Modification of titanium alloys surface properties by plasma electrolytic oxidation (PEO) and influence on biological response

Layer-by-Layer Deposition of Regenerated Silk Fibroin─An Approach to the Surface Coating of Biomedical Implant Materials

Biomaterials and coating techniques unlock major benefits for advanced medical therapies. Here, we explored layer-by-layer (LbL) deposition of silk fibroin (SF) by dip coating to deploy homogeneous films on different materials (titanium, magnesium, and polymers) frequently used for orthopedic and other bone-related implants. Titanium and magnesium specimens underwent preceding plasma electrolytic oxidation (PEO) to increase hydrophilicity. This was determined as surface properties were visualized by scanning electron microscopy and contact angle measurements as well as Fourier transform infrared spectroscopy (FTIR) analysis. Finally, biological in vitro evaluations of hemocompatibility, THP-1 cell culture, and TNF-α assays were conducted. A more hydrophilic surface could be achieved using the PEO surface, and the contact angle for magnesium and titanium showed a reduction from 73 to 18° and from 58 to 17°, respectively. Coating with SF proved successful on all three surfaces, and coating thicknesses of up to 5.14 μm (±SD 0.22 μm) were achieved. Using FTIR analysis, it was shown that the insolubility of the material was achieved by post-treatment with water vapor annealing, although the random coil peak (1640-1649 cm-1) and the α-helix peak (at 1650 cm-1) were still evident. SF did not change hemocompatibility, regardless of the substrate, whereas the PEO-coated materials showed improved hemocompatibility. THP-1 cell culture showed that cells adhered excellently to all of the tested material surfaces. Interestingly, SF coatings induced a significantly higher amount of TNF-α for all materials, indicating an inflammatory response, which plays an important role in a variety of physiological processes, including osteogenesis. LbL coatings of SF are shown to be promising candidates to modulate the body's immune response to implants manufactured from titanium, magnesium, and polymers. They may therefore facilitate future applications for bioactive implant coatings. However, further in vivo studies are needed to confirm the proposed effects on osteogenesis in a physiological environment.

Micro-arc oxidation (MAO) and its potential for improving the performance of titanium implants in biomedical applications

Titanium (Ti) and its alloys have good biocompatibility, mechanical properties and corrosion resistance, making them attractive for biomedical applications. However, their biological inertness and lack of antimicrobial properties may compromise the success of implants. In this review, the potential of micro-arc oxidation (MAO) technology to create bioactive coatings on Ti implants is discussed. The review covers the following aspects: 1) different factors, such as electrolyte, voltage and current, affect the properties of MAO coatings; 2) MAO coatings affect biocompatibility, including cytocompatibility, hemocompatibility, angiogenic activity, corrosion resistance, osteogenic activity and osseointegration; 3) antibacterial properties can be achieved by adding copper (Cu), silver (Ag), zinc (Zn) and other elements to achieve antimicrobial properties; and 4) MAO can be combined with other physical and chemical techniques to enhance the performance of MAO coatings. It is concluded that MAO coatings offer new opportunities for improving the use of Ti and its alloys in biomedical applications, and some suggestions for future research are provided.

Comparative analysis of the biocompatibility of endothelial cells on surfaces treated by thermal plasma and cold atmospheric plasma

In recent years, cold atmospheric plasma (CAP) is used for surface disinfection. However, little is known about its ability to improve biocompatibility of metallic surfaces when compared to thermal plasma methods. In this context, the study aimed to evaluate the response of human endothelial cells (Ea.hy926) on titanium surfaces treated by non-thermal plasma method and thermal plasma method under nitriding atmosphere. The wettability was characterized by the sessile drop method, the topography and roughness were evaluated by atomic force microscopy (AFM), and the microstructure by grazing angle X-ray diffraction (GIXRD). Endothelial cells were cultured and evaluated for morphology by scanning electron microscopy and viability by an MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. CAP treatment reduced the contact angle of the Ti surface (13.43° ± 1.48; p<0.05), increasing hydrophilicity. Rz roughness was higher on the nitrided surface (220.44±20.30; p< 0.001) compared to the CAP treated surfaces (83.29 ± 11.61; p< 0.001) and polished (75.98 ±34.21a); p<0.001). The different applied plasma treatments created different titanium surfaces improving the biocompatibility of endothelial cells, however CAP results demonstrate its potential for biomedical applications, considering the low cost and ease of use of the technique, allowing surface treatments before clinical procedures.

