Interfacial shear strength and histology of plasma sprayed and sintered hydroxyapatite implants in vivo

A novel multi-structural reinforced treatment on Ti implant utilizing a combination of alkali solution and bioactive glass sol

OBJECTIVE

Alkali treatment and bioactive glass (BG) sol dip-coating are well-known individual methods for titanium (Ti) surface modification. In this study, a unique combination of alkali treatment and bioactive glass sol dip coating was applied to the Ti substrate, then the mechanical properties and cell responses were investigated.

METHODS

Based on the methods introduced above, the Ti substrate was treated by 6 mL of an NaOH 5 M aqueous solution for 24 h at 60 ̊C; this was followed by adding 1.2 mL of a BG 58S sol to form a novel combined nanostructure network covered by a thin BG layer. For the assessment of the formed coating layer, the morphology, elemental analysis, phase structure, adhesion property and the cell response of the untreated and treated surfaces were investigated.

RESULTS

The BG coating layer was reinforced by the nanostructure, fabricated through the alkali treatment. The results obtained by applying the combined modification method confirmed that the mechanical and biological properties of the fabricated surface demonstrated the highest performance compared to that of the unmodified and individually modified surfaces.

SIGNIFICANCE

The achieved upgrades for this method could be gained from the demanded porous nanostructure and the apatite transformation ability of the alkali treatment. Therefore, the hybridized application of the alkali-BG treatment could be introduced as a promising surface modification strategy for hard-tissue replacement applications.

Fabrication of bioactive glass coating on pure titanium by sol-dip method: Dental applications

This study aimed to assess the mechanical and biological properties of bioactive glass (BG) coating on titanium (Ti). Bioinert Ti substrates were coated by BG to induce bioactivity to the surface. The sol-gel derived BG 58S sol was successfully prepared and coated on the abraded and blasted Ti surface using the sol-dip method. The characterization and cell study for all substrates' surface was carried out. Adhesion test confirmed that a firmly adhered BG coating layer was formed on the abraded and blasted Ti. The measured bonding strength between the coating and the blasted Ti substrate was the highest among all samples, which was 41.03±2.31 MPa. In-vitro cell viability and alkaline phosphatase activity (ALP) tests results also showed that BG coating on the Ti substrate improved the biological properties of the surface. The BG sol-dip coating method could be used to fabricate Ti substrate with a bioactive surface.

Antimicrobial Properties of MgO Nanostructures on Magnesium Substrates

Magnesium (Mg) and its alloys have attracted increasing attention in recent years as medical implants for repairing musculoskeletal injuries because of their promising mechanical and biological properties. However, rapid degradation of Mg and its alloys in physiological fluids limited their clinical translation because the accumulation of hydrogen (H2) gas and fast release of OH- ions could adversely affect the healing process. Moreover, infection is a major concern for internally implanted devices because it could lead to biofilm formation, prevent host cell attachment on the implants, and interfere osseointegration, resulting in implant failure or other complications. Fabricating nanostructured magnesium oxide (MgO) on magnesium (Mg) substrates is promising in addressing both problems because it could slow down the degradation process and improve the antimicrobial activity. In this study, nanostructured MgO layers were created on Mg substrates using two different surface treatment techniques, i.e., anodization and electrophoretic deposition (EPD), and cultured with Staphylococcus aureus in vitro to determine their antimicrobial properties. At the end of the 24-h bacterial culture, the nanostructured MgO layers on Mg prepared by anodization or EPD both showed significant bactericidal effect against S. aureus. Thus, nanostructured MgO layers on Mg are promising for reducing implant-related infections and complications and should be further explored for clinical translation toward antimicrobial biodegradable implants.

