclusions: It was possible to conclude that treatment with vitamin D associated with teriparatide increases bone volume and improves bone quality.
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Affiliation(s)
- Pedro Henrique Silva Gomes-Ferreira
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba 16018-805, Brazil
- Correspondence: (P.H.S.G.-F.); (R.O.); Tel.: +55-18-981109555 (P.H.S.G.-F.)
| | - Paula Buzo Frigério
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba 16018-805, Brazil
| | - Juliana de Moura
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba 16018-805, Brazil
| | - Nathália Dantas Duarte
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba 16018-805, Brazil
| | - Danila de Oliveira
- Department of Basic Sciences, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba 16018-805, Brazil
| | - Joseph Deering
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Kathryn Grandfield
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON L8S 4L8, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Roberta Okamoto
- Department of Basic Sciences, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba 16018-805, Brazil
- Correspondence: (P.H.S.G.-F.); (R.O.); Tel.: +55-18-981109555 (P.H.S.G.-F.)
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Schulze F, Lang A, Schoon J, Wassilew GI, Reichert J. Scaffold Guided Bone Regeneration for the Treatment of Large Segmental Defects in Long Bones. Biomedicines 2023; 11:biomedicines11020325. [PMID: 36830862 PMCID: PMC9953456 DOI: 10.3390/biomedicines11020325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Bone generally displays a high intrinsic capacity to regenerate. Nonetheless, large osseous defects sometimes fail to heal. The treatment of such large segmental defects still represents a considerable clinical challenge. The regeneration of large bone defects often proves difficult, since it relies on the formation of large amounts of bone within an environment impedimental to osteogenesis, characterized by soft tissue damage and hampered vascularization. Consequently, research efforts have concentrated on tissue engineering and regenerative medical strategies to resolve this multifaceted challenge. In this review, we summarize, critically evaluate, and discuss present approaches in light of their clinical relevance; we also present future advanced techniques for bone tissue engineering, outlining the steps to realize for their translation from bench to bedside. The discussion includes the physiology of bone healing, requirements and properties of natural and synthetic biomaterials for bone reconstruction, their use in conjunction with cellular components and suitable growth factors, and strategies to improve vascularization and the translation of these regenerative concepts to in vivo applications. We conclude that the ideal all-purpose material for scaffold-guided bone regeneration is currently not available. It seems that a variety of different solutions will be employed, according to the clinical treatment necessary.
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Affiliation(s)
- Frank Schulze
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Annemarie Lang
- Departments of Orthopaedic Surgery & Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Janosch Schoon
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Georgi I. Wassilew
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Johannes Reichert
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
- Correspondence: ; Tel.: +49-3834-86-22530
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Wang X, Liu W, Yu X, Wang B, Xu Y, Yan X, Zhang X. Advances in surface modification of tantalum and porous tantalum for rapid osseointegration: A thematic review. Front Bioeng Biotechnol 2022; 10:983695. [PMID: 36177183 PMCID: PMC9513364 DOI: 10.3389/fbioe.2022.983695] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022] Open
Abstract
After bone defects reach a certain size, the body can no longer repair them. Tantalum, including its porous form, has attracted increasing attention due to good bioactivity, biocompatibility, and biomechanical properties. After a metal material is implanted into the body as a medical intervention, a series of interactions occurs between the material’s surface and the microenvironment. The interaction between cells and the surface of the implant mainly depends on the surface morphology and chemical composition of the implant’s surface. In this context, appropriate modification of the surface of tantalum can guide the biological behavior of cells, promote the potential of materials, and facilitate bone integration. Substantial progress has been made in tantalum surface modification technologies, especially nano-modification technology. This paper systematically reviews the progress in research on tantalum surface modification for the first time, including physicochemical properties, biological performance, and surface modification technologies of tantalum and porous tantalum.
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Affiliation(s)
- Xi Wang
- Department of Emergency and Oral Medicine, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Wentao Liu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China
| | - Xinding Yu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China
| | - Biyao Wang
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yan Xu
- The Comprehensive Department of Shenyang Stomatological Hospital, Shenyang, China
| | - Xu Yan
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
- *Correspondence: Xu Yan, ; Xinwen Zhang,
| | - Xinwen Zhang
- Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
- *Correspondence: Xu Yan, ; Xinwen Zhang,
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Shao H, Ma M, Wang Q, Yan T, Zhao B, Guo S, Tong S. Advances in the superhydrophilicity-modified titanium surfaces with antibacterial and pro-osteogenesis properties: A review. Front Bioeng Biotechnol 2022; 10:1000401. [PMID: 36147527 PMCID: PMC9485881 DOI: 10.3389/fbioe.2022.1000401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 12/12/2022] Open
Abstract
In recent years, the rate of implant failure has been increasing. Microbial infection was the primary cause, and the main stages included bacterial adhesion, biofilm formation, and severe inhibition of implant osseointegration. Various biomaterials and their preparation methods have emerged to produce specific implants with antimicrobial or bactericidal properties to reduce implant infection caused by bacterial adhesion and effectively promote bone and implant integration. In this study, we reviewed the research progress of bone integration promotion and antibacterial action of superhydrophilic surfaces based on titanium alloys. First, the adverse reactions caused by bacterial adhesion to the implant surface, including infection and bone integration deficiency, are briefly introduced. Several commonly used antibacterial methods of titanium alloys are introduced. Secondly, we discuss the antibacterial properties of superhydrophilic surfaces based on ultraviolet photo-functionalization and plasma treatment, in contrast to the antibacterial principle of superhydrophobic surface morphology. Thirdly, the osteogenic effects of superhydrophilic surfaces are described, according to the processes of osseointegration: osteogenic immunity, angiogenesis, and osteogenic related cells. Finally, we discuss the challenges and prospects for the development of this superhydrophilic surface in clinical applications, as well as the prominent strategies and directions for future research.