Bioabsorbable WE43 Mg alloy wires modified by continuous plasma electrolytic oxidation for implant applications. Part II: Degradation and biological performance

The corrosion, mechanical degradation and biological performance of cold-drawn WE43 Mg wires were analyzed as a function of thermo-mechanical processing and the presence of a protective oxide layer created by continuous plasma electrolytic oxidation (PEO). It was found that the corrosion properties of the non-surface-treated wire could be optimized by means of thermal treatment within certain limits, but the corrosion rate remained very high. Hence, strength and ductility of these wires vanished after 24 h of immersion in simulated body fluid at 37 °C and, as a result of that rather quick degradation, direct tests did not show any MC3T3-E1 preosteoblast cell attachment on the surface of the Mg wires. In contrast, surface modification of the annealed WE43 Mg wires by a continuous PEO process led to the formation of a homogeneous oxide layer of ≈8 μm and significantly improved the corrosion resistance and hence the biocompatibility of the WE43 Mg wires. It was found that a dense layer of Ca/P was formed at the early stages of degradation on top of the Mg(OH)₂ layer and hindered the diffusion of the Cl^- ions which dissolve Mg(OH)₂ and accelerate the corrosion of Mg alloys. As a result, pitting corrosion was suppressed and the strength of the Mg wires was above 100 MPa after 96 h of immersion in simulated body fluid at 37 °C. Moreover, many cells were able to attach on the surface of the PEO surface-modified wires during cell culture testing. These results demonstrate the potential of thin Mg wires surface-modified by continuous PEO in terms of mechanical, degradation and biological performance for bioabsorbable wire-based devices.

Surface Free Energy Dominates the Biological Interactions of Postprocessed Additively Manufactured Ti-6Al-4V

Additive manufacturing (AM) has emerged as a disruptive technique within healthcare because of its ability to provide personalized devices; however, printed metal parts still present surface and microstructural defects, which may compromise mechanical and biological interactions. This has made physical and/or chemical postprocessing techniques essential for metal AM devices, although limited fundamental knowledge is available on how alterations in physicochemical properties influence AM biological outcomes. For this purpose, herein, powder bed fusion Ti-6Al-4V samples were postprocessed with three industrially relevant techniques: polishing, passivation, and vibratory finishing. These surfaces were thoroughly characterized in terms of roughness, chemistry, wettability, surface free energy, and surface ζ-potential. A significant increase in Staphylococcus epidermidis colonization was observed on both polished and passivated samples, which was linked to high surface free energy donor γ^– values in the acid–base, γ^AB component. Early osteoblast attachment and proliferation (24 h) were not influenced by these properties, although increased mineralization was observed for both these samples. In contrast, osteoblast differentiation on stainless steel was driven by a combination of roughness and chemistry. Collectively, this study highlights that surface free energy is a key driver between AM surfaces and cell interactions. In particular, while low acid–base components resulted in a desired reduction in S. epidermidis colonization, this was followed by reduced mineralization. Thus, while surface free energy can be used as a guide to AM device development, optimization of bacterial and mammalian cell interactions should be attained through a combination of different postprocessing techniques.

A Nanoindentation Approach for Time-Dependent Evaluation of Surface Free Energy in Micro- and Nano-Structured Titanium

Surface free energy (SFE) of titanium surfaces plays a significant role in tissue engineering, as it affects the effectiveness and long-term stability of both active coatings and functionalization and the establishment of strong bonds to the newly growing bone. A new contact–mechanics methodology based on high-resolution non-destructive elastic contacting nanoindentation is applied here to study SFE of micro- and nano-structured titanium surfaces, right after their preparation and as a function of exposure to air. The effectiveness of different surface treatments in enhancing SFE is assessed. A time-dependent decay of SFE within a few hours is observed, with kinetics related to the sample preparation. The fast, non-destructive method adopted allowed for SFE measurements in very hydrophilic conditions, establishing a reliable comparison between surfaces with different properties.