Effect of CeO₂ on Microstructure and Wear Resistance of TiC Bioinert Coatings on Ti6Al4V Alloy by Laser Cladding

To solve the lack of wear resistance of titanium alloys for use in biological applications, various prepared coatings on titanium alloys are often used as wear-resistant materials. In this paper, TiC bioinert coatings were fabricated on Ti6Al4V by laser cladding using mixed TiC and ZrO₂ powders as the basic pre-placed materials. A certain amount of CeO₂ powder was also added to the pre-placed powders to further improve the properties of the TiC coatings. The effects of CeO₂ additive on the phase constituents, microstructures and wear resistance of the TiC coatings were researched in detail. Although the effect of CeO₂ on the phase constituents of the coatings was slight, it had a significant effect on the microstructure and wear resistance of the coatings. The crystalline grains in the TiC coatings, observed by a scanning electron microscope (SEM), were refined due to the effect of the CeO₂. With the increase of CeO₂ additive content in the pre-placed powders, finer and more compact dendrites led to improvement of the micro-hardness and wear resistance of the TiC coatings. Also, 5 wt % content of CeO₂ additive in the pre-placed powders was the best choice for improving the wear properties of the TiC coatings.

Effect of HAp and β-TCP incorporation on the tribological response of Ti6Al4V biocomposites for implant parts

Titanium and its alloys have been widely used in many engineering areas due to their properties. Despite having a high implant-tissue osseointegration time, Ti6Al4V has been extensively used in prosthesis and articular implants. To promote a faster bone ingrowth and consequently reduce the implant fixation time, the addition of a bioactive phase to form a biocomposite seems to be an excellent solution. Because of their bioactivity and similarity in composition with the human bone, HAp and β-TCP are two of the most widely used calcium phosphates in biomedical applications. To guarantee a strong adhesion of the previous bioactive materials in the implants surface, samples of Ti6Al4V, Ti6Al4V+HAp (10 vol %) and Ti6Al4V+β-TCP (10 vol %) TCP were processed by the hot pressing technique. Tribological tests against Al₂ O_3, lubricated in PBS at 37°C were carried out on a ball-on-flat reciprocating sliding geometry. Loads in the range of 3 N to 30 N were applied and their effect on the friction behavior and wear resistance of the tested materials was evaluated. Values of the coefficient of friction as well as the wear rate tend to increase with the addition of a bioactive phase to the Ti alloy. Micrographs of the worn surfaces showed that abrasion and plastic deformation are the prevailing wear mechanisms in the studied tribosystems. For biocomposites, particularly in the case of Ti6Al4V+HAp, pull-out of bioactive particle clusters has a determinant role on the tribological response, increasing both the friction coefficient and the specific wear rate. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1010-1016, 2018.

Impact of vertical loading on the implant-bone interface

OBJECTIVES

The main aim of this study was to evaluate the impact of vertical loading occurring during removal of cemented restorations on the implant-bone interface.

METHODS

Thirty-six titanium implants (Camlog 4.3 × 9 mm) were placed 1 mm supraosseous in the frontal skull of four minipigs. After a 13 week healing period the implants were exposed and the implant stability was measured. Three implants per minipig were vertically loaded using 20 or 100 impulses, respectively with an 18 Ns impulse imitating a crown removal. Three implants were left unloaded as control. The animals were sacrificed after 13 or 18 weeks. The harvested specimens were analyzed using scanning electron microscopy (SEM), light and fluorescence microscopy.

RESULTS

No post operative complications or deaths of the minipigs occurred. All implants osseointegrated. The average bone-implant contact area (BIC) was 78 ± 5.1%. No statistically significant difference could be found when comparing the BIC areas of the control and the experimental groups between the sacrificed animals at 13 weeks and 18 weeks (P > 0.05). Therefore, the results of each subgroup were pooled. No significant differences regarding the BIC area could be detected between the control and the experimental groups (P > 0.05). Except one failing implant no cracks due to vertical loading could be evaluated in the SEM. Fluorescence microscopy revealed a significantly higher bone remodeling activity in the vertically loaded groups.

CONCLUSIONS

Removal of cemented implant restorations seems not to have an impact on the mechanical implant stability, but seems to increase bone remodeling activity.

