In vitro and in vivo studies on zinc-hydroxyapatite composites as novel biodegradable metal matrix composite for orthopedic applications

An adaptive biodegradable zinc alloy with bidirectional regulation of bone homeostasis for treating fractures and aged bone defects

Healing of fractures or bone defects is significantly hindered by overactivated osteoclasts and inhibited osteogenesis in patients with abnormal bone metabolism. Current clinical approaches using titanium alloys or stainless steel provide mechanical support but have no biological effects on bone regeneration. Therefore, designing and fabricating degradable metal materials with sufficient mechanical strength and bidirectional regulation of both osteoblasts and osteoclasts is a substantial challenge. Here, this study first reported an adaptive biodegradable Zn-0.8 Mg alloy with bidirectional regulation of bone homeostasis, which promotes osteogenic differentiation by activating the Pi3k/Akt pathway and inhibits osteoclast differentiation by inhibiting the GRB2/ERK pathway. The anti-osteolytic ability of the Zn-0.8 Mg alloy was verified in a mouse calvarial osteolysis model and its suitability for internal fracture fixation with high-strength screws was confirmed in the rabbit femoral condyle fracture model. Furthermore, in an aged postmenopausal rat femoral condyle defect model, 3D printed Zn-0.8 Mg scaffolds promoted excellent bone regeneration through adaptive structures with good mechanical properties and bidirectionally regulated bone metabolism, enabling personalized bone defect repair. These findings demonstrate the substantial potential of the Zn-0.8 Mg alloy for treating fractures or bone defects in patients with aberrant bone metabolism.

Imidazole functionalized photo-crosslinked aliphatic polycarbonate drug-eluting coatings on zinc alloys for osteogenesis, angiogenesis, and bacteriostasis in bone regeneration

Zinc (Zn) alloys have demonstrated significant potential in healing critical-sized bone defects. However, the clinical application of Zn alloys implants is still hindered by challenges including excessive release of zinc ions (Zn2+), particularly in the early stage of implantation, and absence of bio-functions related to complex bone repair processes. Herein, a biodegradable aliphatic polycarbonate drug-eluting coating was fabricated on zinc-lithium (Zn-Li) alloys to inhibit Zn2+ release and enhance the osteogenesis, angiogenesis, and bacteriostasis of Zn alloys. Specifically, the photo-curable aliphatic polycarbonates were co-assembled with simvastatin and deposited onto Zn alloys to produce a drug-loaded coating, which was crosslinked by subsequent UV light irradiation. During the 60 days long-term immersion test, the coating showed distinguished stable drug release and Zn2+ release inhibition properties. Benefiting from the regulated release of Zn2+ and simvastatin, the coating facilitated the adhesion, proliferation, and differentiation of MC3T3-E1 cells, as well as the migration and tube formation of EA.hy926 cells. Astonishingly, the coating also showed remarkable antibacterial properties against both S. aureus and E. coli. The in vivo rabbit critical-size femur bone defects model demonstrated that the drug-eluting coating could efficiently promote new bone formation and the expression of platelet endothelial cell adhesion molecule-1 (CD31) and osteocalcin (OCN). The enhancement of osteogenesis, angiogenesis, and bacteriostasis is achieved by precisely controlling of the released Zn2+ at an appropriate level, as well as the stable release profile of simvastatin. This tailored aliphatic polycarbonate drug-eluting coating provides significant potential for clinical applications of Zn alloys implants.

Feasibility Insights of the Green-Assisted Calcium-Phosphate Coating on Biodegradable Zinc Alloys for Biomedical Application: In Vitro and In Vivo Studies

In the field of bone tissue engineering, recently developed Zn alloy scaffolds are considered potential candidates for biodegradable implants for bone regeneration and defect reconstruction. However, the clinical success of these alloys is limited due to their insufficient surface bioactivities. Further, the higher concentration of Zn2+ produced during degradation promotes antibacterial activity, but deteriorates osteogenic properties. This study fabricated an Azadirachta indica (neem)-assisted brushite-hydroxyapatite (HAp) coating on the recently developed Zn-2Cu-0.5Mg alloy to tackle the above dilemma. The microstructure, degradation behavior, antibacterial activity, and hemocompatibility, along with in vitro and in vivo cytocompatibility of the coated alloys, are systematically investigated. Microstructural analysis reveals flower-like morphology with uniformly grown flakes for neem-assisted deposition. The neem-assisted deposition significantly improves the adhesion strength from 12.7 to 18.8 MPa, enhancing the mechanical integrity. The potentiodynamic polarization study shows that the neem-assisted deposition decreases the degradation rate, with the lowest degradation rate of 0.027 mm/yr for the ZHN2 sample. In addition, the biomineralization process shows the apatite formation on the deposited coating after 21 days of immersion. In vitro cytotoxicity assay exhibits the maximum cell viability of 117% for neem-assisted coated alloy in 30% extract after 5d and the improved cytocompatibility which is due to the controlled release of Zn2+ ions. Meanwhile, neem-assisted coated alloy increases the ZOI by 32 and 24% for Gram-positive and Gram-negative bacteria, respectively. Acceptable hemolysis (<5%) and anticoagulation parameters demonstrate a promising hemocompatibility of the coated alloy. In vivo implantation illustrates a slight inflammatory response and vascularization after 2 weeks of subcutaneous implantation, and neo-bone formation in the defect areas of the rat femur. Micro-CT and histology studies demonstrate better osseointegration with satisfactory biosafety response for the neem-assisted coated alloy as compared to that without neem-assisted deposition. Hence, this neem-assisted brushite-Hap coating strategy elucidates a new perspective on the surface modification of biodegradable implants for the treatment of bone defects.

Structural and temporal dynamics analysis of zinc-based biomaterials: History, research hotspots and emerging trends

Objectives

To examine the 16-year developmental history, research hotspots, and emerging trends of zinc-based biodegradable metallic materials from the perspective of structural and temporal dynamics.

Methods

The literature on zinc-based biodegradable metallic materials in WoSCC was searched. Historical characteristics, the evolution of active topics and development trends in the field of zinc-based biodegradable metallic materials were analyzed using the bibliometric tools CiteSpace and HistCite.

Results

Over the past 16 years, the field of zinc-based biodegradable metal materials has remained in a hotspot stage, with extensive scientific collaboration. In addition, there are 45 subject categories and 51 keywords in different research periods, and 80 papers experience citation bursts. Keyword clustering anchored 3 emerging research subfields, namely, #1 plastic deformation #4 additive manufacturing #5 surface modification. The keyword alluvial map shows that the longest-lasting research concepts in the field are mechanical property, microstructure, corrosion behavior, etc., and emerging keywords are additive manufacturing, surface modification, dynamic recrystallization, etc. The most recent research on reference clustering has six subfields. Namely, #0 microstructure, #2 sem, #3 additive manufacturing, #4 laser powder bed fusion, #5 implant, and #7 Zn-1Mg.

Conclusion

The results of the bibliometric study provide the current status and trends of research on zinc-based biodegradable metallic materials, which can help researchers identify hot spots and explore new research directions in the field.

Zinc based biodegradable metals for bone repair and regeneration: Bioactivity and molecular mechanisms

Bone fractures and critical-size bone defects are significant public health issues, and clinical treatment outcomes are closely related to the intrinsic properties of the utilized implant materials. Zinc (Zn)-based biodegradable metals (BMs) have emerged as promising bioactive materials because of their exceptional biocompatibility, appropriate mechanical properties, and controllable biodegradation. This review summarizes the state of the art in terms of Zn-based metals for bone repair and regeneration, focusing on bridging the gap between biological mechanism and required bioactivity. The molecular mechanism underlying the release of Zn ions from Zn-based BMs in the improvement of bone repair and regeneration is elucidated. By integrating clinical considerations and the specific bioactivity required for implant materials, this review summarizes the current research status of Zn-based internal fixation materials for promoting fracture healing, Zn-based scaffolds for regenerating critical-size bone defects, and Zn-based barrier membranes for reconstituting alveolar bone defects. Considering the significant progress made in the research on Zn-based BMs for potential clinical applications, the challenges and promising research directions are proposed and discussed.

Development of patient-specific finite element model for study of composite dental implants

Traumatic dental injuries can occur due to various reasons such as accidents, sports injuries, fights, falls, and others. These injuries can affect the teeth, gums, and surrounding tissues, and can range from minor chips and cracks to severe fractures, dislocations, and avulsions (when the tooth is completely knocked out of the socket). The most common way to address this is by replacing affected teeth with dental implants. The purpose of this research is to evaluate the use of composite materials in dental implants and compare them with the traditionally used materials using a patient specific cone beam computed tomography (CBCT) based finite element model (FEM). To conduct this research, two different implant groups i.e., traditional implant and composite implant were designed using Titanium grade 4, zirconium oxide-reinforced lithium silicate (ZLS), and Zirconia (ZrO2). Six dental implants were designed namely Ti implant, ZLS implant, ZrO2implant, Ti-ZrO2composite, Ti-ZLS composite, and ZLS-ZrO2composite using 3D modelling software. Detailed full-scale 3D models of patient specific dental implant were developed and traumatic loading conditions were applied to the enamel of central incisor teeth or crown of dental implant, and maxilla was constrained in all directions. It was found that the use of composite materials for dental implants can reduce the stresses over the surface of abutment and implant as compared to traditional implants. The detailed models developed as a part of this study can advance the research on dental implants, and with further experimental validation allow the use of composite materials for fabrication of more stable dental implants.

