The influence of controlled surface nanotopography on the early biological events of osseointegration

Surface characteristics and in vitro biocompatibility of titanium preserved in a vitamin C-containing saline storage solution

The purpose of this study is to explore a storage solution for titanium implants and investigate its osteogenic properties. The commercial pure titanium (cp-Ti) surface and double-etched (SLA) titanium surface specimens were preserved in air, saline, 10 mM Vitamin C (VitC)-containing saline and 100 mM VitC-containing saline storage solutions for 2 weeks. The surface microtopography of titanium was observed by scanning electron microscopy (SEM), the surface elemental compositions of the specimens were analyzed by Raman and X-ray photoelectron spectroscopy (XPS), and water contact angle and surface roughness of the specimens were tested. The protein adsorption capacity of two titanium surfaces after storage in different media was examined by BCA kit. The MC3T3-E1 osteoblasts were cultured on two titanium surfaces after storage in different media, and the proliferation, adhesion and osteogenic differentiation activity of osteoblasts were detected by CCK-8, laser confocal microscope (CLSM) and Western blot. The SEM results indicated that the titanium surfaces of the air group were relatively clean while scattered sodium chloride or VitC crystals were seen on the titanium surfaces of the other three groups. There were no significant differences in the micromorphology of the titanium surfaces among the four groups. Raman spectroscopy detected VitC crystals on the titanium surfaces of two experimental groups. The XPS, water contact angle and surface roughness results suggested that cp-Ti and SLA-Ti stored in 0.9% NaCl and two VitC-containing saline storage solutions possessed less carbon contamination and higher surface hydrophilicity. Moreover, the protein adsorption potentials of cp-Ti and SLA-Ti surfaces were significantly improved under preservation in two VitC-containing saline storage solutions. The results of in vitro study showed that the preservation of two titanium surfaces in 100 mM VitC-containing saline storage solution upregulated the cell adhesion, proliferation, osteogenic related protein expressions of MC3T3-E1 osteoblasts. In conclusion, preservation of cp-Ti and SLA-Ti in 100 mM VitC-containing saline storage solution could effectively reduce carbon contamination and enhance surface hydrophilicity, which was conducive to osteogenic differentiation of osteoblasts.

Nanoscale Morphologies on the Surface of 3D-Printed Titanium Implants for Improved Osseointegration: A Systematic Review of the Literature

Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone defects. However, the bio-inert nature of Ti material limits its capability for rapid osseointegration and thus influences the implant lifetime in vivo. Despite the macroscale porosity for promoting osseointegration, 3D-printed Ti implant surface morphologies at the nanoscale have gained considerable attention for their potential to improve specific outcomes. To evaluate the influence of nanoscale surface morphologies on osseointegration outcomes of 3D-printed Ti implants and discuss the available strategies, we systematically searched evidence according to the PRISMA on PubMed, Embase, Web of Science, and Cochrane (until June 2022). The inclusion criteria were in vivo (animal) studies reporting the osseointegration outcomes of nanoscale morphologies on the surface of 3D-printed Ti implants. The risk of bias (RoB) was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE's) tool. The quality of the studies was evaluated using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. (PROSPERO: CRD42022334222). Out of 119 retrieved articles, 9 studies met the inclusion criteria. The evidence suggests that irregular nano-texture, nanodots and nanotubes with a diameter of 40-105nm on the surface of porous/solid 3D-printed Ti implants result in better osseointegration and vertical bone ingrowth compared to the untreated/polished ones by significantly promoting cell adhesion, matrix mineralization, and osteogenic differentiation through increasing integrin expression. The RoB was low in 41.1% of items, unclear in 53.3%, and high in 5.6%. The quality of the studies achieved a mean score of 17.67. Our study demonstrates that nanostructures with specific controlled properties on the surface of 3D-printed Ti implants improve their osseointegration. However, given the small number of studies, the variability in experimental designs, and lack of reporting across studies, the results should be interpreted with caution.

Topography-mediated immunomodulation in osseointegration; Ally or Enemy

Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.

Non-invasive sampling procedure revealing the molecular events at different abutments of bone-anchored hearing systems–A prospective clinical pilot study

Purpose

To investigate the molecular activities in different compartments around the bone-anchored hearing system (BAHS) with either electropolished or machined abutments and to correlate these activities with clinical and microbiological findings.

Materials and methods

Twelve patients received machined or electropolished abutments after implant installation of BAHS. Peri-abutment fluid and tissue were collected from baseline to 12 months. Gene expression of cytokines and factors related to tissue healing and inflammation, regeneration and remodelling, as well as bacterial recognition were determined using quantitative-polymerase chain reaction (qPCR). The clinical status was evaluated using the Holgers scoring system, and bacterial colonisation was investigated by culturing.

Results

The gene expression of inflammatory cytokines (IL-8, IL-1β, and IL-10) and bacteria-related Toll-like receptors (2 and 4) was higher in the peri-abutment fluid than at baseline and in the peri-abutment tissue at 3 and 12 months. Conversely, the expression of genes related to tissue regeneration (Coll1a1 and FOXO1) was higher in the tissue samples than in the peri-abutment fluid at 3 and 12 months. Electropolished abutments triggered higher expression of inflammatory cytokines (IL-8 and IL-1β) (in peri-abutment fluid) and regeneration factor FOXO1 (in peri-abutment tissue) than machined abutments. Several cytokine genes in the peri-abutment fluid correlated positively with the detection of aerobes, anaerobes and Staphylococcus species, as well as with high Holger scores.

Conclusion

This study provides unprecedented molecular information on the biological processes of BAHS. Despite being apparently healed, the peri-abutment fluid harbours prolonged inflammatory activity in conjunction with the presence of different bacterial species. An electropolished abutment surface appears to be associated with stronger proinflammatory activity than that with a machined surface. The analysis of the peri-abutment fluid deserves further verification as a non-invasive sampling and diagnostic procedure of BAHS.

Extramedullary Osseointegration-A Novel Design of Percutaneous Osseointegration Prosthesis for Amputees

The percutaneous osseointegrated (OI) prostheses have greatly improved the overall quality of life for amputees. However, the long-term maintenance of the OI prostheses is still challenging. A major problem is bone resorption around the bone-implant-skin interface, which might cause implant loosening or osteomyelitis. Another problem is the breakage of connecting components between the intramedullary implant and external prosthesis due to excessive stress. We designed a novel osseointegration implant by changing the bone-implant contact from the inner cortex to the outer surface of cortical bone. In the current study, we compared the extramedullary cap-shaped implants with the intramedullary screw-type implants in rabbits. Osteointegration was confirmed at the interface of bone to implant contact (BIC) in both implant types. The external implant induced intramedullary bone regeneration in the medullary canal and increased the cortical bone density at the end of the stump. This study provides a new perspective on the design of osseointegration implants which might prevent the currently reported complications of the intramedullary OI systems.