Investigation of Biocompatible PEO Coating Growth on cp-Ti with In Situ Spectroscopic Methods

The problem of the optimization of properties for biocompatible coatings as functional materials requires in-depth understanding of the coating formation processes; this allows for precise manufacturing of new generation implantable devices. Plasma electrolytic oxidation (PEO) opens the possibility for the design of biomimetic surfaces for better biocompatibility of titanium materials. The pulsed bipolar PEO process of cp-Ti under voltage control was investigated using joint analysis of the surface characterization and by in situ methods of impedance spectroscopy and optical emission spectroscopy. Scanning electron microscopy, X-ray diffractometry, coating thickness, and roughness measurements were used to characterize the surface morphology evolution during the treatment for 5 min. In situ impedance spectroscopy facilitated the evaluation of the PEO process frequency response and proposed the underlying equivalent circuit where parameters were correlated with the coating layer properties. In situ optical emission spectroscopy helped to analyze the spectral line evolutions for the substrate material and electrolyte species and to justify a method to estimate the coating thickness via the relation of the spectral line intensities. As a result, the optimal treatment time was established as 2 min; this provides a 9-11 µm thick PEO coating with Ra 1 µm, 3-5% porosity, and containing 75% of anatase. The methods for in-situ spectral diagnostics of the coating thickness and roughness were justified so that the treatment time can be corrected online when the coating achieves the required properties.

Effect of surface characteristics on the antibacterial properties of titanium dioxide nanotubes produced in aqueous electrolytes with carboxymethyl cellulose

Nanotubular structures were produced on a commercially pure titanium surface by anodization in an aqueous electrolyte that contained carboxymethyl cellulose and sodium fluoride. The internal diameters obtained were about 100, 48, and 9.5 nm, respectively. Several heat treatments at 200, 350, and 600°C were made to produce nanotubes with different titanium dioxide polymorphs (anatase, rutile). All tested surfaces were superhydrophilic, this behavior was maintained after at least 30 days, regardless of the heat treatment. Although in previous works the nanotube features effect on the bacteria behavior had been studied; this item still unclear. For the best of our knowledge, the effect of small internal diameters (about 10 nm) with and without heat treatment and with and without ultraviolet (UV) irradiation on the bacteria strains comportment has not been reported. From our results, both the internal diameter and the postanodized treatments have an effect on the bacteria strains comportment. All nanotubular coatings UV treated and heat treated at 350 and 600°C; despite they have different inner diameters, inhibit the bacteria growth of both Staphylococcus aureus and Pseudomonas aeruginosa strains. The nanotubular coatings obtained at 20 V and heat treated at 350°C produced the lower bacteria adhesion against both strains evaluated.

Crystallized TiO2 Nanosurfaces in Biomedical Applications

Crystallization alters the characteristics of TiO2 nanosurfaces, which consequently influences their bio-performance. In various biomedical applications, the anatase or rutile crystal phase is preferred over amorphous TiO2. The most common crystallization technique is annealing in a conventional furnace. Methods such as hydrothermal or room temperature crystallization, as well as plasma electrolytic oxidation (PEO) and other plasma-induced crystallization techniques, present more feasible and rapid alternatives for crystal phase initiation or transition between anatase and rutile phases. With oxygen plasma treatment, it is possible to achieve an anatase or rutile crystal phase in a few seconds, depending on the plasma conditions. This review article aims to address different crystallization techniques on nanostructured TiO2 surfaces and the influence of crystal phase on biological response. The emphasis is given to electrochemically anodized nanotube arrays and their interaction with the biological environment. A short overview of the most commonly employed medical devices made of titanium and its alloys is presented and discussed.

Predominant surface property of an anodized titanium that enhances the cell response

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.

Potential antibacterial mechanism of silver nanoparticles and the optimization of orthopedic implants by advanced modification technologies

Infection, as a common postoperative complication of orthopedic surgery, is the main reason leading to implant failure. Silver nanoparticles (AgNPs) are considered as a promising antibacterial agent and always used to modify orthopedic implants to prevent infection. To optimize the implants in a reasonable manner, it is critical for us to know the specific antibacterial mechanism, which is still unclear. In this review, we analyzed the potential antibacterial mechanisms of AgNPs, and the influences of AgNPs on osteogenic-related cells, including cellular adhesion, proliferation, and differentiation, were also discussed. In addition, methods to enhance biocompatibility of AgNPs as well as advanced implants modifications technologies were also summarized.