Biocompatibility and osteogenic potential of choline phosphate chitosan-coated biodegradable Zn1Mg

Zinc alloys have demonstrated considerable potentials as implant materials for biodegradable vascular and orthopedic applications. However, the high initial release of Zn2+ can trigger intense immune responses that impede tissue healing. To address this challenge and enhance the osteogenic capacity of zinc alloys, the surface of Zn1Mg was subjected to CO2 plasma modification (Zn1Mg-PP) followed by grafting with choline phosphate chitosan (Zn1Mg-PP-PCCs). This study aims to investigate the in vitro and in vivo biocompatibility of the surface-modified Zn1Mg. The effect of the surface modification on the inflammatory response and osteogenic repair process was investigated. Compared with unmodified Zn1Mg, the degradation rate of Zn1Mg-PP-PCCs was significantly decreased, avoiding the cytotoxicity triggered by the release of large amounts of Zn2+. Moreover, PCCs significantly enhanced the cell-material adhesion, promoted the proliferation of osteoblasts (MC3T3-E1) and upregulated the expression of key osteogenic factors in vitro. Notably, the in vivo experiments revealed that the surface modification of Zn1Mg suppressed inhibited the expression of inflammatory cytokines, promoting the secretion of anti-inflammatory factors, thereby reducing inflammation and promoting bone tissue repair. Furthermore, histological analysis of tissue sections exhibited strong integration between the material and the bone, along with well-defined new bone formation and reduced osteoclast aggregation on the surface. This was attributed to the improved immune microenvironment by PCCs, which promoted osteogenic differentiation of osteoblasts. These findings highlight that the preparation of PCCs coatings on zinc alloy surfaces effectively inhibited ion release and modulated the immune environment to promote bone tissue repair. STATEMENT OF SIGNIFICANCE: Surface modification of biodegradable Zn alloys facilitates the suppression of intense immune responses caused by excessive ion release concentrations from implants. We modified the surface of Zn1Mg with choline phosphate chitosan (PCCs) and investigated the effects of surface modification on the inflammatory response and osteogenic repair process. In vitro results showed that the PCCs coating effectively reduced the degradation rate of Zn1Mg to avoid cytotoxicity caused by high Zn2+ concentration, favoring the proliferation of osteoblasts. In addition, in vivo results indicated that Zn1Mg-PP-PCCs attenuated inflammation to promote bone repair by modulating the release of inflammation-related factors. The surface-modified Zn1Mg implants demonstrated strong osseointegration, indicating that the PCCs coating effectively modulated the immune microenvironment and promoted bone healing.

The Effect of Doping on the Electrical and Dielectric Properties of Hydroxyapatite for Medical Applications: From Powders to Thin Films

Recently, the favorable electrical properties of biomaterials have been acknowledged as crucial for various medical applications, including both bone healing and growth processes. This review will specifically concentrate on calcium phosphate (CaP)-based bioceramics, with a notable emphasis on hydroxyapatite (HA), among the diverse range of synthetic biomaterials. HA is currently the subject of extensive research in the medical field, particularly in dentistry and orthopedics. The existing literature encompasses numerous studies exploring the physical-chemical, mechanical, and biological properties of HA-based materials produced in various forms (i.e., powders, pellets, and/or thin films) using various physical and chemical vapor deposition techniques. In comparison, there is a relative scarcity of research on the electrical and dielectric properties of HA, which have been demonstrated to be essential for understanding dipole polarization and surface charge. It is noteworthy that these electrical and dielectric properties also offer valuable insights into the structure and functioning of biological tissues and cells. In this respect, electrical impedance studies on living tissues have been performed to assess the condition of cell membranes and estimate cell shape and size. The need to fill the gap and correlate the physical-chemical, mechanical, and biological characteristics with the electrical and dielectric properties could represent a step forward in providing new avenues for the development of the next-generation of high-performance HA-doped biomaterials for future top medical applications. Therefore, this review focuses on the electrical and dielectric properties of HA-based biomaterials, covering a range from powders and pellets to thin films, with a particular emphasis on the impact of the various dopants used. Therefore, it will be revealed that each dopant possesses unique properties capable of enhancing the overall characteristics of the produced structures. Considering that the electrical and dielectric properties of HA-based biomaterials have not been extensively explored thus far, the aim of this review is to compile and thoroughly discuss the latest research findings in the field, with special attention given to biomedical applications.

Tailored Coatings for Enhanced Performance of Zinc-Magnesium Alloys in Absorbable Implants

Absorbable metals exhibit potential for next-generation temporary medical implants, dissolving safely in the body during tissue healing and regeneration. Their commercial incorporation could substantially diminish the need for additional surgeries and complications that are tied to permanent devices. Despite extensive research on magnesium (Mg) and iron (Fe), achieving the optimal combination of mechanical properties, biocompatibility, and controlled degradation rate for absorbable implants remains a challenge. Zinc (Zn) and Zn-based alloys emerged as an attractive alternative for absorbable implants, due to favorable combination of in vivo biocompatibility and degradation behavior. Moreover, the development of suitable coatings can enhance their biological characteristics and tailor their degradation process. In this work, four different biodegradable coatings (based on zinc phosphate (ZnP), collagen (Col), and Ag-doped bioactive glass nanoparticles (AgBGNs)) were synthesized by chemical conversion, spin-coating, or a combination of both on Zn-3Mg substrates. This study assessed the impact of the coatings on in vitro degradation behavior, cytocompatibility, and antibacterial activity. The ZnP-coated samples demonstrated controlled weight loss and a decreased corrosion rate over time, maintaining a physiological pH. Extracts from the uncoated, ZnP-coated, and Col-AgBGN-coated samples showed higher cell viability with increasing concentration. Bacterial viability was significantly impaired in all coated samples, particularly in the Col-AgBGN coating. This study showcases the potential of a strategic material-coating combination to effectively tackle multiple challenges encountered in current medical implant technologies by modifying the properties of absorbable metals to tailor patient treatments.

3D-printed tri-element-doped hydroxyapatite/ polycaprolactone composite scaffolds with antibacterial potential for osteosarcoma therapy and bone regeneration

The resection of malignant osteosarcoma often results in large segmental bone defects, and the residual cells can facilitate recurrence. Consequently, the treatment of osteosarcoma is a major challenge in clinical practice. The ideal goal of treatment for osteosarcoma is to eliminate it thoroughly, and repair the resultant bone defects as well as avoid bacterial infections. Herein, we fabricated a selenium/strontium/zinc-doped hydroxyapatite (Se/Sr/Zn-HA) powder by hydrothermal method, and then employed it with polycaprolactone (PCL) as ink to construct composite scaffolds through 3D printing, and finally introduced them in bone defect repair induced by malignant osteosarcoma. The resultant composite scaffolds integrated multiple functions involving anti-tumor, osteogenic, and antibacterial potentials, mainly attributed to the anti-tumor effects of SeO32-, osteogenic effects of Sr2+ and Zn2+, and antibacterial effects of SeO32- and Zn2+. In vitro studies confirmed that Se/Sr/Zn-HA leaching solution could induce apoptosis of osteosarcoma cells, differentiation of MSCs, and proliferation of MC3T3-E1 while showing excellent antibacterial properties. In vivo tests demonstrated that Se/Sr/Zn-HA could significantly suppress tumors after 8 days of injection, and the Se/Sr/Zn-HA-PCLs scaffold repaired femoral defects effectively after 3 months of implantation. Summarily, the Se/Sr/Zn-HA-PCLs composite scaffolds developed in this study were effective for tumor treatment, bone defect repair, and post-operative anti-infection, which provided a great potential to be a facile therapeutic material for osteosarcoma resection.

Biodegradable implant application: Electrodeposition of HA/TiO2/ZrO2 coating onto Zn-composite substrates

Zinc has currently emerged as a promising biodegradable metal due to its good biocompatible property and promising degradation behaviour. Additionally, inadequate mechanical strength and a lower cell viability value fall short of what is needed for biodegradable implants. In this work, we used the stir-casting process to create a biodegradable Zn-1Mg-1Cu-1HA (ZHA) and Zn-1Mg-1Cu-1ZrO2 (ZZR) composite onto which ceramics composite coating is done by electrodeposition technique to enhance the biocompatibility. The as-cast sample has uniformly distributed fine MgZn2 and CuZn2 phases in a α-Zn matrix, according to microstructural analysis. The mechanical test confirms that ZZR composite exhibited high tensile and compressive properties, including compressive yield strength of 369.562 MPa, a yield tensile strength of 88.725 MPa and ultimate tensile strength of 116.21 MPa. The result of potentiodynamic polarization test shows that the coated ZZR composite sample gives a corrosion rate value of 0.112 mm/year. From immersion tests, the degradation rate obtained a much lower value after immersing the sample in PBS solution for 55 days (0.067 mm/year). Moreover, an extract of coated ZZR composite shows good cell viability in comparison to the uncoated sample at a concentration of 25%, 50% and 75%. Also, the hemolysis percentage for coated ZZR sample is lower than the other prepared uncoated sample (3.072%) Overall, the result obtained proves that the coated ZZR composite sample can be expected as a capable material for implant application.