Structural, microstructural, and residual stress investigations of plasma-sprayed hydroxyapatite on Ti-6Al-4 V

Plasma-spray (PS) is a classical technique usually employed to cover orthopaedic titanium implant surfaces with hydroxyapatite (HA - Ca(10)(PO(4))(6)(OH)(2)). The objective of the current study is to investigate the structure and microstructure of HA plasma-spray 50 mum thick coating on titanium alloy (Ti-6Al-4 V) and residual stress due to processing in the substrate and in HA coating. The structure of the coatings was determined by high-energy synchrotron X-ray diffraction in energy dispersive (HESXRD), selected area electron diffraction (saed), Scanning Electron Microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR). No impurity phases in the HA were identified by HESXRD to keep away from the decomposition of HA at high temperature. hcp phase of HA substrate was detected with slight amorphous background. FTIR spectrum of a HA powder shows a typical spectrum for HA material with the characteristic phosphate peaks for HA at wavenumbers of 1090, 1052, 963, 602, and 573 cm(-1) are present. The morphology of HA powder observed by SEM exhibits grains of ca. 0.1 mum well-adapted for cell proliferation. HA/Ti-6Al-4 V interface observed by cross-section scanning and transmission electron microscopy (TEM) presents microcracks. Residual stresses were analyzed by sin(2) Psi X-ray diffraction method on titanium substrates and HA coating. Although the Ti substrates are in a slightly tensile residual state, the coated ones show a compressive state.

Initial responses of human osteoblasts to sol-gel modified titanium with hydroxyapatite and titania composition

Sol-gel thin films of hydroxyapatite (HA) and titania (TiO(2)) have received a great deal of attention in the area of bioactive surface modification of titanium (Ti) implants. Sol-gel coatings were developed on Ti substrates of pure HA and TiO(2) and two composite forms, HA+10% TiO(2) and HA+20% TiO(2), and the biological properties of the coatings were evaluated. All the coating layers exhibited thin and homogeneous structures and phase-pure compositions (either HA or TiO(2)). Primary human osteoblast cells showed good attachment, spreading and proliferation on all the sol-gel coated surfaces, with enhanced cell numbers on all the coated surfaces relative to uncoated Ti control at day 1, as observed by MTT assay and scanning electron microscopy. Cell attachment rates were also enhanced on the pure HA coating relative to control Ti. The pure HA and HA+10% TiO(2) composite coating furthermore enhanced proliferation of osteoblasts at 4 days. Moreover, the gene expression level of several osteogenic markers including bone sialoprotein and osteopontin, as measured by RT-PCR at 24h, was shown to vary according to coating composition. These findings suggest that human primary bone cells show marked and rapid early functional changes in response to HA and TiO(2) sol-gel coatings on Ti.

Plasma Sprayed Zirconia-Hydroxyapatite Composite Coatings

In order to overcome the fragility and to improve the physical stability of hydroxyapatite (HA) on the implant, 5, 10, and 15 % yttria stabilized zirconia (YTZP) was added to the starting plasma spraying HA powder Metco XPT-D-703. From the recent literature it is already known that HA coatings tend to dissolve in body fluid environment. To decrease the dissolution effect many additives like zirconia (Zr) could be added to HA powder. In this study, prepared HA composite powders were sprayed onto titanium (Ti) surfaces with a Metco plasma gun. As a control group, pure HA powder was sprayed onto other Ti samples. All samples were subjected to tensile tests according to the ASTM C-633-79. SEM images were taken using back-scattering from prepared cross-sections. X-ray diffraction images were taken from the surface. It was seen that with the increase of the Zr content, the tensile test values increased. Pure HA showed also that the addition of Zr had improved the tensile bond strenght (TBS) values.

Histological findings in titanium implants coated with calcium phosphate ceramics installed in rabbit's tibias

Oral reconstruction using osteointegrated implants are widely indicated nowadays. The implant bone anchorage is very important for its functional stability. Thus, ceramic biomaterials are widely used as coatings of the implant surfaces to accelerate local osteogenesis. The purpose of this study is to assess the biocompatibility and the osteoconduction of two types of calcium phosphate ceramics used as titanium dental implant coatings. These implants were installed in rabbit tibia during an 8-week healing period. The light and fluorescent microscopy observations showed that the materials are biocompatible and that they have osteoconductive activities.

