Effect of titanium carbide coating on the osseointegration response in vitro and in vivo

Microstructural, Mechanical, and Electrochemical Characterization of CrMoNbTiZr High-Entropy Alloy for Biomedical Application

High-entropy alloys (HEA) with superior biocompatibility, high pitting resistance, minimal debris accumulation, and reduced release of metallic ions into surrounding tissues are potential replacements for traditional metallic bio-implants. A novel equiatomic HEA based on biocompatible metals, CrMoNbTiZr, was consolidated by spark plasma sintering (SPS). The relative sintered density of the alloy was about 97% of the theoretical density, indicating the suitability of the SPS technique to produce relatively dense material. The microstructure of the sintered HEA consisted of a BCC matrix and Laves phase, corresponding to the prediction of the thermodynamic CALPHAD simulation. The HEA exhibited a global Vickers microhardness of 531.5 ± 99.7 HV, while the individual BCC and Laves phases had hardness values of 364.6 ± 99.4 and 641.8 ± 63.0 HV, respectively. Its ultimate compressive and compressive yield strengths were 1235.7 ± 42.8 MPa and 1110.8 ± 78.6 MPa, respectively. The elasticity modulus of 34.9 ± 2.9 GPa of the HEA alloy was well within the range of cortical bone and significantly lower than the values reported for commonly used biomaterials made from Ti-based and Cr-Co-based alloys. In addition, the alloy exhibited good resistance to bio-corrosion in PBS and Hanks solutions. The CrMoNbTiZr HEA exhibited an average COF of 0.43 ± 0.06, characterized mainly by abrasive and adhesive wear mechanisms. The CrMoNbTiZr alloy's mechanical, bio-corrosion, and wear resistance properties developed in this study showed a good propensity for application as a biomaterial.

Bio-corrosion behavior, antibacterial property and interaction with osteoblast of laserin-situfabricated Ti-Si-Cu coatings on Ti-6Al-4V alloy

Ti-Si-xCu coatings (TS-xC,x= 5, 10 and 15 wt.%) with advanced bio-corrosion resistance, excellent antibacterial property and biocompatibility were laser cladded on Ti-6Al-4V (TAV) substrate which is widely used as endosseous implants. The bio-corrosion resistance of the TAV substrate was improved due to the presence of Ti₅Si₃and TiCu phases in the coatings. The addition of Cu in the precursor contributes to the improvement of the antibacterial property of TAV substrate. Meanwhile, induced normal cytoskeleton, well-developed focal adhesion contacts, significant higher cell attachment and proliferation rate were observed for the TS-xC coated samples due to the formation of micro-textured morphology and presence of new phases. The bio-corrosion resistance and antibacterial property depend on Cu content addition in the TS-xC precursor. The results provide a way to fabricate such multiple functional biocoating that would improve the bio-corrosion resistance, antibacterial performance and biocompatibility of TAV.

Amorphous Carbon Coatings for Total Knee Replacements-Part II: Tribological Behavior

Diamond-like carbon coatings may decrease implant wear, therefore, they are helping to reduce aseptic loosening and increase service life of total knee arthroplasties (TKAs). This two-part study addresses the development of such coatings for ultrahigh molecular weight polyethylene (UHMWPE) tibial inlays as well as cobalt-chromium-molybdenum (CoCr) and titanium (Ti64) alloy femoral components. While the deposition of a pure (a-C:H) and tungsten-doped hydrogen-containing amorphous carbon coating (a-C:H:W) as well as the detailed characterization of mechanical and adhesion properties were the subject of Part I, the tribological behavior is studied in Part II. Pin-on-disk tests are performed under artificial synovial fluid lubrication. Numerical elastohydrodynamic lubrication modeling is used to show the representability of contact conditions for TKAs and to assess the influence of coatings on lubrication conditions. The wear behavior is characterized by means of light and laser scanning microscopy, Raman spectroscopy, scanning electron microscopy and particle analyses. Although the coating leads to an increase in friction due to the considerably higher roughness, especially the UHMWPE wear is significantly reduced up to a factor of 49% (CoCr) and 77% (Ti64). Thereby, the coating shows continuous wear and no sudden failure or spallation of larger wear particles. This demonstrated the great potential of amorphous carbon coatings for knee replacements.

In situ transformations during SLM of an ultra-strong TiC reinforced Ti composite

This work demonstrates a successful in situ method capable of producing an ultra-strong novel Ti composite without aluminium and vanadium. In this method, selective laser melting is used to conduct in situ alloying and reinforcing of a Ti/10.5 wt% Mo₂C powder mixture. It is shown that this leads to a metastable β-Ti matrix homogeneously reinforced by high aspect ratio, 50–200 nm wide and up to several micrometre long TiC whiskers. The transformations of the phases are controlled by decomposition, dissolution, diffusion, and reformation of constituents. The whisker morphology of in situ formed TiC particles is associated with directional crystal growth along the TiC_<110> direction. The developed TiC reinforced β-Ti alloy combines a hardness over 500 HV, a Young’s modulus of 126 GPa, and an ultimate compressive strength of 1642 MPa. Improving the ductility of this composite is the subject of another work.

