Biomaterials and interface with bone

CB2 regulates oxidative stress and osteoclastogenesis through NOX1-dependent signaling pathway in titanium particle-induced osteolysis

Periprosthetic osteolysis (PPO) induced by wear particles at the interface between the prosthesis and bone is a crucial issue of periprosthetic bone loss and implant failure. After wear and tear, granular material accumulates around the joint prosthesis, causing a chronic inflammatory response, progressive osteoclast activation and eventual loosening of the prosthesis. Although many studies have been conducted to address bone loss after joint replacement surgeries, they have not fully addressed these issues. Focusing on osteoclast activation induced by particles has important theoretical implications. Cannabinoid type II receptor (CB2) is a seven-transmembrane receptor that is predominantly distributed in the human immune system and has been revealed to be highly expressed in bone-associated cells. Previous studies have shown that modulation of CB2 has a positive effect on bone metabolism. However, the exact mechanism has not yet been elucidated. In our experiments, we found that NOX1-mediated ROS accumulation was involved in titanium particle-stimulated osteoclast differentiation. Furthermore, we confirmed that CB2 blockade alleviated titanium particle-stimulated osteoclast activation by inhibiting the NOX1-mediated oxidative stress pathway. In animal experiments, downregulation of CB2 alleviated the occurrence of titanium particle-induced cranial osteolysis by inhibiting osteoclasts and scavenging intracellular ROS. Collectively, our results suggest that CB2 blockade may be an attractive and promising therapeutic scheme for particle-stimulated osteoclast differentiation and preventing PPO.

Three-Dimensional Printing of Large-Scale, High-Resolution Bioceramics with Micronano Inner Porosity and Customized Surface Characterization Design for Bone Regeneration

Three-dimensional printing technologies have opened up new possibilities for manufacturing bioceramics with complex shapes in a completely digital fabrication process. Some bioceramics have demonstrated elaborate design and high resolution in their small parts through digital light projection (DLP) printing. However, it is still a challenge to prepare large-scale, high-precision ceramics that can effectively regulate the bioactivity of materials. In this study, we fabricated a large-scale hydroxyapatite porous bioceramic (length >150 mm) using DLP. This bioceramic had highly micronanoporous surface structures (printing resolution <65 μm), which could be controlled by adjusting the solid content and sintering process. Both in vitro and in vivo results indicated that the designed bioceramic had promising bone regeneration ability. This study provides significant evidence for exploring the effects of microenvironments on bone tissue regeneration. These results indicated that DLP technology has the potential to produce large-scale bone tissue engineering scaffolds with accurate porosity.

Bone regeneration using Wollastonite/β-TCP scaffolds implants in critical bone defect in rat calvaria

In order to provide favorable conditions for bone regeneration, a lot of biomaterials have been developed and evaluated, worldwide. Composite biomaterials have gained notoriety, as they combine desirable properties of each isolated material. Thus, in this research, bone repair capacity of three developed formulations of ceramic scaffolds were evaluated histomorphometrically, after implantation. Scaffolds were based on wollastonite (W) andβ-tricalcium phosphate (β-TCP) composites in three different ratios (wt.%). ThirtyWistarrats were randomly assigned to three experimental groups: W-20 (20 W/80β-TCP wt.%), W-60 (60 W/40β-TCP wt.%), and W-80 (80 W/20β-TCP wt.%), evaluated by optical microscopy at biological tests after 15 and 45 days of implantation. Throughout the study, the histological results evidenced that the scaffolds remained at the implantation site, were biocompatible and presented osteogenic potential. The percentage of neoformed mineralized tissue was more evident in the W-20 group (51%), at 45 days. The composite of the W-80 group showed more evident biodegradation than the biomaterials of the W-20 and W-60 groups. Thus, it is concluded that the scaffold containing 20 W/80β-TCP (wt.%) promoted more evident bone formation, but all composites evaluated in this study showed notorious bioactivity and promising characteristics for clinical application.

