Evaluation of biocompatibility of various ceramic powders with human fibroblasts in vitro

Implementing Machine Learning approaches for accelerated prediction of bone strain in acetabulum of a hip joint

The Finite Element (FE) methods for biomechanical analysis involving implant design and subject parameters for musculoskeletal applications are extensively reported in literature. Such an approach is manually intensive and computationally expensive with longer simulations times. Although Artificial Intelligence (AI) based approaches are implemented to a limited extent in biomechanics, such approaches to predict bone strain in acetabulum of a hip joint, are hardly explored. In this context, the primary objective of this paper is to evaluate machine learning (ML) models in tandem with high-fidelity FEA data for the accelerated prediction of the biomechanical response in the acetabulum of the human hip joint, during the walking gait. The parameters used in the FEA study included the subject weight, number and distribution of fins on the periphery of the acetabular shell, bone condition and phases of the gait cycle. The biomechanical response has also been evaluated using three different acetabular liners, including pre-clinically validated HDPE-20% HA-20% Al2O3, highly-crosslinked ultrahigh molecular weight polyethylene (HC-UHMWPE) and ZrO2-toughened Al2O3 (ZTA). Such parametric variation in FEA analysis, involving 26 variables and a full factorial design resulted in 10,752 datasets for spatially varying bone strains. The bone condition, as opposed to subject weight, was found to play a statistically significant role in determining the strain response in the periprosthetic bone of the acetabulum. While utilising hyperparameter tuning, K-fold cross validation and statistical learning approaches, a number of ML models were trained on the FEA dataset, and the Random Forest model performed the best with a coefficient of determination (R2) value of 0.99/0.97 and Root Mean Square Error (RMSE) of 0.02/0.01 on the training/test dataset. Taken together, this study establishes the potential of ML approach as a fast surrogate of FEA for implant biomechanics analysis, in less than a minute.

Finite Element Analysis to Probe the Influence of Acetabular Shell Design, Liner Material, and Subject Parameters on Biomechanical Response in Periprosthetic Bone

The implant stability and biomechanical response of periprosthetic bone in acetabulum around total hip joint replacement (THR) devices depend on a host of parameters, including design of articulating materials, gait cycle and subject parameters. In this study, the impact of shell design (conventional, finned, spiked, and combined design) and liner material on the biomechanical response of periprosthetic bone has been analyzed using finite element (FE) method. Two different liner materials: high density polyethylene-20% hydroxyapatite-20% alumina (HDPE-20%HA-20%Al2O3) and highly cross-linked ultrahigh molecular weight polyethylene (HC-UHMWPE) were used. The subject parameters included bone condition and bodyweight. Physiologically relevant load cases of a gait cycle were considered. The deviation of mechanical condition of the periprosthetic bone due to implantation was least for the finned shell design. No significant deviation was observed at the bone region adjacent to the spikes and the fins. This study recommends the use of the finned design, particularly for weaker bone conditions. For stronger bones, the combined design may also be recommended for higher stability. The use of HC-UHMWPE liner was found to be better for convensional shell design. However, similar biomechanical response was captured in our FE analysis for both the liner materials in case of other shell designs. Overall, the study establishes the biomechanical response of periprosthetic bone in the acetabular with preclinically tested liner materials together with new shell design for different subject conditions.

Evaluation of the biological behaviour of various dental implant abutment materials on attachment and viability of human gingival fibroblasts

OBJECTIVE

This study aimed to investigate the biological effects of yttria-stabilized zirconia (Y-TZP) compared to other dental implant abutment materials, i.e. lithium disilicate (LS2) and titanium alloy (Ti), as well as the effects of aging of Y-TZP on viability/proliferation and attachment properties of Human Gingival Fibroblasts (HGFs).