Fabrication and Properties of a Biodegradable Zn-Ca Composite

In recent years, Zn and its alloys have become some of the most promising degradable metals as in vivo implants due to their acceptable biocompatibility and more suitable degradation rate compared with Mg-based and Fe-based alloys. However, the degradation rate of Zn-based materials after implantation in the body for orthopedic applications is relatively slow, leading to long-term retention of the implants after fulfilling their missions. Moreover, the excessive release of Zn2+ during the degradation process of Zn-based implants usually leads to high cytotoxicity and delayed osseointegration. To provide a feasible solution to the problem faced by Zn-based implants, a Zn-Ca composite was fabricated by an air pressure infiltration method in this work. The XRD pattern of the composite suggests that the composite is fully composed of Zn-Ca intermetallic compounds. The degradation tests in vitro show that the composite has a much higher degradation rate than pure Zn, and the high Ca content regions in the composite can preferentially degrade as sacrificial anodes. In addition, the composite can efficiently induce Ca-P deposition during immersion tests in Hank's solution. Cytotoxicity tests indicate that L-929 cells exhibit around 82% cell viability (Grade 1) even after being cultured in the 100% extract prepared from the Zn-Ca composite for 1 day and show excellent cell viability.

A drug-loaded composite coating to improve osteogenic and antibacterial properties of Zn-1Mg porous scaffolds as biodegradable bone implants

Zinc (Zn) alloy porous scaffolds produced by additive manufacturing own customizable structures and biodegradable functions, having a great application potential for repairing bone defect. In this work, a hydroxyapatite (HA)/polydopamine (PDA) composite coating was constructed on the surface of Zn-1Mg porous scaffolds fabricated by laser powder bed fusion, and was loaded with a bioactive factor BMP2 and an antibacterial drug vancomycin. The microstructure, degradation behavior, biocompatibility, antibacterial performance and osteogenic activities were systematically investigated. Compared with as-built Zn-1Mg scaffolds, the rapid increase of Zn²⁺, which resulted to the deteriorated cell viability and osteogenic differentiation, was inhibited due to the physical barrier of the composite coating. In vitro cellular and bacterial assay indicated that the loaded BMP2 and vancomycin considerably enhanced the cytocompatibility and antibacterial performance. Significantly improved osteogenic and antibacterial functions were also observed according to in vivo implantation in the lateral femoral condyle of rats. The design, influence and mechanism of the composite coating were discussed accordingly. It was concluded that the additively manufactured Zn-1Mg porous scaffolds together with the composite coating could modulate biodegradable performance and contribute to effective promotion of bone recovery and antibacterial function.

Metal-organic Zn-zoledronic acid and 1-hydroxyethylidene-1,1-diphosphonic acid nanostick-mediated zinc phosphate hybrid coating on biodegradable Zn for osteoporotic fracture healing implants

Zn and its alloys are increasingly under consideration for biodegradable bone fracture fixation implants owing to their attractive biodegradability and mechanical properties. However, their clinical application is a challenge for osteoporotic bone fracture healing, due to their uneven degradation mode, burst release of zinc ions, and insufficient osteo-promotion and osteo-resorption regulating properties. In this study, a type of Zn2+ coordinated zoledronic acid (ZA) and 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) metal-organic hybrid nanostick was synthesized, which was further mixed into zinc phosphate (ZnP) solution to mediate the deposition and growth of ZnP to form a well-integrated micro-patterned metal-organic/inorganic hybrid coating on Zn. The coating protected noticeably the Zn substrate from corrosion, in particular reducing its localized occurrence as well as suppressing its Zn2+ release. Moreover, the modified Zn was osteo-compatible and osteo-promotive and, more important, performed osteogenesis in vitro and in vivo of well-balanced pro-osteoblast and anti-osteoclast responses. Such favorable functionalities are related to the nature of its bioactive components, especially the bio-functional ZA and the Zn ions it contains, as well as its unique micro- and nano-scale structure. This strategy provides not only a new avenue for surface modification of biodegradable metals but also sheds light on advanced biomaterials for osteoporotic fracture and other applications. STATEMENT OF SIGNIFICANCE: Developing appropriate biodegradable metallic materials is of clinical relevance for osteoporosis fracture healing, whereas current strategies are short of good balance between the bone formation and resorption. Here, we designed a micropatterned metal-organic nanostick mediated zinc phosphate hybrid coating modified Zn biodegradable metal to fulfill such a balanced osteogenicity. The in vitro assays verified the coated Zn demonstrated outstanding pro-osteoblasts and anti-osteoclasts properties and the coated intramedullary nail promoted fracture healing well in an osteoporotic femur fracture rat model. Our strategy may offer not only a new avenue for surface modification of biodegradable metals but also shed light on better understanding of new advanced biomaterials for orthopedic application among others.

A Comprehensive Review of the Current Research Status of Biodegradable Zinc Alloys and Composites for Biomedical Applications

Zinc (Zn)-based biodegradable materials show moderate degradation rates in comparison with other biodegradable materials (Fe and Mg). Biocompatibility and non-toxicity also make them a viable option for implant applications. Furthermore, Pure Zn has poor mechanical behavior, with a tensile strength of around 100-150 MPa and an elongation of 0.3-2%, which is far from reaching the strength required as an orthopedic implant material (tensile strength is more than 300 MPa, elongation more than 15%). Alloy and composite fabrication have proven to be excellent ways to improve the mechanical performance of Zn. Therefore, their alloys and composites have emerged as an innovative category of biodegradable materials. This paper summarizes the most important recent research results on the mechanical and biological characteristics of biodegradable Zn-based implants for orthopedic applications and the most commonly added components in Zn alloys and composites.

Characterization and Biocompatibility Assessment of Boron Nitride Magnesium Nanocomposites for Orthopedic Applications

Magnesium (Mg) has been intensively studied as a promising alternative material to inert metallic alloys for orthopedic fixation devices due to its biodegradable nature inside the body and its favorable biocompatibility. However, the low mechanical strength and rapid corrosion of Mg in physiological environments represent the main challenges for the development of Mg-based devices for orthopedic applications. A possible solution to these limitations is the incorporation of a small content of biocompatible nanoparticles into the Mg matrix to increase strength and possibly corrosion resistance of the resulting nanocomposites. In this work, the effect of adding boron nitride (BN) nanoparticles (0.5 and 1.5 vol.%) on the mechanical properties, corrosion behavior, and biocompatibility of Mg-based nanocomposites was investigated. The properties of the nanocomposites fabricated using powder metallurgy methods were assessed using microstructure analyses, microhardness, compression tests, in vitro corrosion, contact angle, and cytotoxicity tests. A significant increase in the microhardness, strength, and corrosion rates of Mg-BN nanocomposites was detected compared with those of pure Mg (0% BN). Crystalline surface post-corrosion byproducts were detected and identified via SEM, EDX, and XRD. Biocompatibility assessments showed that the incorporation of BN nanoparticles had no significant impact on the cytotoxicity of Mg and samples were hydrophilic based on the contact angle results. These results confirm that the addition of BN nanoparticles to the Mg matrix can increase strength and corrosion resistance without influencing cytotoxicity in vitro. Further investigation into the chemical behavior of nanocomposites in physiological environments is needed to determine the potential impact of corrosive byproducts. Surface treatments and formulation methods that would increase the viability of these materials in vivo are also needed.

Biological Response of Human Gingival Fibroblasts to Zinc-Doped Hydroxyapatite Designed for Dental Applications-An In Vitro Study

This study aimed to investigate the biological response induced by hydroxyapatite (HAp) and zinc-doped HAp (ZnHAp) in human gingival fibroblasts and to explore their antimicrobial activity. The ZnHAp (with xZn = 0.00 and 0.07) powders, synthesized by the sol-gel method, retained the crystallographic structure of pure HA without any modification. Elemental mapping confirmed the uniform dispersion of zinc ions in the HAp lattice. The size of crystallites was 18.67 ± 2 nm for ZnHAp and 21.54 ± 1 nm for HAp. The average particle size was 19.38 ± 1 nm for ZnHAp and 22.47 ± 1 nm for HAp. Antimicrobial studies indicated an inhibition of bacterial adherence to the inert substrate. In vitro biocompatibility was tested on various doses of HAp and ZnHAp after 24 and 72 h of exposure and revealed that cell viability decreased after 72 h starting with a dose of 31.25 µg/mL. However, cells retained membrane integrity and no inflammatory response was induced. High doses (such as 125 µg/mL) affected cell adhesion and the architecture of F-actin filaments, while in the presence of lower doses (such as 15.625 µg/mL), no modifications were observed. Cell proliferation was inhibited after treatment with HAp and ZnHAp, except the dose of 15.625 µg/mL ZnHAp at 72 h of exposure, when a slight increase was observed, proving an improvement in ZnHAp activity due to Zn doping.

