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Matsuura T, Komatsu K, Cheng J, Park G, Ogawa T. Beyond microroughness: novel approaches to navigate osteoblast activity on implant surfaces. Int J Implant Dent 2024; 10:35. [PMID: 38967690 PMCID: PMC11226592 DOI: 10.1186/s40729-024-00554-x] [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: 04/04/2024] [Accepted: 06/15/2024] [Indexed: 07/06/2024] Open
Abstract
Considering the biological activity of osteoblasts is crucial when devising new approaches to enhance the osseointegration of implant surfaces, as their behavior profoundly influences clinical outcomes. An established inverse correlation exists between osteoblast proliferation and their functional differentiation, which constrains the rapid generation of a significant amount of bone. Examining the surface morphology of implants reveals that roughened titanium surfaces facilitate rapid but thin bone formation, whereas smooth, machined surfaces promote greater volumes of bone formation albeit at a slower pace. Consequently, osteoblasts differentiate faster on roughened surfaces but at the expense of proliferation speed. Moreover, the attachment and initial spreading behavior of osteoblasts are notably compromised on microrough surfaces. This review delves into our current understanding and recent advances in nanonodular texturing, meso-scale texturing, and UV photofunctionalization as potential strategies to address the "biological dilemma" of osteoblast kinetics, aiming to improve the quality and quantity of osseointegration. We discuss how these topographical and physicochemical strategies effectively mitigate and even overcome the dichotomy of osteoblast behavior and the biological challenges posed by microrough surfaces. Indeed, surfaces modified with these strategies exhibit enhanced recruitment, attachment, spread, and proliferation of osteoblasts compared to smooth surfaces, while maintaining or amplifying the inherent advantage of cell differentiation. These technology platforms suggest promising avenues for the development of future implants.
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Affiliation(s)
- Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - James Cheng
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
| | - Gunwoo Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA.
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA.
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Schafer S, Swain T, Parra M, Slavin BV, Mirsky NA, Nayak VV, Witek L, Coelho PG. Nonthermal Atmospheric Pressure Plasma Treatment of Endosteal Implants for Osseointegration and Antimicrobial Efficacy: A Comprehensive Review. Bioengineering (Basel) 2024; 11:320. [PMID: 38671741 PMCID: PMC11048570 DOI: 10.3390/bioengineering11040320] [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: 02/21/2024] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
The energy state of endosteal implants is dependent on the material, manufacturing technique, cleaning procedure, sterilization method, and surgical manipulation. An implant surface carrying a positive charge renders hydrophilic properties, thereby facilitating the absorption of vital plasma proteins crucial for osteogenic interactions. Techniques to control the surface charge involve processes like oxidation, chemical and topographical adjustments as well as the application of nonthermal plasma (NTP) treatment. NTP at atmospheric pressure and at room temperature can induce chemical and/or physical reactions that enhance wettability through surface energy changes. NTP has thus been used to modify the oxide layer of endosteal implants that interface with adjacent tissue cells and proteins. Results have indicated that if applied prior to implantation, NTP strengthens the interaction with surrounding hard tissue structures during the critical phases of early healing, thereby promoting rapid bone formation. Also, during this time period, NTP has been found to result in enhanced biomechanical fixation. As such, the application of NTP may serve as a practical and reliable method to improve healing outcomes. This review aims to provide an in-depth exploration of the parameters to be considered in the application of NTP on endosteal implants. In addition, the short- and long-term effects of NTP on osseointegration are addressed, as well as recent advances in the utilization of NTP in the treatment of periodontal disease.
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Affiliation(s)
- Sogand Schafer
- Division of Plastic, Reconstructive and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Tina Swain
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Marcelo Parra
- Center of Excellence in Morphological and Surgical Studies (CEMyQ), Faculty of Medicine, Universidad de la Frontera, Temuco 4811230, Chile
- Department of Comprehensive Adult Dentistry, Faculty of Dentistry, Universidad de la Frontera, Temuco 4811230, Chile
| | - Blaire V. Slavin
- University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | | | - Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Lukasz Witek
- Biomaterials Division, New York University Dentistry, New York, NY 10010, USA
- Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Paulo G. Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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3
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Wang S, Zhao X, Hsu Y, He Y, Wang F, Yang F, Yan F, Xia D, Liu Y. Surface modification of titanium implants with Mg-containing coatings to promote osseointegration. Acta Biomater 2023; 169:19-44. [PMID: 37517617 DOI: 10.1016/j.actbio.2023.07.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Titanium (Ti) and Ti alloys are commonly used in dental implants, which have good biocompatibility, mechanical strength, processability, and corrosion resistance. However, the surface inertia of Ti implants leads to delayed integration of Ti and new bone, as well as problems such as aseptic loosening and inadequate osseointegration. Magnesium (Mg) ions can promote bone regeneration, and many studies have used Mg-containing materials to modify the Ti implant surface. This systematic review summarizes the methods, effects, and clinical applications of surface modification of Ti implants with Mg-containing coatings. Database collection was completed on Janury 1, 2023, and a total of 29 relevant studies were ultimately included. Mg can be compounded with different materials and coated to the surface of Ti implants using different methods. In vitro and in vivo experiments have shown that Mg-containing coatings promote cell adhesion and osteogenic differentiation. On the one hand, the surface roughness of implants increases with the addition of Mg-containing coatings, which is thought to have an impact on the osseointegration of the implant. On the other hand, Mg ions promote cell attachment through binding interactions between the integrin family and FAK-related signaling pathways. And Mg ions could induce osseointegration by activating PI3K, Notch, ERK/c-Fos, BMP-4-related signaling pathways and TRPM7 protein channels. Overall, Mg-based coatings show great potential for the surface modification of Ti implants to promote osseointegration. STATEMENT OF SIGNIFICANCE: The inertia surface of titanium (Ti) implants leads to delayed osseointegration. Magnesium (Mg) ions, known for promoting bone regeneration, have been extensively studied to modify the surface of Ti implants. However, no consensus has been reached on the appropriate processing methods, surface roughness and effective concentration of Mg-containing coatings for osseointegration. This systematic review focus on the surface modification of Ti implants with Mg-containing compounds, highlighting the effects of Mg-containing coatings on the surface properties of Ti implants and its associated mechanisms. Besides, we also provide an outlook on future directions to promote the clinical application of Mg-modified implants.
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Affiliation(s)
- Siyi Wang
- Department of Prosthodontics, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, China
| | - Xiao Zhao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China; National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Yuchien Hsu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China; National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Yunjiao He
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China; National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Feilong Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China; National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Fan Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China; National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Fanyu Yan
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China; National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Dandan Xia
- National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China; Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China.
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China; National Center of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China.