Biomaterials, Biomechanics, Tissue Healing, and Immediate-Function Dental Implants

Selected factors and opinions are reviewed specific to immediate function of dental implants in terms of biomaterial and biomechanical properties and how they might influence postsurgical tissue healing. Comparisons are made among plate, rod, and screw vs plateau, finn, and porous geometry endosteal dental-implant designs with and without alterations in device body-surface microchemistry and microtopography. Available information introduces more questions than answers, and recommendations are made for ongoing studies of bone responses specific to the implant fit and fill parameters focused on the kinetics of postsurgical osteotomy healing and applied loading. The clinical literature supports opportunities for immediate function; however, proposals about pathways for bone healing need further investigation. The current trends within the discipline of implant dentistry offer opportunities to reevaluate current vs previous immediate-function systems.

Thermal residual stresses near the interface between plasma-sprayed hydroxyapatite coating and titanium substrate: Finite element analysis and synchrotron radiation measurements

Plasma-sprayed hydroxyapatite (HA) coatings on titanium alloy are often used in prosthetic implants. The metallic substrate gives the implant good mechanical strength which is combined with good biocompatibility and osteointegration of the ceramic coating. However, the interface between the HA coating and titanium alloy substrate is an area of critical weakness when compared with the interlamellar cohesive strength of the HA coating structure. Knowledge of the stresses in materials near the interface seems to be an important step in understanding why failure occurs. Synchrotron radiation, using Beamline BM16 at the European Synchrotron Radiation Facility (Grenoble, France), has been used to determine local stresses near the interface, down to 10 microm in resolution, between a plasma-sprayed HA coating and a titanium alloy substrate. This experimental determination of residual stresses is compared with the results found by a finite element analysis modeling the thermal effects of the plasma-spraying process. Residual stresses have been found in deposited ceramic near the interface due to a thermal properties mismatch of the materials. If the plane stress state is assumed, meaning the perpendicular component of residual stress is ignored (sigma(z) = 0), then the synchrotron residual stress measurements should be interpreted as mainly compressive in the ceramic coating. This is in contradiction with the coefficient of thermal expansion mismatch; therefore, the simplified plane stresses assumption seems to be inappropriate for the deposited morphology characterized by pores and a network of microcracks. The detailed finite element analysis model, taking into account the real morphology of the coating and the real three-dimensional stress field distribution, allowed the estimation of sigma(z), leading to a more accurate interpretation of synchrotron measurements, which is validated by the experimental results.

Bone response to unloaded titanium implants in the fibula, iliac crest, and scapula: an animal study in the Yorkshire pig

The reconstruction of extended maxillary and mandibular defects with prefabricated free flaps is a two stage procedure, that allows immediate function with implant supported dentures. The appropriate delay between prefabrication and reconstruction depends on the interfacial strength of the bone-implant surface. The purpose of this animal study was to evaluate the removal torque of unloaded titanium implants in the fibula, the scapula and the iliac crest. Ninety implants with a sandblasted and acid-etched (SLA) surface were tested after healing periods of 3, 6, and 12 weeks, respectively. Removal torque values (RTV) were collected using a computerized counterclockwise torque driver. The bicortical anchored 8mm implants in the fibula revealed values of 63.73 Ncm, 91.50 Ncm, and 101.83 Ncm at 3, 6, and 12 weeks, respectively. The monocortical anchorage in the iliac crest showed values of 71.40 Ncm, 63.14 Ncm, and 61.59 Ncm with 12 mm implants at the corresponding times. The monocortical anchorage in the scapula demonstrated mean RTV of 62.28 Ncm, 97.63 Ncm, and 99.7 Ncm with 12 mm implants at 3, 6, and 12 weeks, respectively. The study showed an increase of removal torque with increasing healing time. The interfacial strength for bicortical anchored 8mm implants in the fibula was comparable to monocortical anchored 12 mm implants in the iliac crest and the scapula at the corresponding times. The resistance to shear seemed to be determined by the type of anchorage (monocortical vs. bicortical) and the length of the implant with greater amount of bone-implant interface.

