Surface nanocrystallization of hydroxyapatite coating

In Vivo Assessment of Synthetic and Biological-Derived Calcium Phosphate-Based Coatings Fabricated by Pulsed Laser Deposition: A Review

The aim of this review is to present the state-of-the art achievements reported in the last two decades in the field of pulsed laser deposition (PLD) of biocompatible calcium phosphate (CaP)-based coatings for medical implants, with an emphasis on their in vivo biological performances. There are studies in the dedicated literature on the in vivo testing of CaP-based coatings (especially hydroxyapatite, HA) synthesized by many physical vapor deposition methods, but only a few of them addressed the PLD technique. Therefore, a brief description of the PLD technique, along with some information on the currently used substrates for the synthesis of CaP-based structures, and a short presentation of the advantages of using various animal and human implant models will be provided. For an in-depth in vivo assessment of both synthetic and biological-derived CaP-based PLD coatings, a special attention will be dedicated to the results obtained by standardized and micro-radiographies, (micro) computed tomography and histomorphometry, tomodensitometry, histology, scanning and transmission electron microscopies, and mechanical testing. One main specific result of the in vivo analyzed studies is related to the demonstrated superior osseointegration characteristics of the metallic (generally Ti) implants functionalized with CaP-based coatings when compared to simple (control) Ti ones, which are considered as the “gold standard” for implantological applications. Thus, all such important in vivo outcomes were gathered, compiled and thoroughly discussed both to clearly understand the current status of this research domain, and to be able to advance perspectives of these synthetic and biological-derived CaP coatings for future clinical applications.

In Vivo Assessment of Bone Enhancement in the Case of 3D-Printed Implants Functionalized with Lithium-Doped Biological-Derived Hydroxyapatite Coatings: A Preliminary Study on Rabbits

We report on biological-derived hydroxyapatite (HA, of animal bone origin) doped with lithium carbonate (Li-C) and phosphate (Li-P) coatings synthesized by pulsed laser deposition (PLD) onto Ti6Al4V implants, fabricated by the additive manufacturing (AM) technique. After being previously validated by in vitro cytotoxicity tests, the Li-C and Li-P coatings synthesized onto 3D Ti implants were preliminarily investigated in vivo, by insertion into rabbits’ femoral condyles. The in vivo experimental model for testing the extraction force of 3D metallic implants was used for this study. After four and nine weeks of implantation, all structures were mechanically removed from bones, by tensile pull-out tests, and coatings’ surfaces were investigated by scanning electron microscopy. The inferred values of the extraction force corresponding to functionalized 3D implants were compared with controls. The obtained results demonstrated significant and highly significant improvement of functionalized implants’ attachment to bone (p-values ≤0.05 and ≤0.00001), with respect to controls. The correct placement and a good integration of all 3D-printed Ti implants into the surrounding bone was demonstrated by performing computed tomography scans. This is the first report in the dedicated literature on the in vivo assessment of Li-C and Li-P coatings synthesized by PLD onto Ti implants fabricated by the AM technique. Their improved mechanical characteristics, along with a low fabrication cost from natural, sustainable resources, should recommend lithium-doped biological-derived materials as viable substitutes of synthetic HA for the fabrication of a new generation of metallic implant coatings.

Heat and hydrothermal treatments on the microstructure evolution and mechanical properties of plasma sprayed hydroxyapatite coatings reinforced with graphene nanoplatelets

Recent demands in clinical applications drive a large amount of research to plasma sprayed hydroxyapatite (HA) composite coatings. Herein, graphene nanosheet (GNS) reinforced HA coating was fabricated using plasma spray, the effect of heat and hydrothermal treatments (hereafter referred to as thermal treatment) on microstructural evolution and mechanical properties of the composite coating were investigated. Thermally treated GNS/HA coating not only exhibited ~47.1% improvement in HA crystallinity and more denser microstructure, but also displayed increased surface roughness (3 times of that of the as-sprayed sample) due to the fact that GNSs facilitated HA nanoparticle precipitation on the coating surface. Fracture toughness of the as-sprayed HA coating increased by up to ~44.1% at 2.0 wt% GNSs owing to GNS pullout, GNS bridging and arresting of crack propagation by the embedded GNSs. As for thermally treated HA coatings, crack propagation arrested by the sintered regions was found to act as an important toughening mechanism, but thermal treatment introduced more structural defects into the GNSs and led to the reductions in their length and thickness, resulting in negligible enhancement in toughness of the GNS/HA coating.