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4
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Costa RC, Nagay BE, Dini C, Borges MHR, Miranda LFB, Cordeiro JM, Souza JGS, Sukotjo C, Cruz NC, Barão VAR. The race for the optimal antimicrobial surface: perspectives and challenges related to plasma electrolytic oxidation coating for titanium-based implants. Adv Colloid Interface Sci 2023; 311:102805. [PMID: 36434916 DOI: 10.1016/j.cis.2022.102805] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/01/2022] [Accepted: 10/20/2022] [Indexed: 01/24/2023]
Abstract
Plasma electrolytic oxidation (PEO) is a low-cost, structurally reliable, and environmentally friendly surface modification method for orthopedic and dental implants. This technique is successful for the formation of porous, corrosion-resistant, and bioactive coatings, besides introducing antimicrobial compounds easily. Given the increase in implant-related infections, antimicrobial PEO-treated surfaces have been widely proposed to surmount this public health concern. This review comprehensively discusses antimicrobial implant surfaces currently produced by PEO in terms of their in vitro and in vivo microbiological and biological properties. We present a critical [part I] and evidence-based [part II] review about the plethora of antimicrobial PEO-treated surfaces. The mechanism of microbial accumulation on implanted devices and the principles of PEO technology to ensure antimicrobial functionalization by one- or multi-step processes are outlined. Our systematic literature search showed that particular focus has been placed on the metallic and semi-metallic elements incorporated into PEO surfaces to facilitate antimicrobial properties, which are often dose-dependent, without leading to cytotoxicity in vitro. Meanwhile, there are concerns over the biocompatibility of PEO and its long-term antimicrobial effects in animal models. We clearly highlight the importance of using clinically relevant infection models and in vivo long-term assessments to guarantee the rational design of antimicrobial PEO-treated surfaces to identify the 'finish line' in the race for antimicrobial implant surfaces.
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Affiliation(s)
- Raphael C Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sāo Paulo 13414-903, Brazil
| | - Bruna E Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sāo Paulo 13414-903, Brazil
| | - Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sāo Paulo 13414-903, Brazil
| | - Maria H R Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sāo Paulo 13414-903, Brazil
| | - Luís F B Miranda
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sāo Paulo 13414-903, Brazil
| | - Jairo M Cordeiro
- Department of Dentistry, Centro Universitário das Faculdades Associadas de Ensino (UNIFAE), Sāo Joāo da Boa Vista, Sāo Paulo 13870-377, Brazil
| | - Joāo G S Souza
- Dental Research Division, Guarulhos University, Guarulhos, Sāo Paulo 07023-070, Brazil; Dentistry Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais 39401-303, Brazil
| | - Cortino Sukotjo
- Department of Restorative Dentistry, University of Illinois at Chicago College of Dentistry, Chicago, IL 60612, USA
| | - Nilson C Cruz
- Laboratory of Technological Plasmas, Institute of Science and Technology, Sāo Paulo State University (UNESP), Sorocaba, Sāo Paulo 18087-180, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sāo Paulo 13414-903, Brazil.
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5
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Influence of Femtosecond Laser Modification on Biomechanical and Biofunctional Behavior of Porous Titanium Substrates. MATERIALS 2022; 15:ma15092969. [PMID: 35591307 PMCID: PMC9099494 DOI: 10.3390/ma15092969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022]
Abstract
Bone resorption and inadequate osseointegration are considered the main problems of titanium implants. In this investigation, the texture and surface roughness of porous titanium samples obtained by the space holder technique were modified with a femtosecond Yb-doped fiber laser. Different percentages of porosity (30, 40, 50, and 60 vol.%) and particle range size (100–200 and 355–500 μm) were compared with fully-dense samples obtained by conventional powder metallurgy. After femtosecond laser treatment the formation of a rough surface with micro-columns and micro-holes occurred for all the studied substrates. The surface was covered by ripples over the micro-metric structures. This work evaluates both the influence of the macro-pores inherent to the spacer particles, as well as the micro-columns and the texture generated with the laser, on the wettability of the surface, the cell behavior (adhesion and proliferation of osteoblasts), micro-hardness (instrumented micro-indentation test, P–h curves) and scratch resistance. The titanium sample with 30 vol.% and a pore range size of 100–200 μm was the best candidate for the replacement of small damaged cortical bone tissues, based on its better biomechanical (stiffness and yield strength) and biofunctional balance (bone in-growth and in vitro osseointegration).
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6
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Navarro P, Olmo A, Giner M, Rodríguez-Albelo M, Rodríguez Á, Torres Y. Electrical Impedance of Surface Modified Porous Titanium Implants with Femtosecond Laser. MATERIALS 2022; 15:ma15020461. [PMID: 35057181 PMCID: PMC8779557 DOI: 10.3390/ma15020461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 01/25/2023]
Abstract
The chemical composition and surface topography of titanium implants are essential to improve implant osseointegration. The present work studies a non-invasive alternative of electrical impedance spectroscopy for the characterization of the macroporosity inherent to the manufacturing process and the effect of the surface treatment with femtosecond laser of titanium discs. Osteoblasts cell culture growths on the titanium surfaces of the laser-treated discs were also studied with this method. The measurements obtained showed that the femtosecond laser treatment of the samples and cell culture produced a significant increase (around 50%) in the absolute value of the electrical impedance module, which could be characterized in a wide range of frequencies (being more relevant at 500 MHz). Results have revealed the potential of this measurement technique, in terms of advantages, in comparison to tiresome and expensive techniques, allowing semi-quantitatively relating impedance measurements to porosity content, as well as detecting the effect of surface modification, generated by laser treatment and cell culture.
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Affiliation(s)
- Paula Navarro
- Departamento de Tecnología Electrónica, Escuela Técnica Superior de Ingeniería Informática, Universidad de Sevilla, Av. Reina Mercedes s/n, 41012 Sevilla, Spain;
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (M.R.-A.); (Y.T.)
| | - Alberto Olmo
- Departamento de Tecnología Electrónica, Escuela Técnica Superior de Ingeniería Informática, Universidad de Sevilla, Av. Reina Mercedes s/n, 41012 Sevilla, Spain;
- Instituto de Microelectrónica de Sevilla, IMSE-CNM (CSIC, Universidad de Sevilla), Av. Américo Vespucio s/n, 41092 Sevilla, Spain
- Correspondence: ; Tel.: +34-954556835
| | - Mercè Giner
- Departamento de Citología e Histología Normal y Patológica, Universidad de Sevilla, Av. Doctor Fedriani s/n, 41009 Sevilla, Spain;
| | - Marleny Rodríguez-Albelo
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (M.R.-A.); (Y.T.)
| | - Ángel Rodríguez
- Escuela Politécnica Superior, Universidad da Coruña, Calle Mendizábal s/n, 15403 Ferrol, Spain;
| | - Yadir Torres
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Calle Virgen de África 7, 41011 Seville, Spain; (M.R.-A.); (Y.T.)