Surface Characterization and Biocompatibility of Hydroxyapatite Coating on Anodized TiO2 Nanotubes via PVD Magnetron Sputtering

Hydroxyapatite (HA) coating has received significant attention in the scientific community for the development of implants, and HA coating on titanium oxide (TiO₂) nanotubes has shown potential benefits in the improvement of cell proliferation, adhesion, and differentiation. In this study, a HA coating on a TiO₂ nanotubular surface was developed to improve the biocompatibility of the titanium (Ti) surface via magnetron sputtering. Scanning electron microscopy (SEM), surface profilometry, and water contact goniometry revealed that HA-coated TiO₂ nanotubes influenced the surface roughness (R_a) and hydrophilicity. The XRD and FTIR peaks indicated the presence of crystalline phases of TiO₂ (anatase) and HA-coated TiO₂ nanotubes after annealing at 500 °C for 120 min. The HA-coated TiO₂ nanotubes showed significantly increased R_a and decreased water contact angle (θ) compared to the as-anodized TiO₂ nanotubular and bare CP-Ti surfaces. MTS assay using osteoblast-like cells confirmed that the HA-coated TiO₂ nanotubular surface provided an enhanced cell attachment and growth when compared to as-anodized TiO₂ nanotubular and pure CP-Ti surfaces.

Excessive production of mitochondrion‑derived reactive oxygen species induced by titanium ions leads to autophagic cell death of osteoblasts via the SIRT3/SOD2 pathway

The incidence of peri-implant bone loss is high, and is a difficult condition to treat. Previous studies have shown that titanium (Ti) ions released from implants can lead to osteoblast cell damage, but the specific mechanisms have not been elucidated. The present study established a Ti ion damage osteoblast cell model. The levels of mitochondrion-derived reactive oxygen species (mROS) and autophagy, cell viability and the sirtuin 3 (SIRT3)/superoxide dismutase 2 (SOD2) pathway were examined in this model. It was found that Ti ions decreased osteoblast viability. Moreover, with increased Ti ion concentration, the expression levels of microtubule associated protein 1 light chain 3α (LC3) progressively increased, P62 decreased, autophagic flow increased and mROS levels increased. After the addition of an autophagy inhibitor Bafilomycin A1 and Mito-TEMPO, a mitochondrial antioxidant, the production of mROS was inhibited, the level of autophagy was decreased and cell activity was improved. In addition, with increased Ti ion concentration, the activity of SOD2 decreased, the acetylation level of SOD2 increased, the SIRT3 mRNA and protein expression levels decreased, and the activity of SIRT3 was significantly decreased. Furthermore, it was demonstrated that SIRT3 overexpression reduced the acetylation of SOD2 and increased the activity of SOD2, as well as reducing the production of mROS and the expression level of LC3, thus increasing cell viability. Therefore, the present results suggested that excessive production of mROS induced by Ti ions led to autophagic cell death of osteoblasts, which is dependent on the SIRT3/SOD2 pathway.

Nanostructured TiC Layer is Highly Suitable Surface for Adhesion, Proliferation and Spreading of Cells

Cell culture is usually performed in 2D polymer surfaces; however, several studies are conducted with the aim to screen functional coating molecules to find substrates more suitable for cell adhesion and proliferation. The aim of this manuscript is to compare the cell adhesion and cytoskeleton organization of different cell types on different surfaces. Human primary fibroblasts, chondrocytes and osteoblasts isolated from patients undergoing surgery were seeded on polystyrene, poly-d-lysine-coated glass and titanium carbide slides and left to grow for several days. Then their cytoskeleton was analyzed, both by staining cells with phalloidin, which highlights actin fibers, and using Atomic Force Microscopy. We also monitored the production of Fibroblast Growth Factor-2, Bone Morphogenetic Protein-2 and Osteocalcin, using ELISA, and we highlighted production of Collagen type I in fibroblasts and osteoblasts and Collagen type II in chondrocytes by immunofluorescences. Fibroblasts, chondrocytes and osteoblasts showed both an improved proliferative activity and a good adhesion ability when cultured on titanium carbide slides, compared to polystyrene and poly-d-lysine-coated glass. In conclusion, we propose titanium carbide as a suitable surface to cultivate cells such as fibroblasts, chondrocytes and osteoblasts, allowing the preservation of their differentiated state and good adhesion properties.

