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S. AD, P. SPA, Naveen J, Khan T, Khahro SH. Advancement in biomedical implant materials-a mini review. Front Bioeng Biotechnol 2024; 12:1400918. [PMID: 39021364 PMCID: PMC11252025 DOI: 10.3389/fbioe.2024.1400918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/31/2024] [Indexed: 07/20/2024] Open
Abstract
Metal alloys like stainless steel, titanium, and cobalt-chromium alloys are preferable for bio-implants due to their exceptional strength, tribological properties, and biocompatibility. However, long-term implantation of metal alloys can lead to inflammation, swelling, and itching because of ion leaching. To address this issue, polymers are increasingly being utilized in orthopedic applications, replacing metallic components such as bone fixation plates, screws, and scaffolds, as well as minimizing metal-on-metal contact in total hip and knee joint replacements. Ceramics, known for their hardness, thermal barrier, wear, and corrosion resistance, find extensive application in electrochemical, fuel, and biomedical industries. This review delves into a variety of biocompatible materials engineered to seamlessly integrate with the body, reducing adverse reactions like inflammation, toxicity, or immune responses. Additionally, this review examines the potential of various biomaterials including metals, polymers, and ceramics for implant applications. While metallic biomaterials remain indispensable, polymers and ceramics show promise as alternative options. However, surface-modified metallic materials offer a hybrid effect, combining the strengths of different constituents. The future of biomedical implant materials lies in advanced fabrication techniques and personalized designs, facilitating tailored solutions for complex medical needs.
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Affiliation(s)
- Ashish Daniel S.
- School of Mechanical Engineering, Vellore Institute of Technology, Vellore, India
| | - Suya Prem Anand P.
- School of Mechanical Engineering, Vellore Institute of Technology, Vellore, India
| | - Jesuarockiam Naveen
- School of Mechanical Engineering, Vellore Institute of Technology, Vellore, India
| | - Tabrej Khan
- Department of Engineering Management, Faculty of Engineering, Prince Sultan University, Riyadh, Saudi Arabia
| | - Shabir Hussain Khahro
- Department of Engineering Management, Faculty of Engineering, Prince Sultan University, Riyadh, Saudi Arabia
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2
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Liang W, Zhou C, Bai J, Zhang H, Long H, Jiang B, Dai H, Wang J, Zhang H, Zhao J. Current developments and future perspectives of nanotechnology in orthopedic implants: an updated review. Front Bioeng Biotechnol 2024; 12:1342340. [PMID: 38567086 PMCID: PMC10986186 DOI: 10.3389/fbioe.2024.1342340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Orthopedic implants are the most commonly used fracture fixation devices for facilitating the growth and development of incipient bone and treating bone diseases and defects. However, most orthopedic implants suffer from various drawbacks and complications, including bacterial adhesion, poor cell proliferation, and limited resistance to corrosion. One of the major drawbacks of currently available orthopedic implants is their inadequate osseointegration at the tissue-implant interface. This leads to loosening as a result of immunological rejection, wear debris formation, low mechanical fixation, and implant-related infections. Nanotechnology holds the promise to offer a wide range of innovative technologies for use in translational orthopedic research. Nanomaterials have great potential for use in orthopedic applications due to their exceptional tribological qualities, high resistance to wear and tear, ability to maintain drug release, capacity for osseointegration, and capability to regenerate tissue. Furthermore, nanostructured materials possess the ability to mimic the features and hierarchical structure of native bones. They facilitate cell proliferation, decrease the rate of infection, and prevent biofilm formation, among other diverse functions. The emergence of nanostructured polymers, metals, ceramics, and carbon materials has enabled novel approaches in orthopaedic research. This review provides a concise overview of nanotechnology-based biomaterials utilized in orthopedics, encompassing metallic and nonmetallic nanomaterials. A further overview is provided regarding the biomedical applications of nanotechnology-based biomaterials, including their application in orthopedics for drug delivery systems and bone tissue engineering to facilitate scaffold preparation, surface modification of implantable materials to improve their osteointegration properties, and treatment of musculoskeletal infections. Hence, this review article offers a contemporary overview of the current applications of nanotechnology in orthopedic implants and bone tissue engineering, as well as its prospective future applications.