Nanoscale hybrid implant surfaces and Osterix-mediated osseointegration

Endosseous implant surface topography directly affects adherent cell responses following implantation. The aim of this study was to examine the impact of nanoscale topographic modification of titanium implants on Osterix gene expression since this gene has been reported as key factor for bone formation. Titanium implants with smooth and nanoscale topographies were implanted in the femurs of Osterix-Cherry mice for 1-21 days. Implant integration was evaluated using scanning electron microscopy (SEM) to evaluate cell adhesion on implant surfaces, histology, and nanotomography (NanoCT) to observe and quantify the formed bone-to-implant interface, flow cytometry to quantify of Osterix expressing cells in adjacent tissues, and real-time PCR (qPCR) to quantify the osteoinductive and osteogenic gene expression of the implant-adherent cells. SEM revealed topography-dependent adhesion of cells at early timepoints. NanoCT demonstrated greater bone formation at nanoscale implants and interfacial osteogenesis was confirmed histologically at 7 and 14 days for both smooth and nanosurface implants. Flow cytometry revealed greater numbers of Osterix positive cells in femurs implanted with nanoscale versus smooth implants. Compared to smooth surface implants, nanoscale surface adherent cells expressed higher levels of Osterix (Osx), Alkaline phosphatase (Alp), Paired related homeobox (Prx1), Dentin matrix protein 1 (Dmp1), Bone sialoprotein (Bsp), and Osteocalcin (Ocn). In conclusion, nanoscale surface implants demonstrated greater bone formation associated with higher levels of Osterix expression over the 21-day healing period with direct evidence of surface-associated gene regulation involving a nanoscale-mediated osteoinductive pathway that utilizes Osterix to direct adherent cell osteoinduction.

The Bumpy Road to Stem Cell Therapies: Rational Design of Surface Topographies to Dictate Stem Cell Mechanotransduction and Fate

Cells sense and respond to a variety of physical cues from their surrounding microenvironment, and these are interpreted through mechanotransductive processes to inform their behavior. These mechanisms have particular relevance to stem cells, where control of stem cell proliferation, potency, and differentiation is key to their successful application in regenerative medicine. It is increasingly recognized that surface micro- and nanotopographies influence stem cell behavior and may represent a powerful tool with which to direct the morphology and fate of stem cells. Current progress toward this goal has been driven by combined advances in fabrication technologies and cell biology. Here, the capacity to generate precisely defined micro- and nanoscale topographies has facilitated the studies that provide knowledge of the mechanotransducive processes that govern the cellular response as well as knowledge of the specific features that can drive cells toward a defined differentiation outcome. However, the path forward is not fully defined, and the "bumpy road" that lays ahead must be crossed before the full potential of these approaches can be fully exploited. This review focuses on the challenges and opportunities in applying micro- and nanotopographies to dictate stem cell fate for regenerative medicine. Here, key techniques used to produce topographic features are reviewed, such as photolithography, block copolymer lithography, electron beam lithography, nanoimprint lithography, soft lithography, scanning probe lithography, colloidal lithography, electrospinning, and surface roughening, alongside their advantages and disadvantages. The biological impacts of surface topographies are then discussed, including the current understanding of the mechanotransductive mechanisms by which these cues are interpreted by the cells, as well as the specific effects of surface topographies on cell differentiation and fate. Finally, considerations in translating these technologies and their future prospects are evaluated.

Molecular Response to Nanopatterned Implants in the Human Jaw Bone

Implant surface modification by nanopatterning is an interesting route for enhancing osseointegration in humans. Herein, the molecular response to an intentional, controlled nanotopography pattern superimposed on screw-shaped titanium implants is investigated in human bone. When clinical implants are installed, additional two mini-implants, one with a machined surface (M) and one with a machined surface superimposed with a hemispherical nanopattern (MN), are installed in the posterior maxilla. In the second-stage surgery, after 6-8 weeks, the mini-implants are retrieved by unscrewing, and the implant-adherent cells are subjected to gene expression analysis using quantitative polymerase chain reaction (qPCR). Compared to those adherent to the machined (M) implants, the cells adherent to the nanopatterned (MN) implants demonstrate significant upregulation (1.8- to 2-fold) of bone-related genes (RUNX2, ALP, and OC). No significant differences are observed in the expression of the analyzed inflammatory and remodeling genes. Correlation analysis reveals that older patient age is associated with increased expression of proinflammatory cytokines (TNF-α and MCP-1) on the machined implants and decreased expression of pro-osteogenic factor (BMP-2) on the nanopatterned implants. Controlled nanotopography, in the form of hemispherical 60 nm protrusions, promotes gene expressions related to early osteogenic differentiation and osteoblastic activity in implant-adherent cells in the human jaw bone.

The effects of controlled nanotopography, machined topography and their combination on molecular activities, bone formation and biomechanical stability during osseointegration

The initial cellular and molecular activities at the bone interface of implants with controlled nanoscale topography and microscale roughness have previously been reported. However, the effects of such surface modifications on the development of osseointegration have not yet been determined. This study investigated the molecular events and the histological and biomechanical development of the bone interface in implants with nanoscale topography, microscale roughness or a combination of both. Polished and machined titanium implants with and without controlled nanopatterning (75 nm protrusions) were produced using colloidal lithography and coated with a thin titanium layer to unify the chemistry. The implants were inserted in rat tibiae and subjected to removal torque (RTQ) measurements, molecular analyses and histological analyses after 6, 21 and 28 days. The results showed that nanotopography superimposed on microrough, machined, surfaces promoted an early increase in RTQ and hence produced greater implant stability at 6 and 21 days. Two-way MANOVA revealed that the increased RTQ was influenced by microscale roughness and the combination of nanoscale and microscale topographies. Furthermore, increased bone-implant contact (BIC) was observed with the combined nanopatterned machined surface, although MANOVA results implied that the increased BIC was mainly dependent on microscale roughness. At the molecular level, the nanotopography, per se, and in synergy with microscale roughness, downregulated the expression of the proinflammatory cytokine tumor necrosis factor alpha (TNF-α). In conclusion, controlled nanotopography superimposed on microrough machined implants promoted implant stability during osseointegration. Nanoscale-driven mechanisms may involve attenuation of the inflammatory response at the titanium implant site. STATEMENT OF SIGNIFICANCE: The role of combined implant microscale and nanotopography features for osseointegration is incompletely understood. Using colloidal lithography technique, we created an ordered nanotopography pattern superimposed on screwshaped implants with microscale topography. The midterm and late molecular, bone-implant contact and removal torque responses were analysed in vivo. Nanotopography superimposed on microrough, machined, surfaces promoted the implant stability, influenced by microscale topography and the combination of nanoscale and microscale topographies. Increased bone-implant contact was mainly dependent on microscale roughness whereas the nanotopography, per se, and in synergy with microscale roughness, attenuated the proinflammatory tumor necrosis factor alpha (TNF-α) expression. It is concluded that microscale and nanopatterns provide individual as well as synergistic effects on molecular, morphological and biomechanical implant-tissue processes in vivo.