A Review of the Effect of a Nanostructured Thin Film Formed by Titanium Carbide and Titanium Oxides Clustered around Carbon in Graphitic Form on Osseointegration

Improving the biocompatibility of implants is an extremely important step towards improving their quality. In this review, we recount the technological and biological process for coating implants with thin films enriched in titanium carbide (TiC), which provide improved cell growth and osseointegration. At first, we discuss the use of a Pulsed Laser Ablation Deposition, which produced films with a good biocompatibility, cellular stimulation and osseointegration. We then describe how Ion Plating Plasma Assisted technology could be used to produce a nanostructured layer composed by graphitic carbon, whose biocompatibility is enhanced by titanium oxides and titanium carbide. In both cases, the nanostructured coating was compact and strongly bound to the bulk titanium, thus particularly useful to protect implants from the harsh oxidizing environment of biological tissues. The morphology and chemistry of the nanostructured coating were particularly desirable for osteoblasts, resulting in improved proliferation and differentiation. The cellular adhesion to the TiC-coated substrates was much stronger than to uncoated surfaces, and the number of philopodia and lamellipodia developed by the cells grown on the TiC-coated samples was higher. Finally, tests performed on rabbits confirmed in vivo that the osseointegration process of the TiC-coated implants is more efficient than that of uncoated titanium implants.

Nanostructured TiC Layer is Highly Suitable Surface for Adhesion, Proliferation and Spreading of Cells

Cell culture is usually performed in 2D polymer surfaces; however, several studies are conducted with the aim to screen functional coating molecules to find substrates more suitable for cell adhesion and proliferation. The aim of this manuscript is to compare the cell adhesion and cytoskeleton organization of different cell types on different surfaces. Human primary fibroblasts, chondrocytes and osteoblasts isolated from patients undergoing surgery were seeded on polystyrene, poly-d-lysine-coated glass and titanium carbide slides and left to grow for several days. Then their cytoskeleton was analyzed, both by staining cells with phalloidin, which highlights actin fibers, and using Atomic Force Microscopy. We also monitored the production of Fibroblast Growth Factor-2, Bone Morphogenetic Protein-2 and Osteocalcin, using ELISA, and we highlighted production of Collagen type I in fibroblasts and osteoblasts and Collagen type II in chondrocytes by immunofluorescences. Fibroblasts, chondrocytes and osteoblasts showed both an improved proliferative activity and a good adhesion ability when cultured on titanium carbide slides, compared to polystyrene and poly-d-lysine-coated glass. In conclusion, we propose titanium carbide as a suitable surface to cultivate cells such as fibroblasts, chondrocytes and osteoblasts, allowing the preservation of their differentiated state and good adhesion properties.

Characterization of electron beam deposited Nb2O5 coatings for biomedical applications

Niobium oxide coatings deposited on Ti₆Al₄V substrates by electron beam deposition and annealed in air at 600 °C and 800 °C were evaluated for their suitability towards dental, maxillofacial or orthopaedic implant applications. A detailed physico-chemical properties investigation was carried out in order to determine their elemental and phase composition, surface morphology and roughness, mechanical properties, wettability, and corrosion resistance in simulated body fluid solution (pH = 7.4) at room temperature. The biocompatibility of the bare Ti₆Al₄V substrate and coated surfaces was evaluated by testing the cellular adhesion and viability/proliferation of human osteosarcoma cells (MG-63) after 72 h of incubation. The coatings annealed at 800 °C exhibit more phase pure nanocrystalline Nb₂O₅ surfaces with enhanced wettability, reduced porosity and enhanced corrosion resistance properties making them good candidate for dental, maxillofacial or orthopaedic implant applications.

Ti(C, N) as Barrier Coatings

Metals and their alloys are materials that have long been used in stomatological prosthetics and orthodontics. The side effects of their application include reactions of the body such as allergies. Their source can be corrosion products as well as metal ions released in the corrosion process, which penetrate the surrounding tissue. In order to prevent the harming effect of metal alloys, intensive research has been performed to purify metal prosthetic restorations by way of modifying their surface. The study presents the investigation results of Ti(C, N)-type coatings applied to alloy Ni–Cr by means of the magnetronic method. Five coatings differing in the nitrogen and carbon content were investigated. The studies included the determination of the coatings’ chemical composition, construction, as well as the amount of ions released into the environment: distilled water, 0.9% NaCl and artificial saliva. The performed investigations showed that, in reference to an alloy without a coating, each coating constitutes a barrier reducing the amount of ions transferred into the examined solutions. So, Ti(C, N)-type coatings can be considered for biomedical applications as protective coatings of non-precious metal alloys.