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Affiliation(s)
- Wenqing Liang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Chao Zhou
- Department of Orthopedics, Zhoushan Guanghua Hospital, Zhoushan, China
| | - Juqin Bai
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Hongwei Zhang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Hengguo Long
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Bo Jiang
- Rehabilitation Department, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Haidong Dai
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Jiangwei Wang
- Medical Research Center, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Hengjian Zhang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Jiayi Zhao
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
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Mohanty S, Gokuldoss Prashanth K. Metallic Coatings through Additive Manufacturing: A Review. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2325. [PMID: 36984204 PMCID: PMC10056185 DOI: 10.3390/ma16062325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Metallic additive manufacturing is expeditiously gaining attention in advanced industries for manufacturing intricate structures for customized applications. However, the inadequate surface quality has inspired the inception of metallic coatings through additive manufacturing methods. This work presents a brief review of the different genres of metallic coatings adapted by industries through additive manufacturing technologies. The methodologies are classified according to the type of allied energies used in the process, such as direct energy deposition, binder jetting, powder bed fusion, hot spray coatings, sheet lamination, etc. Each method is described in detail and supported by relevant literature. The paper also includes the needs, applications, and challenges involved in each process.
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Affiliation(s)
- Shalini Mohanty
- Department of Mechanical and Industrial Engineering, Tallinn University of Technology, 12818 Tallinn, Estonia
| | - Konda Gokuldoss Prashanth
- Department of Mechanical and Industrial Engineering, Tallinn University of Technology, 12818 Tallinn, Estonia
- CBCMT, School of Mechanical Engineering, Vellore Institute of Technology, Vellore 630014, Tamil Nadu, India
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Martín-García M, Aguilera-Correa JJ, Arenas MÁ, García-Diego IM, Conde A, de Damborenea JJ, Esteban J. Differences in In Vitro Bacterial Adherence between Ti6Al4V and CoCrMo Alloys. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1505. [PMID: 36837133 PMCID: PMC9959577 DOI: 10.3390/ma16041505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Prosthetic joint infection is an uncommon entity, but it supposes high costs, both from the economic side to the health systems and from the emotional side of the patient. The evaluation of the bacterial adherence to different materials frequently involved in joint prostheses allows us to better understand the mechanisms underlying this and provide information for the future development of prevention strategies. This study evaluated the bacterial adherence of four different species (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa) on Ti6Al4V and CoCrMo. The topography, surface contact angles, and linear average roughness were measured in the samples from both alloys. The interaction with the surface of both alloys was significantly different, with the CoCrMo showing an aggregating effect on all the species, with additional anti-adherent activity in the case of Pseudomonas aeruginosa. The viability also changes, with a significant decrease (p < 0.05) in the CoCrMo alloy. In the case of S. epidermidis, the viability in the supernatant from the samples was different, too, with a decrease in the colony-forming units in the Ti6Al4V, which could be related to cation release from the surface. Beyond adhesion is a multifactorial and complex process, and considering that topography and wettability were similar, the chemical composition could play a main role in the different properties observed.
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Affiliation(s)
- Marta Martín-García
- Department of Clinical Microbiology, University Hospital Fundación Jiménez Díaz, IIS-FJD, 28040 Madrid, Spain
| | - John Jairo Aguilera-Correa
- Department of Clinical Microbiology, University Hospital Fundación Jiménez Díaz, IIS-FJD, 28040 Madrid, Spain
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Ángeles Arenas
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Ignacio M. García-Diego
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Ana Conde
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Juan José de Damborenea
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Jaime Esteban
- Department of Clinical Microbiology, University Hospital Fundación Jiménez Díaz, IIS-FJD, 28040 Madrid, Spain
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
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Atapour M, Sanaei S, Wei Z, Sheikholeslam M, Henderson JD, Eduok U, Hosein YK, Holdsworth DW, Hedberg YS, Ghorbani HR. In vitro corrosion and biocompatibility behavior of CoCrMo alloy manufactured by laser powder bed fusion parallel and perpendicular to the build direction. Electrochim Acta 2023. [DOI: 10.1016/j.electacta.2023.142059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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6
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Metallic Implants Used in Lumbar Interbody Fusion. MATERIALS 2022; 15:ma15103650. [PMID: 35629676 PMCID: PMC9146470 DOI: 10.3390/ma15103650] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/07/2023]
Abstract
Over the last decade, pedicle fixation systems have evolved and modifications in spinal fusion techniques have been developed to increase fusion rates and improve clinical outcomes after lumbar interbody fusion (LIF). Regarding materials used for screw and rod manufacturing, metals, especially titanium alloys, are the most popular resources. In the case of pedicle screws, that biomaterial can be also doped with hydroxyapatite, CaP, ECM, or tantalum. Other materials used for rod fabrication include cobalt-chromium alloys and nitinol (nickel-titanium alloy). In terms of mechanical properties, the ideal implant used in LIF should have high tensile and fatigue strength, Young's modulus similar to that of the bone, and should be 100% resistant to corrosion to avoid mechanical failures. On the other hand, a comprehensive understanding of cellular and molecular pathways is essential to identify preferable characteristics of implanted biomaterial to obtain fusion and avoid implant loosening. Implanted material elicits a biological response driven by immune cells at the site of insertion. These reactions are subdivided into innate (primary cellular response with no previous exposure) and adaptive (a specific type of reaction induced after earlier exposure to the antigen) and are responsible for wound healing, fusion, and also adverse reactions, i.e., hypersensitivity. The main purposes of this literature review are to summarize the physical and mechanical properties of metal alloys used for spinal instrumentation in LIF which include fatigue strength, Young's modulus, and corrosion resistance. Moreover, we also focused on describing biological response after their implantation into the human body. Our review paper is mainly focused on titanium, cobalt-chromium, nickel-titanium (nitinol), and stainless steel alloys.
