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Che Z, Sun Q, Zhao Z, Wu Y, Xing H, Song K, Chen A, Wang B, Cai M. Growth factor-functionalized titanium implants for enhanced bone regeneration: A review. Int J Biol Macromol 2024; 274:133153. [PMID: 38897500 DOI: 10.1016/j.ijbiomac.2024.133153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/02/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
Titanium and titanium alloys are widely favored materials for orthopedic implants due to their exceptional mechanical properties and biological inertness. The additional benefit of sustained local release of bioactive substances further promotes bone tissue formation, thereby augmenting the osseointegration capacity of titanium implants and attracting increasing attention in bone tissue engineering. Among these bioactive substances, growth factors have shown remarkable osteogenic and angiogenic induction capabilities. Consequently, researchers have developed various physical, chemical, and biological loading techniques to incorporate growth factors into titanium implants, ensuring controlled release kinetics. In contrast to conventional treatment modalities, the localized release of growth factors from functionalized titanium implants not only enhances osseointegration but also reduces the risk of complications. This review provides a comprehensive examination of the types and mechanisms of growth factors, along with a detailed exploration of the methodologies used to load growth factors onto the surface of titanium implants. Moreover, it highlights recent advancements in the application of growth factors to the surface of titanium implants (Scheme 1). Finally, the review discusses current limitations and future prospects for growth factor-functionalized titanium implants. In summary, this paper presents cutting-edge design strategies aimed at enhancing the bone regenerative capacity of growth factor-functionalized titanium implants-a significant advancement in the field of enhanced bone regeneration.
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Affiliation(s)
- Zhenjia Che
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China.
| | - Qi Sun
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China
| | - Zhenyu Zhao
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China
| | - Yanglin Wu
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China
| | - Hu Xing
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China
| | - Kaihang Song
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China
| | - Aopan Chen
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China
| | - Bo Wang
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China.
| | - Ming Cai
- Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai 200072, People's Republic of China.
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Grumezescu V, Gherasim O, Gălățeanu B, Hudiță A. Antitumoral-Embedded Biopolymeric Spheres for Implantable Devices. Pharmaceutics 2024; 16:754. [PMID: 38931875 PMCID: PMC11207774 DOI: 10.3390/pharmaceutics16060754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
The bioactive surface modification of implantable devices paves the way towards the personalized healthcare practice by providing a versatile and tunable approach that increase the patient outcome, facilitate the medical procedure, and reduce the indirect or secondary effects. The purpose of our study was to assess the performance of composite coatings based on biopolymeric spheres of poly(lactide-co-glycolide) embedded with hydroxyapatite (HA) and methotrexate (MTX). Bio-simulated tests performed for up to one week evidenced the gradual release of the antitumor drug and the biomineralization potential of PLGA/HA-MTX sphere coatings. The composite materials proved superior biocompatibility and promoted enhanced cell adhesion and proliferation with respect to human preosteoblast and osteosarcoma cell lines when compared to pristine titanium.
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Affiliation(s)
- Valentina Grumezescu
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania
| | - Oana Gherasim
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania
| | - Bianca Gălățeanu
- Department of Biochemistry and Molecular Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Ariana Hudiță
- Department of Biochemistry and Molecular Biology, University of Bucharest, 050095 Bucharest, Romania
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Ma P, Li Z, Miao J, Zhang X, Zong Z, Li T. Finite element analysis of different pedicle screw internal fixations for first lumbar vertebral fracture in different sports conditions. J Int Med Res 2024; 52:3000605241236054. [PMID: 38468383 DOI: 10.1177/03000605241236054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE Lumbar fractures are the most common spinal injuries, and surgery is required for severe fracture. This study aimed to investigate the variations in motion and stress in varying states of activity after minimally invasive and traditional open pedicle screw placement for L1 vertebral fracture stabilization. METHODS We studied a male volunteer (26 years old) with no history of chronic back pain or lumbar spine trauma. We used the finite element method for this investigation. Using finite element software, we created a three-dimensional model of L1 vertebral compression fracture. We also constructed models for four percutaneous pedicle screws spanning the fractured vertebra and four screws traversing the damaged vertebra with transverse fixation. RESULTS In all three-dimensional movement directions, the open pedicle fixation system experienced maximum stress higher than its percutaneous counterpart. With axial spinal rotation, von Mises stress on the traditional open pedicle screw was considerably lower than that with percutaneous pedicle fixation, but peak stress was elevated at the transverse connection. Traditional open pedicle fixation displayed less maximum displacement than percutaneous pedicle internal fixation. CONCLUSIONS During axial spinal movements, high peak stress is observed at the transverse connection. Patients should avoid excessive axial rotation of the spine during recovery.
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Affiliation(s)
- Pengpeng Ma
- Clinical School/College of Orthopedics, Tianjin Medical University, Tianjin, China
- Department of Orthopedics, First Affiliated Hospital of Hebei North University, Zhangjiakou, China
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Zhenyu Li
- Clinical School/College of Orthopedics, Tianjin Medical University, Tianjin, China
| | - Jun Miao
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Xin Zhang
- Department of Orthopedics, First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Zhiguo Zong
- Department of Orthopedics, First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
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Liu G, Wei X, Zhai Y, Zhang J, Li J, Zhao Z, Guan T, Zhao D. 3D printed osteochondral scaffolds: design strategies, present applications and future perspectives. Front Bioeng Biotechnol 2024; 12:1339916. [PMID: 38425994 PMCID: PMC10902174 DOI: 10.3389/fbioe.2024.1339916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
Articular osteochondral (OC) defects are a global clinical problem characterized by loss of full-thickness articular cartilage with underlying calcified cartilage through to the subchondral bone. While current surgical treatments can relieve pain, none of them can completely repair all components of the OC unit and restore its original function. With the rapid development of three-dimensional (3D) printing technology, admirable progress has been made in bone and cartilage reconstruction, providing new strategies for restoring joint function. 3D printing has the advantages of fast speed, high precision, and personalized customization to meet the requirements of irregular geometry, differentiated composition, and multi-layered boundary layer structures of joint OC scaffolds. This review captures the original published researches on the application of 3D printing technology to the repair of entire OC units and provides a comprehensive summary of the recent advances in 3D printed OC scaffolds. We first introduce the gradient structure and biological properties of articular OC tissue. The considerations for the development of 3D printed OC scaffolds are emphatically summarized, including material types, fabrication techniques, structural design and seed cells. Especially from the perspective of material composition and structural design, the classification, characteristics and latest research progress of discrete gradient scaffolds (biphasic, triphasic and multiphasic scaffolds) and continuous gradient scaffolds (gradient material and/or structure, and gradient interface) are summarized. Finally, we also describe the important progress and application prospect of 3D printing technology in OC interface regeneration. 3D printing technology for OC reconstruction should simulate the gradient structure of subchondral bone and cartilage. Therefore, we must not only strengthen the basic research on OC structure, but also continue to explore the role of 3D printing technology in OC tissue engineering. This will enable better structural and functional bionics of OC scaffolds, ultimately improving the repair of OC defects.
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Affiliation(s)
- Ge Liu
- School of Mechanical Engineering, Dalian Jiaotong University, Dalian, China
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Xiaowei Wei
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yun Zhai
- School of Mechanical Engineering, Dalian Jiaotong University, Dalian, China
| | - Jingrun Zhang
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Junlei Li
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Zhenhua Zhao
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Tianmin Guan
- School of Mechanical Engineering, Dalian Jiaotong University, Dalian, China
| | - Deiwei Zhao
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
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Potluri AS, Arza RA, Rullán PJ, Pasqualini I, Ng M, Piuzzi NS. Forty-Six Years of Technological Innovation in Musculoskeletal Medicine: An Analysis of a Patent Database (1973 to 2018). J Am Acad Orthop Surg 2024; 32:130-138. [PMID: 37793147 DOI: 10.5435/jaaos-d-23-00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/20/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Technological innovation in orthopaedics is key to advancing patient care. As emerging technologies near maturity, clinicians must be able to objectively assess where and when these technologies can be implemented. Patent databases are an underappreciated resource for quantifying innovation, especially within orthopaedic surgery. This study used a patent database to assess patent activity and relative growth of technologies in musculoskeletal medicine and orthopaedics over a period of 46 years. METHODS A total of 121,471 patent records were indexed from Lens.org , a patent database. These patents were grouped into subspecialty clusters and technology clusters using patent codes. Five-year (2014 to 2018), 10-year (2009 to 2018), and 30-year (1989 to 2018) compound annual growth rates were calculated and compared for each cluster. RESULTS Annual patent activity increased from one patent in 1973 to 4,866 patents in 2018. Of the eight subspecialty clusters, the largest number of patents were related to 'Inflammation' (n = 63,128; 40.57%). The 'Elbow', 'Shoulder', and 'Knee' clusters experienced increased annual patent activity since 2000. Of the 12 technological clusters, the largest number of patents were related to 'Drugs' (n = 55,324; 39.75%). The 'Custom/patient-specific instrumentation, 'Computer Modeling', 'Robotics', and 'Navigation' clusters saw growth in the average annual patent activity since 2000. DISCUSSION Innovation, as measured by patent activity in musculoskeletal medicine and orthopaedics, has seen notable growth since 1973. The 'Robotics' cluster seems poised to experience exponential growth in industry investment and technological developments over the next 5 to 10 years. The 'Diagnostics', 'Computer Modeling', 'Navigation', and 'Design and Manufacturing' clusters demonstrate potential for exponential growth in industry investment and technological developments within the next 10 to 20 years.
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Affiliation(s)
- Ajay S Potluri
- From the Case Western Reserve University School of Medicine, Cleveland, OH (Potluri and Arza), Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH (Rullán, Pasqualini, and Piuzzi), Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY (Ng), and the Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH (Piuzzi)
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Rayannavar S, Mv SK, Bembalgi M, Shankargouda S, Acharya A, Doddamani M, Hiremath V, Shah MA. Evaluation of Osteoconductive and Antimicrobial Properties of Novel Graphene on Dental Implants: An In Vitro Study. Cureus 2024; 16:e54172. [PMID: 38496143 PMCID: PMC10941632 DOI: 10.7759/cureus.54172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Graphene oxide (GO) has emerged as a promising material in dentistry, leveraging its exceptional properties. This study evaluates the physicochemical attributes of GO and elucidates its derived biological properties. These encompass biocompatibility, antibacterial efficacy, as well as its influence on osteogenic and odontogenic differentiation processes. Understanding the intricate interplay between the physicochemical and biological aspects of GO provides valuable insights into its potential applications in various dental contexts. Materials and methods The study group (so; titanium discs surface coated with GO) and the control group (co; plain/uncoated machined titanium discs) were divided based on cell attachment and cell proliferation assays (n=60). These groups were further divided into subgroups (n=30) based on the tested time intervals, specifically 24 hours, 48 hours, and 72 hours. The study and controlgroups were further subdivided into three subgroups (n=10) based on the microorganisms tested i.e Porphyromonas gingivalis, Prevotella intermedia and Fusobacteria nucleatum. Results The results of this in vitro study suggest that GO-coated titanium dental implants have both increased osteogenic potential and antimicrobial efficacy. Graphene has good potential as a promising alternative to traditional surface treatments, and a graphene-coated implant can be used for enhanced osseointegration. Conclusion The osteogenic potential and the cell attachment were higher on titanium surfaces coated with GO nanoparticles when compared to plain titanium discs at 24, 48 and 72 hours respectively.
