In vitro and in vivo bioactivity of CoBlast hydroxyapatite coating and the effect of impaction on its osteoconductivity

Synthesis and characterization of nano-hydroxyapatite from Sardinella longiceps fish bone and its effects on human osteoblast bone cells

Organic debris in the form of fish bone wastes account to several thousand tons annually. In recent years, researchers have turned attention towards the bioconversion of organic debris into materials with biomedical applications. Accordingly, the present study synthesized nano-Hydroxyapatite (n-HAP) from bones of discarded Sardinella longiceps by the alkaline hydrolysis method. The synthesized n-HAP was characterized by using the scanning electron microscope (SEM), X-ray diffraction (XRD), atomic force microscope (AFM), and Fourier transform infrared spectroscopy (FTIR). Crushed fish bone demonstrated an agglomerate of fine and rod-like crystals as observed in SEM, whereas n-HAP exhibited a structure of dense thick particles. FTIR spectral data confirmed the functional groups such as alkanes, esters, saturated aliphatic, and aromatic groups. XRD analysis exhibited strong diffraction peaks of HAP confirming its presence in synthesized n-HAP. AFM analysis affirmed that the synthesized particles had an average size of 19.65 nm. Cell viability was tested at different concentrations (10, 50, 100, 250 μg/mL) against human osteoblast bone cells (MG-63).The maximum cell viability (141.3 ± 3.1%) was observed at 100 μg/mL (24 h). Mineralization was evaluated using Alizarin red staining of osteoblast MG-63 cells treated with n-HAP at the concentration of 50 and 100 μg/mL (0.54 ± 0.03 and 0.99 ± 0.05%) which exhibited red color indicating good results. The size, morphology, functional groups, viability and mineralization of the synthesized n-HAP are favorable for its use in bone tissue engineering and other potential osteo and dental applications.

Vacuum plasma sprayed porous titanium coating on polyetheretherketone for ACDF improves the osteogenic ability: An in vitro and in vivo study

Cervical degenerative disease is a common and frequently occurring disease, which seriously affects the health and quality of the life of patients worldwide. Anterior cervical decompression and interbody fusion is currently recognized as the gold standard for the treatment of degenerative cervical spondylosis. Polyetheretherketone (PEEK) has become the prevailing material for cervical fusion surgery. Although PEEK has excellent biocompatibility, it is difficult to form bone connection at its bone-implant interface due to its low surface hydrophilicity and conductivity. It is widely accepted that Ti has excellent osteogenic activity and biocompatibility. In this study, a Ti-PEEK composite cage was prepared by coating Ti on the surface of a PEEK cage using a vacuum plasma spraying technique to enhance the osteogenic property of PEEK. The Ti-PEEK samples were evaluated in terms of their in vitro cellular behaviors and in vivo osteointegration, and the results were compared to a pure PEEK substrate. The skeleton staining and MTS assay indicated that the MC3T3-E1 cells spread and grew well on the surface of Ti-PEEK cages. The osteogenic gene expression and western blot analysis of osteogenic protein showed upregulated bone-forming activity of MC3T3-E1 cells in Ti-PEEK cages. Furthermore, a significant increase in new bone formation was demonstrated on Ti-PEEK implants in comparison with PEEK implants at 12 weeks in a sheep cervical spine fusion test. These results proved that the Ti-PEEK cage exhibited enhanced osseointegrative properties compared to the PEEK cage both in vitro and in vivo.