METHODS

Cylindrical specimens of each material were prepared as per manufacturer's instructions. Y-TZP specimens were divided into three groups: 1. no aging (Zr0), 2. aging for 5 h, 134 °C, 2 bars, 100% humidity (Zr5), 3. aging for 10 h under the same conditions (Zr10). Surface roughness was evaluated by optical profilometry; cell metabolic activity/viability by MTT assay, morphological changes by Scanning Electron Microscopy (SEM) and ratio of live/dead cells by confocal microscopy.

RESULTS

Results showed statistically significant reduction of HGF metabolic activity/viability in contact with Y-TZP after aging. Nevertheless, non-aged zirconia showed no significant differences compared with LS2, Ti and control cultures. In contrast, significant stimulation of cell metabolic activity/viability was observed in HGFs exposed to LS2 eluates. Differential morphological patterns were observed for HGF in contact with different materials/treatments, with obviously increased number of dead cells and sparser distribution of HGFs cultured on Zr10 specimens. These effects were not correlated with surface topography, since Y-TZP aging did not alter surface micro-roughness.

SIGNIFICANCE

These findings indicate that Y-TZP shows comparable biological properties to Ti and LS2 as implant abutment material. Nevertheless, Y-TZP aging might influence gingival cell attachment and proliferation properties, providing an alert to a potentially negative effect on the long-term maintenance of gingival architecture.

Si, Sr, Ag co-doped hydroxyapatite/TiO2 coating: enhancement of its antibacterial activity and osteoinductivity

A multifaceted coating with favourable cytocompatibility, osteogenic activity and antibacterial properties would be of great significance and value due to its capability for improving osseointegration and alleviating prosthesis loosening. This study marks the first report on the coating of TiO2 nanotubular (TNT) arrays with Sr-and-Si-substituted hydroxyapatite (SSHA) endowed with antibacterial characteristics using silver ions. This TNT layer coated with Ag-substituted SSHA (SSAgHA) formed a composite coating with an interconnected microporous structure and a homogeneous distribution of Sr, Si and Ag; such a coating promoted cell adhesion and osteogenic potential. The anchoring effect of the TNT layer improved the adhesion strength of the SSAgHA/TNT coating to 16.9 ± 3.1 MPa, which was higher than the 15 MPa set in the ISO standard 13 779-4:2002. Moreover, the bio-corrosion resistance of the underlying Ti substrate was greatly enhanced by the composite coating. Hydroxyapatite (HA) and SSAgHA coatings provided a suitable environment for the adhesion, spreading and proliferation of mouse osteoblasts. The SSAgHA coating excellently inhibited bacterial activity and enhanced osteoinductivity with higher osteogenic differentiation compared with the HA coating. Sr and Si dopants increased the expression levels of the genes related to osteogenesis and successfully offset the potential cytotoxicity of Ag ions. Super-osteoinductivity was attributed to the rough and superhydrophilic surface of the composite coating. Therefore, the present study demonstrated the potential of the electrodeposited SSAgHA/TNT composite coating as a promising metallic implant with great intrinsic antibacterial activity and osteointegration ability.

Zirconia based dental ceramics: structure, mechanical properties, biocompatibility and applications

Zirconia (ZrO₂) based dental ceramics have been considered to be advantageous materials with adequate mechanical properties for the manufacturing of medical devices.

Enhanced Biological Behavior of In Vitro Human Gingival Fibroblasts on Cold Plasma-Treated Zirconia

Objective

To evaluate whether atmospheric-pressure dielectric-barrier-discharge plasma treatment of zirconia enhances its biocompatibility with human gingival fibroblasts.

Materials and Methods

The zirconia disks were divided into four groups and treated using helium atmospheric-pressure dielectric-barrier-discharge plasmas for 30, 60 or 90 s or left untreated. The surface morphology, wettability and chemical elements were analyzed. Fibroblasts density, morphology, morphometry and attachment-related genes expression were measured at different time points from 3 to 72 h.

Results

After plasma treatment, the surface morphology and roughness remained the same, while the contact angle decreased from 78.31° to 43.71°, and the surface C/O ratio decreased from 3.17 to 0.89. The surficial areas and perimeters of HGFs were increased two-fold in the treated groups at 3 h. Fibroblasts density increased on treated disks at all time points, especially the ones treated for 60 s. Attachment-related genes in the groups treated for 30 and 60 s were significantly higher at 3 and 24 h.