Tunability of mechanical and biodegradation properties of zinc-based biomaterial with calcium Micronutrient alloying

Biodegradable metals are being investigated as temporary implants that dissolve safely in the body after bone regeneration. Zinc (Zn) has an intermediate biodegradation rate between magnesium and stainless steels, yet its degradation rate is too slow to function as a temporary orthopedic implant. Alloying with nutrient elements is considered a strategy to tune its mechanical properties and in vivo biodegradability. Zn/calcium (Zn/Ca) alloys (with 0.5, 1, and 2 wt% Ca) were processed by spark plasma sintering and their microstructure, mechanical, and biodegradation properties were investigated. Ca was distributed in the grain boundary regions of Zn due to its low miscibility in Zn. Furthermore, the corrosion rates of Zn/Ca alloys determined from linear polarization measurements (0.164-0.325 mm/yr) accelerated by at least 10% compared with pure sintered Zn (0.149 mm/yr) with simultaneous dissolution of Zn and Ca, as verified from X-ray diffraction analysis of the corrosion products. The alloy specimens exhibited hardness (52-58 HV) and compressive strength (93-119 MPa) comparable with those of human cortical and cancellous bones (49 HV; 90-209 MPa). This study demonstrated the tunability of the mechanical and biodegradation properties of Zn-based materials by alloying them with a nutrient element for potential application as temporary orthopedic implants.

Long-Bone-Regeneration Process in a Sheep Animal Model, Using Hydroxyapatite Ceramics Prepared by Tape-Casting Method

This study was designed to investigate the effects of hydroxyapatite (HA) ceramic implants (HA cylinders, perforated HA plates, and nonperforated HA plates) on the healing of bone defects, addressing biocompatibility, biodegradability, osteoconductivity, osteoinductivity, and osteointegration with the surrounding bone tissue. The HA ceramic implants were prepared using the tape-casting method, which allows for shape variation in samples after packing HA paste into 3D-printed plastic forms. In vitro, the distribution and morphology of the MC3T3E1 cells grown on the test discs for 2 and 9 days were visualised with a fluorescent live/dead staining assay. The growth of the cell population was clearly visible on the entire ceramic surfaces and very good osteoblastic cell adhesion and proliferation was observed, with no dead cells detected. A sheep animal model was used to perform in vivo experiments with bone defects created on the metatarsal bones, where histological and immunohistochemical tissue analysis as well as X-ray and CT images were applied. After 6 months, all implants showed excellent biocompatibility with the surrounding bone tissue with no observed signs of inflammatory reaction. The histomorphological findings revealed bone growth immediately over and around the implants, indicating the excellent osteoconductivity of the HA ceramic implants. A number of islands of bone tissue were observed towards the centres of the HA cylinders. The highest degree of biodegradation, bioresorption, and new bone formation was observed in the group in which perforated HA plates were applied. The results of this study suggest that HA cylinders and HA plates may provide a promising material for the functional long-bone-defect reconstruction and further research.

Blending with transition metals improves bioresorbable zinc as better medical implants

Zinc (Zn) is a new class of bioresorbable metal that has potential for cardiovascular stent material, orthopedic implants, wound closure devices, etc. However, pure Zn is not ideal for these applications due to its low mechanical strength and localized degradation behavior. Alloying is the most common/effective way to overcome this limitation. Still, the choice of alloying element is crucial to ensure the resulting alloy possesses sufficient mechanical strength, suitable degradation rate, and acceptable biocompatibility. Hereby, we proposed to blend selective transition metals (i.e., vanadium-V, chromium-Cr, and zirconium-Zr) to improve Zn's properties. These selected transition metals have similar properties to Zn and thus are beneficial for the metallurgy process and mechanical property. Furthermore, the biosafety of these elements is of less concern as they all have been used as regulatory approved medical implants or a component of an implant such as Ti6Al4V, CoCr, or Zr-based dental implants. Our study showed the first evidence that blending with transition metals V, Cr, or Zr can improve Zn's properties as bioresorbable medical implants. In addition, three in vivo implantation models were explored in rats: subcutaneous, aorta, and femoral implantations, to target the potential clinical applications of bioresorbable Zn implants.

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Tensile strength and elongation of Zn alloys can reach over 220 MPa and 30%, respectively.

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Three in vivo implantation models to investigate and compare biodegradations behavior at different locations of the body.

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Zn–Zr and Zn–V alloys can induce pro-regenerative inflammation responses in aortas.

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All Zn alloys can promote osteointegration in femur.

Microstructures, mechanical and corrosion properties of graphene nanoplatelet-reinforced zinc matrix composites for implant applications

Zinc (Zn)-based alloys and composites are gaining increasing interest as promising biodegradable implant materials due to their appropriate biodegradation rates and biological functionalities. However, the inadequate mechanical strength and ductility of pure Zn have restricted its application. In this study, Zn matrix composites (ZMCs) reinforced with 0.1-0.4 wt.% graphene nanoplatelets (GNP) fabricated via powder metallurgy were investigated as potential biodegradable implant materials. The microstructures, mechanical properties, and corrosion behaviors of the GNP-reinforced ZMCs were characterized using optical microscopy, scanning electron microscopy combined with energy-dispersive X-ray spectroscopy, Raman spectroscopy, compression testing, and electrochemical and immersion testing in Hanks' balanced salt solution (HBSS). The microstructural study revealed that the GNP was uniformly dispersed in the ZMCs after ball milling and sintering at 420°C for 6 h. The microhardness, compressive yield strength, ultimate compressive strength, and compressive strain of the ZMC-0.2GNP were 69 HV, 123 MPa, 247 MPa, and 23 %, respectively, improvements of ∼ 18 %, 50%, ∼ 28%, and ∼ 15% compared to pure Zn. The corrosion rate of the ZMCs were lower than that of the pure Zn in HBSS, and the ZMC-0.2GNP composite exhibited the lowest corrosion rate of 0.09 mm/y as measured by electrochemical testing. Biocompatibility assessment indicated that the diluted extracts of pure Zn and GNP-reinforced ZMCs with concentrations of 12.5% and 6.25% exhibited no cytotoxicity after cell culturing for up to 5 days, and the diluted extracts of ZMC-0.2 GNP composite revealed more than 90% cell viability after cell culturing of 3 days, showing the satisfying cytocompatibility. STATEMENT OF SIGNIFICANCE: Biodegradable Zn is a promising candidate material for orthopedic implant applications. Nonetheless, the inadequate mechanical strength and ductility of pure Zn limited its clinical application. In this study, Zn matrix composites (ZMCs) reinforced with 0.1-0.4 wt.% graphene nanoplatelets (GNP) were developed via powder metallurgy, and the reinforcing efficacy of GNP on their mechanical properties was investigated. The addition of GNP significantly improved the compressive properties of ZMCs, with the Zn-0.2GNP composite exhibiting the best compressive properties, including 123 MPa compressive yield strength, 247 MPa ultimate compressive strength, and 22.9% compressive strain. Further, the 12.5% concentration extract of the ZMCs exhibited no cytotoxicity after cell culturing for 5 d toward SaOS2 cells.

Systematic in vitro and in vivo study on biodegradable binary Zn-0.2 at% Rare Earth alloys (Zn-RE: Sc, Y, La-Nd, Sm-Lu)

Biomedical implants and devices for tissue engineering in clinics, mainly made of polymers and stiff metallic materials, require possibly secondary surgery or life-long medicine. Biodegradable metals for biomedical implants and devices exhibit huge potential to improve the prognosis of patients. In this work, we developed a new type of biodegradable binary zinc (Zn) alloys with 16 rare earth elements (REEs) including Sc, Y, La to Nd, and Sm to Lu, respectively. The effects of REEs on the alloy microstructure, mechanical properties, corrosion behavior and in vitro and in vivo biocompatibility of Zn were systematically investigated using pure Zn as control. All Zn-RE alloys generally exhibited improved mechanical properties, and biocompatibilities compared to pure Zn, especially the tensile strength and ductility of Zn-RE alloys were dramatically enhanced. Among the Zn-RE alloys, different REEs presented enhancement effects at varied extent. Y, Ho and Lu were the three elements displaying greatest improvements in majority of alloys properties, while Eu, Gd and Dy exhibited least improvement. Furthermore, the Zn-RE alloys were comparable with other Zn alloys and also exhibited superior properties to Mg-RE alloys. The in vivo experiment using Zn-La, Zn-Ce, and Zn-Nd alloys as tibia bone implants in rabbit demonstrated the excellent tissue biocompatibility and much more obvious osseointegration than the pure Zn control group. This work presented the significant potential of the developed Zn-RE binary alloys as novel degradable metal for biomedical implants and devices.

Additively manufactured pure zinc porous scaffolds for critical-sized bone defects of rabbit femur

Additive manufacturing has received attention for the fabrication of medical implants that have customized and complicated structures. Biodegradable Zn metals are revolutionary materials for orthopedic implants. In this study, pure Zn porous scaffolds with diamond structures were fabricated using customized laser powder bed fusion (L-PBF) technology. First, the mechanical properties, corrosion behavior, and biocompatibility of the pure Zn porous scaffolds were characterized in vitro. The scaffolds were then implanted into the rabbit femur critical-size bone defect model for 24 weeks. The results showed that the pure Zn porous scaffolds had compressive strength and rigidity comparable to those of cancellous bone, as well as relatively suitable degradation rates for bone regeneration. A benign host response was observed using hematoxylin and eosin (HE) staining of the heart, liver, spleen, lungs, and kidneys. Moreover, the pure Zn porous scaffold showed good biocompatibility and osteogenic promotion ability in vivo. This study showed that pure Zn porous scaffolds with customized structures fabricated using L-PBF represent a promising biodegradable solution for treating large bone defects.

