The preparation, cytocompatibility, and in vitro biodegradation study of pure beta-TCP on magnesium

Ion-bombardment-driven surface modification of porous magnesium scaffolds: Enhancing biocompatibility and osteoimmunomodulation

Porous Mg scaffolds are promising for bone repair but are limited by high corrosion rates and challenges in preserving coating integrity. We used Directed Plasma Nanosynthesis (DPNS) at 400 eV and a fluence of 1 × 1018 cm-2 to augment the bioactivity and corrosion resistance of porous Mg scaffolds, maintaining their overall material integrity. DPNS creates nanostructures that increase surface area, promote apatite nucleation, and enhance osseointegration, improving the bioactivity and corrosion resistance of porous Mg scaffolds without compromising their structure. Our findings indicate a decrease in surface roughness, with pre-irradiated samples having Rq = 60.4 ± 5.3 nm andRa = 48.2 ± 3.1 nm, and post-DPNS samples showing Rq = 36.9 ± 0.3 nm andRa = 28.6 ± 0.8 nm. This suggests changes in topography and wettability, corroborated by the increased water contact angles (CA) of 129.2 ± 3.2 degrees. The complexity of the solution influences the CA: DMEM results in a CA of 120.4 ± 0.1 degrees, while DMEM + SBF decreases it to 103.6 ± 0.5 degrees, in contrast to the complete spreading observed in non-irradiated samples. DPNS-treated scaffolds exhibit significantly reduced corrosion rates at 5.7 × 10-3 ± 3.8 × 10-4 mg/cm²/day, compared to the control's 2.3 × 10-2 ± 3.2 × 10-4 mg/cm²/day over 14 days (P < 0.01). The treatment encourages the formation of a Ca-phosphate-rich phase, which facilitates cell spreading and the development of focal adhesion points in hBM-MSCs on the scaffolds. Additionally, J774A.1 murine macrophages show an enhanced immune response with diminished TNF-α cytokine expression. These results offer insights into nanoscale modifications of Mg-based biomaterials and their promise for bone substitutes or tissue engineering scaffolds.

Characterization of a Magnesium Fluoride Conversion Coating on Mg-2Y-1Mn-1Zn Screws for Biomedical Applications

MgF₂-coated screws made of a Mg-2Y-1Mn-1Zn alloy, called NOVAMag^® fixation screws (biotrics bioimplants AG), were tested in vitro for potential applications as biodegradable implants, and showed a controlled corrosion rate compared to non-coated screws. While previous studies regarding coated Mg-alloys have been carried out on flat sample surfaces, the present work focused on functional materials and final biomedical products. The substrates under study had a complex 3D geometry and a nearly cylindrical-shaped shaft. The corrosion rate of the samples was investigated using an electrochemical setup, especially adjusted to evaluate these types of samples, and thus, helped to improve an already patented coating process. A MgF₂/MgO coating in the µm-range was characterized for the first time using complementary techniques. The coated screws revealed a smoother surface than the non-coated ones. Although the cross-section analysis revealed some fissures in the coating structure, the electrochemical studies using Hanks' salt solution demonstrated the effective role of MgF₂ in retarding the alloy degradation during the initial stages of corrosion up to 24 h. The values of polarization resistance (Rp) of the coated samples extrapolated from the Nyquist plots were significantly higher than those of the non-coated samples, and impedance increased significantly over time. After 1200 s exposure, the Rp values were 1323 ± 144 Ω.cm² for the coated samples and 1036 ± 198 Ω.cm² for the non-coated samples, thus confirming a significant decrease in the degradation rate due to the MgF₂ layer. The corrosion rates varied from 0.49 mm/y, at the beginning of the experiment, to 0.26 mm/y after 1200 s, and decreased further to 0.01 mm/y after 24 h. These results demonstrated the effectiveness of the applied MgF₂ film in slowing down the corrosion of the bulk material, allowing the magnesium-alloy screws to be competitive as dental and orthopedic solutions for the biodegradable implants market.

Biological and Physico-Chemical Properties of Composite Layers Based on Magnesium-Doped Hydroxyapatite in Chitosan Matrix

In the present study, we report the development and characterization of composite layers (by spin coating) based on magnesium-doped hydroxyapatite in a chitosan matrix, (Ca_10-xMg_x(PO₄)₆(OH)₂; x_Mg = 0, 0.08 and 0.3; HApCh, 8MgHApCh and 30MgHApCh). The MgHApCh composite layers were investigated using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and X-ray photoelectron spectroscopy (XPS) techniques. The in vitro biological evaluation included the assessment of their cytotoxicity on MG63 osteoblast-like cells and antifungal activity against Candida albicans ATCC 10231 fungal cell lines. The results of the physico-chemical characterization highlighted the obtaining of uniform and homogeneous composite layers. In addition, the biological assays demonstrated that the increase in the magnesium concentration in the samples enhanced the antifungal effect but also decreased their cytocompatibility. However, for certain optimal magnesium ion concentrations, the composite layers presented both excellent biocompatibility and antifungal properties, suggesting their promising potential for biomedical applications in both implantology and dentistry.