Conclusion

The helium atmospheric-pressure dielectric-barrier-discharge plasma treatment enhances the biological behavior of fibroblasts on zirconia by increasing the expression of attachment-related genes within 24 h and promoting the cell density during longer culture times. Wettability of zirconia, an important physicochemical property, has a vital influence on the cell behaviors.

Zirconia Intra Mucosal Inserts as a Retentive Aid for Maxillary Complete Dentures: A Case Report

Complete dentures fabricated for edentulous patients with resorbed ridges generally have compromised retention and stability. The use of intramucosal inserts in order to aid retention of a maxillary denture has been reported in the past. Zirconia is a tissue compatible biomaterial whose scope and application in dentistry is on the rise. This paper reports the fabrication of zirconia intramucosal inserts and the technique of its incorporation in the maxillary complete denture in order to enhance retention, stability and thereby oral function.

Odontogenic effects of a fast-setting calcium-silicate cement containing zirconium oxide

A fast-setting calcium-silicate cement (Endocem) was introduced in the field of dentistry for use in vital pulp therapy. Similar to mineral trioxide aggregate (MTA), it contains bismuth oxide to provide radiopacity. Recently, another product, EndocemZr, which contains zirconium oxide (ZrO2) as a radiopacifier, was developed by the same company. In this study, the biological/odontogenic effects of EndocemZr were investigated in human primary dental pulp cells (hpDPCs) in vitro and on capped rat teeth in vivo. The biocompatibility of EndocemZr was similar to that of ProRoot and Endocem on the basis of cell viability tests and cell morphological analysis. The mineralization nodule formation, expression of odontogenic-related markers, and reparative dentin formation of EndocemZr group was similar to those of other material groups. Our results suggest that EndocemZr has the potential to be used as an effective material for vital pulp therapy, similar to ProRoot and Endocem.

Biological response to prosthetic debris

Joint arthroplasty had revolutionized the outcome of orthopaedic surgery. Extensive and collaborative work of many innovator surgeons had led to the development of durable bearing surfaces, yet no single material is considered absolutely perfect. Generation of wear debris from any part of the prosthesis is unavoidable. Implant loosening secondary to osteolysis is the most common mode of failure of arthroplasty. Osteolysis is the resultant of complex contribution of the generated wear debris and the mechanical instability of the prosthetic components. Roughly speaking, all orthopedic biomaterials may induce a universal biologic host response to generated wear débris with little specific characteristics for each material; but some debris has been shown to be more cytotoxic than others. Prosthetic wear debris induces an extensive biological cascade of adverse cellular responses, where macrophages are the main cellular type involved in this hostile inflammatory process. Macrophages cause osteolysis indirectly by releasing numerous chemotactic inflammatory mediators, and directly by resorbing bone with their membrane microstructures. The bio-reactivity of wear particles depends on two major elements: particle characteristics (size, concentration and composition) and host characteristics. While any particle type may enhance hostile cellular reaction, cytological examination demonstrated that more than 70% of the debris burden is constituted of polyethylene particles. Comprehensive understanding of the intricate process of osteolysis is of utmost importance for future development of therapeutic modalities that may delay or prevent the disease progression.

Ceramic on ceramic hip prostheses: a review of past and modern materials

Ceramic on ceramic hip prostheses are an increasingly popular choice for hip replacement. Modern manufacturing techniques and developments have increased the strength and reliability of ceramic materials. The alternative bearing couples such as metal-on-polyethylene and metal-on-metal are more inclined to wear and produce particulate debris. Despite reports of fractures and stripe wear, harder, more inert and more wear resistant, modern ceramic-ceramic hip replacements provide a strong alternative to traditional bearings.