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Affiliation(s)
- Sounyala Rayannavar
- Department of Prosthodontics Crown and Bridge, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, IND
| | - Sunil Kumar Mv
- Department of Prosthodontics Crown and Bridge, Jaipur Dental College, Maharaj Vinayak Global University, Jaipur, IND
| | - Mahantesh Bembalgi
- Department of Prosthodontics Crown and Bridge, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, IND
| | - Swapnil Shankargouda
- Department of Prosthodontics Crown and Bridge, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, IND
| | - Aditya Acharya
- Department of Prosthodontics Crown and Bridge, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, IND
| | - Mallikarjun Doddamani
- Department of Prosthodontics Crown and Bridge, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, IND
| | - Vinuta Hiremath
- Department of Prosthodontics Crown and Bridge, Private Practitioner, Belagavi, IND
| | - Mehul A Shah
- Research scholar, Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi, IND
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Wang D, Yu J, Liu H, Zhang T, Haney EF, Hancock REW, Peng L, Shen Y. Influence of a D-enantiomeric peptide on the anticorrosion ability of titanium with different surface roughness against Streptococcus mutans biofilms. J Dent 2023; 139:104777. [PMID: 37944630 DOI: 10.1016/j.jdent.2023.104777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/05/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE To investigate the effectiveness of a d-enantiomeric antibiofilm peptide (DJK-5) on the anticorrosion ability of titanium (Ti) with different surface roughness against Streptococcus mutans biofilms. METHODS Commercially pure Ti disks with machined (MA, smooth) or sandblasted + acid-etched (SLA, rough) surfaces were prepared and characterized. All disks were divided into three groups: a positive control (PC) group with S. mutans, a DJK-5-treated group, and a negative control (NC) group without S. mutans. Biofilm formation and corrosion on Ti surfaces were determined by confocal laser scanning microscopy and scanning electron microscopy after 2 and 6 days, and the electrochemical properties were evaluated. RESULTS Ten μg/mL of DJK-5 killed 83.3 % and 87.4 % of biofilms on SLA and MA Ti surfaces, respectively after 2 days, and 72.9 % and 77.7 % after 6 days, with more bacteria surviving on SLA surfaces with higher roughness (p < 0.05). DJK-5 treatment induced less surface defects with tiny pit corrosion than PC. DJK-5 treatment when compared to PC, led to electrochemical properties more reflecting NC surfaces, including significantly less negative corrosion potential, lower corrosion current, and higher passive film resistance (p < 0.05). SLA surfaces exhibited higher current density and lower resistance than MA surfaces (p < 0.05). CONCLUSION DJK-5 effectively enhanced the corrosion resistance of Ti with different surface roughness while killing S. mutans biofilms, and smooth surfaces were more susceptible to peptide treatment. CLINICAL SIGNIFICANCE The antibiofilm peptide is promising for promoting the anticorrosion ability of Ti against biofilms, thereby preventing biofilm-related infections.
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Affiliation(s)
- Dan Wang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Jian Yu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Tian Zhang
- School of Medicine, Vanderbilt University, Nashville, TN, United States
| | - Evan F Haney
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, Canada
| | - Robert E W Hancock
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, Canada
| | - Lin Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
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Phuoc HD, Hoang PN, Yang S, Fraser D, Nguyen VT. Osseointegrability of 3D-printed porous titanium alloy implant on tibial shaft bone defect in rabbit model. PLoS One 2023; 18:e0282457. [PMID: 37682822 PMCID: PMC10490944 DOI: 10.1371/journal.pone.0282457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/11/2023] [Indexed: 09/10/2023] Open
Abstract
Previous studies have demonstrated the ability of osseointegration of porous titanium implants in cancellous bone. Our study was designed to (i) investigate the ability of bone ingrowth into 3D-printed porous titanium alloy implant on the cortical bone of rabbits using CT-scan and histology, and (ii) to identify the consistency of the radiology information between clinical Cone Beam Computed Tomography (CBCT) and Micro Computed Tomography (μCT) in the evaluation of bone ingrowth. The porous titanium alloy implants were 3D-printed employing the Electron Beam Melting (EBM) technology with an intended pore size of 600 μm and porosity of approximately 50 percent. Each implant was inserted into tibial diaphysis in one rabbit and its pores were classified as contacting bone or non-contacting bone. Depending on the time of explantation, the rabbits were divided into two groups: group 1 consisting of 6 rabbits between 13 and 20 weeks and group 2 consisting of 6 rabbits between 26 and 32 weeks. Tissue ingrowth into the non-bone contacting pores were evaluated by CBCT and histology. μCT was used to further investigate the bone ingrowth into four implants (two from each group were randomly chosen). The CBCT detected the present of tissue with bone-like density in both bone-contacting pores and non-bone-contacting pores of all implants. The μCT analysis also supported this result. All the bone-like tissues were then histologically confirmed to be mature bone. The analysis of CBCT data to assess bone ingrowth in porous implants had the sensitivity, specificity, positive and negative predictive values of 85, 84, 93 and 70 percent, respectively, when considering μCT assessment as the gold standard. Fully porous titanium alloy implant has great potential to reconstruct diaphyseal bone defect due to its good ability of osseointegration. CBCT is a promising method for evaluation of bone ingrowth into porous implants.
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Affiliation(s)
- Hung Do Phuoc
- Department of Orthopaedics and Rehabilitation, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Orthopaedics and Traumatology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Phu Nguyen Hoang
- Department of Orthopaedics and Rehabilitation, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Orthopaedics and Traumatology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Sam Yang
- Manufacturing, Commonwealth Scientific and Industrial Research Organisation, Clayton, Victoria, Australia
| | - Darren Fraser
- Manufacturing, Commonwealth Scientific and Industrial Research Organisation, Clayton, Victoria, Australia
| | - Vu Thua Nguyen
- Manufacturing, Commonwealth Scientific and Industrial Research Organisation, Clayton, Victoria, Australia
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Sun C, Kang J, Wang L, Jin Z, Liu C, Li D. Stress-dependent design and optimization methodology of gradient porous implant and application in femoral stem. Comput Methods Biomech Biomed Engin 2023; 26:1308-1319. [PMID: 36036151 DOI: 10.1080/10255842.2022.2115291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022]
Abstract
Gradient porous structure made by additive manufacturing (AM) technology is potential to improve the long-term stability of orthopaedic implants through bone ingrowth while maintaining mechanical safety. In this study, a parametrical optimization methodology for the customized gradient porous implants was developed based on a stress-dependent design algorithm. Clinical requirements and manufacturing capabilities of AM were considered in the design procedure. A femoral stem with a minimum bone loss proportion of 2.4% by optimizing the control parameters. This study provided a feasible and flexible design approach for the customized implant with gradient porous structure or material components.
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Affiliation(s)
- Changning Sun
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, ShaanXi, China
- National Medical Products Administration (NMPA) Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi'an, ShaanXi, China
| | | | - Ling Wang
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, ShaanXi, China
- National Medical Products Administration (NMPA) Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi'an, ShaanXi, China
| | - Zhongmin Jin
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, ShaanXi, China
- School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Chaozong Liu
- Division of Surgery & Interventional Science, University College London, Royal National Orthopaedic Hospital, London, UK
| | - Dichen Li
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, ShaanXi, China
- National Medical Products Administration (NMPA) Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices, Xi'an, ShaanXi, China
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Wang J, Yang B, Guo S, Yu S, Li H. Manufacture of titanium alloy materials with bioactive sandblasted surfaces and evaluation of osseointegration properties. Front Bioeng Biotechnol 2023; 11:1251947. [PMID: 37671189 PMCID: PMC10475539 DOI: 10.3389/fbioe.2023.1251947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/11/2023] [Indexed: 09/07/2023] Open
Abstract
Titanium alloys are some of the most important orthopedic implant materials currently available. However, their lack of bioactivity and osteoinductivity limits their osseointegration properties, resulting in suboptimal osseointegration between titanium alloy materials and bone interfaces. In this study, we used a novel sandblasting surface modification process to manufacture titanium alloy materials with bioactive sandblasted surfaces and systematically characterized their surface morphology and physicochemical properties. We also analyzed and evaluated the osseointegration between titanium alloy materials with bioactive sandblasted surfaces and bone interfaces by in vitro experiments with co-culture of osteoblasts and in vivo experiments with a rabbit model. In our in vitro experiments, the proliferation, differentiation, and mineralization of the osteoblasts on the surfaces of the materials with bioactive sandblasted surfaces were better than those in the control group. In addition, our in vivo experiments showed that the titanium alloy materials with bioactive sandblasted surfaces were able to promote the growth of trabecular bone on their surfaces compared to controls. These results indicate that the novel titanium alloy material with bioactive sandblasted surface has satisfactory bioactivity and osteoinductivity and exhibit good osseointegration properties, resulting in improved osseointegration between the material and bone interface. This work lays a foundation for subsequent clinical application research into titanium alloy materials with bioactive sandblasted surfaces.
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Affiliation(s)
- Jie Wang
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Baohui Yang
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Shuai Guo
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Sen Yu
- Shaanxi Key Laboratory of Biomedical Metal Materials, Northwest Institute for Nonferrous Metal Research, Xi’an, China
| | - Haopeng Li
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Yang S, Jiang W, Ma X, Wang Z, Sah RL, Wang J, Sun Y. Nanoscale Morphologies on the Surface of 3D-Printed Titanium Implants for Improved Osseointegration: A Systematic Review of the Literature. Int J Nanomedicine 2023; 18:4171-4191. [PMID: 37525692 PMCID: PMC10387278 DOI: 10.2147/ijn.s409033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023] Open
Abstract
Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone defects. However, the bio-inert nature of Ti material limits its capability for rapid osseointegration and thus influences the implant lifetime in vivo. Despite the macroscale porosity for promoting osseointegration, 3D-printed Ti implant surface morphologies at the nanoscale have gained considerable attention for their potential to improve specific outcomes. To evaluate the influence of nanoscale surface morphologies on osseointegration outcomes of 3D-printed Ti implants and discuss the available strategies, we systematically searched evidence according to the PRISMA on PubMed, Embase, Web of Science, and Cochrane (until June 2022). The inclusion criteria were in vivo (animal) studies reporting the osseointegration outcomes of nanoscale morphologies on the surface of 3D-printed Ti implants. The risk of bias (RoB) was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE's) tool. The quality of the studies was evaluated using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. (PROSPERO: CRD42022334222). Out of 119 retrieved articles, 9 studies met the inclusion criteria. The evidence suggests that irregular nano-texture, nanodots and nanotubes with a diameter of 40-105nm on the surface of porous/solid 3D-printed Ti implants result in better osseointegration and vertical bone ingrowth compared to the untreated/polished ones by significantly promoting cell adhesion, matrix mineralization, and osteogenic differentiation through increasing integrin expression. The RoB was low in 41.1% of items, unclear in 53.3%, and high in 5.6%. The quality of the studies achieved a mean score of 17.67. Our study demonstrates that nanostructures with specific controlled properties on the surface of 3D-printed Ti implants improve their osseointegration. However, given the small number of studies, the variability in experimental designs, and lack of reporting across studies, the results should be interpreted with caution.