Impact formation and microstructure characterization of thermal sprayed hydroxyapatite/titania composite coatings

Formation mechanism of hydroxyapatite (HA)/titania (TiO(2)) composite coating deposited by high velocity oxy-fuel (HVOF) thermal spray process was studied, and its structural characterization was conducted and elaborated in this paper. The impact theory was employed to analyze the formation procedure of the HA/titania composite coatings. Results revealed that the crater caused by the impact of entirely unmelted TiO(2) particles on the HA matrix during coating formation was of smaller dimensions than the original size of the reinforcements. It was found that chemical reaction between the mechanically blended HA and TiO(2) powder took place exclusively during the impingement stage, and calcium titanate, CaTiO(3), was one notable by-product. The bonding between the HA matrix and TiO(2) reinforcement might have been achieved predominantly through a chemical bond that resulted from the mutual chemical reactions among the components. Differential scanning calorimetry analyses showed that the chemical reaction between HA and TiO(2) was at approximately 1410 degrees C. The TiO(2) addition was found to exert particular effects on the thermal behavior of HA at elevated temperatures, during both heating and cooling cycles. Transmission electron microscopy observation identified the chemical reaction zone between HA and TiO(2), which revealed an improved splats' interface. The reaction zone demonstrated some influence on the grain size of HA nearby during resolidification of the melted portion. A structural model was proposed to illustrate the location of the different phases in the HA/titania composite coating.

In vitro and in vivo biocompatibility testing of Ti-6Al-7Nb alloy with and without plasma-sprayed hydroxyapatite coating

The Ti-6Al-7Nb alloy has been recently developed for biomedical use, particularly for orthopedics and dental applications. Osteosynthesis has been used to analyze biocompatibility and osseoconduction properties. The interaction of the implant with its biological environment, the formation of the implant material/tissue interface, and the long-term success or failure of integration in the human body is strongly connected with the surface properties of the implant device. This study was undertaken to evaluate the processes involved in biological responses of the Ti-6Al-7Nb alloy with and without hydroxyapatite coatings with both in vitro and in vivo tests. The results were analyzed by scanning electron microscopy (SEM) and energy-dispersive x-ray (EDX) microanalysis. The morphology of the in vitro and in vivo testing results with hydroxyapatite coating was similar to those obtained on the uncoated samples. A mineralized extracellular matrix was formed on all materials. Observation of the interface between the cell layer and substrata showed the presence of calcium and phosphorous-rich globular deposits associated with collagen fibers on all materials in vitro and in vivo. A higher density of these globular deposits was observed in all samples.

Ion-beam-assisted deposition (IBAD) of hydroxyapatite coating layer on Ti-based metal substrate

A hydroxyapatite layer was formed on the surface of a Ti-based alloy by ion-beam-assisted deposition. The deposition methodology comprised of an electron beam vaporizing a pure hydroxyapatite target, while an Ar ion beam was focused on the metal substrate to assist deposition. All deposited layers were amorphous, regardless of the current level of the ion beam. The bond strength between the layer and the substrate increased steadily with increasing current, while the dissolution rate in a physiological saline solution decreased remarkably. These improvements were attributed to an increase in the Ca/P ratio of the layer. Without ion beam assistance, the Ca/P ratio was much lower than the stoichiometric HAp (Ca/P = 1.67). With ion-beam assistance, the Ca/P ratio of the layer increased presumably due to the high sputtering rate of P compared to that of Ca from the layer being coated.

Bone growth on and resorption of calcium phosphate coatings obtained by pulsed laser deposition

Three different calcium phosphate coatings of crystalline hydroxyapatite (HA), alpha- and beta-tricalcium phosphate (alpha+beta-TCP), or amorphous calcium phosphate (ACP) obtained by pulsed laser deposition on Ti-6Al-4V were incubated in a potentially osteogenic primary cell culture (rat bone marrow) in order to evaluate the amount and mode of mineralized bone matrix formation after 2 weeks with special emphasis on the type of interfacial structure that was created. Evaluation techniques included fluorescence labeling and scanning electron microscopy. The resistance to cellular resorption by osteoclasts was also studied. Bone matrix delaminated from the ACP coatings, while it remained on the HA and the alpha+beta-TCP coatings even after fracturing. A cementlike line was seen as the immediate contiguous interface with the nondegrading dense HA surface and with the surface of the remaining porous beta-TCP coating. Highly dense and crystalline HA coatings do not dissolve but are capable of establishing a strong bond with the bone matrix grown on top. Chemical and mechanical bonding were considered in this case. Cellular resorption was practically not observed on the HA coatings, but it was observed on the alpha+beta-TCP coatings. Resorption took place as dissolution that was due to the acidic microenvironment.