Alkali-treated titanium selectively regulating biological behaviors of bacteria, cancer cells and mesenchymal stem cells

Enhancing antibacterial properties of titanium implants through a novel Ag-TiO2-OTS nanocomposite coating: a comprehensive study on resist-killing-disintegrate approach

Titanium (Ti) implants are widely used in orthopedic and dental applications due to their excellent biocompatibility and mechanical properties. However, bacterial adhesion and subsequent biofilm formation on implant surfaces pose a significant risk of postoperative infections and complications. Conventional surface modifications often lack long-lasting antibacterial efficacy, necessitating the development of novel coatings with enhanced antimicrobial properties. This study aims to develop a novel Ag-TiO2-OTS (Silver-Titanium dioxide-Octadecyltrichlorosilane, ATO) nanocomposite coating, through a chemical plating method. By employing a 'resist-killing-disintegrate' approach, the coating is designed to inhibit bacterial adhesion effectively, and facilitate pollutant removal with lasting effects. Characterization of the coatings was performed using spectroscopy, electron microscopy, and contact angle analysis. Antibacterial efficacy, quantitatively evaluated against E. coli and S. aureus over 168 h, showed a significant reduction in bacterial adhesion by 76.6% and 66.5% respectively, and bacterial removal rates were up to 83.8% and 73.3% in comparison to uncoated Ti-base material. Additionally, antibacterial assays indicated that the ratio of the Lifshitz-van der Waals apolar component to electron donor surface energy components significantly influences bacterial adhesion and removal, underscoring a tunable parameter for optimizing antibacterial surfaces. Biocompatibility assessments with the L929 cell line revealed that the ATO coatings exhibited excellent biocompatibility, with minimal cytotoxicity and no significant impact on cell proliferation or apoptosis. The ATO coatings provided a multi-functionality surface that not only resists bacterial colonization but also possesses self-cleaning capabilities, thereby marking a substantial advancement in the development of antibacterial coatings for medical implants.

Glucose microenvironment sensitive degradation of arginine modified calcium sulfate reinforced poly(lactide-co-glycolide) composite scaffolds

Poly(lactide-co-glycolide) (PLGA) and calcium sulfate composites are promising biodegradable biomaterials but are still challenging to use in people with high levels of blood glucose or diabetes. To date, the influence of glucose on their degradation has not yet been elucidated and thus calls for more research attention. Herein, a novel calcium sulfate whisker with L-arginine was used to effectively tune its crystal morphology and was employed as a reinforced phase to construct the PLGA-based composite scaffolds (ArgCSH/PLGA) with a sleeve porous structure. ArgCSH/PLGA showed excellent elastic modulus and strength in the compression and bending models. Moreover, an in vitro immersion test showed that ArgCSH/PLGA possessed degradation and redeposition behaviors sensitive to glucose concentration, and the adsorbed Arg played a crucial role in the degradation process. The subsequent cell functional evaluation showed that ArgCSH could effectively protect cells from damage caused by AGEs and promote osteogenic differentiation. The corresponding degradation products of ArgCSH/PLGA displayed the ability to regulate osteoblast bone differentiation and accelerate matrix mineralization. These findings provide new insights into the interaction between biomaterials and the physiological environment, which may be useful in expanding the targeted choice of efficient bone graft biodegradable materials for diabetic osteoporosis.

Fabrication of multilevel porous structure networks on Nb-Ta-Ti alloy scaffolds and the effects of surface characteristics on behaviors of MC3T3-E1 cells

Porous Nb-25Ta-25Ti alloys (60% porosity and 100-600 μm pore size) for bone implant applications were manufactured combining impregnation and sintering methods. Surfaces with porous micro-nanostructured networks on Nb-Ta-Ti alloys were successfully modified by various surface pre-treatments (acid etching, alkali-heat treatment and annealing treatment). Surface characteristics and Ca-P layer deposition behaviors of the multilevel structured porous Nb-Ta-Ti alloys were investigated by conducting various tests, including x-ray diffraction, scanning electron microscopy, energy-dispersive x-ray, atomic force microscopy and optical contact angle measurement. In particular, bulk Nb-Ta-Ti alloys were also used as mutual control. The results demonstrated that the porous alloy exhibited a unique multilevel porous structure with macro-networks and micro-pits after pre-treatments. The surface passive TiO₂/Nb₂O₅/Ta₂O₅layers on Nb-Ta-Ti alloys were partially dissolved by the corrosive attack of hydroxyl ions during alkali heat treatment. In addition, subsequent annealing treatment increased the density of the gel layers formed during alkali heat treatment. After immersion in SBF for 14 d, a continuous relatively uniform apatite layer was formed on the multilevel structured surfaces. Moreover, the mechanism of surface mineralization can be construed as electrostatic interactions between substrates and ions. Furthermore,in vitrocell culture showed that Nb-Ta-Ti alloys had a good biocompatibility and the multilevel porous structure could enhance the cellular behaviors including: cell adhesion and spreading.