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Li S, Huan Y, Zhu B, Chen H, Tang M, Yan Y, Wang C, Ouyang Z, Li X, Xue J, Wang W. Research progress on the biological modifications of implant materials in 3D printed intervertebral fusion cages. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 33:2. [PMID: 34940930 PMCID: PMC8702412 DOI: 10.1007/s10856-021-06609-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 10/06/2021] [Indexed: 05/26/2023]
Abstract
Anterior spine decompression and reconstruction with bone grafts and fusion is a routine spinal surgery. The intervertebral fusion cage can maintain intervertebral height and provide a bone graft window. Titanium fusion cages are the most widely used metal material in spinal clinical applications. However, there is a certain incidence of complications in clinical follow-ups, such as pseudoarticulation formation and implant displacement due to nonfusion of bone grafts in the cage. With the deepening research on metal materials, the properties of these materials have been developed from being biologically inert to having biological activity and biological functionalization, promoting adhesion, cell differentiation, and bone fusion. In addition, 3D printing, thin-film, active biological material, and 4D bioprinting technology are also being used in the biofunctionalization and intelligent advanced manufacturing processes of implant devices in the spine. This review focuses on the biofunctionalization of implant materials in 3D printed intervertebral fusion cages. The surface modifications of implant materials in metal endoscopy, material biocompatibility, and bioactive functionalizationare summarized. Furthermore, the prospects and challenges of the biofunctionalization of implant materials in spinal surgery are discussed. Fig.a.b.c.d.e.f.g As a pre-selected image for the cover, I really look forward to being selected. Special thanks to you for your comments.
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Affiliation(s)
- Shan Li
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
- Plastic and Cosmetic Surgery, Hunan Want Want Hospital, Changsha, China
| | - Yifan Huan
- R&D Department, Hunan Yuanpin Cell Biotechnology Co. Ltd., Changsha, China
| | - Bin Zhu
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Haoxiang Chen
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Ming Tang
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Yiguo Yan
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Cheng Wang
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Zhihua Ouyang
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Xuelin Li
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Jingbo Xue
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China.
| | - Wenjun Wang
- Department of Spine Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, Hunan, 421001, China.
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Magić M, Čolović B, Vasilijić S, Tadić N, Stojadinović S, Jokanović V. Nanodesigned coatings obtained by plasma electrolytic oxidation of titanium implant and their cytotoxicity. J Appl Biomater Funct Mater 2021; 19:2280800018822252. [PMID: 34783619 DOI: 10.1177/2280800018822252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The titanium implant was treated with plasma electrolytic oxidation and subsequent ionic exchange and thermal treatment in order to obtain bioactive layer consisting of titanium oxide, calcium and sodium titanates and hydroxyapatite, as confirmed by X-ray diffraction (XRD). Scanning electron microscopy (SEM) revealed that the given method, besides corresponding phase composition, enables suitable nanotopology for cell attachment and proliferation. Cytotoxicity investigations by MTT, LDH and propidium iodide assays and light microscopy showed that these coatings were not toxic to L929 cells.
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Affiliation(s)
- Marko Magić
- School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Božana Čolović
- Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - Saša Vasilijić
- Institute for Medical Research, Military Medical Academy, Medical Faculty MMA, University of Defence, Belgrade, Serbia
| | - Nenad Tadić
- Faculty of Physics, University of Belgrade, Belgrade, Serbia
| | | | - Vukoman Jokanović
- Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia.,ALBOS d.o.o., Belgrade, Serbia
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9
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Zhang R, Zhong S, Zeng L, Li H, Zhao R, Zhang S, Duan X, Huang J, Zhao Y. Novel Mg-Incorporated Micro-Arc Oxidation Coatings for Orthopedic Implants Application. MATERIALS 2021; 14:ma14195710. [PMID: 34640102 PMCID: PMC8510346 DOI: 10.3390/ma14195710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 12/29/2022]
Abstract
In this study, Ti-6Al-4V alloy samples were processed by micro-arc oxidation (MAO) in phytic acid (H12Phy) electrolytes with the addition of different concentrations of EDTA-MgNa2 (Na2MgY) and potassium hydroxide (KOH). The surface characterization and cytocompatibility of MAO-treated samples were evaluated systematically. H12Phy is a necessary agent for MAO coating formation, and the addition of Na2MgY and KOH into the electrolytes increases the surface roughness, micropore size and Mg contents in the coatings. The MAO coatings are primarily composed of anatase, rutile, MgO and Mg3(PO4)2. Magnesium (Mg) ions in the electrolytes enter into MAO coatings by diffusion and electromigration. The MAO coatings containing 2.97 at% Mg show excellent cell viability, adhesion, proliferation, alkaline phosphatase activity, extracellular matrix (ECM) mineralization and collagen secretion, but the cytocompatibility of the MAO coatings containing 6.82 at% Mg was the worst due to the excessively high Mg content. Our results revealed that MAO coatings with proper Mg contents improve the cytocompatibility of the Ti-6Al-4V alloys and have large potential in orthopedic applications.
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Affiliation(s)
- Rongfa Zhang
- School of Materials and Electromechanics, Jiangxi Science and Technology Normal University, Nanchang 330038, China; (S.Z.); (R.Z.); (S.Z.); (X.D.); (J.H.)
- Correspondence: (R.Z.); (Y.Z.)
| | - Sheng Zhong
- School of Materials and Electromechanics, Jiangxi Science and Technology Normal University, Nanchang 330038, China; (S.Z.); (R.Z.); (S.Z.); (X.D.); (J.H.)
| | - Lilan Zeng
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; (L.Z.); (H.L.)
| | - Hongyu Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; (L.Z.); (H.L.)
| | - Rongfang Zhao
- School of Materials and Electromechanics, Jiangxi Science and Technology Normal University, Nanchang 330038, China; (S.Z.); (R.Z.); (S.Z.); (X.D.); (J.H.)
| | - Shufang Zhang
- School of Materials and Electromechanics, Jiangxi Science and Technology Normal University, Nanchang 330038, China; (S.Z.); (R.Z.); (S.Z.); (X.D.); (J.H.)
| | - Xinting Duan
- School of Materials and Electromechanics, Jiangxi Science and Technology Normal University, Nanchang 330038, China; (S.Z.); (R.Z.); (S.Z.); (X.D.); (J.H.)
| | - Jingsong Huang
- School of Materials and Electromechanics, Jiangxi Science and Technology Normal University, Nanchang 330038, China; (S.Z.); (R.Z.); (S.Z.); (X.D.); (J.H.)
| | - Ying Zhao
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; (L.Z.); (H.L.)