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Affiliation(s)
- Hanyu Shao
- Department of Plastic Surgery, First Hospital of China Medical University, Shenyang, China
| | - Mingchen Ma
- School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Qiang Wang
- School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Tingting Yan
- Faculty of Materials Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Baohong Zhao
- School and Hospital of Stomatology, China Medical University, Shenyang, China
- *Correspondence: Baohong Zhao, ; Shu Guo, ; Shuang Tong,
| | - Shu Guo
- Department of Plastic Surgery, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Baohong Zhao, ; Shu Guo, ; Shuang Tong,
| | - Shuang Tong
- Department of Plastic Surgery, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Baohong Zhao, ; Shu Guo, ; Shuang Tong,
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Wang R, Ni S, Ma L, Li M. Porous construction and surface modification of titanium-based materials for osteogenesis: A review. Front Bioeng Biotechnol 2022; 10:973297. [PMID: 36091459 PMCID: PMC9452912 DOI: 10.3389/fbioe.2022.973297] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Titanium and titanium alloy implants are essential for bone tissue regeneration engineering. The current trend is toward the manufacture of implants from materials that mimic the structure, composition and elasticity of bones. Titanium and titanium alloy implants, the most common materials for implants, can be used as a bone conduction material but cannot promote osteogenesis. In clinical practice, there is a high demand for implant surfaces that stimulate bone formation and accelerate bone binding, thus shortening the implantation-to-loading time and enhancing implantation success. To avoid stress shielding, the elastic modulus of porous titanium and titanium alloy implants must match that of bone. Micro-arc oxidation technology has been utilized to increase the surface activity and build a somewhat hard coating on porous titanium and titanium alloy implants. More recently, a growing number of researchers have combined micro-arc oxidation with hydrothermal, ultrasonic, and laser treatments, coatings that inhibit bacterial growth, and acid etching with sand blasting methods to improve bonding to bone. This paper summarizes the reaction at the interface between bone and implant material, the porous design principle of scaffold material, MAO technology and the combination of MAO with other technologies in the field of porous titanium and titanium alloys to encourage their application in the development of medical implants.
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Affiliation(s)
- Rui Wang
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, China
| | - Shilei Ni
- Department of Plastic and Aesthetic Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Li Ma
- Department of Fever Clinic, The Second Hospital of Jilin University, Changchun, China
| | - Meihua Li
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, China
- *Correspondence: Meihua Li,
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Stogov MV, Emanov AA, Goodovykh NV, Ovchinnikov EN, Tushina NV, Kuznetsov VP. Microbiological Profile of the Implantation Zone under Different Mechanical Compression of Percutaneous Implants: Experimental Study. TRAUMATOLOGY AND ORTHOPEDICS OF RUSSIA 2022; 28:38-47. [DOI: 10.17816/2311-2905-1725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Background. Infection of percutaneous implants in patients with limb amputation is the most common complication.
Aim of the study evaluation of the microflora in the implantation zone depending on the mechanical compression of the implant in conditions of its additional external fixation.
Methods. The study was performed on 36 male rabbits. The tibia of all the rabbits was sawn at the border of the upper and middle parts. The medullary canal was reamed and a percutaneous implant was placed in the tibial stump. The segment and the implant were fixed with an Ilizarov apparatus. An additional compression device was installed in 30 animals. We used 5 compression modes, accordingly, 6 experimental groups were formed, 6 animals in each: group 1 without compression, group 2 compression on the implant with force of 0.053 N/mm2, group 3 compression on the implant with force of 0.105 N/mm2, group 4 compression on the implant with force of 0.158 N/mm2, group 5 compression on the implant with force of 0.211 N/mm2, group 6 compression on the implant with force of 0.263 N/mm2. The restraint was removed 6 weeks after implantation for a total follow-up of 26 weeks. The microflora of the place where the implant enters the skin (the implant / skin interface) was investigated, the level of blood leukocytes and the level of C-reactive protein in blood serum were determined.
Results. On days 9-10 after implantation, significant differences in the microbial landscape were found at the site of the exit of the metal implant in animals of different groups. The largest number of strains was found in animals of groups 1, 5 and 6, the smallest in groups 2 and 3. The most frequently detected strains: S. saprophyticus and Enterococcus spp. It was found that the greatest statistically significant increase in the level of CRP in the blood serum was observed in animals of group 6. The level of leukocytes in animals of all groups did not change statistically significantly relative to preoperative values. Animals with better osseointegration (groups 2 and 3 no cases of implant loss) showed a minimal number of growing strains.
Conclusions. The microbiological profile of the implantation zone of percutaneous implants changes depending on the amount of mechanical compression. The optimal mode is 0.053-0.105 N/mm2.
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A two-phase and long-lasting multi-antibacterial coating enables titanium biomaterials to prevent implants-related infections. Mater Today Bio 2022; 15:100330. [PMID: 35789634 PMCID: PMC9250043 DOI: 10.1016/j.mtbio.2022.100330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 01/08/2023] Open
Abstract
In clinical work, the main challenges for titanium (Ti) implantation are bacterial infection and aseptic loosening, which severely affect the survival rate of implants. The first 4 weeks post-operation is the infection peak phase of implants. Inhibiting implant infection caused by bacteria adhesion and proliferation during the early phase as well as promoting subsequent osteointegration is essential for implant success. Herein, we constructed a quaternary ammonium carboxymethyl chitosan (QCMC), collagen (COL Ⅰ) and hydroxyapatite (HAP) multilayers coating on Ti substrates via a modified layer-by-layer (LBL) technique and polymerization of dopamine. The QCMC/COL/HAP coating exhibited a multi-antibacterial property with a two-phase function: (1) At the first 4 weeks post-operation, the covalently bonded QCMC could be slowly degraded and demonstrated both contact-killing and release-killing properties during the infection peak phase; (2) At the second phase, osteogenesis and osseointegration-promotion capabilities were enhanced by HAP under the effective control of infection. The multifilm coating was degraded for more than 45 days under the action of collagenase Ⅰ, and displayed good biocompatibility in vivo and in vitro. Most importantly, the coating exhibited a long-lasting antibacterial activity for more than 3 months, against the main pathogenic bacteria of peri-implant infections. Both in vitro studies and in vivo animal models revealed a desirable osteogenic differentiation capacity of Ti-CCH. Therefore, our study reports a two-phase, long-lasting multi-antibacterial coating on Ti-CCH and indicates potential applications of the modified LBL strategy in orthopaedic fields, which is enlightening for developing practical implant and scaffold materials. Developing a QCMC/COL/HAP multifilm coating via modified layer-by-layer technique and self-polymerization of dopamine. The QCMC/COL/HAP coating exhibited desirable mechanical properties and excellent biocompatibility. The release kinetics endowed the QCMC/COL/HAP coating with multi-antibacterial activity at the first phase after operation. The QCMC/COL/HAP coating could improve osseointegration at the second phase of post-operation.