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L-PBF used to fabricate pure Zn porous scaffolds for bone implants.

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Degradation rates and mechanical strength suitable for bone implants.

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Pure Zn porous scaffolds showed good in vitro cytocompatibility with MC3T3-E1 cells.

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Pure Zn porous scaffolds have potential for large bone defect applications with osteogenic ability.

Recent Developments in Zn-Based Biodegradable Materials for Biomedical Applications

Zn-based biodegradable alloys or composites have the potential to be developed to next-generation orthopedic implants as alternatives to conventional implants to avoid revision surgeries and to reduce biocompatibility issues. This review summarizes the current research status on Zn-based biodegradable materials. The biological function of Zn, design criteria for orthopedic implants, and corrosion behavior of biodegradable materials are briefly discussed. The performance of many novel zinc-based biodegradable materials is evaluated in terms of biodegradation, biocompatibility, and mechanical properties. Zn-based materials perform a significant role in bone metabolism and the growth of new cells and show medium degradation without the release of excessive hydrogen. The addition of alloying elements such as Mg, Zr, Mn, Ca, and Li into pure Zn enhances the mechanical properties of Zn alloys. Grain refinement by the application of post-processing techniques is effective for the development of many suitable Zn-based biodegradable materials.

Modified Biodegradation Behavior Induced Beneficial Microenvironments for Bone Regeneration by Low Addition of Gadolinium in Zinc

Zinc (Zn) shows a great potential as a biodegradable material for bone implants after a decade of systematic research and development. However, uncontrollable biodegradation behavior and biphasic dose-response prevent Zn from fulfilling its essential role in facilitating bone regeneration. In this study, the low addition of gadolinium (Gd) modifies the intrinsic microstructure of Zn in terms of grain size distribution, grain boundary misorientation, and texture. Adding Gd refines grain size distribution and creates a stronger basal plane texture in Zn, consequently, changing the current density distribution and reducing the anode dissolution rate during corrosion. As a result, uniform degradation is more predominant in Zn-0.4Gd alloy implant, in comparison to localized degradation in pure Zn implant in bone environments. The modified biodegradation behavior of the Zn-0.4Gd alloy implant induces significantly better new bone formation and osseointegration compared to the pure Zn implant. Therefore, Gd with trace amounts is able to tune the degradation behavior and improve the performance of Zn-based implants in promoting bone regeneration.

Zinc-Based Biodegradable Materials for Orthopaedic Internal Fixation

Traditional inert materials used in internal fixation have caused many complications and generally require removal with secondary surgeries. Biodegradable materials, such as magnesium (Mg)-, iron (Fe)- and zinc (Zn)-based alloys, open up a new pathway to address those issues. During the last decades, Mg-based alloys have attracted much attention by researchers. However, the issues with an over-fast degradation rate and release of hydrogen still need to be overcome. Zn alloys have comparable mechanical properties with traditional metal materials, e.g., titanium (Ti), and have a moderate degradation rate, potentially serving as a good candidate for internal fixation materials, especially at load-bearing sites of the skeleton. Emerging Zn-based alloys and composites have been developed in recent years and in vitro and in vivo studies have been performed to explore their biodegradability, mechanical property, and biocompatibility in order to move towards the ultimate goal of clinical application in fracture fixation. This article seeks to offer a review of related research progress on Zn-based biodegradable materials, which may provide a useful reference for future studies on Zn-based biodegradable materials targeting applications in orthopedic internal fixation.

Biocompatibility of Zinc Matrix Biodegradable Composites Reinforced by Graphene Nanosheets

As a new type of biodegradable implant material, zinc matrix composites have excellent potential in the application of biodegradable implants because of their better corrosion resistance than magnesium matrix materials. Our previous studies have shown that graphene nanosheet reinforced zinc matrix composites (Zn-GNS) prepared by spark plasma sintering (SPS) have good mechanical properties and suitable degradation rate. However, the biocompatibility of zinc matrix composites is still a problem of concern. The cytocompatibility and blood compatibility of pure zinc and Zn-GNS composites in vitro were studied. The results showed that Zn-GNS composites had acceptable toxicity to MG-63 human osteosarcoma cells. In addition, the hemolysis rate of pure zinc and its composites were less than 3%, which has no adverse effect on adhered platelets, and has good antithrombotic and antiadhesion platelets properties. In conclusion, the addition of GNS did not adversely affect the biocompatibility of Zn-GNS composites, which indicated that Zn-GNS composites are a promising candidate for bone implantation.

High-strength biodegradable zinc alloy implants with antibacterial and osteogenic properties for the treatment of MRSA-induced rat osteomyelitis

Implant-related infections caused by drug-resistant bacteria remain a major challenge faced by orthopedic surgeons. Furthermore, ideal prevention and treatment methods are lacking in clinical practice. Here, based on the antibacterial and osteogenic properties of Zn alloys, Ag and Li were selected as alloying elements to prepare biodegradable Zn-Li-Ag ternary alloys. Li and Ag addition improved the mechanical properties of Zn-Li-Ag alloys. The Zn-0.8Li-0.5Ag alloy exhibited the highest ultimate tensile strength (>530 MPa). Zn-Li-Ag alloys showed strong bactericidal effects on methicillin-resistant Staphylococcus aureus (MRSA) in vitro. RNA sequencing revealed two MRSA-killing mechanisms exhibited by the Zn-0.8Li-0.5Ag alloy: cellular metabolism disturbance and induction of reactive oxygen species production. To verify that the therapeutic potential of the Zn-0.8Li-0.5Ag alloy is greater than that of Ti intramedullary nails, X-ray, micro-computed tomography, microbiological, and histological analyses were conducted in a rat femoral model of MRSA-induced osteomyelitis. Treatment with Zn-0.8Li-0.5Ag alloy implants resulted in remarkable infection control and favorable bone retention. The in vivo safety of this ternary alloy was confirmed by evaluating vital organ functions and pathological morphologies. We suggest that, with its good antibacterial and osteogenic properties, Zn-0.8Li-0.5Ag alloy can serve as an orthopedic implant material to prevent and treat orthopedic implant-related infections.

A biodegradable Fe/Zn-3Cu composite with requisite properties for orthopedic applications

Zinc (Zn)-based metals and alloys are emerging as promising biodegradable implant materials due to their inherent biodegradability and good biocompatibility. However, this class of materials exhibits low mechanical strength and a slow degradation rate, which hinders their clinical application. Here we report the development of a new biodegradable Fe/Zn-3Cu composite fabricated by infiltration casting of a Zn-3Cu alloy into an Fe foam followed by hot-rolling. Our results indicate that the hot-rolled (HR) Fe/Zn-3Cu composite exhibited an α-Zn matrix phase, a secondary CuZn₅ phase, and an α-Fe phase. The HR Fe/Zn-3Cu composite exhibited an ultimate tensile strength of 269 MPa, a tensile yield strength of 210 MPa, and an elongation of 27%. The HR Fe/Zn-3Cu composite showed a degradation rate of 228 µm/year after immersion in Hanks' solution for 30 d The diluted extract of the HR Fe/Zn-3Cu composite exhibited a higher cell viability than that of the HR Zn-3Cu alloy in relation to MC3T3-E1 and MG-63 cells. Furthermore, the HR Fe/Zn-3Cu composite showed significantly better antibacterial ability than that of the HR Zn-3Cu alloy in relation to S. aureus. Overall, the HR Fe/Zn-3Cu composite can be anticipated to be a promising biodegradable implant material for bone-fixation applications. STATEMENT OF SIGNIFICANCE: This work reports a new biodegradable Fe/Zn-3Cu composite fabricated by infiltration casting and followed by hot-rolling for biodegradable bone-fixation application. Our findings demonstrated that the hot-rolled (HR) Fe/Zn-3Cu composite exhibited an ultimate tensile strength of 269.1 MPa, a tensile yield strength of 210.3 MPa, and an elongation of 26.7%. HR Fe/Zn-3Cu composite showed a degradation rate of 227.6 µm/a, higher than HR Zn-3Cu alloy after immersion in Hanks' solution for 30 d The diluted extracts of the HR Fe/Zn-3Cu composite exhibited a higher cell viability than HR Zn-3Cu alloy toward MC3T3-E1 cells. Furthermore, the HR Fe/Zn-3Cu composite showed significantly better antibacterial ability than the HR Zn-3Cu alloy toward S. aureus.