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Affiliation(s)
- Shiyan Yang
- Orthopedic Medical Center, the Second Hospital of Jilin University, Changchun, Jilin, 130000, People's Republic of China
| | - Weibo Jiang
- Orthopedic Medical Center, the Second Hospital of Jilin University, Changchun, Jilin, 130000, People's Republic of China
| | - Xiao Ma
- Department of Orthopedics, the China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, People's Republic of China
| | - Zuobin Wang
- International Research Centre for Nano Handling and Manufacturing of China, Changchun University of Science and Technology, Changchun, Jilin, 130000, People's Republic of China
| | - Robert L Sah
- Department of Bioengineering, University of California-San Diego, La Jolla, CA, 92037, USA
- Center for Musculoskeletal Research, Institute of Engineering in Medicine, University of California-San Diego, La Jolla, CA, 92037, USA
| | - Jincheng Wang
- Orthopedic Medical Center, the Second Hospital of Jilin University, Changchun, Jilin, 130000, People's Republic of China
| | - Yang Sun
- Orthopedic Medical Center, the Second Hospital of Jilin University, Changchun, Jilin, 130000, People's Republic of China
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12
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Laubach M, Hildebrand F, Suresh S, Wagels M, Kobbe P, Gilbert F, Kneser U, Holzapfel BM, Hutmacher DW. The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective. J Funct Biomater 2023; 14:341. [PMID: 37504836 PMCID: PMC10381286 DOI: 10.3390/jfb14070341] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
The treatment of bone defects remains a challenging clinical problem with high reintervention rates, morbidity, and resulting significant healthcare costs. Surgical techniques are constantly evolving, but outcomes can be influenced by several parameters, including the patient's age, comorbidities, systemic disorders, the anatomical location of the defect, and the surgeon's preference and experience. The most used therapeutic modalities for the regeneration of long bone defects include distraction osteogenesis (bone transport), free vascularized fibular grafts, the Masquelet technique, allograft, and (arthroplasty with) mega-prostheses. Over the past 25 years, three-dimensional (3D) printing, a breakthrough layer-by-layer manufacturing technology that produces final parts directly from 3D model data, has taken off and transformed the treatment of bone defects by enabling personalized therapies with highly porous 3D-printed implants tailored to the patient. Therefore, to reduce the morbidities and complications associated with current treatment regimens, efforts have been made in translational research toward 3D-printed scaffolds to facilitate bone regeneration. Three-dimensional printed scaffolds should not only provide osteoconductive surfaces for cell attachment and subsequent bone formation but also provide physical support and containment of bone graft material during the regeneration process, enhancing bone ingrowth, while simultaneously, orthopaedic implants supply mechanical strength with rigid, stable external and/or internal fixation. In this perspective review, we focus on elaborating on the history of bone defect treatment methods and assessing current treatment approaches as well as recent developments, including existing evidence on the advantages and disadvantages of 3D-printed scaffolds for bone defect regeneration. Furthermore, it is evident that the regulatory framework and organization and financing of evidence-based clinical trials remains very complex, and new challenges for non-biodegradable and biodegradable 3D-printed scaffolds for bone regeneration are emerging that have not yet been sufficiently addressed, such as guideline development for specific surgical indications, clinically feasible design concepts for needed multicentre international preclinical and clinical trials, the current medico-legal status, and reimbursement. These challenges underscore the need for intensive exchange and open and honest debate among leaders in the field. This goal can be addressed in a well-planned and focused stakeholder workshop on the topic of patient-specific 3D-printed scaffolds for long bone defect regeneration, as proposed in this perspective review.
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Affiliation(s)
- Markus Laubach
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Sinduja Suresh
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Michael Wagels
- Department of Plastic Surgery, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia;
- The Herston Biofabrication Institute, The University of Queensland, Herston, QLD 4006, Australia
- Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD 4102, Australia
- Department of Plastic and Reconstructive Surgery, Queensland Children’s Hospital, South Brisbane, QLD 4101, Australia
- The Australian Centre for Complex Integrated Surgical Solutions, Woolloongabba, QLD 4102, Australia
| | - Philipp Kobbe
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Fabian Gilbert
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Boris M. Holzapfel
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Dietmar W. Hutmacher
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD 4000, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies (CTET), Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
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13
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Tang J, Sang Z, Zhang X, Song C, Tang W, Luo X, Yan M. Impacts of residual 3D printing metal powders on immunological response and bone regeneration: an in vivo study. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:29. [PMID: 37227574 DOI: 10.1007/s10856-023-06727-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/03/2023] [Indexed: 05/26/2023]
Abstract
Residual powder is a defect in powder bed fusion-based additive manufacturing (3D printing), and it is difficult to completely remove it from as-printed materials. In addition, it is not necessary to apply 3D printed implants with residual powder in the clinic. The immunological response triggered by the residual powder is an important area of study in medical research. To further understand the possible immunological reactions and hidden dangers caused by residual powders in vivo, this study compared the immunological reactions and osteolysis caused by typical powders for four implant materials: 316 L stainless steel, CoCrMo, CP-Ti, and Ti-6Al-4V (particle size range of 15-45 μm), in a mouse skull model. Furthermore, the possible immunological responses and bone regeneration induced by the four 3D printed implants with residual powder in a rat femur model were compared. In the mouse skull model, it was found that the 316L-S, CoCrMo-S, and especially the 316L-M powders, upregulated the expression of pro-inflammatory factors, increased the ratio of RANKL/OPG, and activated more functional osteoclasts, resulting in more severe bone resorption compared with those in other groups. In the rat femur model, which is more suitable for clinical practice, there is no bone resorption in implants with residual powders, but they show good bone regeneration and integration ability because of their original roughness. The results indicate that the expressions of inflammatory cytokines in all experimental groups were the same as those in the control group, showing good biological safety. The results answered some critical questions related to additively manufactured medical materials in vivo and indicated that as-printed implants may have great potential in future clinical applications.
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Affiliation(s)
- Jincheng Tang
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Zhuo Sang
- The Eighth Affiliated Hospital, Sun Yat- sen University, Shenzhen, 518033, China.
| | - Xiaolei Zhang
- The Eighth Affiliated Hospital, Sun Yat- sen University, Shenzhen, 518033, China
| | - Changhui Song
- Department of Mechanical and Automotive Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Wei Tang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xiaoping Luo
- Nanjing Stomatological Hospital Medical School of Nanjing University, Nanjing, 210008, China
| | - Ming Yan
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China.
- Jiaxing Research Institute, Southern University of Science and Technology, Jiaxing, 314001, China.
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Sedelnikova MB, Kashin AD, Uvarkin PV, Tolmachev AI, Sharkeev YP, Ugodchikova AV, Luginin NA, Bakina OV. Porous Biocoatings Based on Diatomite with Incorporated ZrO 2 Particles for Biodegradable Magnesium Implants. J Funct Biomater 2023; 14:jfb14050241. [PMID: 37233351 DOI: 10.3390/jfb14050241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/04/2023] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
In the present work, the surface of a biodegradable Mg alloy was modified to create porous diatomite biocoatings using the method of micro-arc oxidation. The coatings were applied at process voltages in the range of 350-500 V. We have studied the influence of the addition of ZrO2 microparticles on the structure and properties of diatomite-based protective coatings for Mg implants. The structure and properties of the resulting coatings were examined using a number of research methods. It was found that the coatings have a porous structure and contain ZrO2 particles. The coatings were mostly characterized by pores less than 1 μm in size. However, as the voltage of the MAO process increases, the number of larger pores (5-10 μm in size) also increases. However, the porosity of the coatings varied insignificantly and amounted to 5 ± 1%. It has been revealed that the incorporation of ZrO2 particles substantially affects the properties of diatomite-based coatings. The adhesive strength of the coatings has increased by approximately 30%, and the corrosion resistance has increased by two orders of magnitude compared to the coatings without zirconia particles.
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Affiliation(s)
- Mariya B Sedelnikova
- Laboratory of Physics of Nanostructured Biocomposites, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
| | - Alexander D Kashin
- Laboratory of Physics of Nanostructured Biocomposites, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
| | - Pavel V Uvarkin
- Laboratory of Physics of Nanostructured Biocomposites, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
| | - Alexey I Tolmachev
- Laboratory of Physics of Nanostructured Biocomposites, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
| | - Yurii P Sharkeev
- Laboratory of Physics of Nanostructured Biocomposites, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
- Research School of High-Energy Physics, National Research Tomsk Polytechnic University, Tomsk 634050, Russia
| | - Anna V Ugodchikova
- Laboratory of Physics of Nanostructured Biocomposites, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
- Laboratory of Plasma Synthesis of Materials, Troitsk Institute for Innovation & Fusion Research, Troitsk 108840, Russia
| | - Nikita A Luginin
- Laboratory of Physics of Nanostructured Biocomposites, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
- Research School of High-Energy Physics, National Research Tomsk Polytechnic University, Tomsk 634050, Russia
| | - Olga V Bakina
- Laboratory of Nanobioengineering, Institute of Strength Physics and Materials Science of SB RAS, Tomsk 634055, Russia
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Porous surface with fusion peptides embedded in strontium titanate nanotubes elevates osteogenic and antibacterial activity of additively manufactured titanium alloy. Colloids Surf B Biointerfaces 2023; 224:113188. [PMID: 36773409 DOI: 10.1016/j.colsurfb.2023.113188] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Abstract
It is still a big challenge in orthopedics to treat infected bone defects properly using medical metals. The use of three-dimensional (3D) scaffold materials that simultaneously mimic the skeletal hierarchy and induce sustainable osteogenic and antibacterial functions are a promising solution with an increasing appeal. In this study, we first designed a bifunctional fusion peptide (HHC36-RGD, HR) by linking antimicrobial peptide (HHC36) and arginine-glycine-aspartate (RGD) peptide via 6-aminohexanoic acid. Then the 3D scaffold was fabricated by additive manufacturing, and the strontium titanate nanotube structure (3D-STN) was constructed on its surface. Finally, the HR was anchored to the 3D-STN with the aid of polydopamine (PDA, P), forming the 3D-STN-P-HR scaffold. The results showed that the scaffold exhibited an ordered 3D porous structure, and that the surface was covered by a dense HHC36-RGD layer. Expectedly, the adsorption of PDA effectively slowed down the release of HR. Moreover, the functionalized scaffold had a significant inhibitory effect on Staphylococcus aureus and Escherichia coli, and its antibacterial rate could reach more than 95%. The results of in vitro cell culture experiments demonstrated that the 3D-STN-P-HR scaffold possessed excellent cytocompatibility and could promote the transcription of osteogenic differentiation-related genes and the expression of related proteins. In conclusion, the functionally modified 3D porous titanium alloy scaffold (3D-STN-P-HR) has a balanced antibacterial and osteogenic function, which bodes well for future potential in the customized functional reconstruction of complex-shaped infected bone defects.
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16
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Orłowska A, Szewczenko J, Kajzer W, Goldsztajn K, Basiaga M. Study of the Effect of Anodic Oxidation on the Corrosion Properties of the Ti6Al4V Implant Produced from SLM. J Funct Biomater 2023; 14:jfb14040191. [PMID: 37103281 PMCID: PMC10145819 DOI: 10.3390/jfb14040191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Additive technologies allowed for the development of medicine and implantology, enabling the production of personalized and highly porous implants. Although implants of this type are used clinically, they are usually only heat treated. Surface modification using electrochemical methods can significantly improve the biocompatibility of biomaterials used for implants, including printed ones. The study examined the effect of anodizing oxidation on the biocompatibility of a porous implant made of Ti6Al4V by the SLM method. The study used a proprietary spinal implant intended for the treatment of discopathy in the c4–c5 section. As part of the work, the manufactured implant was assessed in terms of compliance with the requirements for implants (structure testing—metallography) and the accuracy of the pores produced (pore size and porosity). The samples were subjected to surface modification using anodic oxidation. The research was carried out for 6 weeks in in vitro conditions. Surface topographies and corrosion properties (corrosion potential, ion release) were compared for unmodified and anodically oxidized samples. The tests showed no effect of anodic oxidation on the surface topography and improved corrosion properties. Anodic oxidation stabilized the corrosion potential and limited the release of ions to the environment.