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Chen MQ. Recent Advances and Perspective of Nanotechnology-Based Implants for Orthopedic Applications. Front Bioeng Biotechnol 2022; 10:878257. [PMID: 35547165 PMCID: PMC9082310 DOI: 10.3389/fbioe.2022.878257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Bioimplant engineering strives to provide biological replacements for regenerating, retaining, or modifying injured tissues and/or organ function. Modern advanced material technology breakthroughs have aided in diversifying ingredients used in orthopaedic implant applications. As such, nanoparticles may mimic the surface features of real tissues, particularly in terms of wettability, topography, chemistry, and energy. Additionally, the new features of nanoparticles support their usage in enhancing the development of various tissues. The current study establishes the groundwork for nanotechnology-driven biomaterials by elucidating key design issues that affect the success or failure of an orthopaedic implant, its antibacterial/antimicrobial activity, response to cell attachment propagation, and differentiation. The possible use of nanoparticles (in the form of nanosized surface or a usable nanocoating applied to the implant’s surface) can solve a number of problems (i.e., bacterial adhesion and corrosion resilience) associated with conventional metallic or non-metallic implants, particularly when implant techniques are optimised. Orthopaedic biomaterials’ prospects (i.e., pores architectures, 3D implants, and smart biomaterials) are intriguing in achieving desired implant characteristics and structure exhibiting stimuli-responsive attitude. The primary barriers to commercialization of nanotechnology-based composites are ultimately discussed, therefore assisting in overcoming the constraints in relation to certain pre-existing orthopaedic biomaterials, critical factors such as quality, implant life, treatment cost, and pain alleviation.
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Affiliation(s)
- Ming-Qi Chen
- Traumatic Orthopedics Yantai Mountain Hospital, Yantai, China
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8
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Fu W, Liu S, Jiao J, Xie Z, Huang X, Lu Y, Liu H, Hu S, Zuo E, Kou N, Ma G. Wear Resistance and Biocompatibility of Co-Cr Dental Alloys Fabricated with CAST and SLM Techniques. MATERIALS 2022; 15:ma15093263. [PMID: 35591597 PMCID: PMC9104588 DOI: 10.3390/ma15093263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/21/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022]
Abstract
Cobalt–chromium (Co-Cr) alloys have been widely used as dental-restoration materials for many years. This study sought to investigate whether selective laser melting (SLM) is a more appropriate process than traditional casting (CAST) for fabricating dental Co-Cr alloys. Metallurgical microscopy, X-ray photoelectron spectroscopy (XPS), Vickers hardness and nanoindentation tests, and friction and wear tests were used to evaluate the microstructure, surface compositions, mechanical properties, and wear resistance, respectively. Additionally, the biocompatibilities and cell adhesion of the alloys were evaluated with L-929 fibroblasts via CCK-8 assay, Live/Dead staining, flow cytometric analysis, scanning electron microscopy (SEM) observation and real-time PCR (RT-PCR) assay. The XPS results showed that the two alloys were all mainly comprised of Co, Cr, and O. The hardness in the CAST group equaled 7.15 ± 0.48 GPa, while in the SLM group, it equaled 9.06 ± 0.49 GPa. The friction coefficient of SLM alloys remained at approximately 0.46, but the CAST specimens fluctuated significantly. SLM alloys exhibited shallower wear scars and less wear debris compared with CAST alloys, simultaneously. Additionally, there were higher survival and expression of cell-adhesion-related genes on SLM alloys of L-929 cells, which meant that the deleterious effect on L-929 cells was significantly reduced compared with that for the CAST alloys. Overall, the wear resistances and biocompatibilities of the Co-Cr dental alloys were dramatically affected by the fabrication technique. The SLM technique is advantageous over the CAST technique for fabricating Co-Cr dental alloys.