The effect of laser frequency on roughness, microstructure, cell viability and attachment of Ti6Al4V alloy

Titanium alloys are commonly used in orthopedic devices due to their good corrosion resistance, high specific strength and excellent biological response. The direct contact between the implant surface and the host tissue results in notable effect of surface properties such as surface topography on the biological responses. The aim of this study is to investigate the effect of frequency of pulsed Nd-YAG laser on Ti6Al4V alloy surface topography and its influence on the improvement of biocompatibility while other laser parameters kept constant. The range of applied frequency values were selected from 1 to 20 Hz. The range of surface roughness was found between 452 nm and 3.37 μm. The untreated sample and also samples with the highest and the lowest average surface roughness parameter were subjected to the further analyses. Characterization of the samples was performed with surface roughness tester, Scanning Electron Microscopy (SEM), and Atomic Force Microscopy (AFM). The high rate of melt and solidification during the laser treatment led to the martensite formation and consequently an increase about 12-25% in hardness. Furthermore, in vitro study was carried out using MG-63 osteoblast like cells. The analyses of cell viability for 3 culture times, cell morphology and cell spreading area revealed that sample with the highest average surface roughness parameter is more biocompatible. 10 Hz frequency was found as the optimum parameter which led to the highest surface roughness and thus the biocompatibility enhancement. In conclusion, the pulsed Nd-YAG laser with an optimum value of applied frequency can be utilized as an effective technique to improve the biological characteristics.

Lithium-Doped Biological-Derived Hydroxyapatite Coatings Sustain In Vitro Differentiation of Human Primary Mesenchymal Stem Cells to Osteoblasts

This study is focused on the adhesion and differentiation of the human primary mesenchymal stem cells (hMSC) to osteoblasts lineage on biological-derived hydroxyapatite (BHA) and lithium-doped BHA (BHA:LiP) coatings synthesized by Pulsed Laser Deposition. An optimum adhesion of the cells on the surface of BHA:LiP coatings compared to control (uncoated Ti) was demonstrated using immunofluorescence labelling of actin and vinculin, two proteins involved in the initiation of the cell adhesion process. BHA:LiP coatings were also found to favor the differentiation of the hMSC towards an osteoblastic phenotype in the presence of osteoinductive medium, as revealed by the evaluation of osteoblast-specific markers, osteocalcin and alkaline phosphatase. Numerous nodules of mineralization secreted from osteoblast cells grown on the surface of BHA:LiP coatings and a 3D network-like organization of cells interconnected into the extracellular matrix were evidenced. These findings highlight the good biocompatibility of the BHA coatings and demonstrate that the use of lithium as a doping agent results in an enhanced osteointegration potential of the synthesized biomaterials, which might therefore represent viable candidates for future in vivo applications.

Hyaluronic Acid Stimulates Osseointegration of β-TCP in Young and Old Ewes

Cross-linked hyaluronic acid (HyAR) increases the local concentration of growth factors. We compared β-TCP osseointegration in old and young ewes with/without HyAR addition. A blind tunnel was drilled on the medial femoral condyle of each knee in nine young and nine old ewes and was filled with β-TCP, β-TCP + HyAR or left unfilled. Double labeling with calcein allowed histodynamic analysis. Ewes were sacrificed at 84 days and the knees were harvested. MicroCT provided histomorphometric parameters: trabecular bone volume, residual volume of biomaterial. Histodynamic parameters were: mineralization rate, mineralized surfaces, bone formation rate. A non-parametric ANOVA and post hoc test analyzed differences between subgroups. Osseointegration of β-TCP was similar in the aged/young grafted groups. Trabecular bone volume was significantly increased versus ungrafted animals (p < 0.001). There were no significant difference for bone volume, residual volume of biomaterial and histodynamic parameters when a single parameter was considered but additional effects of β-TCP and HyAR were evidenced by 3D analysis. Addition of HyAR to ß-TCP does not significantly increase bone volume but tends to increase histodynamic parameters. However, considering the reduction of osteoblastic activity in aged animals, β-TCP, and HyAR boosts osteoblastic activity. HyAR leads to an equivalent response between young and old animals.