Chemical, Electrochemical, and Surface Morphological Studies of the Corrosion Behavior of the AZ31 Alloy in Simulated Body Fluid: Effect of NaOH and H2O2 Surface Pretreatments on the Corrosion Resistance Property

Magnesium and its alloys have attracted attention for biomedical implant materials in dental and orthopedic applications because of their biodegradability and similar properties to human bones. The very high rate of degradation in the physiological systems is, however, a major setback to their utilization. Chemical modification is one of the approaches adopted to enhance the corrosion resistance property of Mg and its alloys. In this work, NaOH and H₂O₂ were used as a pretreatment procedure to improve the corrosion resistance of the AZ31 Mg alloy in simulated body fluid (SBF). Advanced techniques such as dynamic electrochemical impedance spectroscopy (dynamic-EIS), atomic force microscopy, and optical profilometry were used in addition to the classical mass loss, hydrogen evolution, EIS, and polarization techniques to study the corrosion resistance property of the alloy in SBF for 30 h. Results obtained show that the surface treatment significantly enhanced the corrosion resistance property of the alloy. From dynamic-EIS at 30 h, the charge transfer resistance of the untreated AZ31 Mg alloy is 432.6 Ω cm², whereas 822.7 and 2617.3 Ω cm² are recorded for NaOH- and H₂O₂-treated surfaces, respectively. H₂O₂ is a better treatment reagent than NaOH. The mechanism of corrosion of both untreated and treated samples in the studied corrosive medium has been discussed.

Biodegradable materials for bone defect repair

Compared with non-degradable materials, biodegradable biomaterials play an increasingly important role in the repairing of severe bone defects, and have attracted extensive attention from researchers. In the treatment of bone defects, scaffolds made of biodegradable materials can provide a crawling bridge for new bone tissue in the gap and a platform for cells and growth factors to play a physiological role, which will eventually be degraded and absorbed in the body and be replaced by the new bone tissue. Traditional biodegradable materials include polymers, ceramics and metals, which have been used in bone defect repairing for many years. Although these materials have more or fewer shortcomings, they are still the cornerstone of our development of a new generation of degradable materials. With the rapid development of modern science and technology, in the twenty-first century, more and more kinds of new biodegradable materials emerge in endlessly, such as new intelligent micro-nano materials and cell-based products. At the same time, there are many new fabrication technologies of improving biodegradable materials, such as modular fabrication, 3D and 4D printing, interface reinforcement and nanotechnology. This review will introduce various kinds of biodegradable materials commonly used in bone defect repairing, especially the newly emerging materials and their fabrication technology in recent years, and look forward to the future research direction, hoping to provide researchers in the field with some inspiration and reference.

Biodegradable magnesium alloy (WE43) in bone-fixation plate and screw

The purpose of the present study was to evaluate the mechanical strength and the absorption rate of WE43 material and to develop an absorbable metallic plate and screw for craniofacial application. The extruded WE43 plate and screw were evaluated using a LeFort I osteotomy canine model of 10 beagle dogs. Animals were divided into two groups: five dogs in the experimental group and five dogs in the control group. μCT was acquired at 4, 12, and 24 weeks. At 24 weeks after the operation, all animals were sacrificed, and histologic evaluation was performed. Swelling and gas formation were observed in three dogs in the experimental groups at 8 weeks. From 12 weeks, infraorbital fistula and inflammation were observed in three dogs in the experimental group, which gradually decreased and disappeared at 24 weeks. Other two dogs showed less gas formation at 12 weeks. The plates were completely absorbed, and gas formation was not observed at 24 weeks in these two dogs. New bone was well formed around the plates and screws in both groups. Histologic examination showed no specific differences between two groups. The mechanical strength of extruded WE43 was sufficient for mid‐facial application. Plates and screws made with appropriately treated WE43 have the potential to be useful clinically.

Electrodeposition of hydroxyapatite coating on Mg alloy modified with organic acid self-assembled monolayers

Calcium phosphate coatings are used in orthopedics due to their excellent bioactivity, which improves the bonding between the metal implant and the bone. The use of self-assembling monolayers of long-chain organic acids can induce calcium phosphate growth. In this article, the self-assembling monolayers of stearic acid and octadecylphosphonic acid formed on the Mg alloy surface were additionally modified with electrodeposited hydroxyapatite coating to increase the bioactivity and biocompatibility of the Mg alloy in a physiological solution. Hydroxyapatite coating was prepared by a two-step reaction: hydrogen phosphate formed by electrodeposition at constant potential was converted into hydroxyapatite coating through an acid–base reaction. The results obtained by voltammetry and electrochemical impedance spectroscopy have shown a beneficial effect of organic acid self-assembling monolayer and especially of organic acid self-assembling monolayer modification by hydroxyapatite electrodeposition on the corrosion properties of Mg alloy in physiological solution. Fourier transform infrared spectroscopy and scanning electron microscopy were used to verify the existence of the organic acid SAM|HAp film on the Mg alloy surface and their morphology.