Surface modification of titanium with antibacterial porous N-halamine coating to prevent peri-implant infection

Peri-implant infection remains one of the greatest threats to orthopedics. The construction of bone implants with good antibacterial and osteogenic properties is beneficial for reducing the risk of implant-related infections and healing bone defects. In this study, N-halamine coating (namely N-Cl) was grafted onto alkali-heat treated titanium (Ti) using polydopamine to endow Ti-based orthopedic implants with strong bactericidal activity. Surface characterization revealed that the N-Cl coating has porous structure loaded with active chlorine (Cl⁺). The N-Cl coating also provided micro/nano-structured Ti surfaces with excellent antibacterial ability via transformation between N-H and N-Cl, and approximately 100% disinfection was achieved. Furthermore, the as-prepared N-Cl coating exhibited good biocompatibility and osteogenesis abilityin vitro. These results indicate that applying N-Cl coatings on Ti could prevent and treat peri-implant infections.

Construction of tellurium-doped mesoporous bioactive glass nanoparticles for bone cancer therapy by promoting ROS-mediated apoptosis and antibacterial activity

The commonly used treatment methods for bone cancer include chemotherapy, surgery and radiotherapy, but there are disadvantages such as nonspecific distribution, high toxicity of chemotherapy drugs, implantable infections and low monitoring. Nanoparticles are the new development direction of nanomedicine in cancer treatment. Structural characteristics of nanoparticles make it an excellent model for targeting and penetrating cancer-induced abnormal cell growth. In this study, a kind of novel and interesting tellurium ion doped mesoporous bioactive glasses (Te-MBG) nanoparticles were successfully synthesized by a simple sol-gel method, which had uniform spherical morphology (≈ 500 nm), high surface area (> 300 m²/g) and mesopore volume (> 0.30 cm³/g). Results found that Te doping does not affect the mineralization and degradation of the MBG nanoparticles. Meanwhile, compared to the undoped MBG, Te doped MBG not merely had the ability to promote MG63 cell apoptosis to inhibit bone cancer growth by ROS-mediated, but also had significant antibacterial activity. This all depends on the concentration of Te doping. It can be seen that Te-MBG nanoparticles can not only potentially fill bone defects caused by bone cancer removal, but also induce cancer cell apoptosis by tellurium release inducing reactive oxygen species (ROS) excessive production to inhibit bone cancer formation. This study provides a feasible strategy for the development of Te-MBG nanoparticles as well as their evaluation and basic research for bone cancer therapy.

A novel multi-structural reinforced treatment on Ti implant utilizing a combination of alkali solution and bioactive glass sol

OBJECTIVE

Alkali treatment and bioactive glass (BG) sol dip-coating are well-known individual methods for titanium (Ti) surface modification. In this study, a unique combination of alkali treatment and bioactive glass sol dip coating was applied to the Ti substrate, then the mechanical properties and cell responses were investigated.

METHODS

Based on the methods introduced above, the Ti substrate was treated by 6 mL of an NaOH 5 M aqueous solution for 24 h at 60 ̊C; this was followed by adding 1.2 mL of a BG 58S sol to form a novel combined nanostructure network covered by a thin BG layer. For the assessment of the formed coating layer, the morphology, elemental analysis, phase structure, adhesion property and the cell response of the untreated and treated surfaces were investigated.

RESULTS

The BG coating layer was reinforced by the nanostructure, fabricated through the alkali treatment. The results obtained by applying the combined modification method confirmed that the mechanical and biological properties of the fabricated surface demonstrated the highest performance compared to that of the unmodified and individually modified surfaces.