Ion-substituted calcium phosphate coatings by physical vapor deposition magnetron sputtering for biomedical applications: A review

Coatings based on ion-substituted calcium phosphate (Ca-P) have attracted great attention in the scientific community over the past decade for the development of biomedical applications. Among such Ca-P based structures, hydroxyapatite (HA) has shown significant influence on cell behaviors including cell proliferation, adhesion, and differentiation. These cell behaviors determine the osseointegration between the implant and host bone and the biocompatibility of implants. This review presents a critical analysis on the physical vapor deposition magnetron sputtering (PVDMS) technique that has been used for ion-substituted Ca-P based coatings on implants materials. The effect of PVDMS processing parameters such as discharge power, bias voltage, deposition time, substrate temperature, and post-heat treatment on the surface properties of ion-substituted Ca-P coatings is elucidated. Moreover, the advantages, short comings and future research directions of Ca-P coatings by PVDMS have been comprehensively analyzed. It is revealed that the topography and surface chemistry of amorphous HA coatings influence the cell behavior, and ion-substituted HA coatings significantly increase cell attachment but may result in a cytotoxic effect that reduces the growth of the cells attached to the coating surface areas. Meanwhile, low-crystalline HA coatings exhibit lower rates of osteogenic cell proliferation as compared to highly crystalline HA coatings developed on Ti based surfaces. PVDMS allows a close reproduction of bioapatite characteristics with high adhesion strength and substitution of therapeutic ions. It can also be used for processing nanostructured Ca-P coatings on polymeric biomaterials and biodegradable metals and alloys with enhanced corrosion resistance and biocompatibility. STATEMENT OF SIGNIFICANCE: Recent studies have utilized the physical vapor deposition magnetron sputtering (PVDMS) for the deposition of Ca-P and ion-substituted Ca-P thin film coatings on orthopedic and dental implants. This review explains the effect of PVDMS processing parameters, such as discharge power, bias voltage, deposition time, substrate temperature, and post-heat treatment, on the surface morphology and crystal structure of ion-substituted Ca-P and ion-substituted Ca-P thin coatings. It is revealed that coating thickness, surface morphology and crystal structure of ion-substituted Ca-P coatings via PVDMS directly affect the biocompatibility and cell responses of such structures. The cell responses determine the osseointegration between the implant and host bone and eventually the success of the implants.

Biomechanical behavior of modular acetabular cups made of poly-ether-ether-ketone: A finite element study

After total hip arthroplasty, stress-shielding is a potential risk factor for aseptic loosening of acetabular cups made of metals. This might be avoided by the use of acetabular cups made of implant materials with lower stiffness. The purpose of this numerical study was to determine whether a modular acetabular cup with a shell made of poly-ether-ether-ketone or poly-ether-ether-ketone reinforced with carbon fibers might be an alternative to conventional metallic shells. Therefore, the press-fit implantation of modular cups with shells made of different materials (Ti6Al4V, poly-ether-ether-ketone, and poly-ether-ether-ketone reinforced with carbon fibers) and varying liner materials (ceramics and ultra-high-molecular-weight polyethylene) into an artificial bone cavity was simulated using finite element analysis. The shell material had a major impact on the radial shell deformation determined at the rim of the shell, ranging from 17.9 µm for titanium over 92.2 µm for poly-ether-ether-ketone reinforced with carbon fibers up to 475.9 µm for poly-ether-ether-ketone. Larger radial liner deformations (up to 618.4 µm) occurred in combination with the shells made of poly-ether-ether-ketone compared to titanium and poly-ether-ether-ketone reinforced with carbon fibers. Hence, it can be stated that conventional poly-ether-ether-ketone is not a suitable shell material for modular acetabular cups. However, the radial shell deformation can be reduced if the poly-ether-ether-ketone reinforced with carbon fiber material is used, while deformation of ceramic liners is similar to the deformation in combination with titanium shells.