- Correspondence: (R.Z.); (Y.Z.)
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10
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Lederer S, Arat S, Fuerbeth W. Influence of Process Parameters on the Tribological Behavior of PEO Coatings on CP-Titanium 4+ Alloys for Biomedical Applications. MATERIALS 2021; 14:ma14185364. [PMID: 34576588 PMCID: PMC8465984 DOI: 10.3390/ma14185364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/03/2021] [Accepted: 09/11/2021] [Indexed: 01/20/2023]
Abstract
Wear resistant ceramic coatings were generated on novel commercially pure titanium grade 4+ alloys by the plasma electrolytic oxidation technique (PEO) in an aluminate and zirconia containing electrolyte. The coatings were obtained adopting a full regular two-level factorial design of experiments (DoE) varying the PEO process parameters current density, repetition rate and duty cycle. The generated coatings were characterized with respect to its wear resistance and mechanical properties by reciprocal ball-on-flat tests and nanoindentation measurements. Thickness, morphology and phase formation of the PEO coatings was analyzed by scanning electron microscopy (SEM/EDS) and X-ray diffraction. XRD results indicate the formation of crystalline aluminium titanate (TiAl2O5) as well as t-ZrO2 and alumina leading to an increase in hardness and wear resistance of the PEO coatings. Evaluation of the DoE’s parameter interaction shows that the main effects for generating wear resistant coatings are current density and repetition rate. In particular, the formation of mechanically stable and adhesive corundum and zirconia containing coatings with increasing current density and frequency turned out to be responsible for the improvement of the tribological properties. Overall, the PEO processing significantly improves the wear resistance of the CP titanium base alloy.
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11
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Šalandová M, Hengel IAJ, Apachitei I, Zadpoor AA, Eerden BCJ, Fratila‐Apachitei LE. Inorganic Agents for Enhanced Angiogenesis of Orthopedic Biomaterials. Adv Healthc Mater 2021; 10:e2002254. [PMID: 34036754 DOI: 10.1002/adhm.202002254] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/30/2021] [Indexed: 01/02/2023]
Abstract
Aseptic loosening of a permanent prosthesis remains one of the most common reasons for bone implant failure. To improve the fixation between implant and bone tissue as well as enhance blood vessel formation, bioactive agents are incorporated into the surface of the biomaterial. This study reviews and compares five bioactive elements (copper, magnesium, silicon, strontium, and zinc) with respect to their effect on the angiogenic behavior of endothelial cells (ECs) when incorporated on the surface of biomaterials. Moreover, it provides an overview of the state-of-the-art methodologies used for the in vitro assessment of the angiogenic properties of these elements. Two databases are searched using keywords containing ECs and copper, magnesium, silicon, strontium, and zinc. After applying the defined inclusion and exclusion criteria, 59 articles are retained for the final assessment. An overview of the angiogenic properties of five bioactive elements and the methods used for assessment of their in vitro angiogenic potential is presented. The findings show that silicon and strontium can effectively enhance osseointegration through the simultaneous promotion of both angiogenesis and osteogenesis. Therefore, their integration onto the surface of biomaterials can ultimately decrease the incidence of implant failure due to aseptic loosening.
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Affiliation(s)
- Monika Šalandová
- Additive Manufacturing Laboratory Department of Biomechanical Engineering Faculty of Mechanical, Maritime, and Materials Engineering Delft University of Technology Mekelweg 2 Delft 2628 CD The Netherlands
| | - Ingmar A. J. Hengel
- Additive Manufacturing Laboratory Department of Biomechanical Engineering Faculty of Mechanical, Maritime, and Materials Engineering Delft University of Technology Mekelweg 2 Delft 2628 CD The Netherlands
| | - Iulian Apachitei
- Additive Manufacturing Laboratory 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
- Additive Manufacturing Laboratory Department of Biomechanical Engineering Faculty of Mechanical, Maritime, and Materials Engineering Delft University of Technology Mekelweg 2 Delft 2628 CD The Netherlands
| | - Bram C. J. Eerden
- Department of Internal Medicine Erasmus Medical Center Doctor Molewaterplein 40 Rotterdam 3015 GD The Netherlands
| | - Lidy E. Fratila‐Apachitei
- Additive Manufacturing Laboratory 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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12
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Tamayo JA, Riascos M, Vargas CA, Baena LM. Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry. Heliyon 2021; 7:e06892. [PMID: 34027149 PMCID: PMC8120950 DOI: 10.1016/j.heliyon.2021.e06892] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.
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Affiliation(s)
- José A. Tamayo
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Mateo Riascos
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Carlos A. Vargas
- Grupo Materiales Avanzados y Energía (Matyer), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Libia M. Baena
- Grupo de Química Básica, Aplicada y Ambiente (Alquimia), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
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13
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Nevado P, Lopera A, Bezzon V, Fulla MR, Palacio J, Zaghete MA, Biasotto G, Montoya A, Rivera J, Robledo SM, Estupiñan H, Paucar C, Garcia C. Preparation and in vitro evaluation of PLA/biphasic calcium phosphate filaments used for fused deposition modelling of scaffolds. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 114:111013. [PMID: 32993985 DOI: 10.1016/j.msec.2020.111013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/30/2020] [Accepted: 04/22/2020] [Indexed: 02/02/2023]
Abstract
Ceramic materials such as calcium phosphates (CaPs) with a composition similar to the mineral phase of bones and polymeric polylactic acid (PLA) are potential candidates for the manufacturing of scaffolds to act as bone substitutes and for tissue engineering applications, due to their bioresorbability and biocompatibility. Variables such as porosity, topography, morphology, and mechanical properties play an essential role in the scaffolds response. In this paper, a polymer/ceramic composite filament of 1.7 mm in diameter based on PLA and biphasic calcium phosphates (BCPs) was obtained by hot-melt extrusion in a single screw extruder. The particles of BCP were obtained by solution-combustion synthesis, and the PLA used was commercial grade. The BCPs ceramics were characterized by X-ray diffraction (XRD), scanning electron microscopic (SEM), transmission electron microscopy (TEM), and Brunauer, Emmett, and Teller (BET). It was possible to confirm that the main inorganic phases were hydroxyapatite (HAP) and tricalcium phosphate (TCP) with grain sizes below 100 nm and with high porosity. The Filaments obtained are a bit fragile but were able to be used in fused deposition modelling (FDM) using low-cost commercial printers. The filaments were characterized by SEM and energy dispersive X-ray (EDX). The in-vitro tests of filaments showed deposition of apatite phases on their surface, non-cytotoxic behavior, adequate cell proliferation and cell adhesion.