In vitro and in vivo evaluation of the biocompatibility of a calcium phosphate/poly(lactic-co-glycolic acid) composite

This study assess the effects of bioceramic and poly(lactic-co-glycolic acid) composite (BCP/PLGA) on the viability of cultured macrophages and human dental pulp fibroblasts, and we sought to elucidate the temporal profile of the reaction of pulp capping with a composite of bioceramic of calcium phosphate and biodegradable polymer in the progression of delayed dentine bridge after (30 and 60 days) in vivo. Histological evaluation of inflammatory infiltrate and dentin bridge formation were performed after 30 and 60 days. There was similar progressive fibroblast growth in all groups and the macrophages showed viability. The in vivo study showed that of the three experimental groups: BCP/PLGA composite, BCP and calcium hydroxide (Ca(OH)(2)) dentin bridging was the most prevalent (90 %) in the BCP/PLGA composite after 30 days, mild to moderate inflammatory response was present throughout the pulp after 30 days. After 60 days was observed dentine bridging in 60 % and necrosis in 40 %, in both groups. The results indicate that understanding BCP/PLGA composite is biocompatible and by the best tissue response as compared to calcium hydroxide in direct pulp capping may be important in the mechanism of delayed dentine bridge after 30 and 60 days.

Zirconia: Established facts and perspectives for a biomaterial in dental implantology

Currently, zirconia is widely used in biomedical area as a material for prosthetic devices because of its good mechanical and chemical properties. Largely employed in clinical area for total hip replacement, zirconia ceramics (ZrO(2)) are becoming a prevalent biomaterial in dentistry and dental implantology. Although titanium is used in dental implantology currently, there is a trend to develop new ceramic-based implants as an alternative to monolithic titanium. This article reviews the evolution and development of zirconia through data published between 1963 and January 2008 in English language. Articles were identified via a MEDLINE search using the following keywords: zirconia, zirconia/biocompatibility, zirconia/osseointegration, zirconia/periointegration, zirconia/review, and zirconia/bacterial adhesion or colonization. This review of the literature aims at highlighting and discussing zirconia properties in biological systems for their future use in dental implantology. In conclusion, zirconia with its interesting microstructural properties has been confirmed to be a material of choice for the "new generation" of implants, thanks to its biocompatibility, osseoconductivity, tendency to reduce plaque accumulation, and interaction with soft tissues, which leads to periointegration. However, scientific studies are promptly needed to fulfill gaps like long-term clinical evaluations of "all zirconia implants," currently leading to propose an alternative use of "hybrid systems" (i.e., titanium screw with zirconia collar) and also bacterial colonization of zirconia. Moreover, there is a permanent need for consistent information about topography and chemistry of zirconia allowing easier cross-product comparisons of clinical devices.

Zirconium oxide regulates RNA interfering of osteoblast-like cells

Zirconium oxide (ZO) has outstanding mechanical properties, high biocompatibility and high resistance to scratching. Since dental implants are made with ZO and the genetic effects of ZO on osteoblasts are incompletely understood, we used microRNA microarray techniques to investigate the translation process in osteoblasts exposed to ZO. By using miRNA microarrays containing 329 probes designed from Human miRNA sequences, we identified in osteoblast-like cells line (MG-63) cultured on ZO disks several miRNA whose expression was significantly modified. The most notable regulated genes acting on osteoblasts are: NOG, SHOX, IGF1, BMP1 and FGFR1. The data reported below represent the first study on translation regulation in osteoblasts exposed to zirconium and one in which the effect of ZO on bone formation has been detected.