Characterization of thick titanium plasma spray coatings on PEEK materials used for medical implants and the influence on the mechanical properties

Coating poly-ether-ether-ketone (PEEK) with rough and porous titanium plasma spray (TPS) coatings is a technique which is commonly used to enhance the osseointegrative properties of medical implants. However, the influence of the TPS coating on the PEEK mechanical properties has not been sufficiently evaluated to date. In this study, PEEK samples were coated with a thick TPS layer with grains of 90µm and 180µm diameter. The coating characteristics and the adhesive strength of the coatings on the samples were determined and compared to coatings on titanium samples. The influence of the coating process on the mechanical and chemical-physical properties of PEEK was also evaluated. All TPS coatings on PEEK and titanium fulfilled the manufacturer's requirements for thickness (200 ± 50µm), porosity (30 ± 10%) and roughness (90µm grain diameter coating: 25 ± 5µm and 180µm grain diameter coating: 45 ± 15µm) and were able to meet the demands required for adhesive strength (> 22MPa) and shear strength (> 20MPa). However, the mechanical properties i.e. yield stress, fracture strain, flexural modulus and flexural stress, of the PEEK samples were influenced by the coating process, while the chemical-physical properties were not altered.

Strontium ranelate improves the interaction of osteoblastic cells with titanium substrates: Increase in cell proliferation, differentiation and matrix mineralization

We describe direct effects of strontium ranelate on the interaction of osteoblastic cells with different titanium substrates. Our goal was to better understand the potential of this drug for improving the efficacy of bone implants. Treatment was done with 0.12 and 0.5 mM Sr(2+) of strontium ranelate in cell culture. We analyzed cell response to the drug on titanium substrates with surface topographies obtained using acid etching, electro-erosion processing, sandblasting, and machine-tooling. Treatment preserved the initial cell adhesion to the substrates, cell shape parameters (area, aspect ratio, circularity, and solidity), and the orientation of cells on grooved surfaces. However, both concentrations of the drug increased cell proliferation in all substrates. Moreover, a dose-dependent increase in alkaline phosphatase activity and in the production of mineralized matrix with typical features of bone tissue was shown. The observed effects were similar in the different substrates. In conclusion, strontium ranelate improved the interaction of osteoblastic cells with titanium substrates, increasing cell proliferation and differentiation into mature osteoblasts and the production of bone-like mineralized matrix for all substrates. This study highlights a promising role of strontium ranelate on enhancing the clinical success of bone implants, particularly in patients with osteoporosis.

Improving Osteoblast Response In Vitro by a Nanostructured Thin Film with Titanium Carbide and Titanium Oxides Clustered around Graphitic Carbon

Introduction

Recently, we introduced a new deposition method, based on Ion Plating Plasma Assisted technology, to coat titanium implants with a thin but hard nanostructured layer composed of titanium carbide and titanium oxides, clustered around graphitic carbon. The nanostructured layer has a double effect: protects the bulk titanium against the harsh conditions of biological tissues and in the same time has a stimulating action on osteoblasts.

Results

The aim of this work is to describe the biological effects of this layer on osteoblasts cultured in vitro. We demonstrate that the nanostructured layer causes an overexpression of many early genes correlated to proteins involved in bone turnover and an increase in the number of surface receptors for α3β1 integrin, talin, paxillin. Analyses at single-cell level, by scanning electron microscopy, atomic force microscopy, and single cell force spectroscopy, show how the proliferation, adhesion and spreading of cells cultured on coated titanium samples are higher than on uncoated titanium ones. Finally, the chemistry of the layer induces a better formation of blood clots and a higher number of adhered platelets, compared to the uncoated cases, and these are useful features to improve the speed of implant osseointegration.