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17
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Li W, Wang Y, Yang X, Xie Q, Wang C. Comparison of bone ingrowth between two porous titanium alloy rods with biogenic lamellar structures and diamond crystal lattice on femoral condyles in rabbits. Biochem Biophys Res Commun 2023; 641:155-161. [PMID: 36527750 DOI: 10.1016/j.bbrc.2022.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 11/24/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE The comparison of bone ingrowth between two types of porous titanium alloy rods with different micro-architectures including diamond crystal lattice (Re-rod) and biogenic lamellar configurations (Bi-rod) on femoral condyles was investigated in this study. METHODS Twelve rabbits were used. Re-rod (Re-rod group) and Bi-rod (Bi-rod group) were implanted randomly in femoral condyles of each rabbits respectively. Bone ingrowth of these two rods were investigated and compared. 4 and 12 weeks after the operation, X-ray, micro-CT and histological examinations were performed. RESULTS No femoral condyle fracture and rod defluxion in the two groups was noted in the X-ray images during the observation period. Micro-CT images showed that all metal trabeculae in the Bi-rod group were covered by new bone at 4 and 12 weeks, whereas partial metal trabeculae in the Re-rod group were still uncovered at 12 weeks. Histological images showed that there was new bone growth in the centre and periphery of Bi-rods at 4 and 12 weeks, and there were several areas without new bone ingrowth at 4 and 12 weeks in the centre of Re-rods. In micro-CT analysis, the bone volume to total volume (BV/TV) of the volume of interest (VOI) of the Bi-rod group was higher than in the Re-rod group [(0.0794 ± 0.0021) % Vs (0.0521 ± 0.0032) % and (0.0875 ± 0.0039) % Vs (0.0702 ± 0.0028) % respectively, P < 0.05] at 4 weeks and 12 weeks. Whereas, the mean trabecular thickness (Tb.Th) values of VOI between the two groups were not significantly statistically different at 4 and 12 weeks. In histological analysis, the BV/TV of the VOI of the Bi-rod group was higher than in the Re-rod group [(0.0624 ± 0.0021) % Vs (0.0435 ± 0.0028) % and (0.0675 ± 0.0024) % Vs (0.0476 ± 0.0031) % respectively, P < 0.05] at 4 weeks and 12 weeks. CONCLUSION These results showed that Bi-rods got better bone ingrowth in femoral condyles of rabbits compared with Re-rods.
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Affiliation(s)
- Wei Li
- Medical College, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China; Department of Orthopaedics, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, China
| | - Yu Wang
- Department of Information, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, China
| | - Xinglan Yang
- Clinic of Military Patients, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, China
| | - Qingyun Xie
- Medical College, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China; Department of Orthopaedics, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, China.
| | - Cairu Wang
- Medical College, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China; Department of Orthopaedics, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, China.
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Evans LM, Sözümert E, Keenan BE, Wood CE, du Plessis A. A Review of Image-Based Simulation Applications in High-Value Manufacturing. ARCHIVES OF COMPUTATIONAL METHODS IN ENGINEERING : STATE OF THE ART REVIEWS 2023; 30:1495-1552. [PMID: 36685137 PMCID: PMC9847465 DOI: 10.1007/s11831-022-09836-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/15/2022] [Indexed: 06/17/2023]
Abstract
Image-Based Simulation (IBSim) is the process by which a digital representation of a real geometry is generated from image data for the purpose of performing a simulation with greater accuracy than with idealised Computer Aided Design (CAD) based simulations. Whilst IBSim originates in the biomedical field, the wider adoption of imaging for non-destructive testing and evaluation (NDT/NDE) within the High-Value Manufacturing (HVM) sector has allowed wider use of IBSim in recent years. IBSim is invaluable in scenarios where there exists a non-negligible variation between the 'as designed' and 'as manufactured' state of parts. It has also been used for characterisation of geometries too complex to accurately draw with CAD. IBSim simulations are unique to the geometry being imaged, therefore it is possible to perform part-specific virtual testing within batches of manufactured parts. This novel review presents the applications of IBSim within HVM, whereby HVM is the value provided by a manufactured part (or conversely the potential cost should the part fail) rather than the actual cost of manufacturing the part itself. Examples include fibre and aggregate composite materials, additive manufacturing, foams, and interface bonding such as welding. This review is divided into the following sections: Material Characterisation; Characterisation of Manufacturing Techniques; Impact of Deviations from Idealised Design Geometry on Product Design and Performance; Customisation and Personalisation of Products; IBSim in Biomimicry. Finally, conclusions are drawn, and observations made on future trends based on the current state of the literature.
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Affiliation(s)
- Llion Marc Evans
- Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN UK
- United Kingdom Atomic Energy Authority, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB UK
| | - Emrah Sözümert
- Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN UK
| | - Bethany E. Keenan
- Cardiff School of Engineering, Cardiff University, Cardiff, CF24 3AA UK
| | - Charles E. Wood
- School of Mechanical & Design Engineering, University of Portsmouth, Portsmouth, PO1 3DJ UK
| | - Anton du Plessis
- Object Research Systems, Montreal, H3B 1A7 Canada
- Research Group 3DInnovation, Stellenbosch University, Stellenbosch, 7602 South Africa
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Additively manufactured controlled porous orthopedic joint replacement designs to reduce bone stress shielding: a systematic review. J Orthop Surg Res 2023; 18:42. [PMID: 36647070 PMCID: PMC9841707 DOI: 10.1186/s13018-022-03492-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Total joint replacements are an established treatment for patients suffering from reduced mobility and pain due to severe joint damage. Aseptic loosening due to stress shielding is currently one of the main reasons for revision surgery. As this phenomenon is related to a mismatch in mechanical properties between implant and bone, stiffness reduction of implants has been of major interest in new implant designs. Facilitated by modern additive manufacturing technologies, the introduction of porosity into implant materials has been shown to enable significant stiffness reduction; however, whether these devices mitigate stress-shielding associated complications or device failure remains poorly understood. METHODS In this systematic review, a broad literature search was conducted in six databases (Scopus, Web of Science, Medline, Embase, Compendex, and Inspec) aiming to identify current design approaches to target stress shielding through controlled porous structures. The search keywords included 'lattice,' 'implant,' 'additive manufacturing,' and 'stress shielding.' RESULTS After the screening of 2530 articles, a total of 46 studies were included in this review. Studies focusing on hip, knee, and shoulder replacements were found. Three porous design strategies were identified, specifically uniform, graded, and optimized designs. The latter included personalized design approaches targeting stress shielding based on patient-specific data. All studies reported a reduction of stress shielding achieved by the presented design. CONCLUSION Not all studies used quantitative measures to describe the improvements, and the main stress shielding measures chosen varied between studies. However, due to the nature of the optimization approaches, optimized designs were found to be the most promising. Besides the stiffness reduction, other factors such as mechanical strength can be considered in the design on a patient-specific level. While it was found that controlled porous designs are overall promising to reduce stress shielding, further research and clinical evidence are needed to determine the most superior design approach for total joint replacement implants.
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Nanohydroxyapatite/Titanate Nanotube Composites for Bone Tissue Regeneration. J Funct Biomater 2022; 13:jfb13040306. [PMID: 36547566 PMCID: PMC9786793 DOI: 10.3390/jfb13040306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Strategies for the production of new nanocomposites that promote bone tissue regeneration are important, particularly those that enhance the osteoinduction of hydroxyapatite in situ. Here, we studied and report the synthesis of nanohydroxyapatite and titanate nanotube (nHAp/TiNT) composites formulated at different concentrations (1, 2, 3, and 10 wt % TiNT) by means of a wet aqueous chemical reaction. The addition of TiNT affects the morphology of the nanocomposites, decreasing the average crystallite size from 54 nm (nHAp) to 34 nm (nHAp/TiNT10%), while confirming its interaction with the nanocomposite. The crystallinity index (CI) calculated by Raman spectroscopy and XRD showed that the values decreased according to the increase in TiNT concentration, which confirmed their addition to the structure of the nanocomposite. SEM images showed the presence of TiNTs in the nanocomposite. We further verified the potential cytotoxicity of murine fibroblast cell line L929, revealing that there was no remarkable cell death at any of the concentrations tested. In vivo regenerative activity was performed using oophorectomized animal (rat) models organized into seven groups containing five animals each over two experimental periods (15 and 30 days), with bone regeneration occurring in all groups tested within 30 days; however, the nHAp/TiNT10% group showed statistically greater tissue repair, compared to the untreated control group. Thus, the results of this study demonstrate that the presently formulated nHAp/TiNT nanocomposites are promising for numerous improved bone tissue regeneration applications.
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Alipour S, Nour S, Attari SM, Mohajeri M, Kianersi S, Taromian F, Khalkhali M, Aninwene GE, Tayebi L. A review on in vitro/ in vivo response of additively manufactured Ti-6Al-4V alloy. J Mater Chem B 2022; 10:9479-9534. [PMID: 36305245 DOI: 10.1039/d2tb01616h] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bone replacement using porous and solid metallic implants, such as Ti-alloy implants, is regarded as one of the most practical therapeutic approaches in biomedical engineering. The bone is a complex tissue with various mechanical properties based on the site of action. Patient-specific Ti-6Al-4V constructs may address the key needs in bone treatment for having customized implants that mimic the complex structure of the natural tissue and diminish the risk of implant failure. This review focuses on the most promising methods of fabricating such patient-specific Ti-6Al-4V implants using additive manufacturing (AM) with a specific emphasis on the popular subcategory, which is powder bed fusion (PBF). Characteristics of the ideal implant to promote optimized tissue-implant interactions, as well as physical, mechanical/chemical treatments and modifications will be discussed. Accordingly, such investigations will be classified into 3B-based approaches (Biofunctionality, Bioactivity, and Biostability), which mainly govern native body response and ultimately the success in implantation.
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Affiliation(s)
- Saeid Alipour
- Department of Materials Science and Engineering, Missouri University of Science and Technology, Rolla, MO 65409, USA
| | - Shirin Nour
- Tissue Engineering Group, Department of Biomedical Engineering, University of Melbourne, VIC 3010, Australia.,Polymer Science Group, Department of Chemical Engineering, University of Melbourne, VIC 3010, Australia
| | - Seyyed Morteza Attari
- Department of Material Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Mohammad Mohajeri
- Department of Biomedical Engineering, College of Engineering, Texas A&M University, TX, USA
| | - Sogol Kianersi
- CÚRAM, SFI Centre for Research in Medical Devices, Biomedical Sciences, University of Galway, Galway, Ireland
| | - Farzaneh Taromian
- Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Mohammadparsa Khalkhali
- Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - George E Aninwene
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences, University of California-Los Angeles, Los Angeles, California, USA.,Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, Los Angeles, California, USA.,California NanoSystems Institute (CNSI), University of California-Los Angeles, Los Angeles, California, USA
| | - Lobat Tayebi
- School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA.
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22
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The Promotion of Mechanical Properties by Bone Ingrowth in Additive-Manufactured Titanium Scaffolds. J Funct Biomater 2022; 13:jfb13030127. [PMID: 36135562 PMCID: PMC9505383 DOI: 10.3390/jfb13030127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022] Open
Abstract
Although the initial mechanical properties of additive-manufactured (AM) metal scaffolds have been thoroughly studied and have become a cornerstone in the design of porous orthopaedic implants, the potential promotion of the mechanical properties of the scaffolds by bone ingrowth has barely been studied. In this study, the promotion of bone ingrowth on the mechanical properties of AM titanium alloy scaffolds was investigated through in vivo experiments and numerical simulation. On one hand, the osseointegration characteristics of scaffolds with architectures of body-centred cubic (BCC) and diamond were compared through animal experiments in which the mechanical properties of both scaffolds were not enhanced by the four-week implantation. On the other hand, the influences of the type and morphology of bone tissue in the BCC scaffolds on its mechanical properties were investigated by the finite element model of osseointegrated scaffolds, which was calibrated by the results of biomechanical testing. Significant promotion of the mechanical properties of AM metal scaffolds was only found when cortical bone filled the pores in the scaffolds. This paper provides a numerical prediction method to investigate the effect of bone ingrowth on the mechanical properties of AM porous implants, which might be valuable for the design of porous implants.