Magnesium Enhances Osteogenesis of BMSCs by Tuning Osteoimmunomodulation

In the process of bone tissue engineering, the osteoimmunomodulatory property of biomaterials is very important for osteogenic differentiation of stem cells, which determines the outcome of bone regeneration. Magnesium (Mg) is a biodegradable, biocompatible metal that has osteoconductive properties and has been regarded as a promising bone biomaterial. However, the high degradation rate of Mg leads to excessive inflammation, thereby restricting its application in bone tissue engineering. Importantly, different coatings or magnesium alloys have been utilized to lower the rate of degradation. In fact, a prior study proved that β-TCP coating of Mg scaffolds can modulate the osteoimmunomodulatory properties of Mg-based biomaterials and create a favorable immune microenvironment for osteogenesis. However, the osteoimmunomodulatory properties of Mg ions themselves have not been explored yet. In this study, the osteoimmunomodulatory properties of Mg ions with involvement of macrophages and bone marrow stem cells (BMSCs) were systematically investigated. Microscale Mg ions (100 mg/L) were found to possess osteoimmunomodulatory properties that favor bone formation. Specifically, microscale Mg ions induced M2 phenotype changes of macrophages and the release of anti-inflammatory cytokines by inhibiting the TLR-NF-κB signaling pathway. Microscale Mg ions also stimulated the expression of osteoinductive molecules in macrophages while Mg ions/macrophage-conditioned medium promoted osteogenesis of BMSCs through the BMP/SMAD signaling pathway. These findings indicate that manipulating Mg ion concentration can endow the Mg biomaterial with favorable osteoimmunomodulatory properties, thereby providing fundamental evidence for improving and modifying the effect of Mg-based bone biomaterials.

The Bioresorption and Guided Bone Regeneration of Absorbable Hydroxyapatite-Coated Magnesium Mesh

INTRODUCTION

Nonabsorbable metallic membrane for guided bone regeneration is remained permanently even though after complete healing. There would be metallic exposure followed by the risk of infection; the membrane should be removed for the additional procedure such as implant installation. Since absorbable nonmetallic mesh is absorbed within 3 to 6 months, it is unnecessary to be removed. However, the absorbable membrane shows lower retention, lower mechanical strength, and difficulty of manipulation than the nonabsorbable ones.The purpose of this study is to evaluate the ability of absorbable metallic mesh (hydroxyapatite-coated magnesium mesh) with acceptable mechanical properties and satisfying biocompatibility.

METHODS

The bioresorption and fate of magnesium were evaluated in Sprague Dawley rat (SD rat) with critical defect of calvarium. The critical defect with a diameter of 8 mm was made on calvarium using trephine bur in 18 SD rats. The defected models were divided into 2 groups: the control group (9 SD rat) without mesh and the experimental group (9 SD rat) with the insertion of prototype HA-coated magnesium mesh. The 3 SD rats were sacrificed at 6, 12, and 18 weeks. The histopathological and radiographic examinations were performed afterward.

RESULTS

In the control group, there was no specific symptom. The experimental group also showed no specific symptom including swelling and dehiscence related to hydrogen gas formation. From 6 to 18 weeks, the experimental group showed the progressive absorption and fracture of magnesium mesh. However, there was no specific effectiveness of guided bone regeneration in both groups. There was no significant difference in bone volume, bone surface, and bone volume fraction between the negative control group and the group with magnesium mesh (P >0.05).

CONCLUSION

Hydroxyapatite-coated magnesium mesh showed reasonable process of bioresorption and bony reaction; however, the effectiveness of guided bone regeneration and management of the bioresorption rate should be reconsidered.

Mechanism for corrosion protection of β-TCP reinforced ZK60 via laser rapid solidification

It remains the primary issue to enhance the corrosion resistance of Mg alloys for their clinical applications. In this study, β-tricalcium phosphate (β-TCP) was composited with Mg-6Zn-1Zr (ZK60) using laser rapid solidification to improve the degradation behavior. Results revealed rapid solidification effectively restrained the aggregation of β-TCP, which thus homogenously distributed along grain boundaries of α-Mg. Significantly, the uniformly distributed β-TCP in the matrix promoted the formation of apatite layer on the surface, which contributed to the formation of a compact corrosion product layer, hence retarding the further degradation. Furthermore, ZK60/8β-TCP (wt. %) composite showed improved mechanical strength, as well as improved cytocompatibility. It was suggested that laser rapidly solidified ZK60/8β-TCP composite might be a potential materials for tissue engineering.

Current status on clinical applications of magnesium-based orthopaedic implants: A review from clinical translational perspective

As a new generation of medical metallic material, magnesium (Mg) and its alloys with or without surface coating have attracted a great deal of attention due to its biodegradability and potential for avoiding a removal operation after the implant has fulfilled its function for surgical fixation of injured musculoskeletal tissues. Although a few clinical cases on Mg-based orthopaedic implants were reported more than a century ago, it was not until recently that clinical trials using these implants with improved physicochemical properties were carried out in Germany, China and Korea for bone fracture fixation. The promising results so far suggest a bright future for biodegradable Mg-based orthopaedic implants and would warrant large scale phase II/III studies. Given the increasing interest on this emerging biomaterials and intense effort to improve its properties for various clinical applications, this review covers the evolution, current strategies, and future perspectives in the development of Mg-based orthopaedic implants. We also highlight a few clinical cases performed in China that may be unfamiliar to the general orthopaedic community.