Study of laser created ZRO2 and hydroxyapatite/ZrO2 films for implantology

Thin films of ZrO2 and hydroxyapatite/ZrO2 were created by excimer laser ablation on Ti6Al4V substrates. ZrO2 layers were fabricated in vacuum by KrF laser at various substrate temperatures and hydroxyapatite (HA) layers were fabricated in water vapor ambient by ArF laser and in water vapor/argon ambient by KrF excimer laser. Film properties were evaluated by XRD, SEM and WDX methods. The test of mechanical adhesion was proceeded on ZrO2 films. XRD analysis proved the presence of amorphous or crystalline HA in the deposited films. SEM method demonstrated smooth surface covered by droplets for both HA and ZrO2 films. Ca/P ratio of the HA films is higher than that of the natural HA and is within the range of 2.8-3.0. The HA/ZrO2 and ZrO2 samples were tested in vitro for cytotoxicity. The best results were received by the HA/ZrO2 samples in the test of cytotoxicity. Fibroblasts cultivating with HA/ZrO2 samples exhibited subconfluent and confluent growth and showed fibronectin homogenously.

Preparation of Graded Zirconia—Hydroxyapatite Composite Bioceramic and Its Immunocompatibility in vitro

To obtain immunocompatibility, graded zirconia—hydroxyapatite (ZrO 2-HA) composite bioceramic and simplex ZrO2-HA composite bioceramic are prepared. Peripheral blood mononuclear cells (PBMCs) harvested from healthy individuals are cultured with the two ceramic extracts to assess their effect on the transformation of lymphocytes, apoptotic ratio, CD69 expression, and expression of cytokine of TNFα and IL-6, with or without phytohemoagglutinin (PHA)-stimulated cells. Ceramic extracts did not activate the resting lymphocytes, whereas the response of the PHA-stimulated cells was significantly modified. The PBMCs activated by graded ZrO2-HA composite bioceramic is noticeably smaller than that by simplex ZrO2-HA composite bioceramic; these results, however can only be seen under the amplified effect of PHA-stimulation.

The effect of hydroxyapatite nanocrystals on microvascular endothelial cell viability and functions

To favor bone reconstitution with biomaterials endothelial cells should maintain proper functions to drive angiogenesis. To this aim nanocrystals of hydroxyapatite (HA) have been synthesized and characterized on endothelial cells. Microvascular endothelial cells have been exposed to stoichiometric HA nanocrystals. Cell morphology and organization of cytoskeletal proteins have been monitored by SEM analysis and immunofluorescence. Biochemical markers of physiological and pathological responses of endothelial cells, endothelial constitutive nitric oxide synthase, and cycloxygenase-2 (ecNOS and COX-2, respectively) have been measured by immunofluorescence. Crystallized HA sustained endothelial survival without any cytotoxic effect. At the observation with SEM, endothelial cell morphology was maintained in the presence of HA. The localization and organization of beta-actin documented the formation of stress fibers, indicating an activation of endothelial cells induced by HA nanocrystals. Immunohistochemistry for biochemical key signaling pathways in endothelium demonstrated that nanocrystals of HA maintained the expression of ecNOS and did not increase COX-2 expression. In conclusion, the present findings indicate that HA nanocrystals exhibit high biocompatibility for microvascular endothelium. In the presence of HA nanocrystals endothelial cells maintain biochemical markers of healthy endothelium. They do not acquire a proinflammatory or thrombogenic phenotype, but express markers of functioning endothelium that might contribute to angiogenesis.

Ability of zirconia double coated with titanium and hydroxyapatite to bond to bone under load-bearing conditions

As a preclinical study, we evaluated the ability of hydroxyapatite and titanium on zirconia (HTOZ) to bond to bone under load-bearing conditions in animal experiments. HTOZ, HA, and Ti on Co-Cr alloy (HTOC) and Ti on Co-Cr alloy (TOC) were implanted into the weight-bearing portion of the femoral condyles of nine beagle dogs. Femurs were extracted 4, 12, and 52 weeks after implantation and examined mechanically by pullout testing, and histologically by toluidine blue staining, SEM, and calculation of the affinity index. The interfacial shear strengths (mean+/-SD) of the HTOZ, HTOC, and TOC groups were 4.42+/-0.453, 3.90+/-0.903, and 4.08+/-0.790 MPa at 4 weeks; 6.82+/-2.64, 6.00+/-1.88, and 6.63+/-1.63 MPa at 12 weeks; and 13.98+/-1.94, 11.95+/-1.51, and 10.78+/-0.83 MPa at 52 weeks. There were no significant differences in the interfacial shear strengths between the three groups at any time. Affinity indices (mean+/-SD) obtained from SEM images of the HTOZ, HTOC, and TOC groups were 49.6+/-6.52%, 43.3+/-10.43%, and 23.7+/-3.95% at 4 weeks; 55.0+/-6.72%, 51.5+/-3.07%, and 28.6+/-4.09% at 12 weeks; and 59.1+/-6.73%, 63.0+/-6.40%, and 34.3+/-6.72% at 52 weeks. HA-coated implants (HTOZ, HTOC) had significantly higher affinity indices than non-HA-coated implants (TOC) at all times. HTOZ has the ability to bond to bone equivalent to HTOC and TOC. HTOZ is an excellent material for components of cementless joint prostheses.