Fabrication and characterization of biodegradable Zn scaffold by vacuum heating-press sintering for bone repair

Bone repair materials with excellent mechanical properties are highly desirable, especially in load-bearing sits. However, the currently used ceramic- and polymer-based ones mainly show poor mechanical properties. Recently, biodegradable metals have attracted extensive attention due to their reliable mechanical strength and degradability. As biodegradable metals, zinc-based materials are promising due to their suitable degradation rate and good biocompatibility. Here, we fabricated biodegradable porous Zn scaffolds with relatively high mechanical properties by vacuum heating-press sintering using NaCl particles as space holders. The microstructure, actual porosity, compressive mechanical properties, in vitro degradation behavior and the vitality of osteoblasts of porous Zn scaffolds were tested and investigated. The results show the porosities of the prepared porous Zn scaffolds are ranging from 11.3 % to 63.3 %, and the pore sizes are similar to the size range of the screened NaCl particles (200-500 μm). Compressive yield strength of 14.2-73.7 MPa and compressive elastic modulus of 1.9-6.7 GPa are shown on porous Zn scaffolds, some of which approach to that of cancellous bone (2-12 MPa and 0.1-5 GPa). Compared to bulk Zn, although the porous structures cause a partial loss of strength, the reliable mechanical properties are still retained. In addition, the porous structures not only greatly increase the degradation rate, but also promote the proliferation of osteoblasts. Based on these results, biodegradable porous Zn scaffolds (porosity in the 40 %-50 %) fabricated by vacuum heating-press sintering method show high application potential for clinical bone repair.

Zinc substituted hydroxyapatite/silk fiber/methylcellulose nanocomposite for bone tissue engineering applications

Fibrous bio-composite based on silk fiber (SF), methylcellulose (MC) and zinc substituted hydroxyapatite (Zn_xCa_5-x (PO₄)₃(OH) (x = 0.1, 0.2, 0.5 and 1.0)) were obtained with the use of electrospinning (E-Spin) method. XRD, FTIR, SEM-EDAX, swelling, porosity and mechanical properties of the composites were analyzed. The elongation at break (%) (20.97-317.20 %) and tensile strength (29.85-110.92 MPa) of nanocomposites was increased with an increase in the wt% of Zn-HAP in SF/MC. An increase in the zone of inhibition with an increase in the wt% of Zn-HAP into the SF/MC was observed against E. coli (34 ± 0.33 to 47 ± 1.15), S. aureus (28 ± 0.24 to 38 ± 1.32) and C. albicans (24 ± 0.36 to 39 ± 2.36). The in-vitro biomineralization study using SBF (simulated body fluid) showed apatite layer formation on the nano-composite. In addition, the optimized (20 wt % of Zn₁.₀Ca_4.0(PO₄)₃(OH)/SF/MC) nano-composite showed good cell viability against human bone osteosarcoma (MG-63) cells.

Fabrication of Zinc loaded silicon carbide Nanocomposite for in vitro cell viability and in vivo wound dressing care

AIM

In this investigation, Zinc-silicon carbide (Zn-SiC) materials were fabricated by a simple approach by using Zn nanoparticles (Zn-NPs) loaded on silicon carbide (SiC) with enhanced antibacterial and healing activity.

METHODS

Zn-NPs loaded on SiC fabricated by the DIY laser melting technique. The TEM and Zeta-sizer confirmed the morphology and size of the nanoparticles. The characterization was done using Fourier transforms infrared spectroscopy (FTIR), and X-ray diffraction (XRD), Thermogravimetric analysis (TGA). Further, the fabricated nanoparticles were evaluated for their mechanical properties and biocompatibility under storage conditions. In-vivo wound healing was measured by observing a percentage reduction in the wound.

RESULTS

Zn-SiC NPs have 54.6 ± 5.25 nm mean particle size, -15.9 ± 2.35 mV zeta potential with 0.187 ± 0.05 polydispersity index (PD1). The nanoparticles showed good biocompatibility and in-vivo wound healing properties.

CONCLUSIONS

These results strongly support the possibility of using these Zn particles loaded on SiC NPs as a promising wound healing agent after cesarean section.

Surface Modification of Pure Zinc by Acid Etching: Accelerating the Corrosion Rate and Enhancing Biocompatibility and Antibacterial Characteristics

Zinc (Zn) has recently been identified as an auspicious biodegradable metal for medical implants and devices due to its tunable mechanical properties and good biocompatibility. However, the slow corrosion rate of Zn in a physiological environment does not meet the requirements for biodegradable implants, hindering its clinical translation. The present study aimed to accelerate the corrosion rate of pure Zn by utilizing acid etching to roughen the surface and increase the substrate surface area. The effects of acid etching on surface morphology, surface roughness, tensile properties, hardness, electrochemical corrosion and degradation behavior, cytocompatibility, direct cell attachment, and biofilm formation were investigated. Interestingly, acid-treated Zn showed an exceptionally high rate of corrosion (∼226-125 μm/year) compared to untreated Zn (∼62 μm/year), attributed to the increased surface roughness (R_a ∼ 1.12 μm) of acid-etched samples. Immersion tests in Hank's solution revealed that acid etching accelerated the degradation rate of Zn samples. In vitro, MC3T3-E1 cell lines in 50 and 25% conditioned media extracts of treated samples showed good cytocompatibility. Reduced bacterial adhesion, biofilm formation, and dispersion were observed for Staphylococci aureus biofilms cultured on acid-etched pure Zn substrates. These results suggest that the surface modification of biodegradable pure Zn metals by acid etching markedly increases the translation potential of zinc for various biomedical applications.

Feasibility evaluation of a Zn-Cu alloy for intrauterine devices: In vitro and in vivo studies

The comprehensively adopted copper-containing intrauterine devices (Cu-IUDs) present typical adverse effects such as bleeding and pain at the initial stage of post-implantation. The replacement of Cu material is demanded. Zinc and its alloys, the emerging biodegradable materials, exhibited contraceptive effects since 1969. In this work, we evaluated the feasibility of bulk Zn alloys as IUD active material. Using pure Cu and pure Zn as control groups, we investigated the contraceptive performance of Zn-0.5Cu and Zn-1Cu alloys via in vitro and in vivo tests. The results showed that the main corrosion product of Zn-Cu alloys is ZnO from both in vitro and in vivo studies. CaZn₂(PO₄)₂·2H₂O is formed atop after long-term immersion in simulated uterine fluid, whereas CaCO₃ is generally formed atop after implantation in the rat uterine environment. The cytocompatibility of the Zn-1Cu alloy was significantly higher than that of the pure Zn and pure Cu to the human endometrial epithelial cell lines. Furthermore, the in vivo results showed that the Zn-1Cu alloy presented much improved histocompatibility, least damage and the fastest recovery on endometrium structure in comparison to pure Zn, Zn-0.5Cu and pure Cu. The systematic and comparing studies suggest that Zn-1Cu alloy can be considered as a possible candidate for IUD with great biochemical and biocompatible properties as well as high contraceptive effectiveness. STATEMENT OF SIGNIFICANCE: The existing adverse effects with the intrinsic properties of copper materials for copper-containing intrauterine devices (Cu-IUD) are of concerns in their employment. Such as burst release of cupric ions (Cu²⁺) at the initial stage of the Cu-IUD. Zinc and its alloys which have been emerging as a potential biodegradable material exhibited contraceptive effects since 1969. In this study, Zn-1Cu alloys displayed significantly improved biocompatibility with human uterus cells and a decreased inflammatory response within the uterus. Therefore, high antifertility efficacy of the Zn-1Cu alloy was well maintained, while the adverse effects are significantly eased, suggesting that the Zn-1Cu alloy is promising for IUD.

A review on current research status of the surface modification of Zn-based biodegradable metals

Recently, zinc and its alloys have been proposed as promising candidates for biodegradable metals (BMs), owning to their preferable corrosion behavior and acceptable biocompatibility in cardiovascular, bone and gastrointestinal environments, together with Mg-based and Fe-based BMs. However, there is the desire for surface treatment for Zn-based BMs to better control their biodegradation behavior. Firstly, the implantation of some Zn-based BMs in cardiovascular environment exhibited intimal activation with mild inflammation. Secondly, for orthopedic applications, the biodegradation rates of Zn-based BMs are relatively slow, resulting in a long-term retention after fulfilling their mission. Meanwhile, excessive Zn2+ release during degradation will cause in vitro cytotoxicity and in vivo delayed osseointegration. In this review, we firstly summarized the current surface modification methods of Zn-based alloys for the industrial applications. Then we comprehensively summarized the recent progress of biomedical bulk Zn-based BMs as well as the corresponding surface modification strategies. Last but not least, the future perspectives towards the design of surface bio-functionalized coatings on Zn-based BMs for orthopedic and cardiovascular applications were also briefly proposed.

Zinc-nutrient element based alloys for absorbable wound closure devices fabrication: Current status, challenges, and future prospects

The need for the development of load-bearing, absorbable wound closure devices is driving the research for novel materials that possess both good biodegradability and superior mechanical characteristics. Biodegradable metals (BMs), namely: magnesium (Mg), zinc (Zn) and iron (Fe), which are currently being investigated for absorbable vascular stent and orthopaedic implant applications, are slowly gaining research interest for the fabrication of wound closure devices. The current review presents an overview of the traditional and novel BM-based intracutaneous and transcutaneous wound closure devices, and identifies Zn as a promising substitute for the traditional materials used in the fabrication of absorbable load-bearing sutures, internal staples, and subcuticular staples. In order to further strengthen Zn to be used in highly stressed situations, nutrient elements (NEs), including calcium (Ca), Mg, Fe, and copper (Cu), are identified as promising alloying elements for the strengthening of Zn-based wound closure device material that simultaneously provide potential therapeutic benefit to the wound healing process during implant biodegradation process. The influence of NEs on the fundamental characteristics of biodegradable Zn are reviewed and critically assessed with regard to the mechanical properties and biodegradability requirements of different wound closure devices. The opportunities and challenges in the development of Zn-based wound closure device materials are presented to inspire future research on this rapidly growing field.