Direct ink writing of porous titanium (Ti6Al4V) lattice structures

Ti6Al4V components, for biomedical and aerospace sectors, are receiving a great interest especially after the advent of additive manufacturing technologies. The most used techniques are Selective Laser Sintering (SLS), Selective Laser Melting (SLM) and Electron Beam Melting (EBM). In the current research, we developed 3D-printed Ti6Al4V scaffolds by Direct Ink Writing (DIW) technology. Appropriate ink formulations, based on water-titanium powder suspensions, were achieved by controlling the rheological properties of the developed inks. After printing process, and drying, the printed components were sintered at 1400 °C under high vacuum for 3 h. Highly porous titanium scaffolds (with porosity up to 65 vol%) were produced and different geometries were printed. The influence of the porosity on the morphology, compression strength and biocompatibility of the scaffolds was investigated.

Tribocorrosion Response of Surface-Modified Ti in a 0.9% NaCl Solution

Titanium use is limited due to its poor tribological properties, and thermal oxidation (TO) and pack carburisation with limited oxygen diffusion (PCOD) are just two of the surface treatments that can be used to enhance the surface properties of Ti. In this study, commercially pure titanium was surface modified using thermal oxidation (TO) and pack carburisation with limited oxygen diffusion (PCOD). Samples were tribological tested in a 0.9% NaCl solution under a contact load of 20 N to investigate the mechanical and electrochemical response of the surface treatments. The tests conducted show that a clear benefit can be obtained in terms of the overall material loss rate using both TO and PCOD. The TO and PCOD treatments generate very different surface structures: TO produces a rutile TiO2 surface film and the PCOD treatment produces a TiC network structure. Both treatments improve the load bearing capacity with the assistance of an oxygen diffusion zone (ODZ). When subjected to sliding contact in a 0.9% NaCl solution, the results show the PCOD-Ti produced the best overall results, with a material loss rate 7.5 times lower than untreated Ti and 2.4 times lower than TO-Ti. The improved wear rate of the PCOD-Ti is attributed to the TiC network structure. The TO-Ti suffers from rapid film failure and high friction. The reduced material loss rate (MLR) of the TO-Ti is attributed to the hard wearing ODZ.

Classification and Effects of Implant Surface Modification on the Bone: Human Cell-Based In Vitro Studies

Implant surfaces are continuously being improved to achieve faster osseointegration and a stronger bone to implant interface. This review will present the various implant surfaces, the parameters for implant surface characterization, and the corresponding in vitro human cell-based studies determining the strength and quality of the bone-implant contact. These in vitro cell-based studies are the basis for animal and clinical studies and are the prelude to further reviews on how these surfaces would perform when subjected to the oral environment and functional loading.

In Vitro Biocompatibility of Si Alloyed Multi-Principal Element Carbide Coatings

In the current study, we have examined the possibility to improve the biocompatibility of the (TiZrNbTaHf)C through replacement of either Ti or Ta by Si. The coatings were deposited on Si and 316L stainless steel substrates by magnetron sputtering in an Ar+CH₄ mixed atmosphere and were examined for elemental composition, chemical bonds, surface topography, surface electrical charge and biocompatible characteristics. The net surface charge was evaluated at nano and macroscopic scale by measuring the electrical potential and work function, respectively. The biocompatible tests comprised determination of cell viability and cell attachment to the coated surface. The deposited coatings had C/(metal+Si) ratios close to unity, while a mixture of metallic carbide, free-carbon and oxidized species formed on the film surface. The coatings’ surfaces were smooth and no influence of surface roughness on electrical charge or biocompatibility was found. The biocompatible characteristics correlated well with the electrical potential/work function, suggesting a significant role of surface charge in improving biocompatibility, particularly cell attachment to coating's surface. Replacement of either Ti or Ta by Si in the (TiZrNbTaHf)C coating led to an enhanced surface electrical charge, as well as to superior biocompatible properties, with best results for the (TiZrNbSiHf)C coating.

Glass-ceramic coated Mg-Ca alloys for biomedical implant applications

Biodegradable metals and alloys are promising candidates for biomedical bone implant applications. However, due to the high rate of their biodegradation in human body environment, they should be coated with less reactive materials, such, for example, as bioactive glasses or glass-ceramics. Fort this scope, RKKP composition glass-ceramic coatings have been deposited on Mg-Ca(1.4wt%) alloy substrates by Pulsed Laser Deposition method, and their properties have been characterized by a number of techniques. The prepared coatings consist of hydroxyapatite and wollastonite phases, having composition close to that of the bulk target material used for depositions. The 100μm thick films are characterized by dense, compact and rough morphology. They are composed of a glassy matrix with various size (from micro- to nano-) granular inclusions. The average surface roughness is about 295±30nm due to the contribution of micrometric aggregates, while the roughness of the fine-texture particulates is approximately 47±4nm. The results of the electrochemical corrosion evaluation tests evidence that the RKKP coating improves the corrosion resistance of the Mg-Ca (1.4wt%) alloy in Simulated Body Fluid.

Improving Osteoblast Response In Vitro by a Nanostructured Thin Film with Titanium Carbide and Titanium Oxides Clustered around Graphitic Carbon

Introduction

Recently, we introduced a new deposition method, based on Ion Plating Plasma Assisted technology, to coat titanium implants with a thin but hard nanostructured layer composed of titanium carbide and titanium oxides, clustered around graphitic carbon. The nanostructured layer has a double effect: protects the bulk titanium against the harsh conditions of biological tissues and in the same time has a stimulating action on osteoblasts.