Conclusion

In summary, the nanostructured TiC film, due to its physical and chemical properties, can be used to protect the implants and to improve their acceptance by the bone.

Development of Ti-Nb-Zr alloys with high elastic admissible strain for temporary orthopedic devices

A new series of beta Ti-Nb-Zr (TNZ) alloys with considerable plastic deformation ability during compression test, high elastic admissible strain, and excellent cytocompatibility have been developed for removable bone tissue implant applications. TNZ alloys with nominal compositions of Ti-34Nb-25Zr, Ti-30Nb-32Zr, Ti-28Nb-35.4Zr and Ti-24.8Nb-40.7Zr (wt.% hereafter) were fabricated using the cold-crucible levitation technique, and the effects of alloying element content on their microstructures, mechanical properties (tensile strength, yield strength, compressive yield strength, Young's modulus, elastic energy, toughness, and micro-hardness), and cytocompatibilities were investigated and compared. Microstructural examinations revealed that the TNZ alloys consisted of β phase. The alloy samples displayed excellent ductility with no cracking, or fracturing during compression tests. Their tensile strength, Young's modulus, elongation at rupture, and elastic admissible strain were measured in the ranges of 704-839 MPa, 62-65 GPa, 9.9-14.8% and 1.08-1.31%, respectively. The tensile strength, Young's modulus and elongation at rupture of the Ti-34Nb-25Zr alloy were measured as 839 ± 31.8 MPa, 62 ± 3.6 GPa, and 14.8 ± 1.6%, respectively; this alloy exhibited the elastic admissible strain of approximately 1.31%. Cytocompatibility tests indicated that the cell viability ratios (CVR) of the alloys are greater than those of the control group; thus the TNZ alloys possess excellent cytocompatibility.

Fabrication of magnetite-based core-shell coated nanoparticles with antibacterial properties

We report the fabrication of biofunctionalized magnetite core/sodium lauryl sulfate shell/antibiotic adsorption-shell nanoparticles assembled thin coatings by matrix assisted pulsed laser evaporation for antibacterial drug-targeted delivery. Magnetite nanoparticles have been synthesized and subsequently characterized by transmission electron microscopy and x-ray diffraction. The obtained thin coatings have been investigated by FTIR and scanning electron microscope, and tested by in vitro biological assays, for their influence on in vitro bacterial biofilm development and cytotoxicity on human epidermoid carcinoma (HEp2) cells.

In vitro and in vivo evaluation of the inflammatory potential of various nanoporous hydroxyapatite biomaterials

Aim: To discriminate the most important physicochemical parameters for bone reconstruction, the inflammatory potential of seven nanoporous hydroxyapatite powders synthesized by hard or soft templating was evaluated both in vitro and in vivo. Materials & methods: After physical and chemical characterization of the powders, we studied the production of inflammatory mediators by human primary monocytes after 4 and 24 h in contact with powders, and the host response after 2 weeks implantation in a mouse critical size defect model. Results: In vitro results highlighted increases in the secretion of TNF-α, IL-1, -8, -10 and proMMP-2 and -9 and decreases in the secretion of IL-6 only for powders prepared by hard templating. In vivo observations confirmed an extensive inflammatory tissue reaction and a strong resorption for the most inflammatory powder in vitro. Conclusion: These findings highlight that the most critical physicochemical parameters for these nanoporous hydroxyapatite are, the crystallinity that controls dissolution potential, the specific surface area and the size and shape of crystallites.