3D-Printed Scaffolds and Biomaterials: Review of Alveolar Bone Augmentation and Periodontal Regeneration Applications

To ensure a successful dental implant therapy, the presence of adequate vertical and horizontal alveolar bone is fundamental. However, an insufficient amount of alveolar ridge in both dimensions is often encountered in dental practice due to the consequences of oral diseases and tooth loss. Although postextraction socket preservation has been adopted to lessen the need for such invasive approaches, it utilizes bone grafting materials, which have limitations that could negatively affect the quality of bone formation. To overcome the drawbacks of routinely employed grafting materials, bone graft substitutes such as 3D scaffolds have been recently investigated in the dental field. In this review, we highlight different biomaterials suitable for 3D scaffold fabrication, with a focus on “3D-printed” ones as bone graft substitutes that might be convenient for various applications related to implant therapy. We also briefly discuss their possible adoption for periodontal regeneration.

Biodegradable Materials for Bone Repair and Tissue Engineering Applications

This review discusses and summarizes the recent developments and advances in the use of biodegradable materials for bone repair purposes. The choice between using degradable and non-degradable devices for orthopedic and maxillofacial applications must be carefully weighed. Traditional biodegradable devices for osteosynthesis have been successful in low or mild load bearing applications. However, continuing research and recent developments in the field of material science has resulted in development of biomaterials with improved strength and mechanical properties. For this purpose, biodegradable materials, including polymers, ceramics and magnesium alloys have attracted much attention for osteologic repair and applications. The next generation of biodegradable materials would benefit from recent knowledge gained regarding cell material interactions, with better control of interfacing between the material and the surrounding bone tissue. The next generations of biodegradable materials for bone repair and regeneration applications require better control of interfacing between the material and the surrounding bone tissue. Also, the mechanical properties and degradation/resorption profiles of these materials require further improvement to broaden their use and achieve better clinical results.

Cellular response of chondrocytes to magnesium alloys for orthopedic applications

In the present study, the effects of Mg-Nd-Zn-Zr (JDBM), brushite (CaHPO₄·₂H₂O)-coated JDBM (C-JDBM), AZ31, WE43, pure magnesium (Mg) and Ti alloy (TC4) on rabbit chondrocytes were investigated in vitro. Adhesion experiments revealed the satisfactory morphology of chondrocytes on the surface of all samples. An indirect cytotoxicity test using MTT assay revealed that C-JDBM and TC4 exhibited results similar to those of the negative control, better than those obtained with JDBM, AZ31, WE43 and pure Mg (p<0.05). There were no statistically significant differences observed between the JDBM, AZ31, WE43 and pure Mg group (p>0.05). The results of indirect cell cytotoxicity and proliferation assays, as well as those of apoptosis assay, glycosaminoglycan (GAG) quantification, assessment of collagen II (Col II) levels and RT-qPCR revealed a similar a trend as was observed with MTT assay. These findings suggested that the JDBM alloy was highly biocompatible with chondrocytes in vitro, yielding results similar to those of AZ31, WE43 and pure Mg. Furthermore, CaHPO₄·₂H₂O coating significantly improved the biocompatibility of this alloy.

Surface modification of biodegradable magnesium and its alloys for biomedical applications

Magnesium and its alloys are being paid much attention recently as temporary implants, such as orthopedic implants and cardiovascular stents. However, the rapid degradation of them in physiological environment is a major obstacle preventing their wide applications to date, which will result in rapid mechanical integrity loss or even collapse of magnesium-based implants before injured tissues heal. Moreover, rapid degradation of the magnesium-based implants will also cause some adverse effects to their surrounding environment, such as local gas cavity around the implant, local alkalization and magnesium ion enrichment, which will reduce the integration between implant and tissue. So, in order to obtain better performance of magnesium-based implants in clinical trials, special alloy designs and surface modifications are prerequisite. Actually, when a magnesium-based implant is inserted in vivo, corrosion firstly happens at the implant-tissue interface and the biological response to implant is also determined by the interaction at this interface. So the surface properties, such as corrosion resistance, hemocompatibility and cytocompatibility of the implant, are critical for their in vivo performance. Compared with alloy designs, surface modification is less costly, flexible to construct multi-functional surface and can prevent addition of toxic alloying elements. In this review, we would like to summarize the current investigations of surface modifications of magnesium and its alloys for biomedical application. The advantages/disadvantages of different surface modification methods are also discussed as a suggestion for their utilization.

Osteoimmunomodulatory properties of magnesium scaffolds coated with β-tricalcium phosphate

The osteoimmunomodulatory property of bone biomaterials is a vital property determining the in vivo fate of the implants. Endowing bone biomaterials with favorable osteoimmunomodulatory properties is of great importance in triggering desired immune response and thus supports the bone healing process. Magnesium (Mg) has been recognized as a revolutionary metal for applications in orthopedics due to it being biodegradable, biocompatible, and having osteoconductive properties. However, Mg's high rate of degradation leads to an excessive inflammatory response and this has restricted its application in bone tissue engineering. In this study, β-tricalcium phosphate (β-TCP) was used to coat Mg scaffolds in an effort to modulate the detrimental osteoimmunomodulatory properties of Mg scaffolds, due to the reported favorable osteoimmunomodulatory properties of β-TCP. It was noted that macrophages switched to the M2 extreme phenotype in response to the Mg-β-TCP scaffolds, which could be due to the inhibition of the toll like receptor (TLR) signaling pathway. VEGF and BMP2 were significantly upregulated in the macrophages exposed to Mg-β-TCP scaffolds, indicating pro-osteogenic properties of macrophages in β-TCP modified Mg scaffolds. This was further demonstrated by the macrophage-mediated osteogenic differentiation of bone marrow stromal cells (BMSCs). When BMSCs were stimulated by conditioned medium from macrophages cultured on Mg-β-TCP scaffolds, osteogenic differentiation of BMSCs was significantly enhanced; whereas osteoclastogenesis was inhibited, as indicated by the downregualtion of MCSF, TRAP and inhibition of the RANKL/RANK system. These findings suggest that β-TCP coating of Mg scaffolds can modulate the scaffold's osteoimmunomodulatory properties, shift the immune microenvironment towards one that favors osteogenesis over osteoclastogenesis. Endowing bone biomaterials with favorable osteoimmunomodulatory properties can be a highly valuable strategy for the development or modification of advanced bone biomaterials.