SIGNIFICANCE

The achieved upgrades for this method could be gained from the demanded porous nanostructure and the apatite transformation ability of the alkali treatment. Therefore, the hybridized application of the alkali-BG treatment could be introduced as a promising surface modification strategy for hard-tissue replacement applications.

Gallium (Ga)-strontium (Sr) layered double hydroxide composite coating on titanium substrates for enhanced osteogenic and antibacterial abilities

Bacterial infection and poor osteogenic capacity can result in the loosing or failure of titanium (Ti)-based implants in the clinic. Therefore, it is urgent to design an effective approach to enhance the osteogenic property and restrict bacterial activity. In this study, a layered double hydroxide (LDH) composed of Ga and Sr ions on Ti substrates by a hydrothermal method, then calcined in 250°C and denoted as LDH250. The scanning electron microscopy (SEM), X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS) were confirmed that the LDH films were successfully formed on the Ti substrates. Importantly, the obtained LDH films can induce an alkaline microenvironment around the Ti surface and regulate the behaviors of osteogenic cells and bacteria. In vitro cellular experiments, the LDH250 can enhance the differentiation of both MC3T3-E1 cells and osteoblasts, stimulate alkaline phosphatase activity (ALP), collagen secretion, and mineralization levels. Meanwhile, antimicrobial assay against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) demonstrated that the LDH250 samples had strong antibacterial abilities, which attributed to the release profile of Ga³⁺ could act as a "Trojan horse" to destroy the bacterial iron metabolism, inducing of local alkaline environment, and producing reactive oxygen species. Hence, this study provides an effective method for reducing antibacterial infection and enhancing the bone integrative capacity of Ti-based implants for orthopedic applications.

Mg(OH)2 nanoparticles enhance the antibacterial activities of macrophages by activating the reactive oxygen species

Infection often causes disastrous consequences in all fields of clinical medicine, especially orthopedics. Hence, critical efforts are being made to engineer novel nanomaterials for the treatment of orthopedic infections due to the high biocompatibility and antibacterial properties they possess. The purpose of this study was to investigate the antibacterial effects of magnesium hydroxide (Mg(OH)₂ ) nanoparticles (NPs) in vitro and determine their possible mechanisms of action. In this study, Escherichia coli was selected as the pathogenic bacteria and it was found that Mg(OH)₂ NPs significantly inhibited the growth of E. coli by promoting nucleic acid leakage, inhibiting protein synthesis, and suppressing the metabolic activity. The minimum inhibitory concentration for these bacteria was determined to be 4.4 μg/ml. In vitro flow cytometry and immunofluorescence tests indicated that Mg(OH)₂ NPs induced the macrophages to generate reactive oxygen species to kill the bacteria. To understand the mechanisms involved in this process, western blotting was performed and it was found that Mg(OH)₂ NPs activated the phosphatidylinositol-3-kinase/serine-threonine kinase (PI3K/Akt) signaling pathway of macrophages to enhance their phagocytosis with no obvious cytotoxicity. Thus, Mg(OH)₂ NPs are a suitable choice to develop promising agents or coating materials for the treatment of clinically widespread infections in view of their safety, biocompatibility, and powerful antibacterial properties.

PEI-modified diatomite/chitosan composites as bone tissue engineering scaffold for sustained release of BMP-2

The bone healing defects resulting from bone disease remain a significant clinical challenge. The bone tissue engineering scaffolds combined with osteoinductive compounds represent an effective approach to overcome this challenge. In this study, a novel chitosan-based scaffold was prepared by incorporating modified natural diatomite (DE) as filler and adsorption element. Specifically, modified-diatomite (MDE) was synthesized by grafting polyethyleneimine (PEI) on the surface of diatomite via hydroxyl groups. The physicochemical characteristics of MDE, including chemical composition, zeta potential, and adsorption behavior, were investigated successively. Further, the mechanical strength, drug release, cytotoxicity and osteogenic activity analyses were carried out for the scaffold material. The FTIR and zeta potential analyses exhibited that the amino groups (-NH₂) were grafted on MDE, and the surface potential of diatomite altered from -24 mV to 55 mV. Subsequently, the protein adsorption capacity and cytocompatibility of MDE were observed to be improved as compared to DE. The compressive strength was observed to be enhanced due to the addition of MDE. Besides, the composite scaffold loaded with rhBMP-2 demonstrated a more positive impact on proliferation and osteogenic differentiation of the bone mesenchymal stem cells, thus, indicating an optimal bone regeneration capacity. The findings obtained in this study reveal that the MDE-rhBMP-2/CS composite scaffold can be potentially used to promote the bone tissue regeneration.