The influence of titania-zirconia-zirconium titanate nanotube characteristics on osteoblast cell adhesion

Studies of biomaterial surfaces and their influence on cell behavior provide insights concerning the design of surface physicochemical and topography properties of implant materials. Fabrication of biocompatible metal oxide nanotubes on metallic biomaterials, especially titanium alloys such as Ti50Zr via anodization, alters the surface chemistry as well as surface topography of the alloy. In this study, four groups of TiO2-ZrO2-ZrTiO4 nanotubes that exhibit diverse nanoscale dimensional characteristics (i.e. inner diameter Di, outer diameter Do and wall thicknesses Wt) were fabricated via anodization. The nanotubes were annealed and characterized using scanning electron microscopy and 3-D profilometry. The potential applied during anodization influenced the oxidation rate of titanium and zirconium, thereby resulting in different nanoscale characteristics for the nanotubes. The different oxidation and dissolution rates both led to changes in the surface roughness parameters. The in vitro cell response to the nanotubes with different nanoscale dimensional characteristics was assessed using osteoblast cells (SaOS2). The results of the MTS assay indicated that the nanotubes with inner diameter (Di)≈40nm exhibited the highest percentage of cell adhesion of 41.0%. This result can be compared to (i) 25.9% cell adhesion at Di≈59nm, (ii) 33.1% at Di≈64nm, and (iii) 33.5% at Di≈82nm. The nanotubes with Di≈59nm exhibited the greatest roughness parameter of Sa (mean roughness), leading to the lowest ability to interlock with SaOS2 cells.

Significance of calcium phosphate coatings for the enhancement of new bone osteogenesis--a review

A systematic analysis of results available from in vitro, in vivo and clinical trials on the effects of biocompatible calcium phosphate (CaP) coatings is presented. An overview of the most frequently used methods to prepare CaP-based coatings was conducted. Dense, homogeneous, highly adherent and biocompatible CaP or hybrid organic/inorganic CaP coatings with tailored properties can be deposited. It has been demonstrated that CaP coatings have a significant effect on the bone regeneration process. In vitro experiments using different cells (e.g. SaOS-2, human mesenchymal stem cells and osteoblast-like cells) have revealed that CaP coatings enhance cellular adhesion, proliferation and differentiation to promote bone regeneration. However, in vivo, the exact mechanism of osteogenesis in response to CaP coatings is unclear; indeed, there are conflicting reports of the effectiveness of CaP coatings, with results ranging from highly effective to no significant or even negative effects. This review therefore highlights progress in CaP coatings for orthopaedic implants and discusses the future research and use of these devices. Currently, an exciting area of research is in bioactive hybrid composite CaP-based coatings containing both inorganic (CaP coating) and organic (collagen, bone morphogenetic proteins, arginylglycylaspartic acid etc.) components with the aim of promoting tissue ingrowth and vascularization. Further investigations are necessary to reveal the relative influences of implant design, surgical procedure, and coating characteristics (thickness, structure, topography, porosity, wettability etc.) on the long-term clinical effects of hybrid CaP coatings. In addition to commercially available plasma spraying, other effective routes for the fabrication of hybrid CaP coatings for clinical use still need to be determined and current progress is discussed.

Trabecular titanium can induce in vitro osteogenic differentiation of human adipose derived stem cells without osteogenic factors

Trabecular Titanium (TT) is an innovative highly porous structure that imitates the morphology of trabecular bone with good mechanical properties. Adipose-derived stem cells are a multipotent cell population that can be used in regenerative medicine, in particular, for bone therapeutic applications. The ability of TT to induce the osteogenic differentiation of human adipose derived stem cells (hASCs) in the absence of osteogenic factors was evaluated using molecular biological, biochemical, and immunohistochemical methods. At 7 and 21 days from differentiation, the hASCs grown on TT scaffolds showed similar expressions of alkaline phosphatase (ALP) and Runx-2 both in the presence and in the absence of osteogenic factors, as well as at transcript and protein levels. hASCs cultured on monolayer in the presence of the medium obtained from the wells where hASCs/scaffold constructs were cultured in the absence of osteogenic factors differentiated towards the osteogenic phenotype: their gene and protein expression of ALP and Runx-2 was similar to that of the same cells cultured in the presence of osteogenic factors, and significantly higher than that of the ones cultured in growth medium.