Biologic and tribologic considerations of alternative bearing surfaces

Patients who are young or active or both who require total joint replacement pose a unique challenge; their high activity demands wear-resistant bearings that will perform for decades, without suffering from the adverse effects of accumulated wear products. We discuss the tribologic and biologic properties of newly introduced bearing materials for hip prostheses. The new PEs are intended to address the aseptic loosening problem by reducing the volume of submicron PE particles to a level well below that historically associated with osteolysis. However, choosing among the several variations of the cross-linked thermally-stabilized PEs is confounded by conflicting opinions regarding the optimum balance between long-term wear resistance and mechanical strength, and regarding potential effects of differences in morphologic features of the submicron-sized wear particles on their relative osteolytic potential. Metal-on-metal bearings have clinically proven wear resistance and the advantage of self-polishing, but the long-term biologic effects of metallic ions remain unknown. Ceramic-on-ceramic bearings have the advantage of high biocompatibility and usually very low wear, but fracture remains a rare but catastrophic complication. The choice of an appropriate bearing couple should be made after a thorough consideration of the relative risks and potential benefits of each of these materials.

In vitro cytotoxicity of traditional versus contemporary dental ceramics

STATEMENT OF PROBLEM

The biocompatibility of new dental ceramics has not been assessed with the same scrutiny as has been applied to alloys and composites. Yet, the biocompatibility of ceramics is critical to the long-term success of dental prostheses because ceramics are in close contact with oral tissues for extended periods.

MATERIAL AND METHODS

Five dental ceramics (2 traditional feldspathic veneer porcelains [Vita Omega and Duceragold], 2 lithium disilicate pressable materials [Stylepress and Empress-2], and a pressable leucite-based material [Empress-1]) were tested for their ability to alter cellular mitochondrial dehydrogenase activity after fabrication using a tetrazolium assay, after aging for 2 weeks in a biologic solution and after post-aging polishing with either a fine diamond or diamond polishing paste. Cellular responses were compared with polytetrafluoroethylene controls (analysis of variance, Tukey pairwise post-hoc comparison, alpha=.05).

RESULTS

The feldspathic porcelains caused only mild (<25% of controls) mitochondrial suppression regardless of aging or polishing. The pressable leucite-based material initially caused a 5% stimulation (not significant) of mitochondrial activity, which decreased significantly (P<.05) by 30% with aging to levels comparable to the feldspathic porcelains, and did not change with polishing. Both lithium disilicate materials caused an initial suppression of mitochondrial activity that decreased significantly with aging, but Empress-2 was severely cytotoxic initially (<20% of controls, P<.01), and became more cytotoxic again after polishing. Stylepress was less cytotoxic initially (85% of controls, not significant) and did not become cytotoxic again after polishing.

CONCLUSIONS

Dental ceramics are not equivalent in their in vitro biologic effects, even within the same class of material, and biologic safety should not be assumed. Most ceramics caused only mild in vitro suppression of cell function to levels that would be acceptable on the basis of standards used to evaluate alloys and composites. However, 1 Li-disilicate material (Empress-2) exhibited cytotoxicity that would not be deemed biologically acceptable on the basis of prevailing empirical standards for dental alloys and composites.