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Affiliation(s)
- Wenqi Fu
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
| | - Shuang Liu
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
| | - Jun Jiao
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
| | - Zhiwen Xie
- School of Mechanical Engineering and Automation, University of Science and Technology Liaoning, Anshan 114051, China; (Z.X.); (X.H.)
| | - Xinfang Huang
- School of Mechanical Engineering and Automation, University of Science and Technology Liaoning, Anshan 114051, China; (Z.X.); (X.H.)
| | - Yun Lu
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
| | - Huiying Liu
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
| | - Shuhai Hu
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
| | - Enjun Zuo
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
| | - Ni Kou
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
- Correspondence: (N.K.); (G.M.)
| | - Guowu Ma
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Lvshun South Road, Dalian 116044, China; (W.F.); (S.L.); (J.J.); (Y.L.); (H.L.); (S.H.); (E.Z.)
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Lvshun South Road, Dalian 116044, China
- Correspondence: (N.K.); (G.M.)
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Singh S, Vashisth P, Meena VK, Kalyanasundaram D. Cellular studies and sustained drug delivery via nanostructures fabricated on 3D printed porous Neovius lattices of Ti6Al4V ELI. Biomed Mater 2022; 17. [PMID: 35447615 DOI: 10.1088/1748-605x/ac6922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/21/2022] [Indexed: 11/11/2022]
Abstract
Site-specific drug delivery has the potential to reduce drug dosage by 3 to 5-folds. Given the propensity of drugs used in the treatment of tuberculosis and cancers, the increased drug dosages via oral ingestion for several months to a few years of medication is often detrimental to the health of patients. In this study, the sustained delivery of drugs with multiscale structured novel Neovius lattices was achieved. 3D Neovius Open Cell Lattices (NOCL) with porosities of 40, 45, and 50 % were fabricated layer-by-layer on the laser bed fusion process. Micron-sized Ti6Al4V Eli powder was used for 3D printing. The Young's modulus achieved from the novel Neovius lattices were in the range of 1.2 to 1.6 GPa, which is comparable to human cortical bone and helps to improve implant failure due to the stress shielding effect. To provide sustained drug delivery, nanotubes (NTs) were fabricated on NOCLs via high-voltage anodisation. The osteogenic agent icariin was loaded onto the NOCL-NT samples and their release profiles were studied for 7 days. A significantly steady and slow release rate of 0.05% per hour of the drug was achieved using NOCL-NT. In addition, the initial burst release of NOCL-NT was 4 fold lower than that of the open-cell lattices without nanotubes. Cellular studies using MG63 human osteoblast-like cells were performed to determine their biocompatibility and osteogenesis which were analysed using Calcein AM staining and Alamar Blue after 1, 5, and 7 days. 3D printed NOCL samples with NTs and with Icariin loaded NTs demonstrated a significant increase in cell proliferation as compared to as printed NOCL samples.
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Affiliation(s)
- Sonu Singh
- Indian Institute of Technology Delhi, Centre for Biomedical Engineering, New Delhi, 110016, INDIA
| | - Priya Vashisth
- Mechanical Engineering, Indian Institute of Technology Delhi, II/253, Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, New Delhi, 110016, INDIA
| | - Vijay Kumar Meena
- Council of Scientific & Industrial Research, CSIR, Chandigarh, New Delhi, 110001, INDIA
| | - Dinesh Kalyanasundaram
- Indian Institute of Technology Delhi, Centre for Biomedical Engineering, New Delhi, 110016, INDIA
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Qiao K, Xu L, Tang J, Wang Q, Lim KS, Hooper G, Woodfield TBF, Liu G, Tian K, Zhang W, Cui X. The advances in nanomedicine for bone and cartilage repair. J Nanobiotechnology 2022; 20:141. [PMID: 35303876 PMCID: PMC8932118 DOI: 10.1186/s12951-022-01342-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/01/2022] [Indexed: 12/24/2022] Open
Abstract
With the gradual demographic shift toward an aging and obese society, an increasing number of patients are suffering from bone and cartilage injuries. However, conventional therapies are hindered by the defects of materials, failing to adequately stimulate the necessary cellular response to promote sufficient cartilage regeneration, bone remodeling and osseointegration. In recent years, the rapid development of nanomedicine has initiated a revolution in orthopedics, especially in tissue engineering and regenerative medicine, due to their capacity to effectively stimulate cellular responses on a nanoscale with enhanced drug loading efficiency, targeted capability, increased mechanical properties and improved uptake rate, resulting in an improved therapeutic effect. Therefore, a comprehensive review of advancements in nanomedicine for bone and cartilage diseases is timely and beneficial. This review firstly summarized the wide range of existing nanotechnology applications in the medical field. The progressive development of nano delivery systems in nanomedicine, including nanoparticles and biomimetic techniques, which are lacking in the current literature, is further described. More importantly, we also highlighted the research advancements of nanomedicine in bone and cartilage repair using the latest preclinical and clinical examples, and further discussed the research directions of nano-therapies in future clinical practice.