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Bregoli C, Biffi CA, Morellato K, Gruppioni E, Primavera M, Rampoldi M, Lando M, Adani R, Tuissi A. Osseointegrated Metallic Implants for Finger Amputees: A Review of the Literature. Orthop Surg 2022; 14:1019-1033. [PMID: 35524645 PMCID: PMC9163974 DOI: 10.1111/os.13296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 12/01/2022] Open
Abstract
Digital trauma amputations and digital agenesis strongly affect the functionality and aesthetic appearance of the hand. Autologous reconstruction is the gold standard of treatment. Unfortunately, microsurgical options and transplantation procedures are not possible for patients who present contraindications or refuse to undergo transplantation from the toe (e.g. toe‐to‐thumb transplantation). To address these issues, osseointegrated finger prostheses are a promising alternative. The functional assessments registered during follow‐up confirmed the promising outcomes of osseointegrated prostheses in the treatment of hand finger amputees. This review outlines (a) a detailed analysis of osseointegrated finger metallic components of the implants, (b) the surgical procedures suggested in the literature, and (c) the functional assessments and promising outcomes that demonstrate the potential of these medical osseointegrated devices in the treatment of finger amputees.
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Affiliation(s)
- Chiara Bregoli
- Unit of Lecco, CNR ICMATE, National Research Council, Lecco, Italy
| | | | | | | | - Matteo Primavera
- Hand and Reconstructive Surgery Unit, Centro Traumatologico Ortopedico A. Alesini, Rome, Italy
| | - Michele Rampoldi
- Hand and Reconstructive Surgery Unit, Centro Traumatologico Ortopedico A. Alesini, Rome, Italy
| | - Mario Lando
- Department of Hand surgery and Microsurgery, University Hospital of Modena, Modena, Italy
| | - Roberto Adani
- Department of Hand surgery and Microsurgery, University Hospital of Modena, Modena, Italy
| | - Ausonio Tuissi
- Unit of Lecco, CNR ICMATE, National Research Council, Lecco, Italy
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Effects of Magnetic Stimulation on Dental Implant Osseointegration: A Scoping Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This PRISMA-ScR driven scoping review aims to evaluate the influence of magnetic field stimulation on dental implant osseointegration. Seven databases were screened adopting ad-hoc strings. All clinical and preclinical studies analyzing the effects of magnetic fields on dental implant osseointegration were included. From 3124 initial items, on the basis of the eligibility criteria, 33 articles, regarding both Pulsed ElectroMagnetic Fields (PEMF) and Static magnetic Fields from permanent Magnets (SFM) were finally included and critically analyzed. In vitro studies showed a positive effect of PEMF, but contrasting effects of SFM on bone cell proliferation, whereas cell adhesion and osteogenic differentiation were induced by both types of stimulation. In vivo studies showed an increased bone-to-implant contact rate in different animal models and clinical studies revealed positive effects on implant stability, under magnetic stimulation. In conclusion, although positive effects of magnetic exposure on osteogenesis activity and osseointegration emerged, this scoping review highlighted the need for further preclinical and clinical studies. More standardized designs, accurate choice of stimulation parameters, adequate methods of evaluation of the outcomes, greater sample size and longer follow-ups are needed to clearly assess the effect of magnetic fields on dental implant osseointegration.
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Tamimi I, Carnero P, Bautista D, Gonzalez D, Rodrigo P, Bravo MJ, Gómez A, Tamimi F, Garcia de Quevedo D. Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty. Geriatr Orthop Surg Rehabil 2022; 13:21514593221091664. [PMID: 35433100 PMCID: PMC9006357 DOI: 10.1177/21514593221091664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 03/26/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction The use of proton pump inhibitors (PPIs) has been associated with a higher risk of osteoporotic fractures and non-unions rates. However, the relation between the use of PPIs and the development of aseptic loosening in arthroplasty procedures has not been studied. The objective of this study is to analyze the relation between the use of PPIs, and the risk of early aseptic loosening in total knee arthroplasty (TKA) and total hip arthroplasty (THA). Materials and methods A nested case-control study was conducted on patients who were subjected THA or TKA in our center between 2010 and 2014. Cases were patients subjected to revision surgery due to early aseptic loosening during the study period. Cases were matched with controls who did not require any type of revision surgery by type of joint replacement (THA/TKA), gender, age (+/- 2 years), and follow-up time (±6 months). Odds Ratios were adjusted to potential confounders. Results The crude and adjusted ORs (95% CI) of undergoing revision surgery for aseptic loosening following primary total knee arthroplasty or total hip arthroplasty, were 6.25 (2.04-19.23) and 6.10 (1.71-21.73), respectively, for any use PPIs compared with non-users. Crude and adjusted ORs, were 11.6 (2.93-45.88) and 17.1 (2.41-121.66), respectively, for patients with a Proportion of Days Covered (PDC) for PPIs <.5 (Table 2). In addition, the crude and adjusted ORs of undergoing revision surgery, were 5.05 (1.59-16.02) and 5.01 (1.36-18.44), respectively, for patients with a PDC for PPIs ≥.5. Discussion These results suggest that PPIs should be used with caution in patients with TKA and THA, and that the use of these drugs should not be prolonged unless there was a justifiable indication. Conclusions The use of PPIs and was associated with a higher risk of early aseptic loosening in patients subjected to THA and TKA.