Tailoring Materials for Modulation of Macrophage Fate

Human immune system acts as a pivotal role in the tissue homeostasis and disease progression. Immunomodulatory biomaterials that can manipulate innate immunity and adaptive immunity hold great promise for a broad range of prophylactic and therapeutic purposes. This review is focused on the design strategies and principles of immunomodulatory biomaterials from the standpoint of materials science to regulate macrophage fate, such as activation, polarization, adhesion, migration, proliferation, and secretion. It offers a comprehensive survey and discussion on the tunability of material designs regarding physical, chemical, biological, and dynamic cues for modulating macrophage immune response. The range of such tailorable cues encompasses surface properties, surface topography, materials mechanics, materials composition, and materials dynamics. The representative immunoengineering applications selected herein demonstrate how macrophage-immunomodulating biomaterials are being exploited for cancer immunotherapy, infection immunotherapy, tissue regeneration, inflammation resolution, and vaccination. A perspective on the future research directions of immunoregulatory biomaterials is also provided.

Approaches to promoting bone marrow mesenchymal stem cell osteogenesis on orthopedic implant surface

Bone marrow-derived mesenchymal stem cells (BMSCs) play a critical role in the osseointegration of bone and orthopedic implant. However, osseointegration between the Ti-based implants and the surrounding bone tissue must be improved due to titanium’s inherent defects. Surface modification stands out as a versatile technique to create instructive biomaterials that can actively direct stem cell fate. Here, we summarize the current approaches to promoting BMSC osteogenesis on the surface of titanium and its alloys. We will highlight the utilization of the unique properties of titanium and its alloys in promoting tissue regeneration, and discuss recent advances in understanding their role in regenerative medicine. We aim to provide a systematic and comprehensive review of approaches to promoting BMSC osteogenesis on the orthopedic implant surface.

In vitro evaluation of contact-active antibacterial efficacy of Ti-Al-V alloys coated with the antimicrobial agent PHMB

Immobilized polycationic substances on biomaterial surfaces kill adhering bacteria upon contact and are considered a promising non-antibiotic alternative. Unfortunately, there is no generally accepted in vitro method for quantitatively evaluating the antibacterial efficacy of contact-active non-leachable antimicrobial surfaces. Moreover, guidelines of generally accepted international industrial standards do not reflect the basic principle of bacterial contamination and/or are performed in the presence of a solid covering material. Therefore, in the present study, six bacterial adherence tests on non-porous surfaces with no covering material were compared with respect to their efficacy and reproducibility, as well as to evaluate the bactericidal contact-killing of relevant device-associated slime-producing bacteria using antimicrobially coated Ti6Al4V surfaces with positively-charged poly(hexamethylene biguanide) hydrochloride (PHMB). After direct bacterial inoculation to simulate a perioperative infection, non-leaching PHMB reacts bactericidally against the slime-producing bacteria Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa after surface contact. The 6-h drop technique was found to be a suitable method to quantitatively evaluate contact-active antibacterial surfaces. Adjunctively, however, damage of bacterial membrane integrity should be confirmed by LIVE/DEAD staining and the presence of non-leaching agents. STATEMENT OF SIGNIFICANCE: Unintentional perioperative bacterial adhesion to implant surfaces can generate biomaterial-associated infections. Adhered bacteria produce biofilms that protect them from antibiotic attack, which may be complicated by possible antibiotic resistance. Polycationic surfaces can prevent such unwanted biofilm formation by killing bacteria upon initial contact. Unfortunately, no reliable in vitro methods exist to evaluate the efficacy of contact-active antimicrobial surfaces. In this study, we show that the 6-h drop technique may be a suitable method to evaluate positively-charged contact-killing surfaces. Identification of suitable screening assays for evaluating the bactericidal efficacy of non-leachable antimicrobial agents will greatly improve this newly developing field as a prophylactic alternative to postoperative treatment of implant-associated infections by antibiotics.