Nanoporous titanium implant surface promotes osteogenesis by suppressing osteoclastogenesis via integrin β1/FAKpY397/MAPK pathway

Macrophages and osteoclasts are both derived from monocyte/macrophage lineage, which plays as the osteoclastic part of bone metabolism. Although they are regulated by bone implant surface nanoarchitecture and involved in osseointegration, the beneath mechanism has not been simultaneously analyzed in a given surface model and their communication with osteoblasts is also blurring. Here, the effect of implant surface topography on monocyte/macrophage lineage osteoclastogenesis and the subsequent effect on osteogenesis are systematically investigated. The nanoporous surface is fabricated on titanium implant by etching and anodizing to get the nanotubes structure. The early bone formation around implant is significantly accelerated by the nanoporous surface in vivo. Meanwhile, the macrophage recruitment and osteoclast formation are increased and decreased respectively. Mechanistically, the integrin mediated FAK phosphorylation and its downstream MAPK pathway (p-p38) are significantly downregulated by the nanoporous surface, which account for the inhibition of osteoclastogenesis. In addition, the nanoporous surface can alleviate the inhibition of osteoclasts on osteogenesis by changing the secretion of clastokines, and accelerate bone regeneration by macrophage cytokine profiles. In conclusion, these data indicate that physical topography of implant surface is a critical factor modulating monocyte/macrophage lineage commitment, which provides theoretical guidance and mechanism basis for promoting osseointegration by coupling the osteogenesis and osteoclastogenesis.

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Nanoporous implant inhibits osteoclastogenesis via integrin β1/FAKpY397/MAPK.

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Nanoporous implant with larger diameter inhibits osteoclastogenesis more strongly.

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Nanoporous implant increases osteogenic cytokines of macrophages/osteoclasts.

Strontium-incorporated titanium implant surfaces treated by hydrothermal treatment enhance rapid osseointegration in diabetes: A preclinical vivo experimental study

OBJECTIVES

The aim of the current study was to explore effects of strontium-incorporated titanium implant surfaces by hydrothermal treatment on osseointegration in diabetic rats.

MATERIALS AND METHODS

The surface characteristics of SLA and SLA-Sr surfaces were detected by related instruments. Thirty-six male Sprague-Dawley rats were induced into diabetes, and thirty-six rats were normal. SLA and SLA-Sr implants were, respectively, inserted into bilateral tibial metaphysis of each rat. Percentage of bone-to-implant contact (BIC%) and percentage of bone area (BA%) were analyzed at 4 and 8 weeks after implantation. Immunohistochemistry of osteoprotegerin (OPG) and Wnt5a were conducted at 1 and 4 weeks. Gene expression levels of inflammatory cytokines and related signaling molecules in peri-implant bone tissue were detected at 3 and 7 days.

RESULTS

Strontium was uniformly distributed on SLA-Sr surfaces, and it was released in an effective concentration range. SLA-Sr surfaces showed significantly higher BIC% in diabetic rats at 4 (p < .05) and 8 weeks (p < .05). Besides, it displayed higher BIC% at 4 weeks (p < .05) in normal rats. Also, SLA-Sr surfaces upregulated expression of OPG at 4 weeks (p < .05) in diabetic rats. What's more, SLA-Sr surfaces downregulated inflammation (TNF-α, IL-1β, and IL-6; p < .01) in diabetic rats at 3 days. In addition, expression of Wnt5a and ROR2 was upregulated (p < .05) at 7 days after implantation under diabetes.

CONCLUSION

It is suggested that strontium-incorporated titanium implant surfaces by hydrothermal treatment could enhance implant osseointegration as compared with SLA implant surfaces in diabetic rats.

Modulating the foreign body response of implants for diabetes treatment

Diabetes Mellitus is a group of diseases characterized by high blood glucose levels due to patients' inability to produce sufficient insulin. Current interventions often require implants that can detect and correct high blood glucose levels with minimal patient intervention. However, these implantable technologies have not reached their full potential in vivo due to the foreign body response and subsequent development of fibrosis. Therefore, for long-term function of implants, modulating the initial immune response is crucial in preventing the activation and progression of the immune cascade. This review discusses the different molecular mechanisms and cellular interactions involved in the activation and progression of foreign body response (FBR) and fibrosis, specifically for implants used in diabetes. We also highlight the various strategies and techniques that have been used for immunomodulation and prevention of fibrosis. We investigate how these general strategies have been applied to implants used for the treatment of diabetes, offering insights on how these devices can be further modified to circumvent FBR and fibrosis.

Regulation of macrophage polarization through surface topography design to facilitate implant-to-bone osteointegration

Proper immune responses are critical for successful biomaterial implantation. Here, four scales of honeycomb-like TiO2 structures were custom made on titanium (Ti) substrates to investigate cellular behaviors of RAW 264.7 macrophages and their immunomodulation on osteogenesis. We found that the reduced scale of honeycomb-like TiO2 structures could significantly activate the anti-inflammatory macrophage phenotype (M2), in which the 90-nanometer sample induced the highest expression level of CD206, interleukin-4, and interleukin-10 and released the highest amount of bone morphogenetic protein-2 among other scales. Afterward, the resulting immune microenvironment favorably triggered osteogenic differentiation of murine mesenchymal stem cells in vitro and subsequent implant-to-bone osteointegration in vivo. Furthermore, transcriptomic analysis revealed that the minimal scale of TiO2 honeycomb-like structure (90 nanometers) facilitated macrophage filopodia formation and up-regulated the Rho family of guanosine triphosphatases (RhoA, Rac1, and CDC42), which reinforced the polarization of macrophages through the activation of the RhoA/Rho-associated protein kinase signaling pathway.

Biocompatibility of nanomaterials and their immunological properties

Nanomaterials (NMs) have revolutionized multiple aspects of medicine by enabling novel sensing, diagnostic, and therapeutic approaches. Advancements in processing and fabrication have also allowed significant expansion in the applications of the major classes of NMs based on polymer, metal/metal oxide, carbon, liposome, or multi-scale macro-nano bulk materials. Concomitantly, concerns regarding the nanotoxicity and overall biocompatibility of NMs have been raised. These involve putative negative effects on both patients and those subjected to occupational exposure during manufacturing. In this review, we describe the current state of testing of NMs including those that are in clinical use, in clinical trials, or under development. We also discuss the cellular and molecular interactions that dictate their toxicity and biocompatibility. Specifically, we focus on the reciprocal interactions between NMs and host proteins, lipids, and sugars and how these induce responses in immune and other cell types leading to topical and/or systemic effects.