Recent advances in the implant-based drug delivery in otorhinolaryngology

The surgical implant is an interdisciplinary therapeutic modality that offers unique advantages in the daily practice of otorhinolaryngology. Some well-known examples include cochlear implants, bone-anchored hearing aids, sinus stents, and tracheostomy tubes. Neuroprotective, osteogenic, anti-inflammatory, and antimicrobial effects are among their established or pursued functions. Implant-based drug delivery affords an efficient and potent approach to enhancing these therapeutic functions. Recent innovations have infiltrated all four elements of a drug-eluting implant. The purpose of this pre-clinical, biotechnology-oriented review is to discuss these developments in terms of the implant biomaterial, loaded medication, delivery pattern, and system fabrication. Cell-mediated neurotrophin release, fabrication of a hydroxyapatite-supported system, biodegradable polymer-based implants, and multiclass and multidrug delivery are some representative advancements. The ultimate goal here is to bridge the gap between biotechnology advances and clinical needs. The review is concluded with a perspective regarding the future opportunities and challenges in this popular and rapidly developing subject of research. STATEMENT OF SIGNIFICANCE: Surgical implants and local drug delivery are representative modern modalities of surgical treatment and medical treatment, respectively. Their synergy offers unique therapeutic advantages, such as minimal systemic side effects, proximity-related high efficiency, and potential absorbability. The applications of implant-based drug delivery have infiltrated otorhinolaryngology and head & neck surgery, which is well known for its related tissue diversity and surgical complexity. Examples discussed here include cochlear implants, bone-anchored hearing aids, sinus stents, and airway tubes. This timely review focuses primarily on the four fundamental components of an implant-based drug delivery system, namely implant biomaterial, loaded medication, delivery pattern, and system fabrication. A particular emphasis is placed upon the in vitro cellular and in vivo animal studies that demonstrate pre-clinical potentials.

A multifunctional dexamethasone-delivery implant fabricated using atmospheric plasma and its effects on apoptosis, osteogenesis and inflammation

Implant-based local drug delivery is a unique surgical therapy with many clinical advantages. Atmospheric pressure plasma is a novel non-thermal surface biotechnology that has only recently been applied in enhancing a surgical implant. We are the first to use this technology to successfully create a dexamethasone-delivery metallic implant. Irrespective of the loaded medication, the surface of this novel implant possesses advantageous material features including homogeneity, hydrophilicity, and optimal roughness. UV-vis spectroscopy revealed much more sustainable drug release compared to the implants produced using simple drug attachment. In addition, our drug-releasing implant was found to have multiple biological benefits. As proven by the ELISA data, this multi-layer drug complex provides differential regulation on the cell apoptosis, as well as pro-osteogenic and anti-inflammatory effects on the peri-implant tissue. Furthermore, using the pathway-specific PCR array, our study discovered 28 and 26 upregulated and downregulated genes during osteogenesis and inflammation on our newly fabricated drug-delivery implant, respectively. The medication-induced change in molecular profile serves as a promising clue for designing future implant-based therapy. Collectively, we present atmospheric pressure plasma as a potent tool for creating a surgical implant-based drug-delivery system, which renders multiple therapeutic potentials. Graphical abstract Schematic of the APP-facilitated Dex-delivery implant. This layer-by-layer drug-releasing complex consisted of bottom plasma activation layer, middle medication layer, and top absorbable polymer layer.

Customizable Implant-specific and Tissue-Specific Extracellular Matrix Protein Coatings Fabricated Using Atmospheric Plasma

Progression in implant science has benefited from ample amount of technological contributions from various disciplines, including surface biotechnology. In this work, we successfully used atmospheric plasma to enhance the biological functions of surgical implants by coating them with extracellular matrix proteins. The developed collagen and laminin coatings demonstrate advantageous material properties. Chemical analysis by XPS and morphological investigation by SEM both suggested a robust coating. Contact angle goniometry and dissolution study in simulated body fluid (SBF) elicited increased hydrophilicity and physiological durability. Furthermore, these coatings exhibited improved biological interactions with human mesenchymal and neural stem cells (NSCs). Cell adhesion, proliferation, and differentiation proved markedly refined as shown by enzymatic detachment, flow cytometry, and ELISA data, respectively. Most importantly, using the pathway-specific PCR array, our study discovered dozens of deregulated genes during osteogenesis and neurogenesis on our newly fabricated ECM coatings. The coating-induced change in molecular profile serves as a promising clue for designing future implant-based therapy. Collectively, we present atmospheric plasma as a versatile tool for enhancing surgical implants, through customizable implant-specific and tissue-specific coatings.