Results

The aim of this work is to describe the biological effects of this layer on osteoblasts cultured in vitro. We demonstrate that the nanostructured layer causes an overexpression of many early genes correlated to proteins involved in bone turnover and an increase in the number of surface receptors for α3β1 integrin, talin, paxillin. Analyses at single-cell level, by scanning electron microscopy, atomic force microscopy, and single cell force spectroscopy, show how the proliferation, adhesion and spreading of cells cultured on coated titanium samples are higher than on uncoated titanium ones. Finally, the chemistry of the layer induces a better formation of blood clots and a higher number of adhered platelets, compared to the uncoated cases, and these are useful features to improve the speed of implant osseointegration.

Conclusion

In summary, the nanostructured TiC film, due to its physical and chemical properties, can be used to protect the implants and to improve their acceptance by the bone.

Nanostructured Ti6Al4V alloy fabricated using modified alkali-heat treatment: Characterization and cell adhesion

In order to optimize the creation of a nanostructured surface on Ti6Al4V titanium alloy, an alkali treatment was performed using a 10-M NaOH solution at various temperatures (30, 40, 50, and 60°C) so as to determine the optimal temperature. This was combined with subsequent heat treatments (200, 400, 600, and 800°C) in air. The effects of different temperatures for the latter treatments on the nanostructure surface and the initial cell adhesion were evaluated, and the optimal temperature of the alkali solution was found to be 30°C. Further, the nanotopography, surface chemistry, and surface roughness of the nanoporous structure were retained after heat treatments performed at 200, 400, and 600°C, and only the phase structure was altered. The amorphous sodium titanate phase, the content of which increased with increased heat-treatment temperature, may have played a role in promoting cell adhesion on the nanoporous surface. However, heat treatment at 800°C did not enhance the cell-surface attachment. Rather, the nanostructure degraded significantly with the reappearance of Al and V.

Physical and mechanical characterisation of 3D-printed porous titanium for biomedical applications

The elastic modulus of metallic orthopaedic implants is typically 6-12 times greater than cortical bone, causing stress shielding: over time, bone atrophies through decreased mechanical strain, which can lead to fracture at the implantation site. Introducing pores into an implant will lower the modulus significantly. Three dimensional printing (3DP) is capable of producing parts with dual porosity features: micropores by process (residual pores from binder burnout) and macropores by design via a computer aided design model. Titanium was chosen due to its excellent biocompatibility, superior corrosion resistance, durability, osteointegration capability, relatively low elastic modulus, and high strength to weight ratio. The mechanical and physical properties of 3DP titanium were studied and compared to the properties of bone. The mechanical and physical properties were tailored by varying the binder (polyvinyl alcohol) content and the sintering temperature of the titanium samples. The fabricated titanium samples had a porosity of 32.2-53.4% and a compressive modulus of 0.86-2.48 GPa, within the range of cancellous bone modulus. Other physical and mechanical properties were investigated including fracture strength, density, fracture toughness, hardness and surface roughness. The correlation between the porous 3DP titanium-bulk modulus ratio and porosity was also quantified.

Carboxyl-modified single-wall carbon nanotubes improve bone tissue formation in vitro and repair in an in vivo rat model

The clinical management of bone defects caused by trauma or nonunion fractures remains a challenge in orthopedic practice due to the poor integration and biocompatibility properties of the scaffold or implant material. In the current work, the osteogenic properties of carboxyl-modified single-walled carbon nanotubes (COOH-SWCNTs) were investigated in vivo and in vitro. When human preosteoblasts and murine embryonic stem cells were cultured on coverslips sprayed with COOH-SWCNTs, accelerated osteogenic differentiation was manifested by increased expression of classical bone marker genes and an increase in the secretion of osteocalcin, in addition to prior mineralization of the extracellular matrix. These results predicated COOH-SWCNTs' use to further promote osteogenic differentiation in vivo. In contrast, both cell lines had difficulties adhering to multi-walled carbon nanotube-based scaffolds, as shown by scanning electron microscopy. While a suspension of SWCNTs caused cytotoxicity in both cell lines at levels >20 μg/mL, these levels were never achieved by release from sprayed SWCNTs, warranting the approach taken. In vivo, human allografts formed by the combination of demineralized bone matrix or cartilage particles with SWCNTs were implanted into nude rats, and ectopic bone formation was analyzed. Histological analysis of both types of implants showed high permeability and pore connectivity of the carbon nanotube-soaked implants. Numerous vascularization channels appeared in the formed tissue, additional progenitor cells were recruited, and areas of de novo ossification were found 4 weeks post-implantation. Induction of the expression of bone-related genes and the presence of secreted osteopontin protein were also confirmed by quantitative polymerase chain reaction analysis and immunofluorescence, respectively. In summary, these results are in line with prior contributions that highlight the suitability of SWCNTs as scaffolds with high bone-inducing capabilities both in vitro and in vivo, confirming them as alternatives to current bone-repair therapies.