Molecular Mechanisms of Topography Sensing by Osteoblasts: An Update

Bone is a specialized tissue formed by different cell types and a multiscale, complex mineralized matrix. The architecture and the surface chemistry of this microenvironment can be factors of considerable influence on cell biology, and can affect cell proliferation, commitment to differentiation, gene expression, matrix production and/or composition. It has been shown that osteoblasts encounter natural motifs in vivo, with various topographies (shapes, sizes, organization), and that cell cultures on flat surfaces do not reflect the total potential of the tissue. Therefore, studies investigating the role of topographies on cell behavior are important in order to better understand the interaction between cells and surfaces, to improve osseointegration processes in vivo between tissues and biomaterials, and to find a better topographic surface to enhance bone repair. In this review, we evaluate the main available data about surface topographies, techniques for topographies’ production, mechanical signal transduction from surfaces to cells and the impact of cell–surface interactions on osteoblasts or preosteoblasts’ behavior.

Influence of Nanotopography on Early Bone Healing during Controlled Implant Loading

Nanoscale surface modifications influence peri-implant cell fate decisions and implant loading generates local tissue deformation, both of which will invariably impact bone healing. The objective of this study is to determine how loading affects healing around implants with nanotopography. Implants with a nanoporous surface were placed in over-sized osteotomies in rat tibiae and held stable by a system that permits controlled loading. Three regimens were applied: (a) no loading, (b) one daily loading session with a force of 1.5N, and (c) two such daily sessions. At 7 days post implantation, animals were sacrificed for histomorphometric and DNA microarray analyses. Implants subjected to no loading or only one daily loading session achieved high bone-implant contact (BIC), bone-implant distance (BID) and bone formation area near the implant (BFAt) values, while those subjected to two daily loading sessions showed less BFAt and BIC and more BID. Gene expression profiles differed between all groups mainly in unidentified genes, and no modulation of genes associated with inflammatory pathways was detected. These results indicate that implants with nanotopography can achieve a high level of bone formation even under micromotion and limit the inflammatory response to the implant surface.

Harnessing Inorganic Nanoparticles to Direct Macrophage Polarization for Skeletal Muscle Regeneration

Modulation of macrophage plasticity is emerging as a successful strategy in tissue engineering (TE) to control the immune response elicited by the implanted material. Indeed, one major determinant of success in regenerating tissues and organs is to achieve the correct balance between immune pro-inflammatory and pro-resolution players. In recent years, nanoparticle-mediated macrophage polarization towards the pro- or anti-inflammatory subtypes is gaining increasing interest in the biomedical field. In TE, despite significant progress in the use of nanomaterials, the full potential of nanoparticles as effective immunomodulators has not yet been completely realized. This work discusses the contribution that nanotechnology gives to TE applications, helping native or synthetic scaffolds to direct macrophage polarization; here, three bioactive metallic and ceramic nanoparticles (gold, titanium oxide, and cerium oxide nanoparticles) are proposed as potential valuable tools to trigger skeletal muscle regeneration.

Development of a novel bioactive titanium membrane with alkali treatment for bone regeneration

This study evaluates a bioactive titanium membrane with alkali treatment for stimulating apatite formation and promoting bone regeneration. The titanium thin membranes were either treated with NaOH (alkali-group) or untreated (control). Each sample were incubated in simulated body fluid. Subsequently, the composition of the surface calcium deposition, its weight increase ratio, and optical absorbance were evaluated. Then, the bone defect was trephined on the rats calvaria and covered with each sample membrane or no membrane, and the bone tissue area ratio (BTA) and bone membrane contact ratio (BMC) were evaluated. The spherical crystalline precipitates formed in both groups. In the alkali-group after 21 days, the precipitates matured, forming apatite-like precipitates. The alkali-group showed higher Ca and P contents and weight increase ratios than the control. The alkali-group exhibited a higher BMC than the control in the central area. Thus, this novel membrane has high apatite-forming and bone regeneration abilities.

The osteogenesis performance of titanium modified via plasma-enhanced chemical vapor deposition: in vitro and in vivo studies

Titanium (Ti) and its alloys are widely used in dental implants due to their favorable mechanical properties and biocompatibility. Surface characteristics, including physical and chemical properties, are crucial factors to enhance the osteogenesis performance of Ti. The aim of this study is to evaluate amino group surface modification to facilitate the osteogenic potential and bone repair of dental implants both in vitro and in vivo. Herein, amino group-modified Ti surfaces were constructed via the plasma-enhanced chemical vapor deposition (PECVD) technique with an allylamine monomer. The adhesion, proliferation, alkaline phosphate activity and osteogenesis-related genetic expression of MG-63 cells on the surfaces were performed in vitro and presented a significant increase in amino group-modified Ti compared with that in Ti. The in vivo study in miniature pigs was evaluated through micro-computed tomography analysis and histological evaluation, which exhibited enhanced new bone formation in amino group-modified Ti compared with that in Ti after implantation for 4, 8 and 12 weeks. Consequently, amino group surface modification with the PECVD technique may provide a promising modification method to enhance the osteogenesis performance of Ti implants.

Protruding Nanostructured Surfaces for Antimicrobial and Osteogenic Titanium Implants

Protruding nanostructured surfaces have gained increasing interest due to their unique wetting behaviours and more recently their antimicrobial and osteogenic properties. Rapid development in nanofabrication techniques that offer high throughput and versatility on titanium substrate open up the possibility for better orthopaedic and dental implants that deter bacterial colonisation while promoting osteointegration. In this review we present a brief overview of current problems associated with bacterial infection of titanium implants and of efforts to fabricate titanium implants that have both bactericidal and osteogenic properties. All of the proposed mechano-bactericidal mechanisms of protruding nanostructured surfaces are then considered so as to explore the potential advantages and disadvantages of adopting such novel technologies for use in future implant applications. Different nanofabrication methods that can be utilised to fabricate such nanostructured surfaces on titanium substrate are briefly discussed.

Promoting osteoblasts responses in vitro and improving osteointegration in vivo through bioactive coating of nanosilicon nitride on polyetheretherketone

Objective

To enhance the bioactivity of polyetheretherketone (PEEK) while maintain its mechanical strengths.

Methods

Suspension coating and melt bonding.

Results

Silicon nitride (Si₃N₄, SN) coating lead to higher surface roughness, hydrophilicity and protein absorption; SN coating could slowly release Si ion into simulated body fluid (SBF), which caused weak alkaline of micro-environment owing to the slight dissolution of SN; SN coating resulted in the improvements of adhesion, proliferation, differentiation and gene expressions of MC3T3-E1 cells in vitro; SN coating of PEEK with bioactive SN coating (CSNPK) obviously promoted bone regeneration and osseointegration in vivo.

Conclusions

CSNPK with SN coating as bone implant might be a promising candidate for orthopedic implants.