Interaction of preosteoblasts with surface-immobilized collagen-based nanotubes

In a previous work, we demonstrated the successful use of electrophoretic deposition (EPD) to immobilize collagen-based nanotubes onto indium-tin-oxide-coated glass (ITO glass), leading to the creation of biointerfaces with protein-based chemistry and topography [1]. In this work, we present a first study of preosteoblasts behavior in contact with surface-immobilized collagen-based nanotubes. Changes in cell morphology after their interaction with ITO glass modified with collagen-based nanotubes were studied using fluorescence microscopy and compared to those observed on virgin ITO glass as well as on ITO glass on which a collagen layer was simply adsorbed. Scanning electron microscopy (SEM) was used to study interactions of cell filopodias with the deposited nanotubes. Cytotoxicity of these biointerfaces was examined as well in short term cultures, using Alamar blue assay. Cells showed particular morphologies on ITO glass coated with nanotubes compared to virgin ITO glass or collagen adsorbed layer on ITO glass. High resolution SEM images suggest that apart from cell morphology, length and thickness of filopodias seem to be significantly affected by surface modification with collagen-based nanotubes. Moreover, nanotube-coated ITO glass did not show any obvious cytotoxicity in short term culture, opening new perspectives for the surface modification of biomaterials. We show the versatility of the proposed surface modification procedure by tailoring biointerfaces with a mixture of micro- and nanometer-scale collagen-based tubes.

A comparative study of the influence of three pure titanium plates with different micro- and nanotopographic surfaces on preosteoblast behaviors

There is a great demand for dental implants with the ability to accelerate periimplant bone regeneration. Modification of surface micro- and nanotopographies has been revealed to affect bone cell metabolism. In this study, we utilized dielectric barrier discharge (DBD) technology to modify commercially pure titanium (Ti-tr) surfaces and then investigated the cytocompability of DBD-modified Ti surface when compared with machined (Ti-m) and polished (Ti-p) Ti surfaces. These three kinds of Ti plates exhibited different surface energies and topographies at the micro- and nanoscale levels. The DBD-treated pure Ti surface significantly enhances cell adhesion, spread, and proliferation of MC3T3-E1 preosteoblast cells compared with the Ti-p and Ti-m surfaces, suggesting that Ti-tr has better cytocompatibility compared with the other two surfaces. Preosteoblast cells on Ti-m surface exhibited higher alkaline phosphatase activity than cells on Ti-tr and Ti-p surfaces 14 days after seeding. No significant difference in alkaline phosphatase activity was observed between cells grown on Ti-tr and Ti-p surfaces. Our study demonstrated that DBD modification significantly enhanced cell adhesion, spread, and proliferation of preosteoblasts with no negative effects on cell differentiation. Microtopography and nanotopography of the surfaces of different materials and chemical/energetic properties have a synergistic effect on cell attachment, proliferation, and differentiation.

Cell response of anodized nanotubes on titanium and titanium alloys

Titanium and titanium alloy implants that have been demonstrated to be more biocompatible than other metallic implant materials, such as Co-Cr alloys and stainless steels, must also be accepted by bone cells, bonding with and growing on them to prevent loosening. Highly ordered nanoporous arrays of titanium dioxide that form on titanium surface by anodic oxidation are receiving increasing research interest due to their effectiveness in promoting osseointegration. The response of bone cells to implant materials depends on the topography, physicochemistry, mechanics, and electronics of the implant surface and this influences cell behavior, such as adhesion, proliferation, shape, migration, survival, and differentiation; for example the existing anions on the surface of a titanium implant make it negative and this affects the interaction with negative fibronectin (FN). Although optimal nanosize of reproducible titania nanotubes has not been reported due to different protocols used in studies, cell response was more sensitive to titania nanotubes with nanometer diameter and interspace. By annealing, amorphous TiO2 nanotubes change to a crystalline form and become more hydrophilic, resulting in an encouraging effect on cell behavior. The crystalline size and thickness of the bone-like apatite that forms on the titania nanotubes after implantation are also affected by the diameter and shape. This review describes how changes in nanotube morphologies, such as the tube diameter, the thickness of the nanotube layer, and the crystalline structure, influence the response of cells.