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Affiliation(s)
- Iskandar Tamimi
- Hospital Regional Universitario de Málaga, Málaga, Spain.,Complejo Hospitalario Integral Privado, Málaga, Spain.,Facultad de Medicina, Universidad de Málaga, Spain
| | | | | | - David Gonzalez
- Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Pablo Rodrigo
- Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - Abel Gómez
- Complejo Hospitalario Integral Privado, Málaga, Spain
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Karaman D, Ghahramanzadeh Asl H, Altıntaş Kahriman E. Estimation and Comparison of Effective Elastic Modulus of Different Scaffolds Using Curve Fitting Method for Additive Manufacturing Field. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022. [DOI: 10.1007/s13369-022-06836-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Karczewski AM, Zeng W, Stratchko LM, Bachus KN, Poore SO, Dingle AM. Clinical Basis for Creating an Osseointegrated Neural Interface. Front Neurosci 2022; 16:828593. [PMID: 35495044 PMCID: PMC9039253 DOI: 10.3389/fnins.2022.828593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
As technology continues to improve within the neuroprosthetic landscape, there has been a paradigm shift in the approach to amputation and surgical implementation of haptic neural prosthesis for limb restoration. The Osseointegrated Neural Interface (ONI) is a proposed solution involving the transposition of terminal nerves into the medullary canal of long bones. This design combines concepts of neuroma formation and prevention with osseointegration to provide a stable environment for conduction of neural signals for sophisticated prosthetic control. While this concept has previously been explored in animal models, it has yet to be explored in humans. This anatomic study used three upper limb and three lower limb cadavers to assess the clinical feasibility of creating an ONI in humans. Anatomical measurement of the major peripheral nerves- circumference, length, and depth- were performed as they are critical for electrode design and rerouting of the nerves into the long bones. CT imaging was used for morphologic bone evaluation and virtual implantation of two osseointegrated implants were performed to assess the amount of residual medullary space available for housing the neural interfacing hardware. Use of a small stem osseointegrated implant was found to reduce bone removal and provide more intramedullary space than a traditional implant; however, the higher the amputation site, the less medullary space was available regardless of implant type. Thus the stability of the endoprosthesis must be maximized while still maintaining enough residual space for the interface components. The results from this study provide an anatomic basis required for establishing a clinically applicable ONI in humans. They may serve as a guide for surgical implementation of an osseointegrated endoprosthesis with intramedullary electrodes for prosthetic control.
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Affiliation(s)
- Alison M. Karczewski
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Weifeng Zeng
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Lindsay M. Stratchko
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- *Correspondence: Lindsay M. Stratchko,
| | - Kent N. Bachus
- George E. Wahlen Department of Veterans Affairs Medical Center and the Department of Orthopaedics, University of Utah Orthopaedic Center, Salt Lake City, UT, United States
| | - Samuel O. Poore
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Aaron M. Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Aaron M. Dingle,
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Wu J, Yang J, Wang Y, Wang Y, Yu H, Han J, Zhang J. Biocompatible Coating on Micro‐structured Titanium Implants with Enhanced Osteogenesis to Facilitate Bone‐implant Integration. ChemistrySelect 2022. [DOI: 10.1002/slct.202103540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Jiannan Wu
- Department of Implantology Tianjin Stomatological Hospital School of Medicine Nankai University Tianjin 300041 China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Tianjin 300041 China
| | - Jing Yang
- Department of Implantology Tianjin Stomatological Hospital School of Medicine Nankai University Tianjin 300041 China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Tianjin 300041 China
| | - Yanying Wang
- Department of Implantology Tianjin Stomatological Hospital School of Medicine Nankai University Tianjin 300041 China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Tianjin 300041 China
| | - Yanduo Wang
- Department of Implantology Tianjin Stomatological Hospital School of Medicine Nankai University Tianjin 300041 China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Tianjin 300041 China
| | - Haiyang Yu
- Department of Implantology Tianjin Stomatological Hospital School of Medicine Nankai University Tianjin 300041 China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Tianjin 300041 China
| | - Jing Han
- Department of Implantology Tianjin Stomatological Hospital School of Medicine Nankai University Tianjin 300041 China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Tianjin 300041 China
| | - Jian Zhang
- Department of Implantology Tianjin Stomatological Hospital School of Medicine Nankai University Tianjin 300041 China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Tianjin 300041 China
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Fischer NG, Kobe AC, Dai J, He J, Wang H, Pizarek JA, De Jong DA, Ye Z, Huang S, Aparicio C. Tapping basement membrane motifs: Oral junctional epithelium for surface-mediated soft tissue attachment to prevent failure of percutaneous devices. Acta Biomater 2022; 141:70-88. [PMID: 34971784 PMCID: PMC8898307 DOI: 10.1016/j.actbio.2021.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
Teeth, long-lasting percutaneous organs, feature soft tissue attachment through adhesive structures, hemidesmosomes, in the junctional epithelium basement membrane adjacent to teeth. This soft tissue attachment prevents bacterial infection of the tooth despite the rich - and harsh - microbial composition of the oral cavity. Conversely, millions of percutaneous devices (catheters, dental, and orthopedic implants) fail from infection yearly. Standard of care antibiotic usage fuels antimicrobial resistance and is frequently ineffective. Infection prevention strategies, like for dental implants, have failed in generating durable soft tissue adhesion - like that seen with the tooth - to prevent bacterial colonization at the tissue-device interface. Here, inspired by the impervious natural attachment of the junctional epithelium to teeth, we synthesized four cell adhesion peptide (CAPs) nanocoatings, derived from basement membranes, to promote percutaneous device soft tissue attachment. The two leading nanocoatings upregulated integrin-mediated hemidesmosomes, selectively increased keratinocyte proliferation compared to fibroblasts, which cannot form hemidesmosomes, and expression of junctional epithelium adhesive markers. CAP nanocoatings displayed marked durability under simulated clinical conditions and the top performer CAP nanocoating was validated in a percutaneous implant murine model. Basement membrane CAP nanocoatings, inspired by the tooth and junctional epithelium, may provide an alternative anti-infective strategy for percutaneous devices to mitigate the worldwide threat of antimicrobial resistance. STATEMENT OF SIGNIFICANCE: Prevention and management of medical device infection is a significant healthcare challenge. Overzealous antibiotic use has motivated alternative material innovations to prevent infection. Here, we report implant cell adhesion peptide nanocoatings that mimic a long-lasting, natural "medical device," the tooth, through formation of cell adhesive structures called hemidesmosomes. Such nanocoatings sidestep the use of antimicrobial or antibiotic elements to form a soft-tissue seal around implants. The top performing nanocoatings prompted expression of hemidesmosomes and defensive factors to mimic the tooth and was validated in an animal model. Application of cell adhesion peptide nanocoatings may provide an alternative to preventing, rather that necessarily treating, medical device infection across a range of device indications, like dental implants.
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Affiliation(s)
- Nicholas G Fischer
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Alexandra C Kobe
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Jinhong Dai
- Institute of Stomatology, School and Hospital of Stomatology, Department of Prosthodontics, Wenzhou Medical University, 373 Xueyuan Xi Road, Wenzhou, Zhejiang 325027, China
| | - Jiahe He
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Hongning Wang
- Institute of Stomatology, School and Hospital of Stomatology, Department of Prosthodontics, Wenzhou Medical University, 373 Xueyuan Xi Road, Wenzhou, Zhejiang 325027, China
| | - John A Pizarek
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States; United States Navy Dental Corps, Naval Medical Leader and Professional Development Command, 8955 Wood Road Bethesda, MD 20889, United States
| | - David A De Jong
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Zhou Ye
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Shengbin Huang
- Institute of Stomatology, School and Hospital of Stomatology, Department of Prosthodontics, Wenzhou Medical University, 373 Xueyuan Xi Road, Wenzhou, Zhejiang 325027, China
| | - Conrado Aparicio
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States.