Calcium orthophosphate coatings on magnesium and its biodegradable alloys

Biodegradable metals have been suggested as revolutionary biomaterials for bone-grafting therapies. Of these metals, magnesium (Mg) and its biodegradable alloys appear to be particularly attractive candidates due to their non-toxicity and as their mechanical properties match those of bones better than other metals do. Being light, biocompatible and biodegradable, Mg-based metallic implants have several advantages over other implantable metals currently in use, such as eliminating both the effects of stress shielding and the requirement of a second surgery for implant removal. Unfortunately, the fast degradation rates of Mg and its biodegradable alloys in the aggressive physiological environment impose limitations on their clinical applications. This necessitates development of implants with controlled degradation rates to match the kinetics of bone healing. Application of protective but biocompatible and biodegradable coatings able to delay the onset of Mg corrosion appears to be a reasonable solution. Since calcium orthophosphates are well tolerated by living organisms, they appear to be the excellent candidates for such coatings. Nevertheless, both the high chemical reactivity and the low melting point of Mg require specific parameters for successful deposition of calcium orthophosphate coatings. This review provides an overview of current coating techniques used for deposition of calcium orthophosphates on Mg and its biodegradable alloys. The literature analysis revealed that in all cases the calcium orthophosphate protective coatings both increased the corrosion resistance of Mg-based metallic biomaterials and improved their surface biocompatibility.

The use of physiological solutions or media in calcium phosphate synthesis and processing

This review examined the literature to spot uses, if any, of physiological solutions/media for the in situ synthesis of calcium phosphates (CaP) under processing conditions (i.e. temperature, pH, concentration of inorganic ions present in media) mimicking those prevalent in the human hard tissue environments. There happens to be a variety of aqueous solutions or media developed for different purposes; sometimes they have been named as physiological saline, isotonic solution, cell culture solution, metastable CaP solution, supersaturated calcification solution, simulated body fluid or even dialysate solution (for dialysis patients). Most of the time such solutions were not used as the aqueous medium to perform the biomimetic synthesis of calcium phosphates, and their use was usually limited to the in vitro testing of synthetic biomaterials. This review illustrates that only a limited number of research studies used physiological solutions or media such as Earle's balanced salt solution, Bachra et al. solutions or Tris-buffered simulated body fluid solution containing 27mM HCO3(-) for synthesizing CaP, and these studies have consistently reported the formation of X-ray-amorphous CaP nanopowders instead of Ap-CaP or stoichiometric hydroxyapatite (HA, Ca10(PO4)6(OH)2) at 37°C and pH 7.4. By relying on the published articles, this review highlights the significance of the use of aqueous solutions containing 0.8-1.5 mMMg(2+), 22-27mM HCO3(-), 142-145mM Na(+), 5-5.8mM K(+), 103-133mM Cl(-), 1.8-3.75mM Ca(2+), and 0.8-1.67mM HPO4(2-), which essentially mimic the composition and the overall ionic strength of the human extracellular fluid (ECF), in forming the nanospheres of X-ray-amorphous CaP.

Biodegradation of metallic magnesium elicits an inflammatory response in primary nasal epithelial cells

Resorbable magnesium-based implants hold great promise for various biomedical applications, such as osteosynthesis and coronary stenting. They also offer a new therapeutic option for the treatment of chronic rhinosinusitis, but little data is yet available regarding the use of magnesium in the nasal cavity. To model this field of application, primary porcine nasal epithelial cells were used to test the biocompatibility of degrading pure magnesium and investigate whether the degradation products may also affect cellular metabolism. Magnesium specimens did not induce apoptosis and we found no major influence on enzyme activities or protein synthesis, but cell viability was reduced and elevated interleukin 8 secretion indicated proinflammatory reactions. Necrotic damage was most likely due to osmotic stress, and our results suggest that magnesium ion build-up is also involved in the interleukin 8 release. Furthermore, the latter seems to be mediated, at least in part, by the p38 signaling pathway. These effects probably depended on the accumulation of very high concentrations of magnesium ions in the in vitro set-up, which might not be achieved in vivo, although we cannot exclude that further, as yet unknown, factors played a role in the inflammatory response during the degradation process. In conclusion, the biocompatibility of pure magnesium with cells in the immediate vicinity appears less ideal than is often supposed, and this needs to be considered in the evaluation of magnesium materials containing additional alloying elements.