Evaluation of biocompatibility using in vitro methods: interpretation and limitations

The in vitro biocompatibility of novel materials has to be proven before a material can be used as component of a medical device. This must be done in cell culture tests according to internationally recognized standard protocols. Subsequently, preclinical and clinical tests must be performed to verify the safety of the new material and device. The present chapter focuses on the first step, the in vitro testing according to ISO 10993-5, and critically discusses its limited significance. Alternative strategies and a brief overview of activities to improve the current in vitro tests are presented in the concluding section.

Hydroxyapatite and collagen combination-coated dental implants display better bone formation in the peri-implant area than the same combination plus bone morphogenetic protein-2-coated implants, hydroxyapatite only coated implants, and uncoated implants

PURPOSE

The objective of this study was to compare peri-implant bone formation among uncoated (UC), hydroxyapatite (HA), collagen plus HA (CH), and collagen, HA, plus bone morphogenetic protein-2 (BMP-2) implant groups.

MATERIALS AND METHODS

Implants in the UC group had acid-etched surfaces. The surface coating was applied using the aerosol deposition method. The coated surfaces were examined by scanning electron microscopy, x-ray diffraction (XRD), and Fourier-transformed infrared absorption analysis. Subsequently, 6 implants from each group (total, 24 implants) were installed in the tibias of rabbits. The animals were sacrificed at 6 weeks after implant installation. Peri-implant bone formation and bone-to-implant contact (BIC) were measured in histologic sections. Significant differences among groups were evaluated using analysis of variance.

RESULTS

Based on the measured XRD patterns, there was a characteristic HA phase (International Centre for Diffraction Data [ICDD], 086-0740) coated on the titanium (ICDD, 089-3725). Subsequent coating processes for collagen and BMP-2 did not display additional diffraction peaks, but maintained the diffraction patterns of the HA-coated titanium. The presence of collagen was verified by infrared absorption analysis. When comparing these modifications with UC surfaces, only the CH coating displayed significantly greater peri-implant bone formation and BIC (P = .003 and P < .001, respectively). Adding BMP-2 to the implant surface did not produce any advantage compared with the CH coating.

CONCLUSIONS

In this study, the CH group displayed significantly greater new bone formation and BIC than the other groups. There was no significant difference among the other groups.

Implementing tissue engineering and regenerative medicine solutions in medical implants

BACKGROUND

Surgical implants are widely used in the medical field but their long-term performance is limited due to failure of integration with tissues. This manuscript describes very well-known problems associated with implants and discusses novel solutions used in tissue engineering and regenerative medicine that can be implemented in this uncommonly discussed medical area.

SOURCES OF DATA

General and medical literature describing modifications of medical and surgical implants, biofunctionalization, tissue engineering and regenerative medicine.

AREAS OF AGREEMENT

Procedures for surgical implantation have grown substantially in the last few decades and provided improved quality of life for patients, regardless of area of implantation and device type and purpose.

AREAS OF CONTROVERSY

In general, implants fail because of lack of long-term integration with the surrounding tissues. Implant manufacturers have not addressed implant failure from the point of view of biointegration. In addition, some medical practitioners are inclined to treat implant failure by using anti-infection methods to prevent bacterial adhesion. However, both approaches are conceptually limited, as discussed in this manuscript.

GROWING POINTS

Implantation in the future will not be limited to medically needed procedures but also to a growing number of cosmetic body transformation procedures, which may include perceived 'improved implant functions' over natural tissues or organs. An additional trend is that implant procedures are being progressively performed in younger individuals.

AREAS TIMELY FOR DEVELOPING RESEARCH

Current implants generally do not allow the physician to have controlled long-term access to internal tissues in contact with the implants, for example to release specific compounds when medically needed to the problem area.

Experimental study on the osseointegration of foam TiC/Ti composites

Macroporous ceramics have demonstrated osteoconductive properties because of their biocompatibility and 3D macroporous structure, and these materials have recently been widely studied as bone replacement materials. The foam TiC/Ti composites discussed in this study have good mechanical properties, balancing out metallic toughness and ceramic strength. Furthermore, because of the high porosity and pore connectivity of these TiC/Ti composites, they have the potential to be a new bone replacement material. The purpose of this study was to evaluate the osseointegration of foam TiC/Ti composites, preliminarily discuss the TiC/Ti ossification mechanism, and to obtain reliable data on the use of foam TiC/Ti composites as bone replacement materials. The foam TiC/Ti composites were sited in 40 Japanese white rabbits for 4, 8, 12 and 24 weeks. The foam TiC/Ti composites were compared to foam SiC. M-CT (micro-computed tomography) analysis, histological analysis, SEM (scanning electron microscopy) observation and EDS (energy-dispersive x-ray spectrometer) analysis were conducted to estimate the osseointegration of the materials. The histological observations and quantitative analysis exhibited significantly more ossification area (volume), trabeculae maturity, and calcium and phosphorus content in the foam TiC/Ti composites compared to the foam SiC (p < 0.05). The results from this study suggest that the foam TiC/Ti composites possess good osseointegration capacity and have the potential to be a new bone replacement material.