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Affiliation(s)
- Kai Qiao
- Department of Bone & Joint, the First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Lu Xu
- Department of Bone & Joint, the First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning, China
- Department of Dermatology, the Second Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Junnan Tang
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Qiguang Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 61004, Sichuan, China
| | - Khoon S Lim
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch, 8011, New Zealand
| | - Gary Hooper
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch, 8011, New Zealand
| | - Tim B F Woodfield
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch, 8011, New Zealand
| | - Guozhen Liu
- School of Life and Health Sciences, The Chinese University of Hong Kong (Shenzhen), Shenzhen, 518172, Guangdong, China
| | - Kang Tian
- Department of Bone & Joint, the First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning, China.
| | - Weiguo Zhang
- Department of Bone & Joint, the First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning, China.
| | - Xiaolin Cui
- Department of Bone & Joint, the First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning, China.
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch, 8011, New Zealand.
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12
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Kellens J, Berger P, Vandenneucker H. Metal wear debris generation in primary total knee arthroplasty: is it an issue? Acta Orthop Belg 2021; 87:681-695. [PMID: 35172435 DOI: 10.52628/87.4.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
More durable total knee arthroplasties (TKAs) are needed, due to the rising life expectancy, the higher activity levels of patients and the growing concerns about aseptic loosening being caused by metal hypersensitivity. In response, different hypoallergenic metal coatings have been developed for TKAs. However, possible adverse effects of these different metals (cobalt-chromium-molybdenum, zirconium, titanium and tantalum) have been neglected. The aim was to summarize the local and systemic adverse effects (including metal hypersensitivity), survival ratios, patient-reported outcome measures (PROMs) and the plasma metal ion concentrations of the different TKA coatings. A literature search on PubMed and EMBASE was performed. In total, 15 studies were found eligible. Common adverse effects of TKA were infection, loosening, pain, instability and hyper- coagulation disorders. Serious adverse effects related to TKA implants were not reported. The survival ratios and patient-reported outcome measures seem to confirm these good results. In contrast with chromium and cobalt, no significant differences were reported in the nickel, molybdenum and titanium concentrations. No significant differences between the hypoallergenic and standard TKA implants were found in terms of adverse effects, survival ratios and PROMs. A causal relationship between the common adverse effects and the different metals is unlikely. Due to the heterogeneity of the TKA implants used, no firm conclusions could be made. Further research with longer follow-up studies are needed to find possible adverse effects and differences. Thus far, the hypoallergenic implants seem to perform equal to the standard implants.
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Wei W, Dai H. Articular cartilage and osteochondral tissue engineering techniques: Recent advances and challenges. Bioact Mater 2021; 6:4830-4855. [PMID: 34136726 PMCID: PMC8175243 DOI: 10.1016/j.bioactmat.2021.05.011] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/20/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022] Open
Abstract
In spite of the considerable achievements in the field of regenerative medicine in the past several decades, osteochondral defect regeneration remains a challenging issue among diseases in the musculoskeletal system because of the spatial complexity of osteochondral units in composition, structure and functions. In order to repair the hierarchical tissue involving different layers of articular cartilage, cartilage-bone interface and subchondral bone, traditional clinical treatments including palliative and reparative methods have showed certain improvement in pain relief and defect filling. It is the development of tissue engineering that has provided more promising results in regenerating neo-tissues with comparable compositional, structural and functional characteristics to the native osteochondral tissues. Here in this review, some basic knowledge of the osteochondral units including the anatomical structure and composition, the defect classification and clinical treatments will be first introduced. Then we will highlight the recent progress in osteochondral tissue engineering from perspectives of scaffold design, cell encapsulation and signaling factor incorporation including bioreactor application. Clinical products for osteochondral defect repair will be analyzed and summarized later. Moreover, we will discuss the current obstacles and future directions to regenerate the damaged osteochondral tissues.