In vitro corrosion and cytocompatibility of ZK60 magnesium alloy coated with hydroxyapatite by a simple chemical conversion process for orthopedic applications

Magnesium and its alloys--a new class of degradable metallic biomaterials-are being increasingly investigated as a promising alternative for medical implant and device applications due to their advantageous mechanical and biological properties. However, the high corrosion rate in physiological environments prevents the clinical application of Mg-based materials. Therefore, the objective of this study was to develop a hydroxyapatite (HA) coating on ZK60 magnesium alloy substrates to mediate the rapid degradation of Mg while improving its cytocompatibility for orthopedic applications. A simple chemical conversion process was applied to prepare HA coating on ZK60 magnesium alloy. Surface morphology, elemental compositions, and crystal structures were characterized using scanning electron microscopy, energy dispersive spectroscopy, and X-ray diffraction, respectively. The corrosion properties of samples were investigated by immersion test and electrochemical test. Murine fibroblast L-929 cells were harvested and cultured with coated and non-coated ZK60 samples to determine cytocompatibility. The degradation results suggested that the HA coatings decreased the degradation of ZK60 alloy. No significant deterioration in compression strength was observed for all the uncoated and coated samples after 2 and 4 weeks' immersion in simulated body fluid (SBF). Cytotoxicity test indicated that the coatings, especially HA coating, improved cytocompatibility of ZK60 alloy for L929 cells.

In vitro bioactivity and degradability of β-tricalcium phosphate porous scaffold fabricated via selective laser sintering

Porous scaffolds consisting of β-tricalcium phosphate (β-TCP) were successfully fabricated via selective laser sintering. The scaffolds had a controlled microstructure and totally interconnected porous structure. The microstructure and mechanical properties were studied. The bioactivity and degradability of scaffolds were evaluated through the simulated body fluid (SBF) cultivation experiment. The formation of a biologically active carbonate apatite layer on the surface after immersion in SBF was demonstrated using scanning electron microscope, energy dispersive X-ray, and Fourier transform infrared spectroscopy. Fast nucleation and growth of the carbonate apatite crystals were observed to occur all through the specimen surfaces. The phenomenon was explained in terms of the distribution and dispersion of inorganic phases in the scaffolds and the ionic activity products of the apatite in the SBF. The calculation results of weight loss and Ca/P molar ratio also suggest the good bioactivity and degradability of the scaffolds. These indicate that the β-TCP porous ceramic scaffold is a potential candidate scaffold for bone tissue engineering.

Controlling the degradation rate of AZ91 magnesium alloy via sol-gel derived nanostructured hydroxyapatite coating

Magnesium (Mg) alloys have been introduced as new generation of biodegradable orthopedic materials in recent years since it has been proved that Mg is one of the main minerals required for osseous tissue revival. The main goal of the present study was to establish a desired harmony between the necessities of orthopedic patient body to Mg(2+) ions and degradation rate of the Mg based implants as a new class of biodegradable/bioresorbable materials. This prospect was followed by providing a sol-gel derived nanostructured hydroxyapatite (n-HAp) coating on AZ91 alloy using dip coating technique. Phase structural analysis, morphology study, microstructure characterization, and functional group identification were performed using X-ray diffraction (XRD), Fourier transform infrared (FTIR), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) techniques. The prepared samples were immersed in simulated body fluid in order to study the formation of apatite-like precipitations, barricade properties of the n-HAp coating, and to estimate the dosage of released Mg(2+) ions within a specified and limited time of implantation. Electrochemical polarization tests were carried out to evaluate and compare the corrosion behavior of the n-HAp coated and uncoated samples. The changes of the in vitro pH values were also evaluated. Results posed the noticeable capability of n-HAp coating on stabilizing alkalization behavior and improving the corrosion resistance of AZ91 alloy. It was concluded that n-HAp coated AZ91 alloy could be a good candidate as a type of biodegradable implant material for biomedical applications.

Biocompatibility and biodegradability of Mg-Sr alloys: the formation of Sr-substituted hydroxyapatite

Magnesium is an attractive material for use in biodegradable implants due to its low density, non-toxicity and mechanical properties similar to those of human tissue such as bone. Its biocompatibility makes it amenable for use in a wide range of applications from bone to cardiovascular implants. Here we investigated the corrosion rate in simulated body fluid (SBF) of a series of Mg-Sr alloys, with Sr in the range of 0.3-2.5%, and found that the Mg-0.5 Sr alloy showed the slowest corrosion rate. The degradation rate from this alloy indicated that the daily Sr intake from a typical stent would be 0.01-0.02 mg day⁻¹, which is well below the maximum daily Sr intake levels of 4 mg day⁻¹. Indirect cytotoxicity assays using human umbilical vascular endothelial cells indicated that Mg-0.5 Sr extraction medium did not cause any toxicity or detrimental effect on the viability of the cells. Finally, a tubular Mg-0.5 Sr stent sample, along with a WE43 control stent, was implanted into the right and left dog femoral artery. No thrombosis effect was observed in the Mg-0.5 Sr stent after 3 weeks of implantation while the WE43 stent thrombosed. X-ray diffraction demonstrated the formation of hydroxyapatite and Mg(OH)₂ as a result of the degradation of Mg-0.5 Sr alloy after 3 days in SBF. X-ray photoelectron spectroscopy further showed the possibility of the formation of a hydroxyapatite Sr-substituted layer that presents as a thin layer at the interface between the Mg-0.5 Sr alloy and the corrosion products. We believe that this interfacial layer stabilizes the surface of the Mg-0.5 Sr alloy, and slows down its degradation rate over time.