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23
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Abstract
Ti-6Al-4V (Ti64) alloy is one of the most widely used orthopedic implant materials due to its mechanical properties, corrosion resistance, and biocompatibility nature. Porous Ti64 structures are gaining more research interest as bone implants as they can help in reducing the stress-shielding effect when compared to their solid counterpart. The literature shows that porous Ti64 implants fabricated using different additive manufacturing (AM) process routes, such as laser powder bed fusion (L-PBF) and electron beam melting (EBM) can be tailored to mimic the mechanical properties of natural bone. This review paper categorizes porous implant designs into non-gradient (uniform) and gradient (non-uniform) porous structures. Gradient porous design appears to be more promising for orthopedic applications due to its closeness towards natural bone morphology and improved mechanical properties. In addition, this paper outlines the details on bone structure and its properties, mechanical properties, fatigue behavior, multifunctional porous implant designs, current challenges, and literature gaps in the research studies on porous Ti64 bone implants.
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24
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Nambiar J, Jana S, Nandi SK. Strategies for Enhancing Vascularization of Biomaterial-Based Scaffold in Bone Regeneration. CHEM REC 2022; 22:e202200008. [PMID: 35352873 DOI: 10.1002/tcr.202200008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/12/2022] [Indexed: 12/29/2022]
Abstract
Despite the recent advances in reconstructive orthopedics; fracture union is a challenge to bone regeneration. Concurrent angiogenesis is a complex process governed by events, delicately entwined with osteogenesis. However, poorly perfused scaffolds have lower success rates; necessitating the need for a better vascular component, which is important for the delivery of nutrients, oxygen, waste elimination, recruitment of cells for optimal bone repair. This review highlights the latest strategies to promote biomaterial-based scaffold vascularization by incorporation of cells, growth factors, inorganic ions, etc. into natural or synthetic polymers, ceramic materials, or composites of organic and inorganic compounds. Furthermore, it emphasizes structural modifications, biophysical stimuli, and natural molecules to fabricate scaffolds aiding the genesis of dense vascularization following their implantation to manifest a compatible regenerative microenvironment without graft rejection.
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Affiliation(s)
- Jasna Nambiar
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata, 700037, India
| | - Sonali Jana
- Department of Veterinary Physiology, West Bengal University of Animal & Fishery Sciences, Kolkata, 700037, India
| | - Samit Kumar Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata, 700037, India
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25
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Li J, Cui X, Lindberg G, Alcala-Orozco CR, Hooper GJ, Lim K, Woodfield TBF. Hybrid fabrication of photo-clickable vascular hydrogels with additive manufactured titanium implants for enhanced osseointegration and vascularized bone formation. Biofabrication 2022; 14. [PMID: 35320796 DOI: 10.1088/1758-5090/ac6051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 03/23/2022] [Indexed: 11/11/2022]
Abstract
Bone regeneration of critical-sized bone defects, bone fractures or joint replacements remains a significant unmet clinical challenge. Although there has been rapid advancement in both the fields of bone tissue engineering and additive manufacturing (AM), functional bone implants with rapid vascularization capacity to ensure osseointegration and long-term biological fixation in large bone defects remains limited in clinics. In this study, we developed an in vitro vascularized bone implant by combining cell-laden hydrogels with direct metal printed (DMP) porous titanium alloys (Ti-6Al-4V). 5wt% allylated gelatin (GelAGE), was utilized to co-encapsulate human mesenchymal stromal cells (hMSCs) and human umbilical vein endothelial cells (HUVECs) to investigate concurrent osteogenic and vasculogenic performance. DMP macro-porous Ti-6Al-4V scaffolds were subsequently infused/enriched with cell-laden GelAGE to examine the feasibility to deliver cells and engineer vascular-like networks in the hybrid implant. Furthermore, as a proof of concept, a full-scale porous Ti-6Al-4V acetabular cup was impregnated with cell-laden hydrogel to validate the clinical potential of this strategy. The vasculogenic potential was evaluated by examining micro-capillary formation coupled with capillary network maturation and stabilization. Osteogenic differentiation was assessed via ALP activity as well as osteocalcin and osteopontin expression. Our results suggested that GelAGE supported HUVECs spreading and vascular-like network formation, along with osteogenesis of hMSCs. Titanium hybrid constructs with cell-laden hydrogel demonstrated enhanced osteogenesis with similar vasculogenic capability compared to the cell-laden hydrogel alone constructs. The full-scale implant with cell-laden hydrogel coating similarly showed cell distribution and spreading, implying the potential for further clinical application. Our study presents the feasibility of integrating bio-functional hydrogels with porous titanium implants to fabricate a vascularized hybrid construct with both mechanical support and preferable biological functionality (osteogenesis/vasculogenesis), which paves the way for improved strategies to enhance bone regeneration in complex large bone defects achieving long-term bone-implant fixation.
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Affiliation(s)
- Jun Li
- Dept. of Orthopaedic Surgery , University of Otago, 2 Riccarton Avenue, Christchurch, Christchurch, Canterbury, 8011, NEW ZEALAND
| | - Xiaolin Cui
- University of Otago Christchurch, 2 Riccarton Avenue, Christchurch, 8011, NEW ZEALAND
| | - Gabriella Lindberg
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, 2 Riccarton Avenue, Christchurch, 8011, NEW ZEALAND
| | - Cesar R Alcala-Orozco
- Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, 2 Riccarton Avenue, Christchurch, Christchurch, 8011, NEW ZEALAND
| | - Gary J Hooper
- Christchurch Regenerative Medicine and Tissue Engineering Group Department of Orthopaedic Surgery, Centre for Bioengineering & Nanomedicine, University of Otago Christchurch, PO Box 4345, Christchurch 8140, Christchurch, 8140, NEW ZEALAND
| | - Khoon Lim
- Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, 2 Riccarton Avenue, Christchurch, 8011, NEW ZEALAND
| | - Tim B F Woodfield
- Christchurch Regenerative Medicine and Tissue Engineering Group Department of Orthopaedic Surgery, Centre for Bioengineering & Nanomedicine, University of Otago Christchurch, PO Box 4345, Christchurch 8140, Christchurch, 8140, NEW ZEALAND
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26
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Liu Y, Ruan X, Li J, Wang B, Chen J, Wang X, Wang P, Tu X. The Osteocyte Stimulated by Wnt Agonist SKL2001 Is a Safe Osteogenic Niche Improving Bioactivities in a Polycaprolactone and Cell Integrated 3D Module. Cells 2022; 11:cells11050831. [PMID: 35269452 PMCID: PMC8909416 DOI: 10.3390/cells11050831] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 02/05/2023] Open
Abstract
Finding and constructing an osteogenic microenvironment similar to natural bone tissue has always been a frontier topic in orthopedics. We found that osteocytes are targeting cells controlling bone anabolism produced by PTH (JBMR 2017, PMID: 27704638), and osteocytes with activated Wnt signaling orchestrate bone formation and resorption (PNAS 2015, PMID: 25605937). However, methods for taking advantage of the leading role of osteocytes in bone regeneration remain unexplored. Herein, we found that the osteocytes with SKL2001-activated Wnt signaling could be an osteogenic microenvironment (SOOME) which upregulates the expression of bone transcription factor Runx2 and Bglap and promotes the differentiation of bone marrow stromal cell ST2 into osteoblasts. Interestingly, 60 μM SKL2001 treatment of osteocytic MLO-Y4 for 24 h maintained Wnt signaling activation for three days after removal, which was sufficient to induce osteoblast differentiation. Triptonide, a Wnt inhibitor, could eliminate this differentiation. Moreover, on day 5, the Wnt signaling naturally decreased to the level of the control group, indicating that this method of Wnt-signaling induction is safe to use. We quickly verified in vivo function of SOOME to a good proximation in 3D bioprinted modules composed of reciprocally printed polycaprolactone bundles (for support) and cell bundles (for bioactivity). In the cell bundles, SOOME stably supported the growth and development of ST2 cells, the 7-day survival rate was as high as 91.6%, and proliferation ability increased linearly. Similarly, SOOME greatly promoted ST2 differentiation and mineralization for 28 days. In addition, SOOME upregulated the expression of angiopoietin 1, promoted endothelial cell migration and angiogenesis, and increased node number and total length of tubes and branches. Finally, we found that the function of SOOME could be realized through the paracrine pathway. This study reveals that osteocytes with Wnt signaling activated by SKL2001 are a safe osteogenic microenvironment. Both SOOME itself and its cell-free culture supernatant can improve bioactivity for osteoblast differentiation, with composite scaffolds especially bearing application value.
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Affiliation(s)
| | | | | | | | | | | | | | - Xiaolin Tu
- Correspondence: ; Tel.: +86-185-2382-0685
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27
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Balancing the customization and standardization: exploration and layout surrounding the regulation of the growing field of 3D-printed medical devices in China. Biodes Manuf 2022; 5:580-606. [PMID: 35194519 PMCID: PMC8853031 DOI: 10.1007/s42242-022-00187-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/17/2022] [Indexed: 12/23/2022]
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28
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Adel IM, ElMeligy MF, Elkasabgy NA. Conventional and Recent Trends of Scaffolds Fabrication: A Superior Mode for Tissue Engineering. Pharmaceutics 2022; 14:306. [DOI: https:/doi.org/10.3390/pharmaceutics14020306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Tissue regeneration is an auto-healing mechanism, initiating immediately following tissue damage to restore normal tissue structure and function. This falls in line with survival instinct being the most dominant instinct for any living organism. Nevertheless, the process is slow and not feasible in all tissues, which led to the emergence of tissue engineering (TE). TE aims at replacing damaged tissues with new ones. To do so, either new tissue is being cultured in vitro and then implanted, or stimulants are implanted into the target site to enhance endogenous tissue formation. Whichever approach is used, a matrix is used to support tissue growth, known as ‘scaffold’. In this review, an overall look at scaffolds fabrication is discussed, starting with design considerations and different biomaterials used. Following, highlights of conventional and advanced fabrication techniques are attentively presented. The future of scaffolds in TE is ever promising, with the likes of nanotechnology being investigated for scaffold integration. The constant evolvement of organoids and biofluidics with the eventual inclusion of organ-on-a-chip in TE has shown a promising prospect of what the technology might lead to. Perhaps the closest technology to market is 4D scaffolds following the successful implementation of 4D printing in other fields.
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29
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Conventional and Recent Trends of Scaffolds Fabrication: A Superior Mode for Tissue Engineering. Pharmaceutics 2022; 14:pharmaceutics14020306. [PMID: 35214038 PMCID: PMC8877304 DOI: 10.3390/pharmaceutics14020306] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/16/2022] Open
Abstract
Tissue regeneration is an auto-healing mechanism, initiating immediately following tissue damage to restore normal tissue structure and function. This falls in line with survival instinct being the most dominant instinct for any living organism. Nevertheless, the process is slow and not feasible in all tissues, which led to the emergence of tissue engineering (TE). TE aims at replacing damaged tissues with new ones. To do so, either new tissue is being cultured in vitro and then implanted, or stimulants are implanted into the target site to enhance endogenous tissue formation. Whichever approach is used, a matrix is used to support tissue growth, known as ‘scaffold’. In this review, an overall look at scaffolds fabrication is discussed, starting with design considerations and different biomaterials used. Following, highlights of conventional and advanced fabrication techniques are attentively presented. The future of scaffolds in TE is ever promising, with the likes of nanotechnology being investigated for scaffold integration. The constant evolvement of organoids and biofluidics with the eventual inclusion of organ-on-a-chip in TE has shown a promising prospect of what the technology might lead to. Perhaps the closest technology to market is 4D scaffolds following the successful implementation of 4D printing in other fields.