Effects of carbon and nitrogen plasma immersion ion implantation on in vitro and in vivo biocompatibility of titanium alloy

Growth of bony tissues on titanium biomedical implants can be time-consuming, thereby prolonging recovery and hospitalization after surgery and a method to improve and expedite tissue-implant integration and healing is thus of scientific and clinical interests. In this work, nitrogen and carbon plasma immersion ion implantation (N-PIII and C-PIII) is conducted to modify Ti-6Al-4V to produce a graded surface layer composed of TiN and TiC, respectively. Both PIII processes do not significantly alter the surface hydrophilicity but increase the surface roughness and corrosion resistance. In vitro studies disclose improved cell adhesion and proliferation of MC3T3-E1 preosteoblasts and L929 fibroblasts after PIII. Micro-CT evaluation conducted 1 to 12 weeks after surgery reveals larger average bone volumes and less bone resorption on the N-PIII and C-PIII titanium alloy pins than the unimplanted one at every time point. The enhancements observed from both the in vitro and in vivo studies can be attributed to the good cytocompatibility, roughness, and corrosion resistance of the TiN and TiC structures which stimulate the response of preosteoblasts and fibroblasts and induce early bone formation. Comparing the two PIII processes, N-PIII is more effective and our results suggest a simple and practical means to improve the surface biocompatibility of medical-grade titanium alloy implants.

Effects of a hybrid micro/nanorod topography-modified titanium implant on adhesion and osteogenic differentiation in rat bone marrow mesenchymal stem cells

BACKGROUND AND METHODS

Various methods have been used to modify titanium implant surfaces with the aim of achieving better osseointegration. In this study, we fabricated a clustered nanorod structure on an acid-etched, microstructured titanium plate surface using hydrogen peroxide. We also evaluated biofunctionalization of the hybrid micro/nanorod topography on rat bone marrow mesenchymal stem cells. Scanning electron microscopy and x-ray diffraction were used to investigate the surface topography and phase composition of the modified titanium plate. Rat bone marrow mesenchymal stem cells were cultured and seeded on the plate. The adhesion ability of the cells was then assayed by cell counting at one, 4, and 24 hours after cell seeding, and expression of adhesion-related protein integrin β1 was detected by immunofluorescence. In addition, a polymerase chain reaction assay, alkaline phosphatase and Alizarin Red S staining assays, and osteopontin and osteocalcin immunofluorescence analyses were used to evaluate the osteogenic differentiation behavior of the cells.

RESULTS

The hybrid micro/nanoscale texture formed on the titanium surface enhanced the initial adhesion activity of the rat bone marrow mesenchymal stem cells. Importantly, the hierarchical structure promoted osteogenic differentiation of these cells.

CONCLUSION

This study suggests that a hybrid micro/nanorod topography on a titanium surface fabricated by treatment with hydrogen peroxide followed by acid etching might facilitate osseointegration of a titanium implant in vivo.

Biofunctionalization of a titanium surface with a nano-sawtooth structure regulates the behavior of rat bone marrow mesenchymal stem cells

BACKGROUND

The topography of an implant surface can serve as a powerful signaling cue for attached cells and can enhance the quality of osseointegration. A series of improved implant surfaces functionalized with nanoscale structures have been fabricated using various methods.

METHODS

In this study, using an H(2)O(2) process, we fabricated two size-controllable sawtooth-like nanostructures with different dimensions on a titanium surface. The effects of the two nano-sawtooth structures on rat bone marrow mesenchymal stem cells (BMMSCs) were evaluated without the addition of osteoinductive chemical factors.

RESULTS

These new surface modifications did not adversely affect cell viability, and rat BMMSCs demonstrated a greater increase in proliferation ability on the surfaces of the nano-sawtooth structures than on a control plate. Furthermore, upregulated expression of osteogenic-related genes and proteins indicated that the nano-sawtooth structures promote osteoblastic differentiation of rat BMMSCs. Importantly, the large nano-sawtooth structure resulted in the greatest cell responses, including increased adhesion, proliferation, and differentiation.

CONCLUSION

The enhanced adhesion, proliferation, and osteogenic differentiation abilities of rat BMMSCs on the nano-sawtooth structures suggest the potential to induce improvements in bone-titanium integration in vivo. Our study reveals the key role played by the nano-sawtooth structures on a titanium surface for the fate of rat BMMSCs and provides insights into the study of stem cell-nanostructure relationships and the related design of improved biomedical implant surfaces.