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Affiliation(s)
- P Nevado
- Grupo de Materiales Cerámicos y Vítreos, Escuela de Física Universidad Nacional de Colombia, Calle 59A.63-20, Medellín 050034, Colombia
| | - A Lopera
- Grupo de Materiales Cerámicos y Vítreos, Escuela de Física Universidad Nacional de Colombia, Calle 59A.63-20, Medellín 050034, Colombia; Grupo GICEI, Institución Universitaria Pascual Bravo, Facultad de Ingeniería, Calle 73 No. 73A - 226, Medellín 050034, Colombia
| | - V Bezzon
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André, SP, CEP 09210580, Brazil
| | - M R Fulla
- Grupo de Materiales Cerámicos y Vítreos, Escuela de Física Universidad Nacional de Colombia, Calle 59A.63-20, Medellín 050034, Colombia; Grupo GICEI, Institución Universitaria Pascual Bravo, Facultad de Ingeniería, Calle 73 No. 73A - 226, Medellín 050034, Colombia
| | - J Palacio
- Grupo GICEI, Institución Universitaria Pascual Bravo, Facultad de Ingeniería, Calle 73 No. 73A - 226, Medellín 050034, Colombia
| | - M A Zaghete
- LIEC, Institute of Chemistry, São Paulo State University-UNESP, Araraquara, SP 14800-060, Brazil
| | - G Biasotto
- LIEC, Institute of Chemistry, São Paulo State University-UNESP, Araraquara, SP 14800-060, Brazil
| | - A Montoya
- PECET-Instituto de Investigaciones Médicas, Universidad de Antioquia, Facultad de Medicina, Calle 62 No. 52-59, Medellín 050010, Colombia
| | - J Rivera
- Grupo GICEI, Institución Universitaria Pascual Bravo, Facultad de Ingeniería, Calle 73 No. 73A - 226, Medellín 050034, Colombia
| | - S M Robledo
- PECET-Instituto de Investigaciones Médicas, Universidad de Antioquia, Facultad de Medicina, Calle 62 No. 52-59, Medellín 050010, Colombia
| | - H Estupiñan
- Grupo de Investigación en Biosuperficies, Departamento de Materiales, Universidad Nacional de Colombia, Sede Medellín, Calle 59A.63-20, Medellín 050034, Colombia
| | - C Paucar
- Grupo de Materiales Cerámicos y Vítreos, Escuela de Física Universidad Nacional de Colombia, Calle 59A.63-20, Medellín 050034, Colombia
| | - C Garcia
- Grupo de Materiales Cerámicos y Vítreos, Escuela de Física Universidad Nacional de Colombia, Calle 59A.63-20, Medellín 050034, Colombia.
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14
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Beigi MH, Safaie N, Nasr-Esfahani MH, Kiani A. 3D Titania Nanofiber-Like Webs Induced by Plasma Ionization: A New Direction for Bioreactivity and Osteoinductivity Enhancement of Biomaterials. Sci Rep 2019; 9:17999. [PMID: 31784696 PMCID: PMC6884481 DOI: 10.1038/s41598-019-54533-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/14/2019] [Indexed: 12/17/2022] Open
Abstract
In this study, we describe the formation method of web-like three-dimensional (3-D) titania nanofibrous structures coated on transparent substrate via a high intensity laser induced reverse transfer (HILIRT) process. First, we demonstrate the mechanism of ablation and deposition of Ti on the glass substrates using multiple picosecond laser pulses at ambient air in an explicit analytical form and compare the theoretical results with the experimental results of generated nanofibers. We then examine the performance of the developed glass samples coated by titania nanofibrous structures at varied laser pulse durations by electron microscopy and characterization methods. We follow this by exploring the response of human bone-derived mesenchymal stem cells (BMSCs) with the specimens, using a wide range of in-vitro analyses including MTS assay (colorimetric method for assessing cell metabolic activity), immunocytochemistry, mineralization, ion release examination, gene expression analysis, and protein adsorption and absorption analysis. Our results from the quantitative and qualitative analyses show a significant biocompatibility improvement in the laser treated samples compared to untreated substrates. By decreasing the pulse duration, more titania nanofibers with denser structures can be generated during the HILIRT technique. The findings also suggest that the density of nanostructures and concentration of coated nanofibers play critical roles in the bioreactivity properties of the treated samples, which results in early osteogenic differentiation of BMSCs.
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Affiliation(s)
- Mohammad-Hossein Beigi
- Silicon Hall: Micro/Nano Manufacturing Facility, Faculty of Engineering and Applied Science, Ontario Tech University, Ontario, Canada
- Department of Cellular Biotechnology Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Naghmeh Safaie
- Silicon Hall: Micro/Nano Manufacturing Facility, Faculty of Engineering and Applied Science, Ontario Tech University, Ontario, Canada
| | - Mohammad-Hossein Nasr-Esfahani
- Department of Cellular Biotechnology Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Amirkianoosh Kiani
- Silicon Hall: Micro/Nano Manufacturing Facility, Faculty of Engineering and Applied Science, Ontario Tech University, Ontario, Canada.
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15
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Predominant surface property of an anodized titanium that enhances the cell response. Biointerphases 2019; 14:041002. [PMID: 31357867 DOI: 10.1116/1.5108542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this study is to evaluate the predominant material property that enhances the biocompatibility of an anodized titanium (Ti) implant. A Ti surface was anodized in an H3PO4 electrolyte with various voltages. Then, the cell responses involving attachment, proliferation, and differentiation were evaluated. Anodization using various voltages formed TiO2 layers with various surface morphologies. All the anodized surfaces showed enhanced cell responses; however, the performance differences depending on the surface morphologies were minimal. In addition, enhanced cell responses were not observed on the thermally oxidized Ti surface, although a TiO2 layer was formed; therefore, the beneficial effect was derived from the TiO2 layer fabricated via anodization. Based on these findings, the topmost surface structure of the TiO2 layer predominantly influenced the cell behaviors because this property governed the important surface functions, such as hydrophilicity.