Bone Scaffolds: An Incorporation of Biomaterials, Cells, and Biofactors

Large injuries to bones are still one of the most challenging musculoskeletal problems. Tissue engineering can combine stem cells, scaffold biomaterials, and biofactors to aid in resolving this complication. Therefore, this review aims to provide information on the recent advances made to utilize the potential of biomaterials for making bone scaffolds and the assisted stem cell therapy and use of biofactors for bone tissue engineering. The requirements and different types of biomaterials used for making scaffolds are reviewed. Furthermore, the importance of stem cells and biofactors (growth factors and extracellular vesicles) in bone regeneration and their use in bone scaffolds and the key findings are discussed. Lastly, some of the main obstacles in bone tissue engineering and future trends are highlighted.

Improved mechanical, degradation, and biological performances of Zn–Fe alloys as bioresorbable implants

Zinc (Zn) is a promising bioresorbable implant material with more moderate degradation rate compared to magnesium (Mg) and iron (Fe). However, the low mechanical strength and localized degradation behavior of pure Zn limit its clinical applications. Alloying is one of the most effective ways to overcome these limitations. After screening the alloying element candidates regarding their potentials for improvement on the degradation and biocompatibility, we proposed Fe as the alloying element for Zn, and investigated the in vitro and in vivo performances of these alloys in both subcutaneous and femoral tissues. Results showed that the uniformly distributed secondary phase in Zn–Fe alloys significantly improved the mechanical property and facilitated uniform degradation, which thus enhanced their biocompatibility, especially the Zn-0.4Fe alloy. Moreover, these Zn–Fe alloys showed outstanding antibacterial property. Taken together, Zn–Fe alloys could be promising candidates as bioresorbable medical implants for various cardiovascular, wound closure, and orthopedic applications.

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Zn-0.4Fe alloy significantly improved the mechanical strength and ductility.

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Zn-0.4Fe alloy showed a uniform degradation behavior.

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Subcutaneous and femoral implantations to compare in vivo performances.

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Zn-0.4Fe alloy showed superior hemocompatibility and in vivo osteointegration.

Impact of sterilization treatments on biodegradability and cytocompatibility of zinc-based implant materials

Biodegradable zinc (Zn) and Zn-based alloys have been recognized as promising biomaterials for biomedical implants. Sterilization is an essential step in handling Zn-based implants before their use in clinical practice and there are various sterilization methods are available. However, how these treatments influence the Zn-based biomaterials remains unknown and is of critical relevance. In this study, three commonly-applied standard sterilization methods, namely gamma irradiation, hydrogen peroxide gas plasma and steam autoclave, were used on pure Zn and Zn3Cu (wt%) alloy. The treated Zn and ZnCu alloy were investigated to compare the different influences of sterilizations on surface characteristics, transient and long-term degradation behavior and cytotoxicity of Zn and Zn alloy. Our results indicate that autoclaving brought about apparently a formation of inhomogeneous zinc oxide film whereas the other two methods produced no apparent alterations on the material surfaces. Consequently, the samples after autoclaving showed significantly faster degradation rates and more severe localized corrosion, especially for the ZnCu alloy, owing to the incomplete covering and unstable zinc oxide layer. Moreover, the autoclave-treated Zn and ZnCu alloy exhibited apparent cytotoxic effects towards fibroblasts, which may be due to the excessive Zn ion releasing and its local concentration exceeds the cellular tolerance capacity. In contrast, gamma irradiation and hydrogen peroxide gas plasma had no apparent adverse effects on the biodegradability and cytocompatibility of Zn and ZnCu alloy. Our findings may have significant implications regarding the selection of suitable sterilization methods for Zn-based implant materials among others.

Fabrication and characterization of biodegradable zinc matrix composites reinforced by uniformly dispersed beta-tricalcium phosphate via graphene oxide-assisted hetero-agglomeration

The development of biodegradable Zn matrix composites has been considered a promising approach to achieving enhanced mechanical properties, controllable degradation rate, good biocompatibility, and good osseointegration as orthopedic implants. However, scant literature regarding Zn matrix composites has been reported because of the great difficulty in dispersing the nano-sized bioactive reinforcements uniformly within the Zn matrix. In the present study, a novel and effective method were employed to obtain Zn matrix composites reinforced by uniformly dispersed beta-tricalcium phosphate (β-TCP) via graphene oxide (GO)-assisted hetero-agglomeration and subsequent spark plasma sintering process. A very low-content (0.04 vol%) few-layered GO was used as a coupling reagent to connect the Zn matrix and nano-sized TCP particles. In an appropriate polarity solvent, the negatively charged GO sheets could combine with both the positively charged Zn powder and TCP particles by electrostatic attraction and charge neutralization. Due to the nature of hetero-agglomeration, the flexible GO sheet could adhere to the large Zn powder and attracted a certain amount of TCP particles to form a Zn/GO/TCP sandwich structure by charge neutralization thereby forming a uniform dispersion of TCP particles within Zn matrix. After the spark plasma sintering (SPS) process, the TCP particles incorporated with very thin ZnO layers (thickness of a few dozen nanometers) formed a homogeneous and unique 3D network-like distribution in as-sintered TCP/Zn composites. A unique "snap pea"-like structure was confirmed at the grain boundary of α-Zn grains, which consisted of the TCP particles as "pea" and thin ZnO layer as "pod". Due to the uniform dispersion of bioactive TCP particles and unique structure of the TCP incorporating grain boundary, as-sintered 3TCP/Zn matrix composites possessed yield strength (YS) of 140.8 ± 7.7 MPa, failure strain of 36.0 ± 2.8%, the moderate degradation rate of 19.1 ± 3.3 μm·y^-1 and good cytocompatibility to MC3T3-E1 cells. Moreover, osteogenic differentiation activity evaluation revealed that the addition of TCP could significantly improve the expressions of the osteogenic differentiation-related gene (ALP) in MC3T3-E1 cells, thereby resulting in improved osteogenic capability. Therefore, biodegradable 3TCP/Zn matrix composites fabricated by GO-assisted hetero-agglomeration and subsequent SPS process could be a promising material as orthopedic implants.

Pre-oxidation induced in situ interface strengthening in biodegradable Zn/nano-SiC composites prepared by selective laser melting

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Zn/nano-SiC biocomposites were prepared via pre-oxidation and selective laser melting.

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In situ reaction improved the interface bonding between nano-SiC and the Zn matrix.

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The improved interfacial bonding enhanced the mechanical properties of the biocomposite.

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The biocomposite exhibited favorable biocompatibility on cell proliferation and adhesion.

Introduction

Nano-SiC has attracted great attention as ceramic reinforcement in metal matrix composites, but the weak interface bonding between them remains a bottleneck for efficient strengthening.

Objective

In this study, pre-oxidation treatments and selective laser melting (SLM) were employed to prepare Zn/nano-SiC biocomposites with strengthened interface bonding via in situ reaction.

Methods

Nano-SiC and Zn powders were pre-oxidized respectively, and then used to prepare Zn/nano-SiC biocomposites via SLM. The powder microstructure, and the interface characteristics and mechanical properties of the biocomposites were investigated. The degradation properties and cell response were analyzed to evaluate their feasibility for orthopedic applications.

Results

The results indicated that the pre-oxidation treatments generated a uniform oxide layer on the surface of both nano-SiC and Zn particles and the thickness of the oxide layer increased with pre-oxidation temperature. During the SLM process, the oxide layers not only improved the metal-ceramic wettability by reducing interface energy, but also induced in situ reaction to form chemical bonding between the Zn matrix and nano-SiC, thereby improving the interface bonding. Consequently, the Zn biocomposite reinforced by nano-SiC with a pre-oxidation temperature of 1000 °C (ZS1000 biocomposite) exhibited more transgranular fracture and significantly enhanced compressive yield strength of 171.5 MPa, which was 31.6% higher than that of the Zn biocomposite reinforced by nano-SiC without pre-oxidation. Moreover, the ZS1000 biocomposite presented slightly accelerated degradation which might be ascribed to the facilitated electron transfer by the interface product (Zn₂SiO₄). In addition, the ZS1000 biocomposite also showed appropriate biocompatibility for MG-63 cell adhesion, growth, and proliferation.

Conclusion

This study shows the potential practical applicability for the preparation of Zn-based biocomposites with strong interface bonding and mechanical properties for orthopedic applications.