Bioactive injectable polymethylmethacrylate/silicate bioceramic hybrid cements for percutaneous vertebroplasty and kyphoplasty

Polymethylmethacrylate (PMMA) cement has been widely used to fill and stabilize hard tissue defects in clinical surgery, especially in percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). However, the dense body of pure PMMA in defects has no ability to promote bone regeneration. We herein aim to fabricate novel PMMA/silicate bioceramic hybrid cements by adding bioactive calcium silicate (CS) particles into PMMA to endow PMMA/CS hybrid cements with bioactivity and biodegradability without losing the excellent mechanical strength and injectability. Following comprehensive characterization of the physicochemical properties and in vitro bioactivity study, our results showed compared with PMMA cement, the constructed PMMA/CS hybrid cements possessed significantly lower curing temperatures and simultaneously retained the acceptable mechanical strength and injectability. Moreover, obvious bioactive ion release and hydroxyapatite formation could be detected and observed after the PMMA/CS hybrid cements were soaked in simulated body fluid, indicating their pronounced bioactivity. A further in vivo study of the PMMA/CS hybrid cements on goat vertebral body defect models reflected that the PMMA/CS hybrid cements could be biodegraded well and could significantly promote new bone formation in defects 6 months of post-injection. Our results suggest that PMMA/CS hybrid cements may be promising candidates for PVP and PKP in clinic.

Comparative investigation of human amniotic epithelial cells and mesenchymal stem cells for application in bone tissue engineering

Emerging evidence suggests amniotic epithelial cells (AECs) as a promising source of progenitor cells in regenerative medicine and bone tissue engineering. However, investigations comparing the regenerative properties of AECs with other sources of stem cells are particularly needed before the feasibility of AECs in bone tissue engineering can be determined. This study aimed to compare human amniotic epithelial cells (hAECs), human bone marrow mesenchymal stem cells (hBMSCs), and human amniotic fluid derived mesenchymal stem cells (hAFMSCs) in terms of their morphology, proliferation, immunophenotype profile, and osteogenic capacity in vitro and in vivo. Not only greatly distinguished by cell morphology and proliferation, hAECs, hAFMSCs, and hBMSCs exhibited remarkably different signature regarding immunophenotypical profile. Microarray analysis revealed a different expression profile of genes involved in ossification along the three cell sources, highlighting the impact of different anatomical origin and molecular response to osteogenic induction on the final tissue-forming potential. Furthermore, our data indicated a potential role of FOXC2 in early osteogenic commitment.

Fiber diameter and seeding density influence chondrogenic differentiation of mesenchymal stem cells seeded on electrospun poly(ε-caprolactone) scaffolds

Chondrogenic differentiation of mesenchymal stem cells is strongly influenced by the surrounding chemical and structural milieu. Since the majority of the native cartilage extracellular matrix is composed of nanofibrous collagen fibrils, much of recent cartilage tissue engineering research has focused on developing and utilizing scaffolds with similar nanoscale architecture. However, current literature lacks consensus regarding the ideal fiber diameter, with differences in culture conditions making it difficult to compare between studies. Here, we aimed to develop a more thorough understanding of how cell-cell and cell-biomaterial interactions drive in vitro chondrogenic differentiation of bone-marrow-derived mesenchymal stem cells (MSCs). Electrospun poly(ε-caprolactone) microfibers (4.3  ±  0.8 µm diameter, 90 μm(2) pore size) and nanofibers (440  ±  20 nm diameter, 1.2 μm(2) pore size) were seeded with MSCs at initial densities ranging from 1  ×  10(5) to 4  ×  10(6) cells cm(-3)-scaffold and cultured under transforming growth factor-β (TGF-β) induced chondrogenic conditions for 3 or 6 weeks. Chondrogenic gene expression, cellular proliferation, as well as sulfated glycosaminoglycan and collagen production were enhanced on microfiber in comparison to nanofiber scaffolds, with high initial seeding densities being required for significant chondrogenic differentiation and extracellular matrix deposition. Both cell-cell and cell-material interactions appear to play important roles in chondrogenic differentiation of MSCs in vitro and consideration of several variables simultaneously is essential for understanding cell behavior in order to develop an optimal tissue engineering strategy.

Hydroxyapatite-coated sillicone rubber enhanced cell adhesion and it may be through the interaction of EF1β and γ-actin

Silicone rubber (SR) is a common soft tissue filler material used in plastic surgery. However, it presents a poor surface for cellular adhesion and suffers from poor biocompatibility. In contrast, hydroxyapatite (HA), a prominent component of animal bone and teeth, can promote improved cell compatibility, but HA is an unsuitable filler material because of the brittleness in mechanism. In this study, using a simple and economical method, two sizes of HA was applied to coat on SR to counteract the poor biocompatibility of SR. Surface and mechanical properties of SR and HA/SRs confirmed that coating with HA changes the surface topology and material properties. Analysis of cell proliferation and adhesion as well as measurement of the expression levels of adhesion related molecules indicated that HA-coated SR significantly increased cell compatibility. Furthermore, mass spectrometry proved that the biocompatibility improvement may be related to elongation factor 1-beta (EF1β)/γ-actin adjusted cytoskeletal rearrangement.