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16
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Mokabber T, Zhou Q, Vakis A, van Rijn P, Pei Y. Mechanical and biological properties of electrodeposited calcium phosphate coatings. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 100:475-484. [DOI: 10.1016/j.msec.2019.03.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/22/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
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17
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Alves AC, Thibeaux R, Toptan F, Pinto AMP, Ponthiaux P, David B. Influence of macroporosity on NIH/3T3 adhesion, proliferation, and osteogenic differentiation of MC3T3-E1 over bio-functionalized highly porous titanium implant material. J Biomed Mater Res B Appl Biomater 2018. [PMID: 29520948 DOI: 10.1002/jbm.b.34096] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Highly porous Ti implant materials are being used in order to overcome the stress shielding effect on orthopedic implants. However, the lack of bioactivity on Ti surfaces is still a major concern regarding the osseointegration process. It is known that the rapid recruitment of osteoblasts in bone defects is an essential prerequisite for efficient bone repair. Conventionally, osteoblast recruitment to bone defects and subsequent bone repair has been achieved using growth factors. Thus, in this study highly porous Ti samples were processed by powder metallurgy using space holder technique followed by the bio-functionalization through microarc oxidation using a Ca- and P-rich electrolyte. The biological response in terms of early cell response, namely, adhesion, spreading, viability, and proliferation of the novel biofunctionalized highly porous Ti was carried out with NIH/3T3 fibroblasts and MC3T3-E1 preosteoblasts in terms of viability, adhesion, proliferation, and alkaline phosphatase activity. Results showed that bio-functionalization did not affect the cell viability. However, bio-functionalized highly porous Ti (22% porosity) enhanced the cell proliferation and activity. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 73-85, 2019.
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Affiliation(s)
- A C Alves
- CMEMS-UMinho - Center of MicroElectroMechanical Systems - Universidade do Minho, Campus de Azuém, Guimarães, Portugal
| | - R Thibeaux
- MSSMat, Laboratoire de Mécanique des Sols, Structures et Matériaux, UMR CNRS 8579, CentraleSupélec, Université Paris Saclay, Châtenay-Malabry, France
| | - F Toptan
- CMEMS-UMinho - Center of MicroElectroMechanical Systems - Universidade do Minho, Campus de Azuém, Guimarães, Portugal.,DEM - Departament of Mechanical Engineering - Universidade do Minho, Campus de Azurém, Guimarães, Portugal.,IBTN/Br - Brazilian Branch of the Institute of Biomaterials, Tribocorrosion and Nanomedicine, UNESP, Campus de Bauru, Bauru, SP, Brazil
| | - A M P Pinto
- CMEMS-UMinho - Center of MicroElectroMechanical Systems - Universidade do Minho, Campus de Azuém, Guimarães, Portugal.,DEM - Departament of Mechanical Engineering - Universidade do Minho, Campus de Azurém, Guimarães, Portugal
| | - P Ponthiaux
- LGPM, Laboratoire de Génie des Procédés et Matériaux, CentraleSupélec, Université Paris Saclay, Châtenay-Malabry, France
| | - B David
- MSSMat, Laboratoire de Mécanique des Sols, Structures et Matériaux, UMR CNRS 8579, CentraleSupélec, Université Paris Saclay, Châtenay-Malabry, France
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18
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Li K, Wang C, Yan J, Zhang Q, Dang B, Wang Z, Yao Y, Lin K, Guo Z, Bi L, Han Y. Evaluation of the osteogenesis and osseointegration of titanium alloys coated with graphene: an in vivo study. Sci Rep 2018; 8:1843. [PMID: 29382859 PMCID: PMC5790016 DOI: 10.1038/s41598-018-19742-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 01/04/2018] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to investigate whether a surface coating with graphene could enhance the surface bioactivation of titanium alloys (Ti6Al4V) to further accelerate in vivo osteogenesis and osseointegration at the implant surface. In this study, a New Zealand white rabbit femoral condyle defect model was established. After 4, 12 and 24 weeks, biomechanical testing, micro-computed tomography (Micro-CT) analyses and histological observations were performed. At the highest push-out forces during the test, microstructure parameters, such as the bone volume/total volume fraction (BV/TV) and mineral apposition rate (MAR), of the new bone were significantly higher in the graphene-coated Ti6Al4V group (G-Ti6Al4V) than in the Ti6Al4V group (P < 0.05). Van Gieson (VG) staining showed that the G-Ti6Al4V group had more new bone formation than the Ti6Al4V group, and the G-Ti6Al4V group showed a closer fit between the bone and implant. In conclusion, graphene might be a novel type of nano-coating material for enhancing the surface biological activity of Ti-based alloy materials and may further promote in vivo osteogenesis and osseointegration.
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Affiliation(s)
- Kewen Li
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China.
- Department of Orthopedics, Qinghai University Affiliated Hospital, Xining, 810001, P.R. China.
| | - Chunhui Wang
- Military Frontier Defence Medical Service Tranning Group, Army Medical University, Hutubi, Xinjiang, 831200, P.R. China
| | - Jinhong Yan
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Qi Zhang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Baoping Dang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Zhuo Wang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Yun Yao
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Kaifeng Lin
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Zhongshang Guo
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Long Bi
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China
| | - Yisheng Han
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, P.R. China.
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19
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Kheradmandfard M, Kashani-Bozorg SF, Kim CL, Hanzaki AZ, Pyoun YS, Kim JH, Amanov A, Kim DE. Nanostructured β-type titanium alloy fabricated by ultrasonic nanocrystal surface modification. ULTRASONICS SONOCHEMISTRY 2017; 39:698-706. [PMID: 28732996 DOI: 10.1016/j.ultsonch.2017.03.061] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 06/07/2023]
Abstract
The surface of β-type Ti-Nb-Ta-Zr (TNTZ) alloy, which is a promising material for biomedical applications, was treated with the ultrasonic nanocrystal surface modification (UNSM) technique to enhance its hardness. As a result, a gradient nanostructured (GNS) layer was generated in the surface; the microstructure of the top surface layer consisted of nanoscale lamellae with a width of about 60-200nm. In addition, there were lamellar grains consisting of nanostructured subgrains having unclear and wavy boundaries. The treated surface exhibited a hardness value of ∼385HV compared to 190HV for the untreated alloy. It was further determined that highly dense deformation twins were generated at a depth of ∼40-150µm below the UNSM-treated surface. These deformation twins led to a significant work hardening effect which aided in enhancing the mechanical properties. It was also found that UNSM treatment resulted in the formation of micropatterns on the surface, which would be beneficial for high bioactivity and bone regeneration performance of TNTZ implants.
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Affiliation(s)
- Mehdi Kheradmandfard
- School of Metallurgy and Materials Engineering, College of Engineering, University of Tehran, Tehran, Iran; Center for Nano-Wear, Yonsei University, Seoul 03722, South Korea
| | | | - Chang-Lae Kim
- Center for Nano-Wear, Yonsei University, Seoul 03722, South Korea
| | - Abbas Zarei Hanzaki
- School of Metallurgy and Materials Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Young-Shik Pyoun
- Department of Mechanical Engineering, Sun Moon University, Asan 31460, South Korea
| | - Jung-Hyong Kim
- Department of Mechanical Engineering, Sun Moon University, Asan 31460, South Korea
| | - Auezhan Amanov
- Department of Mechanical Engineering, Sun Moon University, Asan 31460, South Korea.
| | - Dae-Eun Kim
- Center for Nano-Wear, Yonsei University, Seoul 03722, South Korea; Department of Mechanical Engineering, Yonsei University, Seoul 03722, South Korea.