The Translational Potential of this Article

The silicon nitride-coated polyetheretherketone (CSNPK) prepared in this article could induce MC3T3-E1 cells adhesion, proliferation and differentiation in vitro; it could also induce bone regeneration in bone defect in vivo, which indicate its good cytocompatibility and biocompatibility. If the raw materials are medical grade, and preparation process as well as production process of this article are further improved, it will have great translational potential.

Plasma deposited poly-oxazoline nanotextured surfaces dictate osteoimmunomodulation towards ameliorative osteogenesis

Developing "osteoimmune-smart" bone substitute materials have become the forefront of research in bone regeneration. Biocompatible polymer coatings are applied widely to improve the bioactivity of bone substitute materials. In this context, polyoxazolines (Pox) have attracted substantial attention recently due to properties such as biocompatibility, stability, and low biofouling. In view of these useful properties, it is interesting to explore the capacity of Pox as an osteoimmunomodulatory agent to generate a favorable osteoimmune environment for osteogenesis. We applied a technique called plasma polymerization and succeeded in preparing Pox-like coatings (Ppox) and engineered their nanotopography at the nanoscale. We found that Ppox switched macrophages towards M2 extreme, thus inhibiting the release of inflammatory cytokines. The underlying mechanism may be related to the suppression of TLR pathway. The generated osteoimmune environment improved osteogenesis while inhibited osteoclastogenesis. This may be related to the release of osteogenic factors, especially Wnt10b from macrophages. The addition of nanotopography (16 nm, 38 nm, 68 nm) can tune the Ppox-mediated inhibition on inflammation and osteoclastic activities, while no significant effects were observed within the tested nano sizes on the Ppox-mediated osteogenesis. These results collectively suggest that Ppox can be useful as an effective osteoiumunomodulatory agent to endow bone substitute materials with favourable osteoimmunomodulatory property. STATEMENT OF SIGNIFICANCE: In this study, we succeeded in preparing plasma deposited Pox-like nano-coatings (Ppox) via plasma polymerization and found that Ppox nanotopographies are useful osteoimmunomodulatory tools. Their osteoimmunodolatory effects and underlying mechanisms are unveiled. It is the first investigation into the feasibility of applying poly-oxazoline as an osteoimmunomodulatory agent. This expand the application of poly-oxazoline into the forefront in bone regeneration area for the development of advanced "osteoimmune-smart" bone substitute materials.

Understanding the effects of PBF process parameter interplay on Ti-6Al-4V surface properties

Ti-6Al-4V is commonly used in orthopaedic implants, and fabrication techniques such as Powder Bed Fusion (PBF) are becoming increasingly popular for the net-shape production of such implants, as PBF allows for complex customisation and minimal material wastage. Present research into PBF fabricated Ti-6Al-4V focuses on new design strategies (e.g. designing pores, struts or lattices) or mechanical property optimisation through process parameter control-however, it is pertinent to examine the effects of altering PBF process parameters on properties relating to bioactivity. Herein, changes in Ti-6Al-4V microstructure, mechanical properties and surface characteristics were examined as a result of varying PBF process parameters, with a view to understanding how to tune Ti-6Al-4V bio-activity during the fabrication stage itself. The interplay between various PBF laser scan speeds and laser powers influenced Ti-6Al-4V hardness, porosity, roughness and corrosion resistance, in a manner not clearly described by the commonly used volumetric energy density (VED) design variable. Key findings indicate that the relationships between PBF process parameters and ultimate Ti-6Al-4V properties are not straightforward as expected, and that wide ranges of porosity (0.03 ± 0.01% to 32.59 ± 2.72%) and corrosion resistance can be achieved through relatively minor changes in process parameters used-indicating volumetric energy density is a poor predictor of PBF Ti-6Al-4V properties. While variations in electrochemical behaviour with respect to the process parameters used in the PBF fabrication of Ti-6Al-4V have previously been reported, this study presents data regarding important surface characteristics over a large process window, reflecting the full capabilities of current PBF machinery.

Glancing Angle Deposition of Zn-Doped Calcium Phosphate Coatings by RF Magnetron Sputtering

Zn-substituted hydroxyapatite with antibacterial effect was used in radiofrequency (RF) magnetron deposition of calcium phosphate coating onto Ti- and Si-inclined substrates. The development of surface nanopatterns for direct bacteria killing is a growing area of research. Here, we combined two approaches for possible synergetic antibacterial effect by manufacturing a patterned surface of Zn-doped calcium phosphate using glancing angle deposition (GLAD) technique. A significant change in the coating morphology was revealed with a substrate tilt angle of 80°. It was shown that an increase in the coating crystallinity for samples deposited at a tilt angle of 80° corresponds to the formation of crystallites in the bulk structure of the thin film. The variation in the coating thickness, uniformity, and influence of sputtered species energy on Si substrates was analyzed. Coatings deposited on tilted samples exhibit higher scratch resistance. The coating micro- and nano-roughness and overall morphology depended on the tilt angle and differently affected the rough Ti and smooth Si surfaces. GLAD of complex calcium phosphate material can lead to the growth of thin films with significantly changed morphological features and can be utilized to create self-organized nanostructures on various types of surfaces.

Participation of integrin β3 in osteoblast differentiation induced by titanium with nano or microtopography

The major role of integrins is to mediate cell adhesion but some of them are involved in the osteoblasts-titanium (Ti) interactions. In this study, we investigated the participation of integrins in osteoblast differentiation induced by Ti with nanotopography (Ti-Nano) and with microtopography (Ti-Micro). By using a PCR array, we observed that, compared with Ti-Micro, Ti-Nano upregulated the expression of five integrins in mesenchymal stem cells, including integrin β3, which increases osteoblast differentiation. Silencing integrin β3, using CRISPR-Cas9, in MC3T3-E1 cells significantly reduced the osteoblast differentiation induced by Ti-Nano in contrast to the effect on T-Micro. Concomitantly, integrin β3 silencing downregulated the expression of integrin αv, the parent chain that combines with other integrins and several components of the Wnt/β-catenin and BMP/Smad signaling pathways, all involved in osteoblast differentiation, only in cells cultured on Ti-Nano. Taken together, our results showed the key role of integrin β3 in the osteogenic potential of Ti-Nano but not of Ti-Micro. Additionally, we propose a novel mechanism to explain the higher osteoblast differentiation induced by Ti-Nano that involves an intricate regulatory network triggered by integrin β3 upregulation, which activates the Wnt and BMP signal transductions. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1303-1313, 2019.

Microgrooved collagen-based corneal scaffold for promoting collective cell migration and antifibrosis

Microgrooved collagen membrane can effectively promote the epithelialization of corneal epithelial cells and inhibit the fibrosis of corneal stromal cells.