Advanced antibacterial activity of biocompatible tantalum nanofilm via enhanced local innate immunity

Tantalum (Ta) has been shown to enhance osseointegration in clinical practice, yet little is known about whether Ta nanofilms can be used as antimicrobial coatings in vivo. A highly biocompatible Ta nanofilm was developed using magnetron sputtering technology to further study the mechanism of its antibacterial effects in vivo and elucidate its potential for clinical translation. The Ta nanofilms exhibited effective antimicrobial activity against soft tissue infections but did not show an intrinsic antimicrobial effect in vitro. This inconsistency between the in vivo and in vitro antimicrobial effects was further investigated using ex vivo models. The Ta nanofilms could enhance the phagocytosis of bacteria by polymorphonuclear neutrophils (PMNs, neutrophils), reduce the lysis of neutrophils and enhance the proinflammatory cytokine release of macrophages. This accumulative enhancement of the local host defenses contributed to the favorable antibacterial effect in vivo. The alleviated osteolysis observed in the presence of the Ta nanofilms in the osteomyelitis model further proved the practicality of this antibacterial strategy in the orthopedic field. In summary, Ta nanofilms show excellent biocompatibility and in vivo antimicrobial activity mediated by the enhancement of local innate immunity and are promising for clinical application. STATEMENT OF SIGNIFICANCE: In this study, Ta nanofilms were deposited on titanium substrate by magnetron sputtering. Ta nanofilms exhibited excellent in vivo and in vitro biocompatibility. In vivo antimicrobial effects of Ta nanofilms were revealed by soft tissue infection and osteomyelitis models, while no direct antibacterial activity was observed in vitro. Comprehensive ex vivo models revealed that Ta nanofilms could enhance the phagocytosis of bacteria by neutrophils, reduce the lysis of neutrophils and promote the release of proinflammatory cytokines from macrophages. This immunomodulatory effect helps host to eliminate bacteria. In contrast to traditional antimicrobial nanocoatings which apply toxic materials to kill bacteria, this work proposes a safe, practical and effective Ta nanofilm immunomodulatory antimicrobial strategy with clinical translational prospect.

[Advances in titanium dental implant surface modification]

Titanium dental implants have wide clinical application due to their many advantages, including comfort, aesthetics, lack of damage to adjacent teeth, and significant clinical effects. However, the failure of osseointegration, bone resorption, and peri-implantitis limits their application. Physical-chemical and bioactive coatings on the surface of titanium implants could improve the successful rate of dental implants and meet the clinical application requirements. This paper reviews the characteristics of surface modification of titanium implants from the aspects of physics, chemistry, and biology. Results provide information for research and clinical application of dental implant materials.

Vanadium Dioxide Nanocoating Induces Tumor Cell Death through Mitochondrial Electron Transport Chain Interruption

A biomaterials surface enabling the induction of tumor cell death is particularly desirable for implantable biomedical devices that directly contact tumor tissues. However, this specific antitumor feature is rarely found. Consequently, an antitumor-cell nanocoating comprised of vanadium dioxide (VO2) prepared by customized reactive magnetron sputtering has been proposed, and its antitumor-growth capability has been demonstrated using human cholangiocarcinoma cells. The results reveal that the VO2 nanocoating is able to interrupt the mitochondrial electron transport chain and then elevate the intracellular reactive oxygen species levels, leading to the collapse of the mitochondrial membrane potential and the destruction of cell redox homeostasis. Indeed, this chain reaction can effectively trigger oxidative damage in the cholangiocarcinoma cells. Additionally, this study has provided new insights into designing a tumor-cell-inhibited biomaterial surface, which is modulated by the mechanism of mitochondria-targeting tumor cell death.