Characterization of multi-principal-element (TiZrNbHfTa)N and (TiZrNbHfTa)C coatings for biomedical applications

Multi-principal-element (TiZrNbHfTa)N and (TiZrNbHfTa)C coatings were deposited on Ti6Al4V alloy by co-sputtering of Ti, Zr, Nb, Hf and Ta metallic targets in reactive atmosphere. The coatings were analyzed for elemental and phase compositions, crystalline structure, morphology, residual stress, hardness, friction performance, wear-corrosion resistance and cell viability. For all the films, only simple fcc solid solutions with (111) preferred orientations were found, with crystallite sizes in the range 7.2-13.5 nm. The coatings were subjected to compressive stress, with values ranging from 0.8 to 1.6 GPa. The carbide coating with the highest carbon content (carbon/metal ≈1.3) exhibited the highest hardness of about 31 GPa, the best friction behavior (μ = 0.12) and the highest wear resistance (wear rate K=0.2×10(-6)mm(3)N(-1)m(-1)), when testing in simulated body fluids (SBFs). Cell viability tests proved that the osteoblast cells were adherent to the coated substrates, and a very high percentage of live cells were observed on sample surfaces, after 72 h incubation time.

Artesunate inhibits growth and induces apoptosis in human osteosarcoma HOS cell line in vitro and in vivo

This paper aims to investigate the effects of artesunate (ART) on growth and apoptosis in human osteosarcoma HOS cell line in vitro and in vivo and to explore the possible underlying mechanisms. Cell viability was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The induction of apoptosis was detected by light and transmission electron microscopy and flow cytometry. Western blot analysis was used to investigate the related mechanisms. Nude mice were further employed to investigate the antitumour activity of ART in vivo. MTT assay results demonstrated that ART selectively inhibits the growth of HOS cells in a dose- and time-dependent manner. Based on the findings of light and transmission electron microscopy, Hoechst 33258 staining, and fluorescein isothiocyanate (FITC)-annexin V staining, the cytotoxicity of ART in HOS cells occurs through apoptosis. With ART treatment, cytosolic cytochrome c was increased, Bax expression was gradually upregulated, Bcl-2 expression was downregulated, and caspase-9 and caspase-3 were activated. Thus, the intrinsic apoptotic pathway may be involved in ART-induced apoptosis. Cell cycle analysis by flow cytometry indicated that ART may induce cell cycle arrest at G(2)/M phase. In nude mice bearing HOS xenograft tumours, ART inhibited tumour growth and regulated the expressions of cleaved caspase-3 and survivin, in agreement with in vitro observations. ART has a selective antitumour activity against human osteosarcoma HOS cells, which may be related to its effects on induction of apoptosis via the intrinsic pathway. The results suggest that ART is a promising candidate for the treatment of osteosarcoma.

Osteoconductive protamine-based polyelectrolyte multilayer functionalized surfaces

The integration of orthopedic implants with host bone presents a major challenge in joint arthroplasty, spinal fusion and tumor reconstruction. The cellular microenvironment can be programmed via implant surface functionalization allowing direct modulation of osteoblast adhesion, proliferation, and differentiation at the implant--bone interface. The development of layer-by-layer assembled polyelectrolyte multilayer (PEM) architectures has greatly expanded our ability to fabricate intricate nanometer to micron scale thin film coatings that conform to complex implant geometries. The in vivo therapeutic efficacy of thin PEM implant coatings for numerous biomedical applications has previously been reported. We have fabricated protamine-based PEM thin films that support the long-term proliferation and differentiation of pre-osteoblast cells on non-cross-linked film-coated surfaces. These hydrophilic PEM functionalized surfaces with nanometer-scale roughness facilitated increased deposition of calcified matrix by osteoblasts in vitro, and thus offer the potential to enhance implant integration with host bone. The coatings can make an immediate impact in the osteogenic culture of stem cells and assessment of the osteogenic potential of new therapeutic factors.

Shape-memory NiTi with two-dimensional networks of micro-channels

A process was developed for fabricating arrays of micro-channels in shape-memory NiTi for bone implant applications, with a tailorable internal architecture expected to improve biomechanical compatibility and osseointegration. Ni-51.4 at.% Ti with 24-34 vol.% porosity was fabricated by electrochemical dissolution of parallel layers of steel wire meshes embedded within a NiTi matrix during hot pressing of NiTi powders. The resulting NiTi structures exhibit parallel layers of orthogonally interconnected micro-channels with 350-400 μm diameters that exactly replicate the steel meshes. When low-carbon steel wires are used, iron diffuses into the surrounding NiTi during the densification step, creating a Fe-enriched zone near the wires. For high-carbon steel wires, TiC forms at the steel/NiTi interface and inhibits iron diffusion but also depletes some titanium from the adjacent NiTi. In both cases, the NiTi regions near the micro-channels exhibit altered phase transformation characteristics. These NiTi structures with replicated networks of micro-channels have excellent potential as bone implants and scaffolds given: (i) the versatility in channel size, shape, fraction and spatial arrangement; (ii) their low stiffness (15-26 GPa), close to 12-17 GPa for cortical bone; (iii) their high compressive strength (420-600 MPa at 8-9% strain); and (iv) their excellent compressive strain recovery (91-94% of an applied strain of 6%) by a combination of elasticity, superelasticity and the shape-memory effect.