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30
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Chao L, Jiao C, Liang H, Xie D, Shen L, Liu Z. Analysis of Mechanical Properties and Permeability of Trabecular-Like Porous Scaffold by Additive Manufacturing. Front Bioeng Biotechnol 2022; 9:779854. [PMID: 34993188 PMCID: PMC8724551 DOI: 10.3389/fbioe.2021.779854] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Human bone cells live in a complex environment, and the biomimetic design of porous structures attached to implants is in high demand. Porous structures based on Voronoi tessellation with biomimetic potential are gradually used in bone repair scaffolds. In this study, the mechanical properties and permeability of trabecular-like porous scaffolds with different porosity levels and average apertures were analyzed. The mechanical properties of bone-implant scaffolds were evaluated using finite element analysis and a mechanical compression experiment, and the permeability was studied by computational fluid dynamics. Finally, the attachment of cells was observed by confocal fluorescence microscope. The results show that the performance of porous structures can be controlled by the initial design of the microstructure and tissue morphology. A good structural design can accurately match the performance of the natural bone. The study of mechanical properties and permeability of the porous structure can help address several problems, including stress shielding and bone ingrowth in existing biomimetic bone structures, and will also promotes cell adhesion, migration, and eventual new bone attachment.
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Affiliation(s)
- Long Chao
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Chen Jiao
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Huixin Liang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Jiangsu Engineering Research Center for 3D Bioprinting, Nanjing, China
| | - Deqiao Xie
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Lida Shen
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Zhidong Liu
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
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31
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Stich T, Alagboso F, Křenek T, Kovářík T, Alt V, Docheva D. Implant-bone-interface: Reviewing the impact of titanium surface modifications on osteogenic processes in vitro and in vivo. Bioeng Transl Med 2022; 7:e10239. [PMID: 35079626 PMCID: PMC8780039 DOI: 10.1002/btm2.10239] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/08/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022] Open
Abstract
Titanium is commonly and successfully used in dental and orthopedic implants. However, patients still have to face the risk of implant failure due to various reasons, such as implant loosening or infection. The risk of implant loosening can be countered by optimizing the osteointegration capacity of implant materials. Implant surface modifications for structuring, roughening and biological activation in favor for osteogenic differentiation have been vastly studied. A key factor for a successful stable long-term integration is the initial cellular response to the implant material. Hence, cell-material interactions, which are dependent on the surface parameters, need to be considered in the implant design. Therefore, this review starts with an introduction to the basics of cell-material interactions as well as common surface modification techniques. Afterwards, recent research on the impact of osteogenic processes in vitro and vivo provoked by various surface modifications is reviewed and discussed, in order to give an update on currently applied and developing implant modification techniques for enhancing osteointegration.
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Affiliation(s)
- Theresia Stich
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
| | - Francisca Alagboso
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
| | - Tomáš Křenek
- New Technologies Research CentreUniversity of West BohemiaPilsenCzech Republic
| | - Tomáš Kovářík
- New Technologies Research CentreUniversity of West BohemiaPilsenCzech Republic
| | - Volker Alt
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
- Clinic and Polyclinic for Trauma Surgery, University Regensburg Medical CentreRegensburgGermany
| | - Denitsa Docheva
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
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32
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Ma X, Gao Y, Zhao D, Zhang W, Zhao W, Wu M, Cui Y, Li Q, Zhang Z, Ma C. Titanium Implants and Local Drug Delivery Systems Become Mutual Promoters in Orthopedic Clinics. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 12:47. [PMID: 35009997 PMCID: PMC8746425 DOI: 10.3390/nano12010047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Titanium implants have always been regarded as one of the gold standard treatments for orthopedic applications, but they still face challenges such as pain, bacterial infections, insufficient osseointegration, immune rejection, and difficulty in personalizing treatment in the clinic. These challenges may lead to the patients having to undergo a painful second operation, along with increased economic burden, but the use of drugs is actively solving these problems. The use of systemic drug delivery systems through oral, intravenous, and intramuscular injection of various drugs with different pharmacological properties has effectively reduced the levels of inflammation, lowered the risk of endophytic bacterial infection, and regulated the progress of bone tumor cells, processing and regulating the balance of bone metabolism around the titanium implants. However, due to the limitations of systemic drug delivery systems-such as pharmacokinetics, and the characteristics of bone tissue in the event of different forms of trauma or disease-sometimes the expected effect cannot be achieved. Meanwhile, titanium implants loaded with drugs for local administration have gradually attracted the attention of many researchers. This article reviews the latest developments in local drug delivery systems in recent years, detailing how various types of drugs cooperate with titanium implants to enhance antibacterial, antitumor, and osseointegration effects. Additionally, we summarize the improved technology of titanium implants for drug loading and the control of drug release, along with molecular mechanisms of bone regeneration and vascularization. Finally, we lay out some future prospects in this field.
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33
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Parameter Optimization for Printing Ti6Al4V-Alloy Patient-Customized Orthopaedic Implants by Laser Powder Bed Fusion Using Physio-mechanical Properties and Biological Evaluations. Indian J Orthop 2021; 56:797-804. [PMID: 35547343 PMCID: PMC9043156 DOI: 10.1007/s43465-021-00577-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/20/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND A class of additive manufacturing technologies called Laser powder bed fusion (LPBF), which allows fabricating metallic components with complex geometries in near-net-shape, can be employed for fabricating patient-customized orthopaedic implants. Selection and optimization of the LPBF process parameters are critical to achieving the required biomechanical properties and fabricability of such implants. METHODS The process parameters of direct metal laser sintering, the most widely used LPBF process, were optimized for fabricating Ti6Al4V ELI orthopaedic implants, based on ASTM and ASM standards. The parameters included Laser power, Laser velocity and hatch distance, which were varied using Taguchi approach. A multi-criteria decision-making technique (TOPSIS) was employed to optimize the process parameters considering yield and ultimate tensile strength, percentage elongation, part density, volumetric energy density and printing time. In-vitro cytotoxicity and in-vivo muscle implantation were performed on the optimized samples for determining the suitability of the parameters for biomedical applications. RESULTS A combination of medium laser power, higher laser velocity, and lower hatch distance with values 200 W, 2200 mm/s and 0.08 mm, respectively, was found to be suitable for producing implants. Based on the type of LPBF technology in use, an implant manufacturer can select the initial set of parameters using a similar approach and improve them further based on experimental results. CONCLUSION The optimized parameters were found to be suitable for developing orthopaedic implants, in terms of physical, mechanical and biological criteria. The methods and results presented in work are expected to assist the implant manufacturers in meeting the expected user requirements and quality standards.
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34
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Zabala-Travers S. Biomodeling and 3D printing: A novel radiology subspecialty. ANNALS OF 3D PRINTED MEDICINE 2021. [DOI: 10.1016/j.stlm.2021.100038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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35
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Booth MA, Pope L, Sherrell PC, Stacey A, Tran PA, Fox KE. Polycrystalline diamond coating on 3D printed titanium scaffolds: Surface characterisation and foreign body response. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 130:112467. [PMID: 34702542 DOI: 10.1016/j.msec.2021.112467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/10/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
Titanium-based implants are the leading material for orthopaedic surgery, due to their strength, versatility, fabrication via additive manufacturing and invoked biological response. However, the interface between the implant and the host tissue requires improvement to better integrate the implant material and mitigate foreign body response. The interface can be manipulated by changing the surface energy, chemistry, and topography of the Titanium-based implant. Recently, polycrystalline diamond (PCD) has emerged as an exciting coating material for 3D printed titanium scaffolds showing enhanced mammalian cell functions while inhibiting bacterial attachment in vitro. In this study, we performed in-depth characterisation of PCD coatings investigating the surface topography, thickness, surface energy, and compared its foreign body response in vivo with uncoated titanium scaffold. Coating PCD onto titanium scaffolds resulted in a similar microscale surface roughness (RMS(PCD-coated) = 24 μm; RMS(SLM-Ti) = 28 μm), increased nanoscale roughness (RMS(PCD-coated) = 35 nm; RMS(SLM-Ti) = 66 nm) and a considerable decrease in surface free energy (E(PCD-coated) = 4 mN m-1; E(SLM-Ti) = 16 mN m-1). These surface property changes were supported by X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy as corresponding to observed surface chemistry changes induced by the coating. The underlying mechanism of how the diamond coatings chemical and physical properties changes the wettability of implants was examined. In vivo, the coated scaffolds induced similar level of fibrous encapsulation with uncoated scaffolds. This study thus provides further insight into the physicochemical characteristics of PCD coatings, adding evidence to the promising potential of PCD-coatings of medical implants.
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Affiliation(s)
- Marsilea A Booth
- Center for Additive Manufacturing, School of Engineering, RMIT University, VIC 3000, Australia
| | - Leon Pope
- Center for Additive Manufacturing, School of Engineering, RMIT University, VIC 3000, Australia
| | - Peter C Sherrell
- Department of Chemical Engineering, The Faculty of Engineering and Information Technology, University of Melbourne, Australia
| | - Alastair Stacey
- Center for Additive Manufacturing, School of Engineering, RMIT University, VIC 3000, Australia; ARC Centre of Excellence for Nanoscale BioPhotonics, School of Science, RMIT University, VIC 3000, Australia
| | - Phong A Tran
- Interface Science and Materials Engineering Group, School of Mechanical, Medical and Process Engineering, Queensland University of Technology (QUT), 2 George Street, Brisbane, QLD 4000, Australia; Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia.
| | - Kate E Fox
- Center for Additive Manufacturing, School of Engineering, RMIT University, VIC 3000, Australia.
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Gosteva EA, Dymnikov AB, Starkov VV, Sedlovets DM, Valikhov MP, Vishnevsky DA, Chekhonin VP, Tumanyan GA, Ahmad MK. Interaction of Various Variants of the Nanostructured Surface of Titanium with MSCs Isolated from Adipose Tissue. Biomimetics (Basel) 2021; 6:biomimetics6040061. [PMID: 34698073 PMCID: PMC8544202 DOI: 10.3390/biomimetics6040061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/20/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Titanium has been successfully used in dental implantology for a long time. Due to the osseointegration process, titanium implants are able to withstand the chewing load. This article is devoted to the study of surface treatment methods of titanium alloys and the study of their interaction with mesenchymal stem cells (MSCs). The surface microrelief can influence MSC differentiation in different ways, which subsequently gives it osteogenic potential. The paper proposes modes of surface modification of titanium alloys on Grade 4 and Grade 1 by chemical and electrochemical (anodizing) etching. The possibility of modifying the surface of titanium alloys using the synthesis of graphene layers has been proposed in this paper for the first time. The osteogenic potential of a particular surface was assessed by the number of mesenchymal stem cells cultured on them under identical conditions.
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Affiliation(s)
- Ekaterina A. Gosteva
- Department of the Material Science of Semiconductors and Dielectrics, National University of Science and Technology MISiS, 4 Leninskiy Prospekt, 119049 Moscow, Russia
- Academy of Engineering, RUDN University, 117198 Moscow, Russia
- Correspondence:
| | - Alexander B. Dymnikov
- Department of Maxillofacial Surgery and Surgical Dentistry of the FSAEI, The Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St., 117198 Moscow, Russia; (A.B.D.); (G.A.T.); (M.K.A.)
| | - Vitaliy V. Starkov
- Institute of Microelectronics Technology and High Purity Materials of the Russian Academy of Sciences, Academician Ossipyan Str., 142432 Chernogolovka, Russia; (V.V.S.); (D.M.S.)
| | - Daria M. Sedlovets
- Institute of Microelectronics Technology and High Purity Materials of the Russian Academy of Sciences, Academician Ossipyan Str., 142432 Chernogolovka, Russia; (V.V.S.); (D.M.S.)
| | - Marat P. Valikhov
- Department of Basic and Applied Neurobiology, V. Serbsky National Medical Research Center for Psychiatry and Narcology, Kropotkinsky Lane 23, 119034 Moscow, Russia; (M.P.V.); (D.A.V.); (V.P.C.)
| | - Dmytryi A. Vishnevsky
- Department of Basic and Applied Neurobiology, V. Serbsky National Medical Research Center for Psychiatry and Narcology, Kropotkinsky Lane 23, 119034 Moscow, Russia; (M.P.V.); (D.A.V.); (V.P.C.)
| | - Vladimir P. Chekhonin
- Department of Basic and Applied Neurobiology, V. Serbsky National Medical Research Center for Psychiatry and Narcology, Kropotkinsky Lane 23, 119034 Moscow, Russia; (M.P.V.); (D.A.V.); (V.P.C.)
| | - Gurgen A. Tumanyan
- Department of Maxillofacial Surgery and Surgical Dentistry of the FSAEI, The Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St., 117198 Moscow, Russia; (A.B.D.); (G.A.T.); (M.K.A.)
| | - Masound K. Ahmad
- Department of Maxillofacial Surgery and Surgical Dentistry of the FSAEI, The Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St., 117198 Moscow, Russia; (A.B.D.); (G.A.T.); (M.K.A.)