Current Status on Pulsed Laser Deposition of Coatings from Animal-Origin Calcium Phosphate Sources

The aim of this paper is to present the current status on animal-origin hydroxyapatite (HA) coatings synthesized by Pulsed Laser Deposition (PLD) technique for medical implant applications. PLD as a thin film synthesis method, although limited in terms of surface covered area, still gathers interest among researchers due to its advantages such as stoichiometric transfer, thickness control, film adherence, and relatively simple experimental set-up. While animal-origin HA synthesized by bacteria or extracted from animal bones, eggshells, and clams was tested in the form of thin films or scaffolds as a bioactive agent before, the reported results on PLD coatings from HA materials extracted from natural sources were not gathered and compared until the present study. Since natural apatite contains trace elements and new functional groups, such as CO32− and HPO42− in its complex molecules, physical-chemical results on the transfer of animal-origin HA by PLD are extremely interesting due to the stoichiometric transfer possibilities of this technique. The points of interest of this paper are the origin of HA from various sustainable resources, the extraction methods employed, the supplemental functional groups, and ions present in animal-origin HA targets and coatings as compared to synthetic HA, the coatings’ morphology function of the type of HA, and the structure and crystalline status after deposition (where properties were superior to synthetic HA), and the influence of various dopants on these properties. The most interesting studies published in the last decade in scientific literature were compared and morphological, elemental, structural, and mechanical data were compiled and interpreted. The biological response of different types of animal-origin apatites on a variety of cell types was qualitatively assessed by comparing MTS assay data of various studies, where the testing conditions were possible. Antibacterial and antifungal activity of some doped animal-origin HA coatings was also discussed.

Size effect of nano-hydroxyapatite on proliferation of odontoblast-like MDPC-23 cells

Nano-hydroxyapatite (nano-HAP) is supposed to be a promising candidate for apatite substitute in hard tissue engineering. We aimed to investigate the effect of nano-HAP particles on the proliferation of odontoblast-like MDPC-23 cells compared with conventional hydroxyapatite (c-HAP). HAP in diameter of ~20 nm (np20), ~70 nm (np70) and ~200 nm (c-HAP) were synthesized and characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM) and field emission scanning electron microscopy (FESEM). Inverted microscope and MTT assay were used to detect the morphology and proliferation rate of MDPC-23 cells; TEM was used to reveal the internalization of HAP. We found that nano-HAP (np20 and np70), especially np20 expressed obvious growth-promoting effect on MDPC-23 cells compared with c-HAP, which caused the most vacuole in MDPC-23 cells. These results suggest that nano-HAP may be an optimal choice of apatite substitute for MDPC-23 cells on the aspect of cell proliferation.

Characterization and corrosion property of nano-rod-like HA on fluoride coating supported on Mg-Zn-Ca alloy

The poor corrosion resistance of biodegradable magnesium alloys is the dominant factor that limits their clinical application. In this study, to deal with this challenge, fluoride coating was prepared on Mg–Zn–Ca alloy as the inner coating and then hydroxyapatite (HA) coating as the outer coating was deposited on fluoride coating by pulse reverse current electrodeposition (PRC-HA/MgF₂). As a comparative study, the microstructure and corrosion properties of the composite coating with the outer coating fabricated by traditional constant current electrodeposition (TED-HA/MgF₂) were also investigated. Scanning electron microscopy (SEM) images of the coatings show that the morphology of PRC-HA/MgF₂ coating is dense and uniform, and presents nano-rod-like structure. Compared with that of TED-HA/MgF₂, the corrosion current density of Mg alloy coated with PRC-HA/MgF₂ coatings decreases from 5.72 × 10⁻⁵ A/cm² to 4.32 × 10⁻⁷ A/cm², and the corrosion resistance increases by almost two orders of magnitude. In immersion tests, samples coated with PRC-HA/MgF₂ coating always show the lowest hydrogen evolution amount, and could induce deposition of the hexagonal structure-apatite on the surface rapidly. The results show that the corrosion resistance and the bioactivity of the coatings have been improved by adopting double-pulse current mode in the process of preparing HA on fluoride coating, and the PRC-HA/MgF₂ coating is worth of further investigation.

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PRC-HA/MgF₂ coating on Mg–Zn–Ca alloy presented nano-rod-like structure.

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Schematic drawing of growth model of HA coating on Mg-Zn-Ca alloy coated with fluoride coating was shown in the paper.

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The PRC-HA/MgF₂ composite coating provided higher corrosion resistance and better bioactive properties compared to TED-HA/MgF₂.