Initial osteoblast functions on Ti-5Zr-3Sn-5Mo-15Nb titanium alloy surfaces modified by microarc oxidation

This study is intended to evaluate the effects of microarc oxidation (MAO) on the biocompatibility of near beta titanium alloy Ti-5Zr-3Sn-5Mo-15Nb (TLM) in vitro. Two porous bioactive surfaces with different surface characteristics were grown on TLM substrates via MAO process at two different final voltages. Both calcium and phosphorus were incorporated into the oxidized surfaces, and their content was dependent on the voltage applied. Surface roughness was enhanced on the MAO surfaces, which was higher when a higher voltage was applied. After MAO treatment, water contact angles became smaller and surface energies were increased, especially the polar components, which were also related to the MAO final voltage. Cell culture experiments showed an enhanced osteoblasts adhesion, spread, and viability on the microarc oxidized surfaces, and better cell spread and viability were found on the surface formed at 450 V than that at 300 V. No obvious variations in gene expression of integrin beta1 (Itg beta 1), core binding factor-alpha1, osteopontin, collagen type I alpha2-chain, and fibronectin by osteoblasts were observed on different surfaces. The expression of osteocalcin was strikingly increased on MAO surfaces after 72 h, thus indicating enhanced osteoblasts differentiation on MAO surfaces. Interestingly, obvious enhanced bone morphogenetic proteins (BMP)-2 and BMP-4 expression was observed on MAO surfaces, which may be a reason for the enhanced osteoblasts functions on MAO-modified TLM surfaces.

Characterization and in vitro cytocompatibility of an acid-etched titanium surface

The aims of this study were to characterize the microstructure of a commercially pure titanium (cpTi) surface etched with HCl/H2SO4 (AE-cpTi) and to investigate its in vitro cytocompatibility compared to turned cpTi (T-cpTi). T-cpTi showed a grooved surface and AE-cpTi revealed a surface characterized by the presence of micropits. Surface parameters indicated that the AE-cpTi surface is more isotropic and present a greater area compared to T-cpTi. The oxide film thickness was similar between both surfaces; however, AE-cpTi presented more Ti and O and less C. Osteoblastic cell proliferation, alkaline phosphatase activity, and bone-like nodule formation were greater on T-cpTi than on AE-cpTi. These results show that acid etching treatment produced a surface with different topographical and chemical features compared to the turned one, and such surface modification affected negatively the in vitro cytocompatibility of cpTi as demonstrated by decreasing culture growth and expression of osteoblastic phenotype.

Effects of implant surface coatings and composition on bone integration: a systematic review

OBJECTIVE

The aim of the present review was to evaluate the bone integration efficacy of recently developed and marketed oral implants as well as experimental surface alterations.

MATERIALS AND METHODS

A PubMed search was performed for animal studies, human reports and studies presenting bone-to-implant contact percentage or data regarding mechanical testing.

RESULTS

For recently developed and marketed oral implants, 29 publications and for experimental surface alterations 51 publications fulfilled the inclusion criteria for this review.

CONCLUSIONS

As demonstrated in the available literature dealing with recently developed and marketed oral implants, surface-roughening procedures also affect the surface chemical composition of oral implants. There is sufficient proof that surface roughening induces a safe and predictable implant-to-bone response, but it is not clear whether this effect is due to the surface roughness or to the related change in the surface composition. The review of the experimental surface alterations revealed that thin calcium phosphate (CaP) coating technology can solve the problems associated with thick CaP coatings, while they still improve implant bone integration compared with non-coated titanium implants. Nevertheless, there is a lack of human studies in which the success rate of thin CaP-coated oral implants is compared with just roughened oral implants. No unequivocal evidence is available that suggests a positive effect on the implant bone integration of peptide sequences or growth factors coated on titanium oral implants. In contrast, the available literature suggests that bone morphogenetic protein-2 coatings might even impede the magnitude of implant-to-bone response.

Influence of a zirconia sandblasting treated surface on peri-implant bone healing: An experimental study in sheep

A sandblasting process with round zirconia (ZrO(2)) particles might be an alternative surface treatment to enhance the osseointegration of titanium dental implants. Our previous study on sheep compared smooth surface titanium implants (control) with implant surfaces sandblasted with two different granulations of ZrO(2). As the sandblasted surfaces proved superior, the present study further compared the ZrO(2) surface implant with other surface treatments currently employed: machined titanium (control), titanium oxide plasma sprayed (TPS) and alumina sandblasted (Al-SL) at different times after insertion (2, 4 and 12weeks). Twelve sheep were divided into three groups of four animals each and underwent implant insertion in tibia cortical bone under general anaesthesia. The implants with surrounding tissues were subjected to histology, histomorphometry, scanning electron microscopy and microhardness tests. The experimentation indicated that at 2weeks Zr-SL implants had the highest significant bone ingrowth (p<0.05) compared to the other implant surfaces, and a microhardness of newly formed bone inside the threads significantly higher than that of Ti. The present work shows that the ZrO(2) treatment produces better results in peri-implant newly formed bone than Ti and TPS processing, whereas its performance is similar to the Al-SL surface treatment.