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Surgical and Technological Advances in the Management of Upper Limb Amputation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00341-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dey D, Fischer NG, Dragon AH, Ronzier E, Mutreja I, Danielson DT, Homer CJ, Forsberg JA, Bechtold JE, Aparicio C, Davis TA. Culture and characterization of various porcine integumentary-connective tissue-derived mesenchymal stromal cells to facilitate tissue adhesion to percutaneous metal implants. Stem Cell Res Ther 2021; 12:604. [PMID: 34922628 PMCID: PMC8684200 DOI: 10.1186/s13287-021-02666-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/19/2021] [Indexed: 02/08/2023] Open
Abstract
Background Transdermal osseointegrated prosthesis have relatively high infection rates leading to implant revision or failure. A principle cause for this complication is the absence of a durable impervious biomechanical seal at the interface of the hard structure (implant) and adjacent soft tissues. This study explores the possibility of recapitulating an analogous cellular musculoskeletal-connective tissue interface, which is present at naturally occurring integumentary tissues where a hard structure exits the skin, such as the nail bed, hoof, and tooth. Methods Porcine mesenchymal stromal cells (pMSCs) were derived from nine different porcine integumentary and connective tissues: hoof-associated superficial flexor tendon, molar-associated periodontal ligament, Achilles tendon, adipose tissue and skin dermis from the hind limb and abdominal regions, bone marrow and muscle. For all nine pMSCs, the phenotype, multi-lineage differentiation potential and their adhesiveness to clinical grade titanium was characterized. Transcriptomic analysis of 11 common genes encoding cytoskeletal proteins VIM (Vimentin), cell–cell and cell–matrix adhesion genes (Vinculin, Integrin β1, Integrin β2, CD9, CD151), and for ECM genes (Collagen-1a1, Collagen-4a1, Fibronectin, Laminin-α5, Contactin-3) in early passaged cells was performed using qRT-PCR. Results All tissue-derived pMSCs were characterized as mesenchymal origin by adherence to plastic, expression of cell surface markers including CD29, CD44, CD90, and CD105, and lack of hematopoietic (CD11b) and endothelial (CD31) markers. All pMSCs differentiated into osteoblasts, adipocytes and chondrocytes, albeit at varying degrees, under specific culture conditions. Among the eleven adhesion genes evaluated, the cytoskeletal intermediate filament vimentin was found highly expressed in pMSC isolated from all tissues, followed by genes for the extracellular matrix proteins Fibronectin and Collagen-1a1. Expression of Vimentin was the highest in Achilles tendon, while Fibronectin and Col1agen-1a1 were highest in molar and hoof-associated superficial flexor tendon bone marrow, respectively. Achilles tendon ranked the highest in both multilineage differentiation and adhesion assessments to titanium metal. Conclusions These findings support further preclinical research of these tissue specific-derived MSCs in vivo in a transdermal osseointegration implant model. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02666-2.
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Affiliation(s)
- Devaveena Dey
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Henry M Jackson Foundation for Advancement of Military Medicine, Bethesda, USA
| | - Nicholas G Fischer
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - Andrea H Dragon
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Henry M Jackson Foundation for Advancement of Military Medicine, Bethesda, USA
| | - Elsa Ronzier
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Henry M Jackson Foundation for Advancement of Military Medicine, Bethesda, USA
| | - Isha Mutreja
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - David T Danielson
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Cole J Homer
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA.,Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jonathan A Forsberg
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Joan E Bechtold
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA.,Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.,Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Conrado Aparicio
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - Thomas A Davis
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Osseointegration. Tech Orthop 2021. [DOI: 10.1097/bto.0000000000000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liu H, Chen J, Qiao S, Zhang W. Carbon-Based Nanomaterials for Bone and Cartilage Regeneration: A Review. ACS Biomater Sci Eng 2021; 7:4718-4735. [PMID: 34586781 DOI: 10.1021/acsbiomaterials.1c00759] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
As the main load-bearing structure in the human body, bone and cartilage are susceptible to damage in sports and other activities. The repair and regeneration of bone and articular cartilage have been extensively studied in the past decades. Traditional approaches have been widely applied in clinical practice, but the effect varies from person to person and may cause side effects. With the rapid development of tissue engineering and regenerative medicine, various biomaterials show great potential in the regeneration of bone and cartilage. Carbon-based nanomaterials are solid materials with different structures and properties composed of allotropes of carbon, which are classified into zero-, one-, and two-dimensional ones. This Review systemically summarizes the different types of carbon-based nanomaterials, including zero-dimensional (fullerene, carbon dots, nanodiamonds), one-dimensional (carbon nanotubes), and two-dimensional (graphenic materials) as well as their applications in bone, cartilage, and osteochondral regeneration. Current limitations and future perspectives of carbon-based nanomaterials are also discussed.