Effect of Local Alkaline Microenvironment on the Behaviors of Bacteria and Osteogenic Cells

The interactions between material surfaces and bacteria/cells have been widely investigated, based on which biomaterials with antibacterial and osteogenic abilities can be designed to conquer implant failures. The pH of environments is known to affect bacterial growth and bone formation/resorption, and it is possible that the antibacterial and osteogenic abilities of biomaterials can be simultaneously improved by regulating their surface alkalinity. Herein, we fabricated many kinds of films with various alkalinity levels on titanium surface to explore the effect of local alkaline microenvironments around material surfaces on the behaviors of bacteria and osteogenic cells. Both Gram-positive and -negative bacteria were cultured on sample surfaces to investigate their antibacterial effects. Cell adhesion, proliferation, and alkaline phosphatase (ALP) activities were investigated by culturing both bone mesenchymal stem cells (MSCs) and osteoblast cells on sample surfaces. The results show that an appropriate local alkaline environment can effectively inhibit the growth of both Gram-positive and -negative bacteria through inactivating ATP synthesis and inducing oxidative stress. Meanwhile, it can promote the osteogenic differentiation of bone MSCs and enhance the proliferation and ALP activities of osteoblast cells. In conclusion, material surfaces endowed with appropriate alkalinity can possess antibacterial and osteogenic properties, which provide a novel strategy to design multifunctional biomaterials for bone generation.

Regulating the local pH level of titanium via Mg-Fe layered double hydroxides films for enhanced osteogenesis

Hard tissue implant materials which can cause a suitable alkaline microenvironment are thought to be beneficial for stimulating osteoblast differentiation while suppressing osteoclast generation. To make the local pH around the interface between materials and cells controllable, we prepared a series of Mg-Fe layered double hydroxide (LDH) films on acid-etched pure titanium surfaces via hydrothermal treatment. By adjusting the Mg/Fe proportion ratio, the interlayer spacing of Mg-Fe LDHs was regulated, making their OH- exchange abilities adjustable, and this ultimately resulted in a microenvironment with a controllable pH value. In vitro experiments demonstrated that the Mg-Fe LDH film-modified titanium surface possessed good biocompatibility and osteogenic activity, especially the Mg-Fe LDH film with Mg/Fe proportion ratio of 4, which could form a suitable alkaline microenvironment for the growth and osteogenetic differentiation of stem cells. These results demonstrate the potential application of the prepared Mg-Fe LDH films in enhancing the osteogenesis of implant materials while providing a new way into the design of controllable alkaline environment.

Nano vanadium dioxide films deposited on biomedical titanium: a novel approach for simultaneously enhanced osteogenic and antibacterial effects

Vanadium is a trace element in the human body, and vanadium compounds have a promising future in biological and medical applications due to their various biological activities and low toxicity. Herein, a novel pure vanadium dioxide (VO₂) nanofilm was deposited on a substrate of biomedical titanium by magnetron sputtering. The antibacterial effect of VO₂ against the methicillin-resistant Staphylococcus aureus (MRSA) was validated in vitro and in vivo. Moreover, the biocompatibility of VO₂ and its osteogenic effects were systematically illustrated. A possible osteogenic mechanism involving the amelioration of highly reactive oxygen species (ROS) levels were investigated. According to the results of our present and previous studies, the simultaneous antibacterial and osteogenic effects of VO₂ are attributed to its differential regulation of ROS levels in rat bone marrow mesenchymal stem cells (rBMSCs) and bacteria. This study is the first to report the simultaneous effects of VO₂ on bactericidal and osteogenic activities through its differential modification of ROS activity in eukaryotic (rBMSCs) and prokaryotic (MRSA) cells. The findings in this work may yield a deeper understanding of the biological activities of vanadium compounds while also paving the way for the further investigation and application of VO₂ in biological and medical materials.

Graphene oxide as a dual Zn/Mg ion carrier and release platform: enhanced osteogenic activity and antibacterial properties

Graphene oxide as an ion carrier and release platform: enhanced osteogenic activity and antibacterial properties.

Review: the potential impact of surface crystalline states of titanium for biomedical applications

In many biomedical applications, titanium forms an interface with tissues, which is crucial to ensure its long-term stability and safety. In order to exert control over this process, titanium implants have been treated with various methods that induce physicochemical changes at nano and microscales. In the past 20 years, most of the studies have been conducted to see the effect of topographical and physicochemical changes of titanium surface after surface treatments on cells behavior and bacteria adhesion. In this review, we will first briefly present some of these surface treatments either chemical or physical and we explain the biological responses to titanium with a specific focus on adverse immune reactions. More recently, a new trend has emerged in titanium surface science with a focus on the crystalline phase of titanium dioxide and the associated biological responses. In these recent studies, rutile and anatase are the major two polymorphs used for biomedical applications. In the second part of this review, we consider this emerging topic of the control of the crystalline phase of titanium and discuss its potential biological impacts. More in-depth analysis of treatment-related surface crystalline changes can significantly improve the control over titanium/host tissue interface and can result in considerable decreases in implant-related complications, which is currently a big burden on the healthcare system.