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Affiliation(s)
- Wenying Wei
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, China
- International School of Materials Science and Engineering, Wuhan University of Technology, Wuhan, 430070, China
| | - Honglian Dai
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, China
- Foshan Xianhu Laboratory of the Advanced Energy Science and Technology Guangdong Laboratory, Xianhu Hydrogen Valley, Foshan, 528200, China
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Afrouzian A, Avila JD, Bandyopadhyay A. Biotribocorrosion of 3D-Printed silica-coated Ti6Al4V for load-bearing implants. JOURNAL OF MATERIALS RESEARCH 2021; 36:3974-3984. [PMID: 34966214 PMCID: PMC8711032 DOI: 10.1557/s43578-021-00277-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/17/2021] [Indexed: 06/14/2023]
Abstract
Laser-based 3D Printing was utilized to deposit a silica (SiO2) coating on the surface of Ti6Al4V (Ti64) alloy for implementation onto articulating surfaces of load-bearing implants. The surface laser melting (SLM) technique was implemented in 1, and 2 laser passes (1LP and 2LP) after SiO2 deposition to understand the influence of remelting on the coating's hardness and tribological performance. It was observed that compositional and microstructural features increased the cross-sectional hardness. Wear rate was observed to decrease from 2.9×10-4 in the Ti64 to 5.2 ×10-6, 3.8×10-6, and 2.1×10-7 mm3/Nm for the as-processed or zero laser-pass (0LP), 1LP, and 2LP, respectively. Coated samples displayed a positive shift in open-circuit potential (OCP) during linear wear by displaying a 368, 85, and 613 mV increase compared to Ti64 for 0LP, 1LP, and 2LP, respectively. Our results showed promising tribological performance of SiO2 coated Ti6Al4V for articulating surfaces of load-bearing implants.
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Bandyopadhyay A, Traxel KD, Bose S. Nature-inspired materials and structures using 3D Printing. MATERIALS SCIENCE & ENGINEERING. R, REPORTS : A REVIEW JOURNAL 2021; 145:100609. [PMID: 33986582 PMCID: PMC8112572 DOI: 10.1016/j.mser.2021.100609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Emulating the unique combination of structural, compositional, and functional gradation in natural materials is exceptionally challenging. Many natural structures have proved too complex or expensive to imitate using traditional processing techniques despite recent advances. Recent innovations within the field of additive manufacturing (AM) or 3D Printing (3DP) have shown the ability to create structures that have variations in material composition, structure, and performance, providing a new design-for-manufacturing platform for the imitation of natural materials. AM or 3DP techniques are capable of manufacturing structures that have significantly improved properties and functionality over what could be traditionally-produced, giving manufacturers an edge in their ability to realize components for highly-specialized applications in different industries. To this end, the present work reviews fundamental advances in the use of naturally-inspired design enabled through 3DP / AM, how these techniques can be further exploited to reach new application areas, and the challenges that lie ahead for widespread implementation. An example of how these techniques can be applied towards a total hip arthroplasty application is provided to spur further innovation in this area.
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Affiliation(s)
- Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, USA
| | - Kellen D. Traxel
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, USA
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Sahasrabudhe H, Traxel KD, Bandyopadhyay A. Understanding wear behavior of 3D-Printed calcium phosphate-reinforced CoCrMo in biologically relevant media. J Mech Behav Biomed Mater 2021; 120:104564. [PMID: 33965811 DOI: 10.1016/j.jmbbm.2021.104564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/20/2021] [Accepted: 04/24/2021] [Indexed: 11/25/2022]
Abstract
Recent advances in the processing of wear-resistant calcium-phosphate reinforced CoCrMo composites for articulating surface applications has necessitated further investigation of performance in biological conditions relevant to patient applications. To this end, CoCrMo composites containing calcium phosphate in the form of hydroxyapatite (HA) were manufactured to study the influence of the reinforcing phase on the tribofilm formation in biologically-relevant conditions. The CoCrMo-HA composites were processed using a laser engineered net shaping (LENS™) additive manufacturing (AM) system with three distinctive compositions: CoCrMo-0%HA, CoCrMo-1%HA, and CoCrMo-3%HA. Extensive wear testing of the CoCrMo-HA composites was carried out in DMEM (cell media) and DMEM + Hyaluronic acid (found naturally in synovial fluid). Wear tests were performed at loads ranging from 5N to 20N, and wear media was measured post-test using ICP-MS techniques to release Co and Cr ions. During testing, all coefficients of friction remained in the 0.15-0.25 range, which was lower than the previously reported 0.50-0.75 range in DI water, indicating that the DMEM + hyaluronic acid media plays a significant role in reducing frictional contact. At loads higher than 15N, the HA-tribofilm exhibited a breakdown resulting in higher wear rates but still lower overall ion release than the CoCrMo control composition. Our results indicate that CoCrMo alloys with HA addition can significantly reduce wear rates and ion release even in the presence of naturally-occurring synovial-fluid friction-reducing media.
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Affiliation(s)
- Himanshu Sahasrabudhe
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Kellen D Traxel
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA.