Biological reaction to alumina, zirconia, titanium and polyethylene particles implanted onto murine calvaria

Periprosthetic osteolysis is a serious problem that limits long-term survival of total hip arthroplasty. Ceramics have been introduced as a joint surface material to reduce osteolysis due to wear particles. The aim of this study is to investigate the biological reaction of ceramic particles on murine calvarial bone, in comparison with polyethylene and titanium particles. Sixty CL/BL6 mice were divided into five groups according to the materials implanted onto the murine calvariae: control, Al(2)O(3), ZrO(2), high-density polyethylene (HDP) and Ti6Al4V. One week after the implantation, each calvarial tissue was dissected and the release of proinflammatory mediators (IL-1beta, IL-6, TNF-alpha) and bone resorption were assessed. The particles of HDP and Ti6Al4V induced three and two times larger osteolytic lesions than the control, respectively. The levels of IL-1beta and IL-6 were significantly elevated in the medium subcultured with the calvariae of HDP and Ti6Al4V groups. Any particle type did not increase the levels of TNF-alpha. There were no significant differences observed in the levels of proinflammatory mediators or osteolytic area among Al(2)O(3), ZrO(2) and control groups. The inflammatory response and bone resorption induced by ceramic particles were much smaller than those induced by HDP and Ti6Al4V. These biological features suggest the biocompatibility of ceramics as a joint surface material for artificial joints.

Ion leaching from dental ceramics during static in vitro corrosion testing

Dental ceramics are often called inert materials. It can be hypothesized, however, that differences in the composition, microstructure, and environmental conditions will affect the degree of corrosion degradation in an aqueous environment. The aims of the study were, therefore, to study the ion dissolution from glass-phase ceramics, with or without crystalline inclusions, and from all-crystalline ceramics and to compare the effects of different corrosion media. Ceramic specimens were produced from glass-phase and oxide ceramics and given an equivalent surface smoothness, after which they were subjected to in vitro corrosion (Milli-Q water at 37 +/- 2 degrees C for 18 h and 4% acetic acid solution at 80 +/- 2 degrees C for 18 h, respectively). The temperature of the corrosion solution was slowly increased until it reached 80 +/- 2 degrees C to reduce the risk of microcrack formation at the surface. The analyses of ion leakage were performed with inductively coupled plasma optical emission spectroscopy. A large number of inorganic elements leached out from the various dental ceramics. The major leaching elements were sodium and potassium; in the acid-corrosion experiments, there were also magnesium, silicon, and aluminum and, on a lower scale, yttrium, calcium, and chromium. The various glass-phase ceramics displayed significant differences in ion leakage and significantly higher leakage values than all-crystalline alumina and zirconia ceramics. No significant difference in dissolution was found between high and low-sintering glass-phase ceramics or between glass-phase ceramics with high volume fractions of crystallites in the glass phase in comparison with those with lower crystalline content. It can be concluded, therefore, that none of the dental ceramics studied are chemically inert in an aqueous environment.

Use of a modified zirconia support in the separation of immunoproteins

Zirconia beads (25-38 microm in diameter) were modified with N,N,N',N'-ethylenediaminetetramethylenephosphonic acid to generate a zirconia based pseudoaffinity support, further referred to as r_PEZ. The influence of pH, salt concentration and temperature on the binding of human immunoglobulin G (hIgG) to r_PEZ was studied. Temperature had no significant impact on the maximum binding capacity (Qmax), and the equilibrium-binding constant (Kd), whereas pH and the salt concentration had a noticeable impact on both Qmax and Kd. The Qmax value of 55 mg hIgG/ml of bead was obtained at a pH of 5.5 and found to decrease with an increase of pH. The modified zirconia support allowed the separation of immunoglobulins (IgG, IgA and IgM) from untreated human serum. Elution was possible under mild conditions with a step salt gradient. Overall protein recoveries in the range of 109-125% were obtained with human serum. Human IgG, human IgA, and human IgM yields of 29.50+/-6.3, 3.22+/-0.7, and 6.84+/-0.7%, respectively, were obtained at a linear velocity of 4.32 cm/min. Purity of products, obtained from a single chromatographic step was estimated to be greater than 89.0+/-2.6%. The utility of r_PEZ in the selective removal of immunoglobulins, as in immunoadsorption was discussed.