A study on the interfacial chemistry of magnesium hydroxide surfaces in aqueous phosphate solutions: influence of Ca2+, Cl- and protein

In recent years, magnesium based materials have been proposed as a potential biodegradable metallic implant material for orthopedic applications. Magnesium alloys are an excellent material for this purpose because they have mechanical properties that are similar to bone, have been shown to dissolve in biological fluids and are non-toxic. However, there is still relatively little information on the surface chemistry of these materials in physiological solutions. The interaction of phosphates with magnesium alloys is of particular interest because the deposition of calcium phosphate at implant surfaces is critical to the healing process in orthopedic applications. In the present work, the chemistry at the magnesium hydroxide/solution interface for model solutions containing physiologically relevant ions and protein was investigated using in situ ATR-FTIR. These studies are complemented by ex situ analysis of magnesium alloy coupons exposed to similar solutions. Our results demonstrate that precipitation of phosphate minerals at the solid/liquid interface dominates the observed changes in surface chemistry. The mineralization process was further observed to be strongly affected by the presence of chloride salts and protein in solution.

Biodegradable magnesium nanoparticle-enhanced laser hyperthermia therapy

Background

Recently, nanoparticles have been demonstrated to have tremendous merit in terms of improving the treatment specificity and thermal ablation effect on tumors. However, the potential toxicity and long-term side effects caused by the introduced nanoparticles and by expelling them out of the body following surgery remain a significant challenge. Here, we propose for the first time to directly adopt magnesium nanoparticles as the heating enhancer in laser thermal ablation to avoid these problems by making full use of the perfect biodegradable properties of this specific material.

Methods

To better understand the new nano “green” hyperthermia modality, we evaluated the effects of magnesium nanoparticles on the temperature transients inside the human body subject to laser interstitial heating. Further, we experimentally investigated the heating enhancement effects of magnesium nanoparticles on a group of biological samples: oil, egg white, egg yolk, in vitro pig tissues, and the in vivo hind leg of rabbit when subjected to laser irradiation.

Results

Both the theoretical simulations and experimental measurements demonstrated that the target tissues injected with magnesium nanoparticles reached much higher temperatures than tissues without magnesium nanoparticles. This revealed the enhancing behavior of the new nanohyperthermia method.

Conclusion

Given the unique features of magnesium nanoparticles – their complete biological safety and ability to enhance heating – which most other advanced metal nanoparticles do not possess, the use of magnesium nanoparticles in hyperthermia therapy offers an important “green” nanomedicine modality for treating tumors. This method has the potential to be used in clinics in the near future.

Microstructure, in vitro corrosion and cytotoxicity of Ca-P coatings on ZK60 magnesium alloy prepared by simple chemical conversion and heat treatment

Magnesium alloys are potential biodegradable materials for biomedical application. But their poor corrosion resistance may result in premature failure of implants. In this study, to solve this problem, Ca-P coatings were prepared on ZK60 magnesium alloy by a simple chemical conversion process and heat treatment. Surface characterization showed that a flake-like Dicalcium phosphate dihydrate (DCPD) (CaHPO4·2H2O) coating was formed on ZK60 alloy by the chemical conversion process. DCPD transformed into Dicalcium phosphate anhydrous (DCPa) (CaHPO4) and Ca2P2O7 after heat treatment. Results of potentiodynamic polarization showed the corrosion potential of ZK60 was increased from −1666 mV to −1566 mV with DCPD coating, while −1515 mV was obtained after heat treatment. The corrosion current density of ZK60 was measured to be reduced from 35 µA/cm2 to 3.5 µA/cm2 with DCPD coating, while a further reduction to 1 µA/cm2 was observed after heat treatment. This indicated that the coatings improved the substrate corrosion resistance significantly, and apparently, the heat-treated coating had a higher corrosion resistance. Immersion test demonstrated that both the coatings could provide protection for the substrate and the heat-treated coating could induce deposition of bone-like apatite. Cytotoxicity evaluation revealed that none of the samples induced toxicity to L-929 cells after 1- and 3-day culture. The cytocompatibility of ZK60 was improved by the coatings, with the following sequence: uncoated ZK60 < DCPD-coated ZK60 < heat-treated coating.

Surface modification of magnesium alloys developed for bioabsorbable orthopedic implants: a general review

As a bioabsorbable metal with mechanical properties close to bone, pure magnesium or its alloys have great potential to be developed as medical implants for clinical applications. However, great efforts should be made to avoid its fast degradation in vivo for orthopedic applications when used for fracture fixation. Therefore, how to decease degradation rate of pure magnesium or its alloys is one of the focuses in Research and Development (R&D) of medical implants. It has been recognized that surface modification is an effective method to prevent its initial degradation in vivo to maintain its desired mechanical strength. This article reviews the recent progress in surface modifications for prevention of fast degradation of magnesium or its alloys using in vitro testing model, a fast yet relevant model before moving towards time-consuming and expensive in vivo testing. Pros and cons of various surface modifications are also discussed for the goal to design available products to be applied in clinical trials.