A high current anodization to fabricate a nano-porous structure on the surface of Ti-based implants

In this study, an oxide layer on Ti-based implants is fabricated by using a high current anodization (HCA) technique in the nitrate electrolyte. This layer is composed of micro-pits and nano-porous arrays in the honeycomb structure. The results show that both the roughness and the layer thickness are related to the reaction time, whereas the size of nano-pores has little to do with the anodization duration. Compared to the nano-tubular arrays constructed by the conventional anodization, this nano-porous layer shows significantly improved mechanical stability. Furthermore, the in vitro assay of osteoblasts shows that cells behaviors on this surface can be modulated by the topology of this special layer. A suitable hierarchical structure composed of micro-pits and nano-porous structure can significantly stimulate osteoblasts attachment, activity, spreading and ALP function. Therefore, this hierarchical surface layer may provide a promising approach, which endows the Ti-based implants with better stability and osseointegration.

Polydopamine-induced hydroxyapatite coating facilitates hydroxyapatite/polyamide 66 implant osteogenesis: an in vitro and in vivo evaluation

Background

Hydroxyapatite/polyamide 66 (HA/P66) has been clinically used for several years owing to its good biocompatibility and bioactivity. However, it has been found that the osseointegration process of the HA/P66 implant takes a large amount of time because of the small amount of HA on its surface.

Methods

To increase the amount of HA and aid faster osseointegration, we prepared a HA coating using a biomimetic process assisted by polydopamine (PDA) on the HA/P66 substrate. The surface properties of the substrate modified by PDA and HA were characterized, and the capacity of biomaterials for osteogenic induction was investigated both in vitro and in vivo.

Results

The HA coating was successfully prepared on the HA/P66 substrate and verified by X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and X-ray diffraction (XRD). The HA coating remained firmly attached to the underlying PDA-HA/P66 substrate even after strong ultrasound treatment for 1 h, and the calcium and phosphorus of the HA coating was continuously released in vitro in a slow manner. The formation of the HA coating on the PDA film greatly increased the hydrophilicity and surface roughness of HA/P66. In cell-based experiments, as compared with the HA/P66 substrate, the HA coating formation on the PDA film could facilitate the functions of C3H10T1/2 cells, including cell adhesion, proliferation, spreading, alkaline phosphatase activity, calcium nodule formation, and expression of osteogenic differentiation-related proteins. In addition, the HA/P66 scaffolds modified with PDA and HA coatings were implanted in rabbit femoral condyles. At 8 weeks after surgery, micro-computed tomography scanning (micro-CT) and hematoxylin–eosin (HE) staining revealed that more new bones were formed around the HA/P66 scaffold that was modified with a PDA-assisted HA coating.

Conclusion

These results indicate that the preparation of a PDA-assisted HA coating by using a biomimetic process significantly improves the capacity of biomaterials for osteogenic induction.

Synergistic effect of surface phosphorylation and micro-roughness on enhanced osseointegration ability of poly(ether ether ketone) in the rabbit tibia

This study was aimed to investigate the osseointegration ability of poly(ether ether ketone) (PEEK) implants with modified surface roughness and/or surface chemistry. The roughened surface was prepared by a sandblast method, and the phosphate groups on the substrates were modified by a two-step chemical reaction. The in vitro osteogenic activity of rat mesenchymal stem cells (MSCs) on the developed substrates was assessed by measuring cell proliferation, alkaline phosphatase activity, osteocalcin expression, and bone-like nodule formation. Surface roughening alone did not improve MSC responses. However, phosphorylation of smooth substrates increased cell responses, which were further elevated in combination with surface roughening. Moreover, in a rabbit tibia implantation model, this combined surface modification significantly enhanced the bone-to-implant contact ratio and corresponding bone-to-implant bonding strength at 4 and 8 weeks post-implantation, whereas modification of surface roughness or surface chemistry alone did not. This study demonstrates that combination of surface roughness and chemical modification on PEEK significantly promotes cell responses and osseointegration ability in a synergistic manner both in vitro and in vivo. Therefore, this is a simple and promising technique for improving the poor osseointegration ability of PEEK-based orthopedic/dental implants.

An important step towards a prevascularized islet microencapsulation device: in vivo prevascularization by combination of mesenchymal stem cells on micropatterned membranes

Extrahepatic transplantation of islets of Langerhans could aid in better survival of islets after transplantation. When islets are transfused into the liver 60-70% of them are lost immediately after transplantation. An important factor for a successful extrahepatic transplantation is a well-vascularized tissue surrounding the implant. There are many strategies known for enhancing vessel formation such as adding cells with endothelial potential, the combination with angiogenic factors and / or applying surface topography at the exposed surface of the device. Previously we developed porous, micropatterned membranes which can be applied as a lid for an islet encapsulation device and we showed that the surface topography induces human umbilical vein endothelial cell (HUVEC) alignment and interconnection. This was achieved without the addition of hydrogels, often used in angiogenesis assays. In this work, we went one step further towards clinical implementation of the device by combining this micropatterned lid with Mesenchymal Stem Cells (MSCs) to facilitate prevascularization in vivo. As for HUVECs, the micropatterned membranes induced MSC alignment and organization in vitro, an important contributor to vessel formation, whereas in vivo (subcutaneous rat model) they contributed to improved implant prevascularization. In fact, the combination of MSCs seeded on the micropatterned membrane induced the highest vessel formation score in 80% of the sections.

Modification of the Ceramic Implant Surfaces from Zirconia by the Magnetron Sputtering of Different Calcium Phosphate Targets: A Comparative Study

In this study, thin calcium phosphate (Ca-P) coatings were deposited on zirconia substrates by radiofrequency (RF) magnetron sputtering using different calcium phosphate targets (calcium phosphate tribasic (CPT), hydroxyapatite (HA), calcium phosphate monobasic, calcium phosphate dibasic dehydrate (DCPD) and calcium pyrophosphate (CPP) powders). The sputtering of calcium phosphate monobasic and DCPD powders was carried out without an inert gas in the self-sustaining plasma mode. The physico-chemical, mechanical and biological properties of the coatings were investigated. Cell adhesion on the coatings was examined using mesenchymal stem cells (MSCs). The CPT coating exhibited the best cell adherence among all the samples, including the uncoated zirconia substrate. The cells were spread uniformly over the surfaces of all samples.