In vitro evaluation of a new injectable calcium phosphate material

The purpose of this study was to develop an injectable bone substitute (IBS) for percutaneous orthopedic surgery. The multiphasic material used was composed of a 2% aqueous solution of methylhydroxypropylcellulose (MHPC) and biphasic calcium phosphate (BCP, 60% hydroxyapatite and 40% beta-tricalcium phosphate) in which MHPC served as the carrier for 80-200 microm of BCP granules. The best BCP/polymer ratio was determined by the rheological properties and higher BCP content of the material. Steam sterilization was more effective than gamma irradiation in maintaining the stability of the mixture and conserving its physiochemical and mechanical properties. The in vitro biocompatibility of the composite was checked by direct-contact cytotoxicity and cell-proliferation assays. A preliminary in vivo test was performed in the rabbit using intraosseous implantations in the femoral epiphysis. Histological analysis was done after 1, 2, 4, and 10 weeks. Bone ingrowth into the IBS, in close association with BCP granules, was observed after 1 week and increased regularly from the surface inward at 2, 4, and 10 weeks. At the same time, smaller BCP granules (less than 80 microns in diameter) were degraded and resorbed. This injectable biomaterial proved suitable for cavity filling. The water solubility and viscosity of the polymer allow cells to recolonize, with in situ bonding of the mineral phase.

Characterization of in vivo wear debris from ceramic-ceramic total hip arthroplasties

In contrast to the much-studied mechanism of aseptic loosening of the metal-polyethylene joint couple, the mechanism responsible for failure of ceramic-ceramic (CC) total hip arthroplasties (THAs) has not been evaluated. The aim of this study was to conduct a systematic characterization of the in vivo wear debris from 15 cases of CC THAs revised for aseptic loosening. Two methods were used to evaluate the wear debris; a semiquantitative histological analysis of H&E-stained periprosthetic pseudomembranes; and an evaluation of isolated debris particles using SEM, energy-dispersive X-ray analysis, and image analysis. The three main types of particulate debris identified were titanium alloy (TiAlV) and alumina ceramic (Al2O3) of prosthetic origin, and zirconium dioxide (ZrO2) from the contrast agent used in the cement for prosthetic fixation. Alumina debris was present in the smallest proportion (12%) and was consistent with the low wear rate of the CC joint couple. Zirconium dioxide debris was present in the greatest proportion (76%) and was an unexpected finding. The ZrO2 debris represented microstructural grains of the original ZrO2 particles added as contrast agent to the cement. The presence of a histiocytic foreign body reaction to ZrO2 debris on histologic sections leads us to believe that these particles play an important role in aseptic loosening of the CC THAs evaluated in this study.

Size and shape of biomaterial wear debris

A literature review of wear debris is presented. Included are debris retrieved at revision of total joint replacement and at autopsy, as well as debris produced in vitro in wear testers and joint simulators or otherwise fabricated for biological experiments. Observations of wear debris in vivo and in vitro are classified in tabular form according to material type, origin, size, shape and color. Polymer particles, most commonly ultra-high molecular weight polyethylene (UHMWPE), exhibit the largest size range and appear as granules, splinters or flakes, while ceramic particles possess the smallest size range and have a granular structure. Metal particles seen in vivo and in vitro, whether from cobalt-chromium alloys or, less frequently, other alloys, form granular or needle-like shapes and generally are smaller than polymer particles but larger than ceramic particles. Particles generated in joint simulators resemble the size and shape of in vivo wear particles from total joint replacement (TJR) retrieved at revision or autopsy. However, particles prepared in vitro, whether in simulators or by other means, do not consistently resemble wear debris particles from TJR.