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20
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Rizwan M, Alias R, Zaidi UZ, Mahmoodian R, Hamdi M. Surface modification of valve metals using plasma electrolytic oxidation for antibacterial applications: A review. J Biomed Mater Res A 2017; 106:590-605. [PMID: 28975693 DOI: 10.1002/jbm.a.36259] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 09/13/2017] [Accepted: 09/26/2017] [Indexed: 01/15/2023]
Abstract
Plasma electrolytic oxidation (PEO) is an advance technique to develop porous oxidation layer on light metals, primarily to enhance corrosion and wear resistance. The oxidation layer can also offer a wide variety of mechanical, biomedical, tribological, and antibacterial properties through the incorporation of several ions and particles. Due to the increasing need of antimicrobial surfaces for biomedical implants, antibacterial PEO coatings have been developed through the incorporation of antibacterial agents. Metallic nanoparticles that have been employed most widely as antibacterial agents are reported to demonstrate serious health and environmental threats. To overcome the current limitations of these coatings, there is a significant need to develop antibacterial surfaces that are not harmful for patient's health and environment. Attention of the readers has been directed to utilize bioactive glasses as antibacterial agents for PEO coatings. Bioactive glasses are well known for their excellent bioactivity, biocompatibility, and antibacterial character. PEO coatings incorporated with bioactive glasses can provide environment-friendly antimicrobial surfaces with exceptional bioactivity, biocompatibility, and osseointegration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 590-605, 2018.
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Affiliation(s)
- Muhammad Rizwan
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Department of Metallurgical Engineering, Faculty of Chemical and Process Engineering, NED University of Engineering and Technology, Karachi, 75270, Pakistan
| | - Rodianah Alias
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Department of Manufacturing Technology, Faculty of Innovative Design and Technology, University Sultan Zainal Abidin (UNISZA), Kuala Terengganu, 21030, Malaysia
| | - Umi Zhalilah Zaidi
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Centre of Advanced Manufacturing and Material Processing, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - Reza Mahmoodian
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Centre of Advanced Manufacturing and Material Processing, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Department of Research and Development, Azarin Kar Ind. Co., Industrial Park 1, Kerman, 7635168361, Iran
| | - Mohd Hamdi
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Centre of Advanced Manufacturing and Material Processing, University of Malaya, Kuala Lumpur, 50603, Malaysia
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21
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Echeverry-Rendón M, Galvis O, Aguirre R, Robledo S, Castaño JG, Echeverría F. Modification of titanium alloys surface properties by plasma electrolytic oxidation (PEO) and influence on biological response. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:169. [PMID: 28956201 DOI: 10.1007/s10856-017-5972-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 09/01/2017] [Indexed: 05/20/2023]
Abstract
Surface characteristics can mediate biological interaction improving or affecting the tissue integration after implantation of a biomaterial. Features such as topography, wettability, surface energy and chemistry can be key determinants for interactions between cells and materials. Plasma electrolytic oxidation (PEO) is a technique used to control this kind of parameters by the addition of chemical species and the production of different morphologies on the surfaces of titanium and its alloys. With the purpose to improve the biological response, surfaces of c.p titanium and Ti6Al4V were modified by using PEO. Different electrolytes, voltages, current densities and anodizing times were tested in order to obtain surfaces with different characteristics. The obtained materials were characterized by different techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM) and glow discharge optical emission spectroscopy (GDOES). Wettability of the obtained surfaces were measured and the corresponding surface energies were calculated. Superhydrophilic surfaces with contact angles of about 0 degrees were obtained without any other treatment but PEO and this condition in some cases remains stable after several weeks of anodizing; crystal phase composition (anatase-rutile) of the anodic surface appears to be critical for obtaining this property. Finally, in order to verify the biological effect of these surfaces, osteoblast were seeded on the samples. It was found that cell behavior improves as SFE (surface free energy) and coating porosity increases whereas it is affected negatively by roughness. Techniques for surface modification allow changes in the coatings such as surface energy, roughness and porosity. As a consequence of this, biological response can be altered. In this paper, surfaces of c.p Ti and Ti6Al4V were modified by using plasma electrolytic oxidation (PEO) in order to accelerate the cell adhesion process.
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Affiliation(s)
- Mónica Echeverry-Rendón
- Centro de Investigación, Innovación y Desarrollo de Materiales CIDEMAT, Facultad de Ingeniería, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.
- Programa de Estudio y Control de Enfermedades Tropicales PECET, Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.
| | - Oscar Galvis
- Centro de Investigación, Innovación y Desarrollo de Materiales CIDEMAT, Facultad de Ingeniería, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Robinson Aguirre
- Centro de Investigación, Innovación y Desarrollo de Materiales CIDEMAT, Facultad de Ingeniería, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Sara Robledo
- Programa de Estudio y Control de Enfermedades Tropicales PECET, Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Juan Guillermo Castaño
- Centro de Investigación, Innovación y Desarrollo de Materiales CIDEMAT, Facultad de Ingeniería, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Félix Echeverría
- Centro de Investigación, Innovación y Desarrollo de Materiales CIDEMAT, Facultad de Ingeniería, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
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Characterisation of Calcium- and Phosphorus-Enriched Porous Coatings on CP Titanium Grade 2 Fabricated by Plasma Electrolytic Oxidation. METALS 2017. [DOI: 10.3390/met7090354] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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do Nascimento RM, de Carvalho VR, Govone JS, Hernandes AC, da Cruz NC. Effects of negatively and positively charged Ti metal surfaces on ceramic coating adhesion and cell response. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:33. [PMID: 28108961 DOI: 10.1007/s10856-017-5848-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/04/2017] [Indexed: 06/06/2023]
Abstract
This manuscript reports an evaluation of the effects of simple chemical-heat treatments on the deposition of different ceramic coatings, i.e., TiO2, CaTiO3 and CaP, on commercially pure titanium (cp-Ti) and Ti6Al4V and the influence of the coatings on cells interaction with the surfaces. The ceramic materials were prepared by the sol-gel method and the coating adhesion was analyzed by pull-off bending tests. The wettability of positively or negatively charged surfaces was characterized by contact angle measurements, which also enabled the calculation of the surface free energy through the polar-apolar liquids approach. Both acid and alkaline treatments activated the cp-Ti, whereas Ti6Al4V was only activated by the alkaline treatment. Such treatment led to increased hydrophilicity with inhibition of the fibroblastic response on Ti6Al4V. On the other hand, osteoblastic cells adhered to and proliferated on the positively and negatively charged surfaces. The maximum adhesion strength (~ 3400 N) was obtained with a negative Ti6Al4V-CaTiO3-CaP multilayer surface.