Characterization of a micro-roughened TiO2/ZrO2 coating: mechanical properties and HBMSC responses in vitro

Previous studies have shown that using ZrO2 as a second phase to bioceramics can significantly increase the bonding strength of plasma-sprayed composite material. In the present study, micro-roughened titanium dioxide/zirconia (TiO2/ZrO2) (30 wt% ZrO2) coating and TiO2 coating were plasma-sprayed onto Ti plates. The micro-structural characteristics and mechanical properties of both coatings were investigated. Furthermore, the biological behavior and osteogenic differentiation of human bone marrow mesenchymal stem cells (HBMSCs) on both TiO2/ZrO2 and TiO2 coatings were compared. The results indicated that the shear bond strength and microhardness of TiO2/ZrO2 coating were statistically higher than those of TiO2 coating. Scanning electron microscope observation revealed that more irregularly shaped protuberances and denser pores were formed on the surface of TiO2/ZrO2 coating compared with those of TiO2 coating. Further comparative analysis of HBMSC proliferation and osteogenic differentiation on both coatings showed that significantly higher cellular alkaline phosphatase activity and expression levels of Runx2 and Osterix at day 10 after osteogenic culture were found on TiO2/ZrO2 coating compared with TiO2 coating, while no statistically significant difference in cell proliferation and extracellular calcium deposition was observed. The present study suggests that TiO2/ZrO2 coating may be favorable for dental implant applications.

Surface biotechnology for refining cochlear implants

The advent of the cochlear implant is phenomenal because it is the first surgical prosthesis that is capable of restoring one of the senses. The subsequent rapid evolution of cochlear implants through increasing complexity and functionality has been synchronized with the recent advancements in biotechnology. Surface biotechnology has refined cochlear implants by directly influencing the implant–tissue interface. Emerging surface biotechnology strategies are exemplified by nanofibrous polymeric materials, topographical surface modification, conducting polymer coatings, and neurotrophin-eluting implants. Although these novel developments have received individual attention in the recent literature, the time has come to investigate their collective applications to cochlear implants to restore lost hearing.

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

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

Characterisation, corrosion resistance and in vitro bioactivity of manganese-doped hydroxyapatite films electrodeposited on titanium

This work elucidated the corrosion resistance and in vitro bioactivity of electroplated manganese-doped hydroxyapatite (MnHAp) film on NaOH-treated titanium (Ti). The NaOH treatment process was performed on Ti surface to enhance the adhesion of the MnHAp coating on Ti. Scanning electron microscopy images showed that the MnHAp coating had needle-like apatite crystals, and the approximately 10 μm thick layer was denser than HAp. Energy-dispersive X-ray spectroscopy analysis revealed that the MnHAp crystals were Ca-deficient and the Mn/P molar ratio was 0.048. X-ray diffraction confirmed the presence of single-phase MnHAp, which was aligned vertically to the substrate. Fourier transform infrared spectroscopy indicated the presence of phosphate bands ranging from 500 to 650 and 900 to 1,100 cm(-1), and a hydroxyl band at 3,571 cm(-1), which was characteristic of HAp. Bond strength test revealed that adhesion for the MnHAp coating was more enhanced than that of the HAp coating. Potentiodynamic polarisation test showed that the MnHAp-coated surface exhibited superior corrosion resistance over the HAp single-coated surface. Bioactivity test conducted by immersing the coatings in simulated body fluid showed that MnHAp coating can rapidly induce bone-like apatite nucleation and growth. Osteoblast cellular tests revealed that the MnHAp coating was better at improving the in vitro biocompatibility of Ti than the HAp coating.