Effect of ultraviolet treatment on bacterial attachment and osteogenic activity to alkali-treated titanium with nanonetwork structures

Purpose

Alkali-treated titanium with nanonetwork structures (TNS) possesses good osteogenic activity; however, the resistance of this material to bacterial contamination remains inadequate. As such, TNS implants are prone to postoperative infection. In this work, we attempted to alter the biological properties of TNS by treatment with short-duration high-intensity ultraviolet (UV) irradiation.

Methods

TNS discs were treated with UV light (wavelength =254 nm, strength =100 mW/cm²) for 15 minutes using a UV-irradiation machine. We carried out a surface characterization and evaluated the discs for bacterial film formation, protein adsorption, and osteogenic features.

Results

The superhydrophilicity and surface hydrocarbon elimination exhibited by the treated material (UV-treated titanium with a nanonetwork structure [UV-TNS]) revealed that this treatment effectively changed the surface characteristics of TNS. Notably, UV-TNS also showed reduced colonization by Actinomyces oris during an initial attachment period and inhibition of biofilm formation for up to 6 hours. Moreover, compared to conventional TNS, UV-TNS showed superior osteogenic activity as indicated by increased levels of adhesion, proliferation, alkaline phosphatase activity, osteogenic factor production, and osteogenesis-related gene expression by rat bone marrow mesenchymal stem cells (rBMMSCs). This inverse relationship between bacterial attachment and cell adhesion could be due to the presence of electron–hole pairs induced by high-intensity UV treatment.

Conclusion

We suggest that simple UV treatment has great clinical potential for TNS implants, as it promotes the osseointegration of the TNS while reducing bacterial contamination, and can be conducted chair-side immediately prior to implantation.

Cell responses on a H2Ti3O7 nanowire film

Cell morphologies on H₂Ti₃O₇ nanowire film and anatase nanowire film.

Proliferation and osteogenic differentiation of rat BMSCs on a novel Ti/SiC metal matrix nanocomposite modified by friction stir processing

The aims of this study were to fabricate a novel titanium/silicon carbide (Ti/SiC) metal matrix nanocomposite (MMNC) by friction stir processing (FSP) and to investigate its microstructure and mechanical properties. In addition, the adhesion, proliferation and osteogenic differentiation of rat bone marrow stromal cells (BMSCs) on the nanocomposite surface were investigated. The MMNC microstructure was observed by both scanning and transmission electron microscopy. Mechanical properties were characterized by nanoindentation and Vickers hardness testing. Integrin β1 immunofluorescence, cell adhesion, and MTT assays were used to evaluate the effects of the nanocomposite on cell adhesion and proliferation. Osteogenic and angiogenic differentiation were evaluated by alkaline phosphatase (ALP) staining, ALP activity, PCR and osteocalcin immunofluorescence. The observed microstructures and mechanical properties clearly indicated that FSP is a very effective technique for modifying Ti/SiC MMNC to contain uniformly distributed nanoparticles. In the interiors of recrystallized grains, characteristics including twins, fine recrystallized grains, and dislocations formed concurrently. Adhesion, proliferation, and osteogenic and angiogenic differentiation of rat BMSCs were all enhanced on the novel Ti/SiC MMNC surface. In conclusion, nanocomposites modified using FSP technology not only have superior mechanical properties under stress-bearing conditions but also provide improved surface and physicochemical properties for cell attachment and osseointegration.