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Affiliation(s)
- Haoyang Liu
- School of Medicine, Southeast University, 210009 Nanjing, China
| | - Jialin Chen
- School of Medicine, Southeast University, 210009 Nanjing, China.,Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, 210096 Nanjing, China.,China Orthopedic Regenerative Medicine Group (CORMed), 310058 Hangzhou, China
| | - Sen Qiao
- Department of Pharmacology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, 66421 Homburg, Germany
| | - Wei Zhang
- School of Medicine, Southeast University, 210009 Nanjing, China.,Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, 210096 Nanjing, China.,China Orthopedic Regenerative Medicine Group (CORMed), 310058 Hangzhou, China
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Berg D, Frossard L. Health Service Delivery and Economic Evaluation of Limb Lower Bone-Anchored Prostheses: A Summary of the Queensland Artificial Limb Service's Experience. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2021; 4:36210. [PMID: 37614998 PMCID: PMC10443483 DOI: 10.33137/cpoj.v4i2.36210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The emergence of skeletal prosthetic attachments leaves governmental organizations facing the challenge of implementing equitable policies that support the provision of bone-anchored prostheses (BAPs). In 2013, the Queensland Artificial Limb Service (QALS) started a five-year research project focusing on health service delivery and economic evaluation of BAPs. This paper reflects on the QALS experience, particularly the lessons learned. QALS' jurisdiction and drivers are presented first, followed by the impact of outcomes, barriers, and facilitators, as well as future developments of this work. The 21 publications produced during this project (e.g., reimbursement policy, role of prosthetists, continuous improvement procedure, quality of life, preliminary cost-utilities) were summarized. Literature on past, current, and upcoming developments of BAP was reviewed to discuss the practical implications of this work. A primary outcome of this project was a policy developed by QALS supporting up to 22 h of labor for the provision of BAP care. The indicative incremental cost-utility ratio for transfemoral and transtibial BAPs was approximately AUD$17,000 and AUD$12,000, respectively, per quality-adjusted life-year compared to socket prostheses. This project was challenged by 17 barriers (e.g., limited resources, inconsistency of care pathways, design of preliminary cost-utility analyses) but eased by 18 facilitators (e.g., action research plan, customized database, use of free repositories). In conclusion, we concluded that lower limb BAP might be an acceptable alternative to socket prostheses from an Australian government prosthetic care perspective. Hopefully, this work will inform promoters of prosthetic innovations committed to making bionic solutions widely accessible to a growing population of individuals suffering from limb loss worldwide.
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Affiliation(s)
- D Berg
- Queensland Artificial Limb Service, Brisbane, Australia
| | - L Frossard
- Your Research Project Pty Ltd, Brisbane, Australia
- Griffith University, Gold Coast, Australia
- University of the Sunshine Coast, Maroochydore, Australia
- Queensland University of Technology, Brisbane, Australia
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Wang X, Ning B, Pei X. Tantalum and its derivatives in orthopedic and dental implants: Osteogenesis and antibacterial properties. Colloids Surf B Biointerfaces 2021; 208:112055. [PMID: 34438295 DOI: 10.1016/j.colsurfb.2021.112055] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/11/2021] [Accepted: 08/16/2021] [Indexed: 02/08/2023]
Abstract
Implant-associated infections and aseptic loosening are some of the main reasons for implant failure. Therefore, there is an urgent need to improve the osseointegration and antibacterial capabilities of implant materials. In recent years, a large number of breakthroughs in the biological application of tantalum and its derivatives have been achieved. Owing to their corrosion resistance, biocompatibility, osseointegration ability, and antibacterial properties, they have shown considerable potential in orthopedic and dental implant applications. In this review, we provide the latest progress and achievements in the research on osseointegration and antibacterial properties of tantalum as well as its derivatives, and summarize the surface modification methods to enhance their osseointegration and antibacterial properties.
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Affiliation(s)
- Xu Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Boyu Ning
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xibo Pei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
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Lei X, Liu Q, Li S, Zhang Z, Yang X. Effects of fluid shear stress on expression of focal adhesion kinase in MG-63 human osteoblast-like cells on different surface modification of titanium. Bioengineered 2021; 12:4962-4971. [PMID: 34374319 PMCID: PMC8806473 DOI: 10.1080/21655979.2021.1962686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the effect of fluid shear stress (FSS) on cell proliferation and expression of focal adhesion kinase (FAK) in MG-63 cells on different modified titanium surfaces. MG63 cells were cultured on three different surfaces: glass slide, polished treatment (PT) titanium surface and sandblasted/acid-etched surfaces (SLA) titanium surface. The surface topography and roughness were evaluated by scanning electron microscopy (SEM) and atomic force microscopy (AFM), respectively. The cells were subjected to FSS, and the cell appearance before and after the stress was evaluated. MTT assay was applied to estimate cell proliferation. The mRNA and protein levels of FAK were determined by qRT-PCR and western blotting. Titanium plates demonstrated different surface microtopography. Parameter Ra values of SLA group were around 3.4 µm, which was higher than PT group. Exposure to the FSS of 12 dynes/cm2 significantly induced positive upregulation of cellular proliferation and the expression of FAK, which were directly correlated with the duration of exposure and surface. Cells in SLA group were able to endurance the longtime of FSS, especially under the FSS of 16 dynes/cm2. SLA surface had a positive influence on the expression of FAK. Different surface modifications created different microtopography of titanium plates. Cell proliferation and the mRNA and protein expression of FAK were stimulated by FSS and regulated by a marked synergistic effect of surface topography and the level and duration of FSS.
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Affiliation(s)
- Xin Lei
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Qiong Liu
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
| | - Shiyi Li
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
| | - Zhaoqiang Zhang
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
| | - Xiaoyu Yang
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
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Karczewski AM, Dingle AM, Poore SO. The Need to Work Arm in Arm: Calling for Collaboration in Delivering Neuroprosthetic Limb Replacements. Front Neurorobot 2021; 15:711028. [PMID: 34366820 PMCID: PMC8334559 DOI: 10.3389/fnbot.2021.711028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/22/2021] [Indexed: 11/21/2022] Open
Abstract
Over the last few decades there has been a push to enhance the use of advanced prosthetics within the fields of biomedical engineering, neuroscience, and surgery. Through the development of peripheral neural interfaces and invasive electrodes, an individual's own nervous system can be used to control a prosthesis. With novel improvements in neural recording and signal decoding, this intimate communication has paved the way for bidirectional and intuitive control of prostheses. While various collaborations between engineers and surgeons have led to considerable success with motor control and pain management, it has been significantly more challenging to restore sensation. Many of the existing peripheral neural interfaces have demonstrated success in one of these modalities; however, none are currently able to fully restore limb function. Though this is in part due to the complexity of the human somatosensory system and stability of bioelectronics, the fragmentary and as-yet uncoordinated nature of the neuroprosthetic industry further complicates this advancement. In this review, we provide a comprehensive overview of the current field of neuroprosthetics and explore potential strategies to address its unique challenges. These include exploration of electrodes, surgical techniques, control methods, and prosthetic technology. Additionally, we propose a new approach to optimizing prosthetic limb function and facilitating clinical application by capitalizing on available resources. It is incumbent upon academia and industry to encourage collaboration and utilization of different peripheral neural interfaces in combination with each other to create versatile limbs that not only improve function but quality of life. Despite the rapidly evolving technology, if the field continues to work in divided "silos," we will delay achieving the critical, valuable outcome: creating a prosthetic limb that is right for the patient and positively affects their life.