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Avila JD, Stenberg K, Bose S, Bandyopadhyay A. Hydroxyapatite reinforced Ti6Al4V composites for load-bearing implants. Acta Biomater 2021; 123:379-392. [PMID: 33450413 DOI: 10.1016/j.actbio.2020.12.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 01/24/2023]
Abstract
Titanium has been used in various biomedical applications; however, titanium exhibits poor wear resistance, and its bioinert surface slows osseointegration in vivo. In this study, directed energy deposition (DED)-based additive manufacturing (AM) was used to process hydroxyapatite (HA) reinforced Ti6Al4V (Ti64) composites to improve biocompatibility and wear resistance simultaneously. Electron micrographs of the composites revealed dense microstructures where HA was observed at the β-phase grain boundaries. Hardness increased by 57% and 71% for 2 and 3 wt.% HA in Ti64 composites, respectively. XRD analysis revealed no change in the phases with the addition of HA, when compared to the control. Tribological studies displayed an increase in contact resistance (CR) due to an in situ formed HA-based tribofilm, reduction in wear rate when testing in Dulbecco's Modified Eagle Medium (DMEM) with a ZrO2 counter wear ball, <1% wear ball volume loss, and suppression of cohesive shear failure of the Ti matrix. Histomorphometric analysis from a rat distal femur study revealed an increase in the osteoid surface over the bone surface (OS/BS) for 3 wt.% HA composite over the control Ti64 from 9 ± 1% to 14 ± 1%. Additionally, from push-out testing, the shear modulus was observed to increase from 17 ± 3 MPa for control Ti64 to 32 ± 5 MPa for the 3 wt.% HA composite after 5-weeks in vivo. The present study demonstrates that the addition of HA in Ti64 can simultaneously improve bone tissue-implant response and wear resistance.
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Isik M, Avila JD, Bandyopadhyay A. Alumina and tricalcium phosphate added CoCr alloy for load-bearing implants. ADDITIVE MANUFACTURING 2020; 36:101553. [PMID: 33072526 PMCID: PMC7561001 DOI: 10.1016/j.addma.2020.101553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Cobalt-chromium (CoCr) alloys are used in load-bearing implants due to their excellent wear resistance. However, poor tissue-material interactions can originate due to the release of wear and corrosion-induced Co and Cr ions, motivating the use of surface modification to reduce such phenomena. Premixed feedstock powders of CoCrMo + 2 wt.% tricalcium phosphate (TCP, CoCrTCP) and CoCrMo + 2 wt.% tricalcium phosphate + 4 wt.% Al2O3 (CoCrTCP+Al) were used to surface coat CoCr alloy via Laser Engineered Net Shaping (LENS™) with the objective of increasing CoCr alloy's wear resistance. Electron micrographs of the microstructure revealed the dissociation of intergranular globular carbide phases and reprecipitation into a finer network-like microstructure with homogeneous distribution of Co and Cr. X-ray diffraction (XRD) spectra revealed texturing or preferential crystallographic orientation amongst the LENS™ processed materials, with the TCP added CoCr displaying some ε-phase stabilization. Tribological testing resulted in an 82.3% and 71.6% decrease in wear rate and wear coefficient, respectively, for CoCrTCP when compared to commercially available CoCr alloy. Additionally, in situ tribofilm development was observed for the fabricated samples via an increase in contact resistance. The current study resulted in not only a decrease in wear volume but also a decrease in the overall degradation of the coated CoCr alloy.
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Avila JD, Isik M, Bandyopadhyay A. Titanium-Silicon on CoCr Alloy for Load-Bearing Implants Using Directed Energy Deposition-Based Additive Manufacturing. ACS APPLIED MATERIALS & INTERFACES 2020; 12:51263-51272. [PMID: 33167622 DOI: 10.1021/acsami.0c15279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cobalt-chromium (CoCr) alloys offer outstanding wear resistance when compared to other biocompatible metallic materials and are extensively used in articulating surfaces of total hip and knee arthroplasty. However, CoCr alloys' biocompatibility is known to be inferior to titanium (Ti). Wear- and corrosion-induced metal-ion release from CoCr alloys has been reported to cause cancer and negative physiological impacts. In this study, CoCr alloy was coated with commercially pure Ti (CpTi) and CpTi-Silicon (CoCrTi-Si) with the specific objective of reducing Co and Cr ion release during articulation, without degrading the excellent wear resistance of the CoCr alloy. Directed energy deposition (DED), a blown powder-based laser additive manufacturing technique, was utilized to process CpTi- and CpTi-Si-based coatings on Stellite 6B commercial CoCr alloy. Scanning electron microscopy (SEM), X-ray diffraction (XRD) analyses, and hardness testing found that refined carbides and titanium silicides increased the hardness from 321 ± 13 to 758 ± 48 HV0.5. Tribological studies determined a comparable wear rate between Stellite 6B alloy and CoCrTi-Si in DI water but a statistically significant reduction in Dulbecco's Modified Eagle Medium (DMEM). The wear rates for Stellite 6B were 8.5 ± 0.8 × 10-5 and 12.9 ± 0.4 × 10-5 mm3/Nm in DI water and DMEM, respectively. While the wear rates for CoCrTi-Si were 9.1 ± 0.5 × 10-5 and 8.9 ± 0.8 × 10-5 mm3/Nm in DI water and DMEM, respectively. Contact resistance acquisition displayed the presence of a passive film formation during tribological testing. ICP-MS results for Stellite 6B and CoCrTi-Si concluded a reduction of Co ions release in DI water from 149.8 ± 66.7 to 17.5 ± 0.7 ppb and a reduction in Cr ions release from 66.7 ± 32.4 to 18.0 ± 0.5 ppb, respectively. In DMEM media, Co ion release for Stellite 6B and CoCrTi-Si reduced from 10.1 ± 1.4 to 4.1 ± 0.2 ppb and Cr ion release for Stellite 6B and CoCrTi-Si reduced from 8.7 ± 0.2 to 5.0 ± 0.7 ppb, respectively. The current study revealed a new mode of manufacturing for CoCr alloy-based load-bearing implants that can reduce toxic metal ions release due to wear- and corrosion-induced damages.