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This study first discovered the decomposition of fluoride coating in electrodeposition process and discussed the effect of fluoride coating on nucleation and growth of outer coating (HA).

Effects of the surface characteristics of nano-crystalline and micro-particle calcium phosphate/chitosan composite films on the behavior of human mesenchymal stem cells in vitro

Calcium phosphate (CaP) compounds, the main inorganic constituent of mammalian bone tissues, are believed to support bone precursor cell growth and osteogenic differentiation. Chitosan, a deacetylated derivative of chitin, is a versatile biopolymer to offer broad possibilities for cell-based tissue engineering. In the present study, different scales of CaP crystals on chitosan membranes were prepared for culture of human mesenchymal stem cells (hMSCs) in vitro. A series of aqueous CaP suspensions with different concentrations were mixed with chitosan solution and chitosan/calcium phosphate (C/CaP) films were fabricated by the solvent-casting method. With different weight ratios of CaP in chitosan solution, the various surface characteristics of nano-amorphous (C/CaP 0.1), nano-crystalline (C/CaP 0.5) and micro-particle (C/CaP 2) CaP compounds were examined by scanning electron microscopy and electron dispersion spectroscopy. X-ray diffraction on micro-particles of CaP indicated the formation of crystalline hydroxyapatite. The behavior of hMSCs, including proliferation, cell spreading and osteogenic differentiation, was studied on the C/CaP films. In basal culture medium, the incorporation of CaP into chitosan films could promote the proliferation of hMSCs. The C/CaP 0.5 film with connected CaP nano-crystals had better cellular viability. The fluorescence microscope images at 14 days of culture revealed extensive networks of F-actin filaments of hMSCs on chitosan, C/CaP 0.1 and C/CaP 0.5 films. The cellular morphology on C/CaP 2 film with discrete CaP micro-particles was partly restrained. In osteogenic medium, the alkaline phosphatase (ALP) activity of hMSCs increased and showed the process of osteogenic differentiation. The ALP levels on C/CaP 2 film were higher than those on C/CaP 0.1 and C/CaP 0.5 films. These results demonstrated that the crystallinity and topography of CaP on chitosan membranes could modulate the behaviors of cultured hMSCs in vitro.

Calcium orthophosphate deposits: Preparation, properties and biomedical applications

Since various interactions among cells, surrounding tissues and implanted biomaterials always occur at their interfaces, the surface properties of potential implants appear to be of paramount importance for the clinical success. In view of the fact that a limited amount of materials appear to be tolerated by living organisms, a special discipline called surface engineering was developed to initiate the desirable changes to the exterior properties of various materials but still maintaining their useful bulk performances. In 1975, this approach resulted in the introduction of a special class of artificial bone grafts, composed of various mechanically stable (consequently, suitable for load bearing applications) implantable biomaterials and/or bio-devices covered by calcium orthophosphates (CaPO4) to both improve biocompatibility and provide an adequate bonding to the adjacent bones. Over 5000 publications on this topic were published since then. Therefore, a thorough analysis of the available literature has been performed and about 50 (this number is doubled, if all possible modifications are counted) deposition techniques of CaPO4 have been revealed, systematized and described. These CaPO4 deposits (coatings, films and layers) used to improve the surface properties of various types of artificial implants are the topic of this review.

Testing the in vitro performance of hydroxyapatite coated magnesium (AZ91D) and titanium concerning cell adhesion and osteogenic differentiation

In the current study the in vitro outcome of a degradable magnesium alloy (AZ91D) and standard titanium modified by nanostructured-hydroxyapatite (n-HA) coatings concerning cell adhesion and osteogenic differentiation was investigated by direct cell culture. The n-HA modification was prepared via radio-frequency magnetron sputtering deposition and proven by field emission scanning electron microscopy and X-ray powder diffraction patterns revealing a homogenous surface coating. Human mesenchymal stem cell (hMSCs) adhesion was examined after one and 14 days displaying an enhanced initial cell adhesion on the n-HA modified samples. The osteogenic lineage commitment of the cells was determined by alkaline phosphatase (ALP) quantification. On day one n-HA coated AZ91D exhibited a comparable ALP expression to standard tissue culture polystyrene samples. However, after 14 days solely little DNA and ALP amounts were measurable on n-HA coated AZ91D due to the lack of adherent cells. Titanium displayed excellent cell adhesion properties and ALP was detectable after 14 days. An increased pH of the culture was measured for AZ91D as well as for n-HA coated AZ91D. We conclude that n-HA modification improves initial cell attachment on AZ91D within the first 24 h. However, the effect does not persist for 14 days in in vitro conditions.