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Affiliation(s)
| | - Aaron M. Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, United States
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Wang Y, Teng W, Zhang Z, Zhou X, Ye Y, Lin P, Liu A, Wu Y, Li B, Zhang C, Yang X, Li W, Yu X, Gou Z, Ye Z. A trilogy antimicrobial strategy for multiple infections of orthopedic implants throughout their life cycle. Bioact Mater 2021; 6:1853-1866. [PMID: 33336116 PMCID: PMC7732879 DOI: 10.1016/j.bioactmat.2020.11.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 01/03/2023] Open
Abstract
Bacteria-associated infection represents one of the major threats for orthopedic implants failure during their life cycles. However, ordinary antimicrobial treatments usually failed to combat multiple waves of infections during arthroplasty and prosthesis revisions etc. As these incidents could easily introduce new microbial pathogens in/onto the implants. Herein, we demonstrate that an antimicrobial trilogy strategy incorporating a sophisticated multilayered coating system leveraging multiple ion exchange mechanisms and fine nanotopography tuning, could effectively eradicate bacterial infection at various stages of implantation. Early stage bacteriostatic effect was realized via nano-topological structure of top mineral coating. Antibacterial effect at intermediate stage was mediated by sustained release of zinc ions from doped CaP coating. Strong antibacterial potency was validated at 4 weeks post implantation via an implanted model in vivo. Finally, the underlying zinc titanate fiber network enabled a long-term contact and release effect of residual zinc, which maintained a strong antibacterial ability against both Staphylococcus aureus and Escherichia coli even after the removal of top layer coating. Moreover, sustained release of Sr2+ and Zn2+ during CaP coating degradation substantially promoted implant osseointegration even under an infectious environment by showing more peri-implant new bone formation and substantially improved bone-implant bonding strength.
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Affiliation(s)
- Yikai Wang
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Wangsiyuan Teng
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Zengjie Zhang
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Xingzhi Zhou
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Yuxiao Ye
- School of Material Science and Engineering, University of New South Wales, Sydney 2052, Australia
| | - Peng Lin
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - An Liu
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Yan Wu
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Binghao Li
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Chongda Zhang
- New York University Medical Center, New York University, New York, 10016, USA
| | - Xianyan Yang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, PR China
| | - Weixu Li
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Xiaohua Yu
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, PR China
| | - Zhaoming Ye
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, PR China
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Morin CD, Déziel E, Gauthier J, Levesque RC, Lau GW. An Organ System-Based Synopsis of Pseudomonas aeruginosa Virulence. Virulence 2021; 12:1469-1507. [PMID: 34180343 PMCID: PMC8237970 DOI: 10.1080/21505594.2021.1926408] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Driven in part by its metabolic versatility, high intrinsic antibiotic resistance, and a large repertoire of virulence factors, Pseudomonas aeruginosa is expertly adapted to thrive in a wide variety of environments, and in the process, making it a notorious opportunistic pathogen. Apart from the extensively studied chronic infection in the lungs of people with cystic fibrosis (CF), P. aeruginosa also causes multiple serious infections encompassing essentially all organs of the human body, among others, lung infection in patients with chronic obstructive pulmonary disease, primary ciliary dyskinesia and ventilator-associated pneumonia; bacteremia and sepsis; soft tissue infection in burns, open wounds and postsurgery patients; urinary tract infection; diabetic foot ulcers; chronic suppurative otitis media and otitis externa; and keratitis associated with extended contact lens use. Although well characterized in the context of CF, pathogenic processes mediated by various P. aeruginosa virulence factors in other organ systems remain poorly understood. In this review, we use an organ system-based approach to provide a synopsis of disease mechanisms exerted by P. aeruginosa virulence determinants that contribute to its success as a versatile pathogen.
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Affiliation(s)
- Charles D Morin
- Centre Armand-Frappier Santé Biotechnologie, Institut National De La Recherche Scientifique (INRS), Laval, Quebec, Canada
| | - Eric Déziel
- Centre Armand-Frappier Santé Biotechnologie, Institut National De La Recherche Scientifique (INRS), Laval, Quebec, Canada
| | - Jeff Gauthier
- Département De Microbiologie-infectiologie Et Immunologie, Institut De Biologie Intégrative Et Des Systèmes (IBIS), Université Laval, Québec City, Quebec, Canada
| | - Roger C Levesque
- Département De Microbiologie-infectiologie Et Immunologie, Institut De Biologie Intégrative Et Des Systèmes (IBIS), Université Laval, Québec City, Quebec, Canada
| | - Gee W Lau
- Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, IL, US
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Peng J, Liu P, Peng W, Sun J, Dong X, Ma Z, Gan D, Liu P, Shen J. Poly(hexamethylene biguanide) (PHMB) as high-efficiency antibacterial coating for titanium substrates. JOURNAL OF HAZARDOUS MATERIALS 2021; 411:125110. [PMID: 33858091 DOI: 10.1016/j.jhazmat.2021.125110] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Bacterial associated infection is a remaining urgent challenge in clinic application of metallic implants and devices. Here, we developed a new strategy to combat the bacterial associated infection of titanium alloy (TC4). Novel phosphonate/active ester block polymers (pDEMMP-b-pNHSMA) with identical phosphonate segments (DP = 29) as the metal anchorable ligand but varied active ester segments (DPs = 7, 29, and 64) as the conjugation site for poly(hexamethylene biguanide) (PHMB) were precisely prepared. Through a facile two-step process, the polymeric coating were successfully constructed on TC4 substrates as evidenced by water contact angle and XPS measurements. Through systematical in vitro antibacterial evaluations, robust relationship between the chemical structure of coating polymer and the antibacterial property endowed to the TC4 substrates has been established. Results showed that the block polymer, bearing an active ester segment of 64 repeat units, enabled dense packing of PHMB coating on the TC4 surface, which is able to kill 100% of both S. aureus and E. coli. that seeded without compromising the cytocompatibility of TC4 substrates. Furthermore, PHMB coating could significantly inhibit the colony of the bacteria and consequently reduce the bacterial associated inflammatory reaction as verified by a subcutaneous infection model on rat.