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Affiliation(s)
- Jose D Avila
- W. M. Keck Biomedical Materials Research Lab, School of Mechanical and Materials Engineering, Washington State University, Pullman, Washington 99164, United States
| | - Murat Isik
- W. M. Keck Biomedical Materials Research Lab, School of Mechanical and Materials Engineering, Washington State University, Pullman, Washington 99164, United States
| | - Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Lab, School of Mechanical and Materials Engineering, Washington State University, Pullman, Washington 99164, United States
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Tuna SH, Karaca E, Aslan İ, Pekkan G, Pekmez NÖ. Evaluation of corrosion resistance of Co-Cr alloys fabricated with different metal laser sintering systems. J Adv Prosthodont 2020; 12:114-123. [PMID: 32601530 PMCID: PMC7314628 DOI: 10.4047/jap.2020.12.3.114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 03/14/2020] [Accepted: 04/29/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the corrosion resistance of the specimens produced by five different commercial metal laser sintering (MLS) systems with their recommended Co-Cr alloy powders. MATERIALS AND METHODS The MLS machines and the alloy powders used were, ProX 100-ST2724G (St-Pro), Mysint 100-EOS SP2 (SP2-Mys), EOSINT 270-EOS SP2 (SP2-EOS), SLM 100-Starbond CoS (SB-SLM), and MLab Cusing-Remanium® Star (RS-MLab), respectively. Eight specimens from each group were prepared. Open circuit potential (Eocp) and electrochemical impedance spectroscopy (EIS) measurements of polished surfaces of the specimens were conducted in a three-electrode cell using a potentiostat-galvanostat in Fusayama-Meyer artificial saliva (AS). Specimens from each group were immersed in AS and de-ionized water for seven days. Eocp, charge transfer resistance (Rct) values, and released ions (µg/cm2 × 7d) in different solutions were determined. The specimen surfaces were observed with SEM/EDS. Results were analyzed statistically. RESULTS Eocp values have shifted to potentials that are more positive over time. Steady-state Eocp values were from high to low as follows, SB-SLM, SP2-Mys, SP2-EOS, RS-MLab, and ST-Pro, respectively. After 60 mins, RS-MLab specimens had the highest Rct value, followed by SP2-Mys, SB-SLM, SP2-EOS, and ST-Pro. In all groups, ion release was higher in AS than that in de-ionized water. CONCLUSION There were small differences among the corrosion resistances of the Co-Cr alloy specimens produced with MLS systems; meanwhile, the corrosion resistances were quite high for all specimens.
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Affiliation(s)
- Süleyman Hakan Tuna
- Department of Prosthodontics, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Erhan Karaca
- Department of Chemistry, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - İsmail Aslan
- Department of Prosthodontics, Faculty of Dentistry, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Gürel Pekkan
- Department of Prosthodontics, Faculty of Dentistry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Nuran Özçiçek Pekmez
- Department of Chemistry, Faculty of Science, Hacettepe University, Ankara, Turkey
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Kumar S, Nehra M, Kedia D, Dilbaghi N, Tankeshwar K, Kim KH. Nanotechnology-based biomaterials for orthopaedic applications: Recent advances and future prospects. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 106:110154. [DOI: 10.1016/j.msec.2019.110154] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/04/2019] [Accepted: 08/31/2019] [Indexed: 12/13/2022]
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