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Alcala-Orozco CR, Cui X, Hooper GJ, Lim KS, Woodfield TB. Converging functionality: Strategies for 3D hybrid-construct biofabrication and the role of composite biomaterials for skeletal regeneration. Acta Biomater 2021; 132:188-216. [PMID: 33713862 DOI: 10.1016/j.actbio.2021.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/02/2021] [Accepted: 03/02/2021] [Indexed: 12/13/2022]
Abstract
The evolution of additive manufacturing (AM) technologies, biomaterial development and our increasing understanding of cell biology has created enormous potential for the development of personalized regenerative therapies. In the context of skeletal tissue engineering, physical and biological demands play key roles towards successful construct implantation and the achievement of bone, cartilage and blood vessel tissue formation. Nevertheless, meeting such physical and biological demands to mimic the complexity of human tissues and their functionality is still a significant ongoing challenge. Recent studies have demonstrated that combination of AM technologies and advanced biomaterials has great potential towards skeletal tissue engineering. This review aims to analyze how the most prominent technologies and discoveries in the field converge towards the development of advanced constructs for skeletal regeneration. Particular attention is placed on hybrid biofabrication strategies, combining bioinks for cell delivery with biomaterial inks providing physical support. Hybrid biofabrication has been the focus of recent emerging strategies, however there has been limited review and analysis of these techniques and the challenges involved. Furthermore, we have identified that there are multiple hybrid fabrication strategies, here we present a category system where each strategy is reviewed highlighting their distinct advantages, challenges and potential applications. In addition, bioinks and biomaterial inks are the main components of the hybrid biofabrication strategies, where it is recognized that such platforms still lack optimal physical and biological functionality. Thus, this review also explores the development of composite materials specifically targeting the enhancement of physical and biological functionality towards improved skeletal tissue engineering. STATEMENT OF SIGNIFICANCE: Biofabrication strategies capable of recreating the complexity of native tissues could open new clinical possibilities towards patient-specific regenerative therapies and disease models. Several reviews target the existing additive manufacturing (AM) technologies that may be utilised for biomedical purposes. However, this work presents a unique perspective, describing how such AM technologies have been recently translated towards hybrid fabrication strategies, targeting the fabrication of constructs with converging physical and biological properties. Furthermore, we address composite bioinks and biomaterial inks that have been engineered to overcome traditional limitations, and might be applied to the hybrid fabrication strategies outlined. This work offers ample perspectives and insights into the current and future challenges for the fabrication of skeletal tissues aiming towards clinical and biomedical applications.
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Porous Titanium by Additive Manufacturing: A Focus on Surfaces for Bone Integration. METALS 2021. [DOI: 10.3390/met11091343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Additive manufacturing (AM) is gaining increasing interest for realization of customized porous titanium constructs for biomedical applications and, in particular, for bone substitution. As first, the present review gives a short introduction on the techniques used for additive manufacturing of Ti/Ti-Alloys (Direct Energy Deposition—DED, Selective Laser Melting—SLM and Electron Beam Melting—EBM) and on the main bulk properties of additively manufactured titanium porous structures. Then, it discusses the main advancements in surface modifications of additively manufactured titanium constructs for bone contact applications. Even if specific surface modifications of constructs from AM are currently not widely explored, it is a critical open issue for application in biomedical implants. Some thermal, chemical, electrochemical, and hydrothermal treatments as well as different coatings are here described. The main aim of these treatments is the development of surface micro/nano textures, specific ion release, and addition of bioactivity to induce bone bonding and antibacterial activity. Physicochemical characterizations, in vitro bioactivity tests, protein absorption, in vitro (cellular/bacterial) and in vivo tests reported in the literature for bare and surface modified AM Ti-based constructs are here reviewed. Future perspectives for development of innovative additively manufactured titanium implants are also discussed.
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Ghilini F, Fagali N, Pissinis DE, Benítez G, Schilardi PL. Multifunctional Titanium Surfaces for Orthopedic Implants: Antimicrobial Activity and Enhanced Osseointegration. ACS APPLIED BIO MATERIALS 2021; 4:6451-6461. [PMID: 35006865 DOI: 10.1021/acsabm.1c00613] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The use of implants in orthopedics and dental practice is a widespread surgical procedure to treat diverse diseases. However, peri-implantitis due to infections and/or poor osseointegration can lead to metallic implant failure. The aim of this study was to develop a multifunctional coating on titanium (Ti) surfaces, to simultaneously deal with both issues, by combining antibacterial silver nanoparticles (AgNPs) and regenerative properties of lactoferrin (Lf). A simple and cost-effective methodology that allows the direct multifunctionalization of Ti surfaces was developed. The modified surfaces were characterized by atomic force microscopy (AFM), X-ray photoelectron spectroscopy, and contact angle measurements. Additionally, in vitro preosteoblast cell adhesion, cell viability, and differentiation were evaluated. The antibacterial capability of the surfaces was tested against Staphylococcus aureus as a prosthesis infection model strain. Our results showed that Lf adsorbed on both Ti surfaces and Ti surfaces with adsorbed AgNPs. Simultaneously, the presence of Lf and AgNPs notably improved preosteoblast adhesion, proliferation, and differentiation, whereas it reduced the bacterial colonization by 97.7%. Our findings indicate that this simple method may have potential applications in medical devices to both improve osseointegration and reduce bacterial infection risk, enhancing successful implantation and patients' quality of life.
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Affiliation(s)
- Fiorela Ghilini
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Natalia Fagali
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Diego E Pissinis
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Guillermo Benítez
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Patricia L Schilardi
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
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Ständert V, Borcherding K, Bormann N, Schmidmaier G, Grunwald I, Wildemann B. Antibiotic-loaded amphora-shaped pores on a titanium implant surface enhance osteointegration and prevent infections. Bioact Mater 2021; 6:2331-2345. [PMID: 33553819 PMCID: PMC7840776 DOI: 10.1016/j.bioactmat.2021.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/04/2021] [Accepted: 01/10/2021] [Indexed: 12/13/2022] Open
Abstract
Artificial prostheses for joint replacement are indispensable in orthopedic surgery. Unfortunately, the implanted surface is attractive to not only host cells but also bacteria. To enable better osteointegration, a mechanically stable porous structure was created on a titanium surface using laser treatment and metallic silver particles were embedded in a hydrophilic titanium oxide layer on top. The laser structuring resulted in unique amphora-shaped pores. Due to their hydrophilic surface conditions and capillary forces, the pores can be loaded preoperative with the antibiotic of choice/need, such as gentamicin. Cytotoxicity and differentiation assays with primary human osteoblast-like cells revealed no negative effect of the surface modification with or without gentamicin loading. An in vivo biocompatibility study showed significantly enhanced osteointegration as measured by push-out testing and histomorphometry 56 days after the implantation of the K-wires into rat femora. Using a S. aureus infection model, the porous, silver-coated K-wires slightly reduced the signs of bone destruction, while the wires were still colonized after 28 days. Loading the amphora-shaped pores with gentamicin significantly reduced the histopathological signs of bone destruction and no bacteria were detected on the wires. Taken together, this novel surface modification can be applied to new or established orthopedic implants. It enables preoperative loading with the antibiotic of choice/need without further equipment or post-coating, and supports osteointegration without a negative effect of the released dug, such as gentamicin.
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Affiliation(s)
- Viviane Ständert
- Julius Wolff Institute, BIH Center for Regenerative Therapies, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353, Berlin, Germany
| | - Kai Borcherding
- Department of Adhesive Bonding Technology and Surfaces, Fraunhofer Institute for Manufacturing Technology and Advanced Materials (IFAM), 28359, Bremen, Germany
| | - Nicole Bormann
- Julius Wolff Institute, BIH Center for Regenerative Therapies, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353, Berlin, Germany
| | - Gerhard Schmidmaier
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, HTRG - Heidelberg Trauma Research Group, Heidelberg University Hospital, 69118, Heidelberg, Germany
| | - Ingo Grunwald
- Industrial and Environmental Biology, Hochschule Bremen-City University of Applied Sciences, 28199, Bremen, Germany
| | - Britt Wildemann
- Julius Wolff Institute, BIH Center for Regenerative Therapies, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353, Berlin, Germany
- Experimental Trauma Surgery, Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747, Jena, Germany
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Lv Y, Wang B, Liu G, Tang Y, Lu E, Xie K, Lan C, Liu J, Qin Z, Wang L. Metal Material, Properties and Design Methods of Porous Biomedical Scaffolds for Additive Manufacturing: A Review. Front Bioeng Biotechnol 2021; 9:641130. [PMID: 33842445 PMCID: PMC8033174 DOI: 10.3389/fbioe.2021.641130] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 02/23/2021] [Indexed: 12/03/2022] Open
Abstract
Design an implant similar to the human bone is one of the critical problems in bone tissue engineering. Metal porous scaffolds have good prospects in bone tissue replacement due to their matching elastic modulus, better strength, and biocompatibility. However, traditional processing methods are challenging to fabricate scaffolds with a porous structure, limiting the development of porous scaffolds. With the advancement of additive manufacturing (AM) and computer-aided technologies, the development of porous metal scaffolds also ushers in unprecedented opportunities. In recent years, many new metal materials and innovative design methods are used to fabricate porous scaffolds with excellent mechanical properties and biocompatibility. This article reviews the research progress of porous metal scaffolds, and introduces the AM technologies used in porous metal scaffolds. Then the applications of different metal materials in bone scaffolds are summarized, and the advantages and limitations of various scaffold design methods are discussed. Finally, we look forward to the development prospects of AM in porous metal scaffolds.
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Affiliation(s)
- Yuting Lv
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, China.,State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, Shanghai, China
| | - Binghao Wang
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, China
| | - Guohao Liu
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, China
| | - Yujin Tang
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Eryi Lu
- Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Kegong Xie
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Changgong Lan
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Jia Liu
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Zhenbo Qin
- Tianjin Key Laboratory of Composite and Functional Materials, School of Material Science and Engineering, Tianjin University, Tianjin, China
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, Shanghai, China
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42
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Yao Y, Yuan H, Huang H, Liu J, Wang L, Fan Y. Biomechanical design and analysis of auxetic pedicle screw to resist loosening. Comput Biol Med 2021; 133:104386. [PMID: 33878515 DOI: 10.1016/j.compbiomed.2021.104386] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pedicle screws are widely used in fusion surgery, while screw loosening often occurrs. An auxetic structures based pedicle screw was proposed to improve the bone-screw fixation by radial expansion of the screw body under tensile force to resist pulling out. It was optimized to obtain excellent anti-pullout ability for a particular bone based on the biomechanical interaction between screw and surrounding bone. METHODS The screw was designed based on re-entrant unit cells. The mechanical properties of it were adjusted by the wall thickness (t) and re-entrant angle (θ) of the unit cell, and characterized using finite element (FE) method. The designed screws were manufactured using 3D-printing, and Ti6Al4V as the materials. Subsequently, the pullout FE models were established, and verified by pulling the fabricated screws out of Sawbone blocks. The pulling out processes of screws from bone were simulated to explore the optimizing design of the screw. RESULTS The mechanical properties of the screw could be adjusted in a wide range. The biomechanical interaction between the screw and bone can affect the anti-pullout performance of the screw. With an identical elastic modulus (E), better auxiticity of the screw, resulted in a better anti-pullout performance; while an appropriate E is the necessary condition for its excellent anti-pullout performance for a particular bone. CONCLUSION Appropriate mechanical properties are necessary for the auxetic pedicle screw with excellent screw-bone fixation performance for a particular bone, which can be obtained by rationally designing the wall thickness and re-entrant angle of the unit cells.