Electrodeposited dopamine/strontium-doped hydroxyapatite composite coating on pure zinc for anti-corrosion, antimicrobial and osteogenesis

Zinc-based biometal is expected to become a new generation of biodegradable implants. Due to its antibacterial and biocompatibility in vivo, zinc metals is recently considered to be the most promising biodegradable metal, However, cytotoxicity is the thorny problem that currently restrict its application, due to the excessive Zn ions released during degradation. In order to solve these problems, dopamine modified strontium-doped hydroxyapatite coating (SrHA/PDA) was fabricated on alkali-treated pure zinc to improve its corrosion rate and cytocompatibility by electrodeposition for the first time. The obtained coating showed a dense structure and high crystallinity, which was attributed to the attraction of Ca²⁺ ions by polydopamine. The results showed that the SrHA/PDA coating delayedthe degradation rate of zinc metal, which reduced the release of Zn²⁺, thereby reducing its cytotoxicity. Additionally, electrochemical tests showed that SrHA/PDA coating can reduce the corrosion rate of pure zinc. In vitro cell viability showed that even at high Zn²⁺ concentrations (3.11 mg/L), preosteoblasts (MC3T3-E1) cells proliferated at a high rate on SrHA/PDA, thus confirming that Sr²⁺ counteracted the cytotoxic effects of Zn²⁺ and promoted cell differentiation. Moreover, the SrHA/PDA coating still maintained excellent antibacterial effects against pathogenic bacterial strains (Escherichia coli and Staphylococcus aureus). Mild pH changes had no significant effect on the viability of cells and bacterias. Collectively, the present study elucidated that by coating SrHA/PDA/Zn(OH)₂ on Zn, a controllable corrosion rate, original antibacterial properties and better cell compatibility can be achieved. This provided a new strategy for the surface modification of biodegradable Zn.

In vivo biocompatibility and degradability of a Zn-Mg-Fe alloy osteosynthesis system

Zinc is generally considered to be one of the most promising materials to be used in biodegradable implants, and many zinc alloys have been optimized to improve implant biocompatibility, degradation, and mechanical properties. However, long-term degradation leads to the prolonged presence of degradation products, which risks foreign body reactions. Herein, we investigated the in vivo biocompatibility and degradation of a biodegradable Zn–Mg–Fe alloy osteosynthesis system in the frontal bone, mandible, and femur in beagles for 1 year. Results of the routine blood, biochemical, trace element, and histological analyses of multiple organs, peripheral blood CD4/CD8a levels, and serum interleukin 2 and 4 levels showed good biocompatibility of the Zn–Mg–Fe alloy. Zinc content analysis revealed zinc accumulation in adjacent bone tissue, but not in the liver, kidney, and spleen, which was related to the degradation of the Zn–Mg–Fe alloy. The alloy demonstrated a uniform slowing degradation rate in vivo. No degradation differences in the frontal bone, mandible, and femur were observed. The degradation products included zinc oxide [ZnO], zinc hydroxide [Zn(OH)₂], hydrozincite [Zn₅(OH)₆(CO₃)₂], and hopeite [Zn₃(PO₄)₂·4H₂O]. The good biocompatibility and degradation properties of the Zn–Mg–Fe alloy render it a very attractive osteosynthesis system for clinical applications.

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Zn–Mg–Fe alloy possesses good biocompatibility.

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Zn–Mg–Fe alloy demonstrates a uniform slowing-down degradation rate in vivo.

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No degradation differences are observed in different sites, which supports the design of degradable osteosynthesis systems.

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The degradation products are zinc oxide, zinc hydroxide, hydrozincite, and hopeite.

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Zn–Mg–Fe alloy is a promising candidate for an osteosynthesis system.

What affects the biocompatibility of polymers?

In recent decades synthetic polymers have gained increasing popularity, and nowadays they are an integral part of people's daily lives. In addition, owing to their competitive advantage and being susceptible to modification, polymers have stimulated the fast development of innovative technologies in many areas of science. Biopolymers are of particular interest in various branches of medicine, such as implantology of bones, cartilage and skin tissues as well as blood vessels. Biomaterials with such specific applications must have appropriate mechanical and strength characteristics and above all they must be compatible with the surrounding tissues, human blood and its components, i.e. exhibit high hemo- and biocompatibility, low or no thrombo- and carcinogenicity, foreign body response (host response), appropriate osteoconduction, osteoinduction and mineralization. For biocompatibility improvement many surface treatment techniques have been utilized leading to fabricate the polymer biomaterials of required properties, also at nanoscale. This review paper discusses the most important physicochemical and biological factors that affect the biocompatibility, thus the reaction of the living organism after insertion of the polymer-based biomaterials, i.e. surface modification and/or degradation, surface composition (functional groups and charge), size and shapes, hydrophilic-hydrophobic character, wettability and surface free energy, topography (roughness, stiffness), crystalline and amorphous structure, nanostructure, cell adhesion and proliferation, cellular uptake. Particularly, the application of polysaccharides (chitosan, cellulose, starch) in the tissue engineering is emphasized.

Biodegradable Zn-Sr alloy for bone regeneration in rat femoral condyle defect model: In vitro and in vivo studies

Bone defects are commonly caused by severe trauma, malignant tumors, or congenital diseases and remain among the toughest clinical problems faced by orthopedic surgeons, especially when of critical size. Biodegradable zinc-based metals have recently gained popularity for their desirable biocompatibility, suitable degradation rate, and favorable osteogenesis-promoting properties. The biphasic activity of Sr promotes osteogenesis and inhibits osteoclastogenesis, which imparts Zn-Sr alloys with the ideal theoretical osteogenic properties. Herein, a biodegradable Zn-Sr binary alloy system was fabricated. The cytocompatibility and osteogenesis of the Zn-Sr alloys were significantly better than those of pure Zn in MC3T3-E1 cells. RNA-sequencing illustrated that the Zn-0.8Sr alloy promoted osteogenesis by activating the wnt/β-catenin, PI3K/Akt, and MAPK/Erk signaling pathways. Furthermore, rat femoral condyle defects were repaired using Zn-0.8Sr alloy scaffolds, with pure Ti as a control. The scaffold-bone integration and bone ingrowth confirmed the favorable in vivo repair properties of the Zn-Sr alloy, which was verified to offer satisfactory biosafety based on the hematoxylin-eosin (H&E) staining and ion concentration testing of important organs. The Zn-0.8Sr alloy was identified as an ideal bone repair material candidate, especially for application in critical-sized defects on load-bearing sites due to its favorable biocompatibility and osteogenic properties in vitro and in vivo.

Degradation-triggered release from biodegradable metallic surfaces

This work is dedicated to the investigation of drug-release control by a direct effect of degradation from biodegradable metallic surfaces. Degradation behaviors characterized by surface morphology, immersion, and electrochemical techniques demonstrated that curcumin-coated zinc (c-Zn) had a higher degradation rate compared to curcumin-coated Fe (c-Fe). High anodic dissolution rate due to the higher degradation rate and widely extended groove-like degradation structure of c-Zn propelled a higher curcumin release. On the other hand, a slower curcumin release rate shown by c-Fe scaffolds is ascribed to its lower anodic dissolution and to its pitting degradation regime with relatively smaller pits. These findings illuminate the remarkable advantage of different degradation behaviors of degradable metallic surfaces in directly controlling the drug release without the need for external electrical stimulus.

The Influence of Nanometals, Dispersed in the Electrophoretic Nanohydroxyapatite Coatings on the Ti13Zr13Nb Alloy, on Their Morphology and Mechanical Properties

In this work, nanohydroxyapatite coatings with nanosilver and nanocopper have been fabricated and studied. The presented results concern coatings with a chemical composition that has never been proposed before. The present research aims to characterize the effects of nanosilver and nanocopper, dispersed in nanohydroxyapatite coatings and deposited on a new, non-toxic Ti13Zr13Nb alloy, on the physical and mechanical properties of coatings. The coatings were obtained by a one-stage electrophoretic process. The surface topography, and the chemical and phase compositions of coatings were examined with scanning electron microscopy, atomic force microscopy, X-ray diffractometry, glow discharge optical emission spectroscopy, and energy-dispersive X-ray spectroscopy. The mechanical properties of coatings were determined by nanoindentation tests, while coatings adhesion was determined by nanoscratch tests. The results demonstrate that copper addition increases the hardness and adhesion. The presence of nanosilver has no significant influence on the adhesion of coatings.

In vitro and in vivo studies to evaluate the feasibility of Zn-0.1Li and Zn-0.8Mg application in the uterine cavity microenvironment compared to pure zinc

Significant advances have been achieved in the research evaluating Zn and its alloys as degradable metallic biomaterials mainly for application in bone and blood vessels. In the present study, the degradation behaviors of Zn-0.1Li and Zn-0.8Mg alloys in simulated uterine fluid (SUF) were systematically investigated for 300 days. In vitro viability assays were conducted in different uterine cells (HUSMCs, HEECs, and HESCs), and histological examination after the in vivo implantation into the uterine cavity was performed using pure Zn as control. The immersion test results indicated that both Zn-0.1Li and Zn-0.8Mg alloys exhibited better corrosion resistance than pure Zn, with Zn₃(PO₄)₂⋅4H₂O and CaZn₂(PO₄)₂⋅2H₂O being the main corrosion products detected in the SUF in addition to ZnO. The cell cytotoxicity assays revealed that Zn-0.1Li and Zn-0.8Mg exhibited better cytocompatibility than Zn. Moreover, the in vivo experiments demonstrated that the Zn-0.1Li and Zn-0.8Mg alloys induced less inflammation in the uterine tissue than pure Zn, with CaCO₃ and Zn(HPO₄)⋅3H₂O being the major biocorrosion products in addition to ZnO. According to these results, zinc alloys appear to be suitable potential candidate materials for future intrauterine biomedical devices.