The effects of surface bioactivity and sustained-release of genistein from a mesoporous magnesium-calcium-silicate/PK composite stimulating cell responses in vitro, and promoting osteogenesis and enhancing osseointegration in vivo

The surface of a mesoporous magnesium-calcium-silicate (m-MCS)/polyetheretherketone (PK) composite (MPC) was modified by sand blasting, and genistein (GS) was loaded inside the nanopores of the m-MCS on the modified MPC (MPCm) surface. The results showed that compared with MPC, the surface roughness and hydrophilcity of MPCm obviously improved with more m-MCS exposed on its surface. Moreover, no obvious differences in surface roughness and hydrophilcity were found between MPCm and GS loaded MPCm (MPCm-Ge), and both of them possessed an improved apatite mineralization ability in simulated body fluid solution (SBF) compared with MPC, indicating excellent surface bioactivity. Moreover, the MPCm obviously stimulated the adhesion, proliferation, differentiation and gene expressions of MC3T3-E1 cells compared with MPC, and the sustained-release of GS from the MPCm-Ge surface further significantly promoted the cell proliferation, differentiation and gene expression. According to the Micro-CT, histological and SEM analysis, the results demonstrated that the MPCm obviously improved osteogenesis and enhanced osseointegration in vivo compared with MPC, and the release of GS from the MPCm-Ge surface further significantly improved osteogenesis and enhanced osseointegration. In summary, the significant promotion of cell responses in vitro, and the improvements of osteogenesis and the enhancement of osseointegration in vivo were attributed to the effects of surface bioactivity and GS sustained-release from the MPCm-Ge surface. Therefore, MPCm-Ge would be a potential candidate for orthopedic and dental applications.

Biomimetic Tissue Engineering: Tuning the Immune and Inflammatory Response to Implantable Biomaterials

Regenerative medicine technologies rely heavily on the use of well-designed biomaterials for therapeutic applications. The success of implantable biomaterials hinges upon the ability of the chosen biomaterial to negotiate with the biological barriers in vivo. The most significant of these barriers is the immune system, which is composed of a highly coordinated organization of cells that induce an inflammatory response to the implanted biomaterial. Biomimetic platforms have emerged as novel strategies that aim to use the principle of biomimicry as a means of immunomodulation. This principle has manifested itself in the form of biomimetic scaffolds that imitate the composition and structure of biological cells and tissues. Recent work in this area has demonstrated the promising potential these technologies hold in overcoming the barrier of the immune system and, thereby, improve their overall therapeutic efficacy. In this review, a broad overview of the use of these strategies across several diseases and future avenues of research utilizing these platforms is provided.

Selective laser melted titanium alloys for hip implant applications: Surface modification with new method of polymer grafting

A significant number of hip replacements (HR) fail permanently despite the success of the medical procedure, due to wear and progressive loss of osseointegration of implants. An ideal model should consist of materials with a high resistance to wear and with good biocompatibility. This study aims to develop a new method of grafting the surface of selective laser melted (SLM) titanium alloy (Ti-6Al-4V) with poly (2-methacryloyloxyethyl phosphorylcholine) (PMPC), to improve the surface properties and biocompatibility of the implant. PMPC was grafted onto the SLM fabricated Ti-6Al-4V, applying the following three techniques; ultraviolet (UV) irradiation, thermal heating both under normal atmosphere and UV irradiation under N₂ gas atmosphere. Scanning electron microscopy (SEM), 3D optical profiler, energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and Fourier transform infrared spectroscopy (FTIR) were used to characterise the grafted surface. Results demonstrated that a continuous PMPC layer on the Ti-6Al-4V surface was achieved using the UV irradiation under N₂ gas atmosphere technique, due to the elimination of oxygen from the system. As indicated in the results, one of the advantages of this technique is the presence of phosphorylcholine, mostly on the surface, which reveals the existence of a strong chemical bond between the grafted layer (PMPC) and substrate (Ti-6Al-4V). The nano-scratch test revealed that the PMPC grafted surface improves the mechanical strength of the surface and thus, protects the underlying implant substrate from scratching under high loads.

Nano-Architectural Approaches for Improved Intracortical Interface Technologies

Intracortical microelectrodes (IME) are neural devices that initially were designed to function as neuroscience tools to enable researchers to understand the nervous system. Over the years, technology that aids interfacing with the nervous system has allowed the ability to treat patients with a wide range of neurological injuries and diseases. Despite the substantial success that has been demonstrated using IME in neural interface applications, these implants eventually fail due to loss of quality recording signals. Recent strategies to improve interfacing with the nervous system have been inspired by methods that mimic the native tissue. This review focusses on one strategy in particular, nano-architecture, a term we introduce that encompasses the approach of roughening the surface of the implant. Various nano-architecture approaches have been hypothesized to improve the biocompatibility of IMEs, enhance the recording quality, and increase the longevity of the implant. This review will begin by introducing IME technology and discuss the challenges facing the clinical deployment of IME technology. The biological inspiration of nano-architecture approaches will be explained as well as leading fabrication methods used to create nano-architecture and their limitations. A review of the effects of nano-architecture surfaces on neural cells will be examined, depicting the various cellular responses to these modified surfaces in both in vitro and pre-clinical models. The proposed mechanism elucidating the ability of nano-architectures to influence cellular phenotype will be considered. Finally, the frontiers of next generation nano-architecture IMEs will be identified, with perspective given on the future impact of this interfacing approach.

Nanostructured titanium regulates osseointegration via influencing macrophage polarization in the osteogenic environment

Introduction

Fabricating nanostructured surface topography represents the mainstream approach to induce osteogenesis for the next-generation bone implant. In the past, the bone implant was designed to minimize host repulsive reactions in order to acquire biocompatibility. However, increasing reports indicate that the absence of an appropriate immune response cannot acquire adequate osseointegration after implantation in vivo.

Materials and methods

We prepared different topographies on the surface of titanium (Ti) specimens by grinding, etching and anodizing, and they were marked as polished specimen (P), specimen with nanotubes (NTs) in small diameters (NT-30) and specimen with NTs in large diameters (NT-100). We evaluated the ability of different topographies of the specimen to induce osteogenic differentiation of mice bone marrow mesenchymal stem cells (BMSCs) in vitro and to induce osseointegration in vivo. Furthermore, we investigated the effect of different topographies on the polarization and secretion of macrophages, and the effect of macrophage polarization on topography-induced osteogenic differentiation of mice BMSCs. Finally, we verified the effect of macrophage polarization on topography-induced osseointegration in vivo by using Cre*RBP-J^fl/fl mice in which classically activated macrophage was restrained.

Results

The osteogenic differentiation of mice BMSCs induced by specimen with different topographies was NT-100>NT-30>P, while the osseointegration induced by specimen with different topographies in vivo was NT-30>NT-100>P. In addition, specimen of NT-30 could induce more macrophages to M2 polarization, while specimen of P and NT-100 could induce more macrophages to M1 polarization. When co-culture mice BMSCs and macrophages on specimen with different topographies, the osteogenic differentiation of mice BMSCs was NT-30>NT-100≥P. The osseointegration induced by NT-100 in Cre*RBP-J^fl/fl mice was much better than that of wild type mice.

Conclusion

It is suggested that the intrinsic immunomodulatory effects of nanomaterials are not only crucial to evaluate the in vivo biocompatibility but also required to determine the final osseointegration. To clarify the immune response and osseointegration may be beneficial for the designation and optimization of the bone implant.