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Affiliation(s)
- Jiangmei Peng
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China
| | - Peiming Liu
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China
| | - Wan Peng
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China
| | - Jin Sun
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China
| | - Xiaohan Dong
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China
| | - Zhuangzhuang Ma
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China
| | - Donglin Gan
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China
| | - Pingsheng Liu
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China.
| | - Jian Shen
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, PR China; Jiangsu Engineering Research Center of Interfacial Chemistry, Nanjing University, Nanjing 210093, PR China.
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Modaresifar K, Ganjian M, Angeloni L, Minneboo M, Ghatkesar MK, Hagedoorn PL, Fratila-Apachitei LE, Zadpoor AA. On the Use of Black Ti as a Bone Substituting Biomaterial: Behind the Scenes of Dual-Functionality. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2100706. [PMID: 33978318 DOI: 10.1002/smll.202100706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/24/2021] [Indexed: 06/12/2023]
Abstract
Despite the potential of small-scale pillars of black titanium (bTi) for killing the bacteria and directing the fate of stem cells, not much is known about the effects of the pillars' design parameters on their biological properties. Here, three distinct bTi surfaces are designed and fabricated through dry etching of the titanium, each featuring different pillar designs. The interactions of the surfaces with MC3T3-E1 preosteoblast cells and Staphylococcus aureus bacteria are then investigated. Pillars with different heights and spatial organizations differently influence the morphological characteristics of the cells, including their spreading area, aspect ratio, nucleus area, and cytoskeletal organization. The preferential formation of focal adhesions (FAs) and their size variations also depend on the type of topography. When the pillars are neither fully separated nor extremely tall, the colocalization of actin fibers and FAs as well as an enhanced matrix mineralization are observed. However, the killing efficiency of these pillars against the bacteria is not as high as that of fully separated and tall pillars. This study provides a new perspective on the dual-functionality of bTi surfaces and elucidates how the surface design and fabrication parameters can be used to achieve a surface topography with balanced bactericidal and osteogenic properties.
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Affiliation(s)
- Khashayar Modaresifar
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Mahya Ganjian
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Livia Angeloni
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
- Department of Precision and Microsystems Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Michelle Minneboo
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Murali K Ghatkesar
- Department of Precision and Microsystems Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Peter-Leon Hagedoorn
- Department of Biotechnology, Faculty of Applied Sciences, Delft University of Technology, Van der Maasweg 9, Delft, 2629 HZ, The Netherlands
| | - Lidy E Fratila-Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, The Netherlands
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Fischer NG, Chen X, Astleford-Hopper K, He J, Mullikin AF, Mansky KC, Aparicio C. Antimicrobial and enzyme-responsive multi-peptide surfaces for bone-anchored devices. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 125:112108. [PMID: 33965114 DOI: 10.1016/j.msec.2021.112108] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/19/2021] [Accepted: 04/10/2021] [Indexed: 12/21/2022]
Abstract
Functionalization of dental and orthopedic implants with multiple bioactivities is desirable to obtain surfaces with improved biological performance and reduced infection rates. While many approaches have been explored to date, nearly all functionalized surfaces are static, i.e., non-responsive to biological cues. However, tissue remodeling necessary for implant integration features an ever-changing milieu of cells that demands a responsive biomaterial surface for temporal synchronization of interactions between biomaterial and tissue. Here, we successfully synthesized a multi-functional, dynamic coating on titanium by co-immobilizing GL13K antimicrobial peptide and an MMP-9 - a matrix metalloproteinase secreted by bone-remodeling osteoclasts - responsive peptide. Our co-immobilized peptide surface showed potent anti-biofilm activity, enabled effective osteoblast and fibroblast proliferation, and demonstrated stability against a mechanical challenge. Finally, we showed peptide release was triggered for up to seven days when the multi-peptide coatings were cultured with MMP-9-secreting osteoclasts. Our MMP-9 cleavable peptide can be conjugated with osteogenic or immunomodulatory motifs for enhanced bone formation in future work. Overall, we envisage our multifunctional, dynamic surface to reduce infection rates of percutaneous bone-anchored devices via strong anti-microbial activity and enhanced tissue regeneration via temporal synchronization between biomaterial cues and tissue responses.
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Affiliation(s)
- Nicholas G Fischer
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA
| | - Xi Chen
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA
| | - Kristina Astleford-Hopper
- Department of Diagnostic and Biological Sciences, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA
| | - Jiahe He
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA
| | - Alex F Mullikin
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA
| | - Kim C Mansky
- Department of Diagnostic and Biological Sciences, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA
| | - Conrado Aparicio
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA.
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50
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Veronesi F, Torricelli P, Martini L, Tschon M, Giavaresi G, Bellini D, Casagranda V, Alemani F, Fini M. An alternative ex vivo method to evaluate the osseointegration of Ti-6Al-4V alloy also combined with collagen. Biomed Mater 2021; 16:025007. [PMID: 33445161 DOI: 10.1088/1748-605x/abdbda] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Due to the increasing number of orthopedic implantation surgery and advancements in biomaterial manufacturing, chemistry and topography, there is an increasing need of reliable and rapid methods for the preclinical investigation of osseointegration and bone ingrowth. Implant surface composition and topography increase osteogenicity, osteoinductivity, osteoconductivity and osseointegration of a prosthesis. Among the biomaterials used to manufacture an orthopedic prosthesis, titanium alloy (Ti-6Al-4V) is the most used. Type I collagen (COLL I) induces cell function, adhesion, differentiation and bone extracellular matrix component secretion and it is reported to improve osseointegration if immobilized on the alloy surface. The aim of the present study was to evaluate the feasibility of an alternative ex vivo model, developed by culturing rabbit cortical bone segments with Ti-6Al-4V alloy cylinders (Ti-POR), fabricated through the process of electron beam melting (EBM), to evaluate osseointegration. In addition, a comparison was made with Ti-POR coated with COLL I (Ti-POR-COLL) to evaluate osseointegration in terms of bone-to-implant contact (BIC) and new bone formation (nBAr/TAr) at 30, 60 and 90 d of culture. After 30 and 60 d of culture, BIC and nBAr/TAr resulted significantly higher in Ti-POR-COLL implants than in Ti-POR. No differences have been found at 90 d of culture. With the developed model it was possible to distinguish the biomaterial properties and behavior. This study defined and confirmed for the first time the validity of the alternative ex vivo method to evaluate osseointegration and that COLL I improves osseointegration and bone growth of Ti-6Al-4V fabricated through EBM.
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Affiliation(s)
- Francesca Veronesi
- Complex Structure of Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136 Bologna, Italy
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