Oxidative stress-mediated selective antimicrobial ability of nano-VO2 against Gram-positive bacteria for environmental and biomedical applications

Vanadium dioxide (VO2) is a unique thermochromic material as a result of its semiconductor-metal transition, holding great promise for energy-saving intelligent windows. Herein, pure nano-VO2 from discrete nanoparticles to continuous films were successfully deposited on quartz glass by controlling the sputtering parameters. It was demonstrated that, for Gram-positive S. aureus and S. epidermidis, the nano-VO2 could effectively disrupt bacteria morphology and membrane integrity, and eventually cause death. By contrast, the nano-VO2 did not exhibit significant toxicity towards Gram-negative E. coli and P. aeruginosa. To our knowledge, this is the first report on a selective antimicrobial effect of nano-VO2 materials on Gram-positive bacteria. Based on the experimental results, a plausible mechanism was proposed for the antimicrobial selectivity, which might originate from the different sensitivity of Gram-positive and Gram-negative bacteria to intracellular reactive oxygen species (ROS) level. Elevated intracellular ROS levels exceed the threshold that bacteria can self-regulate to maintain cellular redox homeostasis and thus cause oxidative stress, which can be alleviated by the intervention of glutathione (GSH) antioxidant. In addition, nano-VO2 did not produce significant cytotoxicity (hemolysis) against human erythrocytes within 12 h. Meanwhile, potential cytotoxicity against HIBEpiC revealed a time- and dose-dependent behavior that might be controlled and balanced by careful design. The findings in the present work may contribute to understanding the antimicrobial behavior of nano-VO2, and to expanding the new applications of VO2-based nanomaterials in environmental and biomedical fields.

Inhibitor encapsulated, self-healable and cytocompatible chitosan multilayer coating on biodegradable Mg alloy: a pH-responsive design

The design of functional biomaterials that respond intelligently to external stimuli has become a rapidly growing area with widespread interest. This work contributes to the development of a feedback-active anticorrosion system with intriguing self-healing ability to protect magnesium (Mg) from biocorrosion. The system was constituted by an inner micro/nano-porous, ceramic-like pre-coating developed readily from the substrate, and an outermost inhibitor (nanosized cerium (Ce) oxides) containing chitosan (CS) multilayers. Here, the pre-coating acted as both an "anchoring" and a "barrier" layer to acquire structural integrity and improved impedance, respectively. Green CS served as cargo for Ce to be entrapped, harnessing Ce-NH₂ complexation chemistry. The coating barrier properties were evaluated by electrochemical impedance spectroscopy. The active corrosion inhibition was assessed by immersion degradation tests with respect to Mg²⁺ release, pH alteration, crack development, and scanning Kelvin potential. To our delight, the coatings effectively protected the substrate from biocorrosion in vitro compared with bare alloys. Putatively, the pH-triggered formation of Ce oxide precipitation, along with the pH-buffering activity and movable swelling capacity of CS macromolecules, should have contributed to restraining the anodic activity and healing the cracks/defects dynamically. Furthermore, the coated substrate had the biocompatibility to elicit better attachment and growth of osteoblasts.

Multi-disciplinary antimicrobial strategies for improving orthopaedic implants to prevent prosthetic joint infections in hip and knee

Like any foreign object, orthopaedic implants are susceptible to infection when introduced into the human body. Without additional preventative measures, the absolute number of annual prosthetic joint infections will continue to rise, and may exceed the capacity of health care systems in the near future. Bacteria are difficult to eradicate from synovial joints due to their exceptionally diverse taxonomy, complex mechanistic attachment capabilities, and tendency to evolve antibiotic resistance. When a primary orthopaedic implant fails from prosthetic joint infection, surgeons are generally challenged by limited options for intervention. In this review, we highlight the etiology and taxonomic groupings of bacteria known to cause prosthetic joint infections, and examine their key mechanisms of attachment. We propose that antimicrobial strategies should focus on the most harmful bacteria taxa within the context of occurrence, taxonomic diversity, adhesion mechanisms, and implant design. Patient-specific identification of organisms that cause prosthetic joint infections will permit assessment of their biological vulnerabilities. The latter can be targeted using a range of antimicrobial techniques that exploit different colonization mechanisms including implant surface attachment, biofilm formation, and/or hematogenous recruitment. We anticipate that customized strategies for each patient, joint, and prosthetic component will be most effective at reducing prosthetic joint infections, including those caused by antibiotic-resistant and polymicrobial bacteria.

The potential cytotoxicity and mechanism of VO2 thin films for intelligent thermochromic windows

The potential cytotoxicity of a thermochromic VO₂ nanofilm to human cells presumably originates from ATP dyssynthesis by vanadate-phosphate antagonism.

Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats

Strontium-substituted hierarchical Ti surface can enhance the osseointegration by both increasing new bone formation and reducing bone resorption under osteoporotic conditions.