Surface morphology characterization of laser-induced titanium implants: lesson to enhance osseointegration process

The surface properties of implant are responsible to provide mechanical stability by creating an intimate bond between the bone and implant; hence, play a major role on osseointegration process. The current study was aimed to measure surface characteristics of titanium modified by a pulsed Nd:YAG laser. The results of this study revealed an optimum density of laser energy (140 Jcm^-2), at which improvement of osteointegration process was seen. Significant differences were found between arithmetical mean height (Ra), root mean square deviation (Rq) and texture orientation, all were lower for 140 Jcm^-2 samples compared to untreated one. Also it was identified that the surface segments were more uniformly distributed with a more Gaussian distribution for treated samples at 140 Jcm^-2. The distribution of texture orientation at high laser density (250 and 300 Jcm^-2) were approximately similar to untreated sample. The skewness index that indicates how peaks and valleys are distributed throughout the surface showed a positive value for laser treated samples, compared to untreated one. The surface characterization revealed that Kurtosis index, which tells us how high or flat the surface profile is, for treated sample at 140 Jcm^-2 was marginally close to 3 indicating flat peaks and valleys in the surface profile.

Effect of strontium surface-functionalized implants on early and late osseointegration: A histological, spectrometric and tomographic evaluation

Numerous in vivo, in vitro and clinical studies report on beneficial effects of strontium with respect to increased bone growth. Based on this knowledge the aim of this study was to evaluate early and late osseointegration stages of functionalized titanium implants showing sustained release of strontium (Sr) and further investigate its potential systemic effect. Strontium functionalized (Ti-Sr-O) and Grade 4 (Control) titanium implants were inserted in the femoral condyle of New Zealand White rabbits. The Ti-Sr-O coating was characterized using Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectrometry (EDX) for structure, coating thickness and chemical composition. Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES) was used to evaluate released strontium in vitro while Atomic Absorption Spectrometry (AAS) was utilized to monitor serum levels of strontium and calcium. Additionally, histological and tomographic analysis of bone-to-implant contact (BIC%) and bone formation (BF%) was performed, following implantation periods of two or twelve weeks, respectively. Median values for BIC% for Ti-Sr-O revealed significant differences within the two- and twelve-week observation periods, while exceeding BF% was discovered especially after twelve weeks when performing the histological evaluation. The results from the micro-computed tomography (µ-CT) showed no significant differences, when comparing the experimental groups. AAS measurements did not indicate a systemic effect by the local strontium release. Within the limitations of the study, it was shown that a Ti-Sr-O coating with sustained release characteristics of strontium, accelerates bone apposition and represents a potential potent surface modification for endosseous medical implant devices.

STATEMENT OF SIGNIFICANCE

This study presents first data with respect to early and late in vivo response on a strontium functionalized titanium surface comprising a nanotopography manufactured by a magnetron sputtering process. We investigated different osseointegration stages of screw-shaped implants with dental implant geometries in a rabbit femur model observing beneficial effects of the functionalized surface on bone-to-implant contact and bone formation caused by tailored release of the bone anabolic strontium. Histomorphometrical data revealed that a functionalized titanium surface with controlled liberation of strontium accelerates osseointegration while spectrometry measurements did not indicate a potential systemic effect of this osteoinductive agent and could thus have impact on modifications of medical implant devices.

Preparation of well-distributed titania nanopillar arrays on Ti6Al4V surface by induction heating for enhancing osteogenic differentiation of stem cells

Great effort has recently been devoted to the preparation of nanoscale surfaces on titanium-based implants to achieve clinically fast osteoinduction and osseointegration, which relies on the unique characteristics of the nanostructure. In this work, we used induction heating treatment (IHT) as a rapid oxidation method to fabricate a porous nanoscale oxide layer on the Ti6Al4V surface for better medical application. Well-distributed vertical nanopillars were yielded by IHT for 20-35 s on the alloy surface. The composition of the oxides contained rutile/anatase TiO₂ and a small amount of Al₂O₃ between the TiO₂ grain boundaries (GBs). This technology resulted in a reduction and subsequent increase of surface roughness of 26-32 nm when upregulating the heating time, followed by the successive enhancement of the thickness, wettability and adhesion strength of the oxidation layer to the matrix. The surface hardness also distinctly rose to 554 HV in the IHT-35 s group compared with the 350 HV of bare Ti6Al4V. The massive small-angle GBs in the bare alloy promoted the formation of nanosized oxide crystallites. The grain refinement and deformation texture reduction further improved the mechanical properties of the matrix after IHT. Moreover, in vitro experiments on a mesenchymal stem cell (BMSC) culture derived from human bone marrow for 1-7 days indicated that the nanoscale layers did not cause cytotoxicity, and facilitated cell differentiation in osteoblasts by enhancing the gene and osteogenesis-related protein expressions after 1-3 weeks of culturing. The increase of the IHT time slightly advanced the BMSC proliferation and differentiation, especially during long-term culture. Our findings provide strong evidence that IHT oxidation technology is a novel nanosurface modification technology, which is potentially promising for further clinical development.

Upregulation of osteogenesis of mesenchymal stem cells with virus-based thin films

A major aim of tissue engineering is to develop biomimetic scaffolding materials that can guide the proliferation, self-renewal and differentiation of multipotent stem cells into specific lineages. Cellular functions can be controlled by the interactions between cells and biomaterials. Therefore, the surface chemistry and topography of support materials play a pivotal role in modulating cell behaviors at many stages of cell growth and development. Due to their highly ordered structure and programmable surface chemistries, which provide unique topography as biomaterials, viral nanoparticles have been utilized as building blocks for targeted cell growth and differentiation. This review article discusses the fabrication of two-dimensional virus-based thin film on substrates and highlights the study of the effect of chemical and physical cues introduced by plant virus nanoparticle thin films on the promotion of osteogenic differentiation of BMSCs.

Nanomaterial-based bone regeneration

Bone diseases/injuries have been driving an urgent quest for bone substitutes for bone regeneration. Nanoscaled materials with bone-mimicking characteristics may create suitable microenvironments to guide effective bone regeneration. In this review, the natural hierarchical architecture of bone and its regeneration mechanisms are elucidated. Recent progress in the development of nanomaterials which can promote bone regeneration through bone-healing mimicry (e.g., compositional, nanocrystal formation, structural, and growth factor-related mimicking) is summarized. The nanoeffects of nanomaterials on the regulation of bone-related biological functions are highlighted. How to prepare nanomaterials with combinative bone-biomimicry features according to the bone healing process is prospected in order to achieve rapid bone regeneration in situ.

Cell responses on a H2Ti3O7 nanowire film

Cell morphologies on H₂Ti₃O₇ nanowire film and anatase nanowire film.