PRECIPITATION CONTROL AND MECHANICAL PROPERTY OF CALCIUM PHOSPHATE–COATED AZ31B ALLOY FOR BIOMEDICAL APPLICATION

Surface modification is believed to be an effective way to control the biodegradation rate of magnesium alloys and improve their biological properties. In the present work, a calcium phosphate (Ca-P) coating was prepared on the AZ31B magnesium alloy by a chemical deposition method to integrate the mechanical advantages of the magnesium substrate and the good bioactivity of the ceramic coating. It was shown that the coating was mainly composed of magnesium and calcium phosphates. Scanning electron microscope coupled with the energy dispersive spectrum analyses showed that rough and crystallined Ca-P coatings with different Ca/P ratios and thickness were formed on the alloy by variation of deposition time. The corrosion resistance of AZ31B alloy was significantly improved by the Ca-P coating. Electrochemical impedance spectroscopy test was used to illustrate the reaction process of Ca-P coating on the alloy. Upon the above results, Ca-P formation mechanism on the AZ31B alloy was proposed. The heterogeneous nucleation and growth of the calcium phosphate coating may be catalyzed by the anodic dissolution of the magnesium alloy substrate in the early stage of deposition, and the deposition coating is mainly composed of the magnesium phosphate. Then calcium phosphate deposition on the alloy becomes dominant with the increase of time. Tensile test in simulated body environment results showed that the time of fracture and ultimate tensile strength for the coated AZ31B Mg alloy were higher than those of the uncoated, which is beneficial in supporting fractured bone for a longer time.

Hydroxyapatite coating on magnesium with MgF₂ interlayer for enhanced corrosion resistance and biocompatibility

Hydroxyapatite (HA) was coated onto pure magnesium (Mg) with an MgF(2) interlayer in order to reduce the surface corrosion rate and enhance the biocompatibility. Both MgF(2) and HA were successfully coated in sequence with good adhesion properties using the fluoride conversion coating and aerosol deposition techniques, respectively. In a simulated body fluid (SBF), the double layer coating remarkably enhanced the corrosion resistance of the coated Mg specimen. The in vitro cellular responses of the MC3T3-E1 pre-osteoblasts were examined using a cell proliferation assay and an alkaline phosphatase (ALP) assay, and these results demonstrated that the double coating layer also enhanced cell proliferation and differentiation levels. In the in vivo study, the HA/MgF(2) coated Mg corroded less than the bare Mg and had a higher bone-to-implant contact (BIC) ratio in the cortical bone area of the rabbit femora 4 weeks after implantation. These in vitro and in vivo results suggested that the HA coated Mg with the MgF(2) interlayer could be used as a potential candidate for biodegradable implant materials.

Ex vivo examination of the biocompatibility of biodegradable magnesium via microdialysis in the isolated perfused bovine udder model

PURPOSE

Being biodegradable, magnesium is considered a promising future implant material but very little is known about the biocompatibility for the tissues in direct contact with it. In this study, the degradation of pure magnesium implants in the skin of an isolated bovine udder was examined over a period of five hours.

METHODS

Microdialysis technique was used in order to investigate the reactions at the interface of implant and tissue. Pure titanium implants served as control. Degradation behavior and biocompatibility were evaluated via extracellular magnesium ion concentration and PGE2 and TNF alpha served as indicators of inflammation.

RESULTS

Concentrations of 5.5 mmol/l Mg2+ were detected at the beginning, which decreased to a plateau of about 3.5 mmol/l after approximately two and a half hours. PGE2 and TNF alpha concentrations indicated no major inflammatory tissue response to the degradation.

CONCLUSIONS

These results give an idea of the ion burden at the implantation site of degrading magnesium and suggest good biocompatibility even at the tissue-implant interface.

Size dependent induction of proinflammatory cytokines and cytotoxicity of particulate beta-tricalciumphosphate in vitro

Cellular responses to particulate calcium phosphate ceramics can lead to inflammatory reactions under certain conditions that depend on particle composition, size and morphology. In this context, the potential influence of varying sizes of particulate beta-tricalciumphosphate (beta-TCP) on the induction of inflammation and cytotoxicity remains to be determined. The present work investigates the effects of beta-TCP particles of five different sizes (1, 3, 13, 32 and 40 μm) on human peripheral blood mononuclear cells (PBMC) in vitro concerning the release of TNF-alpha, IL-1beta and IL-8 after six and 18 h of incubation (ELISA) as well as intracellular TNF-alpha, IFN-gamma, IL-1alpha, IL-1beta and IL-8 levels within distinct PBMC subpopulations after 12 h (FACS). Potential cytotoxic effects were determined by assaying lactate dehydrogenase (LDH) and morphological analyses (electron microscopy). Beta-TCP 1 μm did not induce any cytokine after 6 h but slightly increases TNF-alpha, IL-1beta and IL-8 release after 18 h. Larger particles (32 and 40 μm) consistently caused higher levels of cytokine release by increasing the fraction of cytokine producing monocytes. They also caused higher levels of LDH release as did smaller, phagocytosable particles. These data suggest a less inflammatory and cytotoxic profile of beta-TCP devices with a smaller primary particle size when compared to larger particles.