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Affiliation(s)
- Rodney Marcelo do Nascimento
- São Carlos Institute of Physics, University of São Paulo, USP, PO Box 369, 1356-6590, São Carlos, SP, Brazil.
- Laboratory of Technologycal Plasmas, Universidade Estadual Paulista, UNESP, Sorocaba, SP, Brazil.
| | | | - José Silvio Govone
- Departamento de Estatística Matemática Aplicada e Computação, Universidade Estadual Paulista, UNESP, Rio Claro, SP, Brazil
| | - Antônio Carlos Hernandes
- São Carlos Institute of Physics, University of São Paulo, USP, PO Box 369, 1356-6590, São Carlos, SP, Brazil
| | - Nilson Cristino da Cruz
- Laboratory of Technologycal Plasmas, Universidade Estadual Paulista, UNESP, Sorocaba, SP, Brazil
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Lauria I, Kramer M, Schröder T, Kant S, Hausmann A, Böke F, Leube R, Telle R, Fischer H. Inkjet printed periodical micropatterns made of inert alumina ceramics induce contact guidance and stimulate osteogenic differentiation of mesenchymal stromal cells. Acta Biomater 2016; 44:85-96. [PMID: 27498177 DOI: 10.1016/j.actbio.2016.08.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 07/01/2016] [Accepted: 08/03/2016] [Indexed: 12/18/2022]
Abstract
Bioinert high performance ceramics exhibit detrimental features for implant components with direct bone contact because of their low osseointegrating capability. We hypothesized that periodical microstructures made of inert alumina ceramics can influence the osteogenic differentiation of human mesenchymal stromal cells (hMSC). In this study, we manufactured pillared arrays made of alumina ceramics with periodicities as low as 100μm and pillar heights of 40μm employing direct inkjet printing (DIP) technique. The response of hMSC to the microstructured surfaces was monitored by measuring cell morphology, viability and formation of focal adhesion complexes. Osteogenic differentiation of hMSCs was investigated by alkaline phosphatase activity, mineralization assays and expression analysis of respective markers. We demonstrated that MSCs react to the pillars with contact guidance. Subsequently, cells grow onto and form connections between the microstructures, and at the same time are directly attached to the pillars as shown by focal adhesion stainings. Cells build up tissue-like constructs with heights up to the micropillars resulting in increased cell viability and osteogenic differentiating properties. We conclude that periodical micropatterns on the micrometer scale made of inert alumina ceramics can mediate focal adhesion dependent cell adhesion and stimulate osteogenic differentiation of hMSCs.
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Affiliation(s)
- Ines Lauria
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Michael Kramer
- Department of Ceramics and Refractory Materials, Institute of Mineral Engineering, RWTH Aachen University, Mauerstrasse 5, 52064 Aachen, Germany.
| | - Teresa Schröder
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Sebastian Kant
- Department of Molecular and Cellular Anatomy, RWTH Aachen University Hospital, Wendlingweg 2, 52057 Aachen, Germany.
| | - Anne Hausmann
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Frederik Böke
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Rudolf Leube
- Department of Molecular and Cellular Anatomy, RWTH Aachen University Hospital, Wendlingweg 2, 52057 Aachen, Germany.
| | - Rainer Telle
- Department of Ceramics and Refractory Materials, Institute of Mineral Engineering, RWTH Aachen University, Mauerstrasse 5, 52064 Aachen, Germany.
| | - Horst Fischer
- Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.
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Yan Y, Chibowski E, Szcześ A. Surface properties of Ti-6Al-4V alloy part I: Surface roughness and apparent surface free energy. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 70:207-215. [PMID: 27770882 DOI: 10.1016/j.msec.2016.08.080] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 08/01/2016] [Accepted: 08/30/2016] [Indexed: 01/20/2023]
Abstract
Titanium (Ti) and its alloys are the most often used implants material in dental treatment and orthopedics. Topography and wettability of its surface play important role in film formation, protein adhesion, following osseointegration and even duration of inserted implant. In this paper, we prepared Ti-6Al-4V alloy samples using different smoothing and polishing materials as well the air plasma treatment, on which contact angles of water, formamide and diiodomethane were measured. Then the apparent surface free energy was calculated using four different approaches (CAH, LWAB, O-W and Neumann's Equation of State). From LWAB approach the components of surface free energy were obtained, which shed more light on the wetting properties of samples surface. The surface roughness of the prepared samples was investigated with the help of optical profilometer and AFM. It was interesting whether the surface roughness affects the apparent surface free energy. It was found that both polar interactions the electron donor parameter of the energy and the work of water adhesion increased with decreasing roughness of the surfaces. Moreover, short time plasma treatment (1min) caused decrease in the surface hydrophilic character, while longer time (10min) treatment caused significant increase in the polar interactions and the work of water adhesion. Although Ti-6Al-4V alloy has been investigated many times, to our knowledge, so far no paper has been published in which surface roughness and changes in the surface free energy of the alloy were compared in the quantitative way in such large extent. This novel approach deliver better knowledge about the surface properties of differently smoothed and polished samples which may be helpful to facilitate cell adhesion, proliferation and mineralization. Therefore the results obtained present also potentially practical meaning.
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Affiliation(s)
- Yingdi Yan
- Department of Physical Chemistry-Interfacial Phenomena, Faculty of Chemistry, Maria Curie-Sklodowska University, Maria Curie-Sklodowska Sq. 3, 2003, Lublin, Poland
| | - Emil Chibowski
- Department of Physical Chemistry-Interfacial Phenomena, Faculty of Chemistry, Maria Curie-Sklodowska University, Maria Curie-Sklodowska Sq. 3, 2003, Lublin, Poland
| | - Aleksandra Szcześ
- Department of Physical Chemistry-Interfacial Phenomena, Faculty of Chemistry, Maria Curie-Sklodowska University, Maria Curie-Sklodowska Sq. 3, 2003, Lublin, Poland.
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26
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Li X, Chen T, Hu J, Li S, Zou Q, Li Y, Jiang N, Li H, Li J. Modified surface morphology of a novel Ti–24Nb–4Zr–7.9Sn titanium alloy via anodic oxidation for enhanced interfacial biocompatibility and osseointegration. Colloids Surf B Biointerfaces 2016; 144:265-275. [DOI: 10.1016/j.colsurfb.2016.04.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/28/2016] [Accepted: 04/09/2016] [Indexed: 01/15/2023]
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