Influence of substrate metal alloy type on the properties of hydroxyapatite coatings deposited using a novel ambient temperature deposition technique

Hydroxyapatite (HA) coatings are applied widely to enhance the level of osteointegration onto orthopedic implants. Atmospheric plasma spray (APS) is typically used for the deposition of these coatings; however, HA crystalline changes regularly occur during this high-thermal process. This article reports on the evaluation of a novel low-temperature (<47°C) HA deposition technique, called CoBlast, for the application of crystalline HA coatings. To-date, reports on the CoBlast technique have been limited to titanium alloy substrates. This study addresses the suitability of the CoBlast technique for the deposition of HA coatings on a number of alternative metal alloys utilized in the fabrication of orthopedic devices. In addition to titanium grade 5, both cobalt chromium and stainless steel 316 were investigated. In this study, HA coatings were deposited using both the CoBlast and the plasma sprayed techniques, and the resultant HA coating and substrate properties were evaluated and compared. The CoBlast-deposited HA coatings were found to present similar surface morphologies, interfacial properties, and composition irrespective of the substrate alloy type. Coating thickness however displayed some variation with the substrate alloy, ranging from 2.0 to 3.0 μm. This perhaps is associated with the electronegativity of the metal alloys. The APS-treated samples exhibited evidence of both coating, and significantly, substrate phase alterations for two metal alloys; titanium grade 5 and cobalt chrome. Conversely, the CoBlast-processed samples exhibited no phase changes in the substrates after depositions. The APS alterations were attributed to the brief, but high-intensity temperatures experienced during processing.

Investigating the feasibility of using a grit blasting process to coat nitinol stents with hydroxyapatite

This study investigates the feasibility of utilising a grit blasting process to coat three nitinol substrates (a planer 2D surface, a circular wire and a cardiovascular stent geometry) with a hydroxyapatite coating. Surface characteristics of the coating on the three substrates were determined and additionally the durability of the coating post fatigue testing was analysed. The coating process resulted in a consistent covering of the substrate that resulted in an extremely hydrophilic stent surface. The surface roughness was dependant on grit blasting particle size. A general trend of smaller particle size resulted in a lower surface roughness, while particle size did not have an effect on the hydroxyapatite coating thickness. Fatigue integrity tests that simulated 16 months implantation demonstrated minimal damage to the coating. In conclusion we demonstrated the initial feasibility of using a grit blasting method to produce a consistent, hydrophilic, and durable HAp stent coating that has the capability of incorporating a drug eluting function.

Hydroxylapatite nanoparticles: fabrication methods and medical applications

Hydroxylapatite (or hydroxyapatite, HAp) exhibits excellent biocompatibility with various kinds of cells and tissues, making it an ideal candidate for tissue engineering, orthopedic and dental applications. Nanosized materials offer improved performances compared with conventional materials due to their large surface-to-volume ratios. This review summarizes existing knowledge and recent progress in fabrication methods of nanosized (or nanostructured) HAp particles, as well as their recent applications in medical and dental fields. In section 1, we provide a brief overview of HAp and nanoparticles. In section 2, fabrication methods of HAp nanoparticles are described based on the particle formation mechanisms. Recent applications of HAp nanoparticles are summarized in section 3. The future perspectives in this active research area are given in section 4.

Cellular and transcriptomic analysis of human mesenchymal stem cell response to plasma-activated hydroxyapatite coating

Atmospheric pressure plasma has recently emerged as a technique with a promising future in the medical field. In this work we used the technique as a post-deposition modification process as a means to activate hydroxyapatite (HA) coatings. Contact angle goniometry, optical profilometry, scanning electron microscopy morphology imaging and X-ray photoelectron spectroscopy analysis demonstrate that surface wettability is improved after treatment, without inducing any concomitant damage to the coating. The protein adsorption pattern has been found to be preferable for MSC, and this may result in greater cell attachment and adhesion to plasma-activated HA than to untreated samples. Cell cycle distribution analysis using flow cytometry reveals a faster transition from G(1) to S phase, thus leading to a faster cell proliferation rate on plasma-activated HA. This indicates that the improvement in surface wettability independently enhances cell attachment and cell proliferation, which is possibly mediated by FAK phosphorylation. Pathway-specific polymerase chain reaction arrays revealed that wettability has a substantial influence on gene expression during osteogenic differentiation of human MSC. Plasma-activated HA tends to enhance this process by systemically deregulating multiple genes. In addition, the majority of these deregulated genes had been appropriately translated, as confirmed by ELISA protein quantification. Lastly, alizarin red staining showed that plasma-activated HA is capable of improving mineralization for up to 3 weeks of in vitro culture. It was concluded from this study that atmospheric pressure plasma is a potent tool for modifying the biological function of a material without causing thermal damage, such that adhesion molecules and drugs might be deposited on the original coating to improve performance.