Significance of calcium phosphate coatings for the enhancement of new bone osteogenesis--a review

A systematic analysis of results available from in vitro, in vivo and clinical trials on the effects of biocompatible calcium phosphate (CaP) coatings is presented. An overview of the most frequently used methods to prepare CaP-based coatings was conducted. Dense, homogeneous, highly adherent and biocompatible CaP or hybrid organic/inorganic CaP coatings with tailored properties can be deposited. It has been demonstrated that CaP coatings have a significant effect on the bone regeneration process. In vitro experiments using different cells (e.g. SaOS-2, human mesenchymal stem cells and osteoblast-like cells) have revealed that CaP coatings enhance cellular adhesion, proliferation and differentiation to promote bone regeneration. However, in vivo, the exact mechanism of osteogenesis in response to CaP coatings is unclear; indeed, there are conflicting reports of the effectiveness of CaP coatings, with results ranging from highly effective to no significant or even negative effects. This review therefore highlights progress in CaP coatings for orthopaedic implants and discusses the future research and use of these devices. Currently, an exciting area of research is in bioactive hybrid composite CaP-based coatings containing both inorganic (CaP coating) and organic (collagen, bone morphogenetic proteins, arginylglycylaspartic acid etc.) components with the aim of promoting tissue ingrowth and vascularization. Further investigations are necessary to reveal the relative influences of implant design, surgical procedure, and coating characteristics (thickness, structure, topography, porosity, wettability etc.) on the long-term clinical effects of hybrid CaP coatings. In addition to commercially available plasma spraying, other effective routes for the fabrication of hybrid CaP coatings for clinical use still need to be determined and current progress is discussed.

Biocompatibility of nano-hydroxyapatite/Mg-Zn-Ca alloy composite scaffolds to human umbilical cord mesenchymal stem cells from Wharton's jelly in vitro

Seeding cells and scaffolds play pivotal roles in bone tissue engineering and regenerative medicine. Wharton's jelly-derived mesenchymal stem cells (WJCs) from human umbilical cord represent attractive and promising seeding cells in tissue regeneration and engineering for treatment applications. This study was carried out to explore the biocompatibility of scaffolds to seeding cells in vitro. Rod-like nano-hydroxyapatite (RN-HA) and flake-like micro-hydroxyapatite (FM-HA) coatings were prepared on Mg-Zn-Ca alloy substrates using micro-arc oxidation and electrochemical deposition. WJCs were utilized to investigate the cellular biocompatibility of Mg-Zn-Ca alloys after different surface modifications by observing the cell adhesion, morphology, proliferation, and osteoblastic differentiation. The in vitro results indicated that the RN-HA coating group was more suitable for cell proliferation and cell osteoblastic differentiation than the FM-HA group, demonstrating better biocompatibility. Our results suggested that the RN-HA coating on Mg-Zn-Ca alloy substrates might be of great potential in bone tissue engineering.

Osteoclast resorption of thermal spray hydoxyapatite coatings is influenced by surface topography

Coating characteristics such as composition, crystallite features and topography collectively impact the cell response. The influence from splats has not yet been assessed for hydroxyapatite (HAp) thermal spray coatings. The objective of this work is to (a) survey the topography on commercial implants, (b) ascertain topography formation from single splats, and (c) determine the osteoclast resorption pattern on a topographically refined coating compared to dentine. Coatings on dental implants, an orthopedic screw, a femoral stem and a knee implant were studied for reference. The effects of substrate pre-heat, roughness, spray distance and particle size on the coating roughness and topography were studied. Human-derived osteoclasts were placed on a coating with refined topography and compared to dentine, a polished coating and polished sintered HAp. A pre-heat of at least 200°C on titanium was required to form rounded splats. The greatest influence on coating roughness and topography arose from particle size. A 2-fold increase in the mean particle size from 30 to 72 μm produced a significant difference (P<0.001) in roughness from 4.8 and 9.7 μm. A model is shown to illustrate topography formation, nanostructure evolution on single splats, and the topography as seen in commercial implants. Osteoclasts showed a clear preference for activity on coatings with refined topography. A one-way ANOVA test revealed a significantly greater pit depth (P=0.022) for dentine (14 μm) compared to the as-sprayed and polished coating (5 μm). Coatings with topography display a similar number of resorption pits with dentine, but a 10-fold greater number than polished coatings, emphasizing the importance of flattened droplet topography on implant surfaces.