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Affiliation(s)
- Yan Yao
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Hao Yuan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Huiwen Huang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Jinglong Liu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Lizhen Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China; School of Engineering Medicine, Beihang University, Beijing, 100191, China.
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43
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Sharma N, Ostas D, Rotar H, Brantner P, Thieringer FM. Design and Additive Manufacturing of a Biomimetic Customized Cranial Implant Based on Voronoi Diagram. Front Physiol 2021; 12:647923. [PMID: 33897455 PMCID: PMC8063040 DOI: 10.3389/fphys.2021.647923] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/15/2021] [Indexed: 12/21/2022] Open
Abstract
Reconstruction of cranial defects is an arduous task for craniomaxillofacial surgeons. Additive manufacturing (AM) or three-dimensional (3D) printing of titanium patient-specific implants (PSIs) made its way into cranioplasty, improving the clinical outcomes in complex surgical procedures. There has been a significant interest within the medical community in redesigning implants based on natural analogies. This paper proposes a workflow to create a biomimetic patient-specific cranial prosthesis with an interconnected strut macrostructure mimicking bone trabeculae. The method implements an interactive generative design approach based on the Voronoi diagram or tessellations. Furthermore, the quasi-self-supporting fabrication feasibility of the biomimetic, lightweight titanium cranial prosthesis design is assessed using Selective Laser Melting (SLM) technology.
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Affiliation(s)
- Neha Sharma
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (SwissMAM), University of Basel, Allschwil, Switzerland
| | - Daniel Ostas
- Department of Oral and Cranio-Maxillofacial Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotar
- Department of Oral and Cranio-Maxillofacial Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Philipp Brantner
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (SwissMAM), University of Basel, Allschwil, Switzerland.,Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Florian Markus Thieringer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (SwissMAM), University of Basel, Allschwil, Switzerland
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Ma P, Yu Y, Yie KHR, Fang K, Zhou Z, Pan X, Deng Z, Shen X, Liu J. Effects of titanium with different micro/nano structures on the ability of osteoblasts to resist oxidative stress. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 123:111969. [PMID: 33812597 DOI: 10.1016/j.msec.2021.111969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/23/2021] [Accepted: 02/10/2021] [Indexed: 12/13/2022]
Abstract
Excessive accumulation of oxidative intermediates in the elderly significantly aggravates bone degradation and hinders the osseointegration of topological titanium (Ti) implants. Thus, it is of great significance to evaluate the antioxidant and osteoinduction capabilities of various nano, micro or micro/nano-composite structures under oxidative stress (OS) microenvironment. In this study, we discovered that 110 nm titania nanotubes (TNTs) enhanced the adsorption of fibronectin (FN) proteins onto smooth and rough titanium surfaces to varying degrees. Compared with Ti and 30 nm TNTs (T30) groups, cells on 110 nm TNTs (T110), microstructure/30 nm TNTs (M30) and microstructure/110 nm TNTs (M110) had smaller area, lower reactive oxygen species (ROS), and better proliferation/osteogenic differentiation abilities under OS condition, but there was no significant difference among the three groups. In addition, combined with our previous study, we suggested that T110, M30 and M110 resistance to OS was also strongly associated with the high expression of FN-receptor integrin α5 or β1. All the findings indicated that the micro/nano-composed structures (M30 & M110) had similar anti-oxidation and osteogenesis abilities to T110, which provided guidance for the application of different titanium implants with different topologies in the elderly.
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Affiliation(s)
- Pingping Ma
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yonglin Yu
- Department of Pathology, Affiliated Hospital of Zunyi Medical College, Zunyi, 563003, China
| | - Kendrick Hii Ru Yie
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kai Fang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zixin Zhou
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaoyi Pan
- Ruian People's Hospital, Ruian, 325200, China
| | - Zhennan Deng
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Xinkun Shen
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Jinsong Liu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
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Gherasim O, Grumezescu AM, Grumezescu V, Negut I, Dumitrescu MF, Stan MS, Nica IC, Holban AM, Socol G, Andronescu E. Bioactive Coatings Based on Hydroxyapatite, Kanamycin, and Growth Factor for Biofilm Modulation. Antibiotics (Basel) 2021; 10:160. [PMID: 33562515 PMCID: PMC7914914 DOI: 10.3390/antibiotics10020160] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
The occurrence of opportunistic local infections and improper integration of metallic implants results in severe health conditions. Protective and tunable coatings represent an attractive and challenging selection for improving the metallic devices' biofunctional performances to restore or replace bone tissue. Composite materials based on hydroxyapatite (HAp), Kanamycin (KAN), and fibroblast growth factor 2 (FGF2) are herein proposed as multifunctional coatings for hard tissue implants. The superior cytocompatibility of the obtained composite coatings was evidenced by performing proliferation and morphological assays on osteoblast cell cultures. The addition of FGF2 proved beneficial concerning the metabolic activity, adhesion, and spreading of cells. The KAN-embedded coatings exhibited significant inhibitory effects against bacterial biofilm development for at least two days, the results being superior in the case of Gram-positive pathogens. HAp-based coatings embedded with KAN and FGF2 protein are proposed as multifunctional materials with superior osseointegration potential and the ability to reduce device-associated infections.
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Affiliation(s)
- Oana Gherasim
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
| | - Valentina Grumezescu
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Irina Negut
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Marius Florin Dumitrescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
| | - Miruna Silvia Stan
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Ionela Cristina Nica
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Alina Maria Holban
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest, 077206 Bucharest, Romania
| | - Gabriel Socol
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
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Dziaduszewska M, Zieliński A. Structural and Material Determinants Influencing the Behavior of Porous Ti and Its Alloys Made by Additive Manufacturing Techniques for Biomedical Applications. MATERIALS (BASEL, SWITZERLAND) 2021; 14:712. [PMID: 33546358 PMCID: PMC7913507 DOI: 10.3390/ma14040712] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 11/20/2022]
Abstract
One of the biggest challenges in tissue engineering is the manufacturing of porous structures that are customized in size and shape and that mimic natural bone structure. Additive manufacturing is known as a sufficient method to produce 3D porous structures used as bone substitutes in large segmental bone defects. The literature indicates that the mechanical and biological properties of scaffolds highly depend on geometrical features of structure (pore size, pore shape, porosity), surface morphology, and chemistry. The objective of this review is to present the latest advances and trends in the development of titanium scaffolds concerning the relationships between applied materials, manufacturing methods, and interior architecture determined by porosity, pore shape, and size, and the mechanical, biological, chemical, and physical properties. Such a review is assumed to show the real achievements and, on the other side, shortages in so far research.
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Affiliation(s)
- Magda Dziaduszewska
- Biomaterials Technology Division, Institute of Machines Technology and Materials, Faculty of Mechanical Engineering and Ship Building, Gdańsk University of Technology, 80-233 Gdańsk, Poland;
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Spece H, Basgul C, Andrews CE, MacDonald DW, Taheri ML, Kurtz SM. A systematic review of preclinical in vivo testing of 3D printed porous Ti6Al4V for orthopedic applications, part I: Animal models and bone ingrowth outcome measures. J Biomed Mater Res B Appl Biomater 2021; 109:1436-1454. [PMID: 33484102 DOI: 10.1002/jbm.b.34803] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/20/2020] [Accepted: 01/09/2021] [Indexed: 01/20/2023]
Abstract
For Ti6Al4V orthopedic and spinal implants, osseointegration is often achieved using complex porous geometries created via additive manufacturing (AM). While AM porous titanium (pTi) has shown clinical success, concerns regarding metallic implants have spurred interest in alternative AM biomaterials for osseointegration. Insights regarding the evaluation of these new materials may be supported by better understanding the role of preclinical testing for AM pTi. We therefore asked: (a) What animal models have been most commonly used to evaluate AM porous Ti6Al4V for orthopedic bone ingrowth; (b) What were the primary reported quantitative outcome measures for these models; and (c) What were the bone ingrowth outcomes associated with the most frequently used models? We performed a systematic literature search and identified 58 articles meeting our inclusion criteria. We found that AM pTi was evaluated most often using rabbit and sheep femoral condyle defect (FCD) models. Additional ingrowth models including transcortical and segmental defects, spinal fusions, and calvarial defects were also used with various animals based on the study goals. Quantitative outcome measures determined via histomorphometry including ''bone ingrowth'' (range: 3.92-53.4% for rabbit/sheep FCD) and bone-implant contact (range: 9.9-59.7% for rabbit/sheep FCD) were the most common. Studies also used 3D imaging to report outcomes such as bone volume fraction (BV/TV, range: 4.4-61.1% for rabbit/sheep FCD), and push-out testing for outcomes such as maximum removal force (range: 46.6-3092 N for rabbit/sheep FCD). Though there were many commonalities among the study methods, we also found significant heterogeneity in the outcome terms and definitions. The considerable diversity in testing and reporting may no longer be necessary considering the reported success of AM pTi across all model types and the ample literature supporting the rabbit and sheep as suitable small and large animal models, respectively. Ultimately, more standardized animal models and reporting of bone ingrowth for porous AM materials will be useful for future studies.
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Affiliation(s)
- Hannah Spece
- Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA
| | - Cemile Basgul
- Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Daniel W MacDonald
- Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Steven M Kurtz
- Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA.,Exponent, Inc., Philadelphia, Pennsylvania, USA
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48
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3D-printed PEEK implant for mandibular defects repair - a new method. J Mech Behav Biomed Mater 2021; 116:104335. [PMID: 33494021 DOI: 10.1016/j.jmbbm.2021.104335] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 12/13/2022]
Abstract
Functional reconstruction of large-size mandibular continuity defect is still a major challenge in the oral and maxillofacial surgery due to the unsatisfactory repair effects and various complications. This study aimed to develop a new functional repair method for mandibular defects combined with 3D-printed polyetheretherketone (PEEK) implant and the free vascularized fibula graft, and evaluated the service performance of the implant under whole masticatory motion. The design criteria and workflows of the mandibular reconstruction were established based on the requirements of safety, functionality, and shape consistency. Both the biomechanical behavior and the mechanobiological property of mandibular reconstruction under various masticatory motion were investigated by the finite element analysis. The maximum von Mises stress of each component was lower than the yield strength of the corresponding material and the safety factor was more than 2.3 times, which indicated the security of the repair method can be guaranteed. Moreover, the actual deformation of the reconstruction model was lower than that of the normal mandible under most clenching tasks, which assured the primary stability. More than 80% of the volume elements in the bone graft can obtain effective mechanical stimulation, which benefited to reduce the risks of bone resorption. Finally, the novel repair method was applied in clinic and good clinical performances have been achieved. Compared with the conventional fibular bone graft for surgical mandibular reconstruction, this study provides excellent safety and stability to accomplish the functional reconstruction and aesthetic restoration of the mandible defect.
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Edelmann A, Dubis M, Hellmann R. Selective Laser Melting of Patient Individualized Osteosynthesis Plates-Digital to Physical Process Chain. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5786. [PMID: 33352930 PMCID: PMC7767064 DOI: 10.3390/ma13245786] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022]
Abstract
We report on the exemplified realization of a digital to physical process chain for a patient individualized osteosynthesis plate for the tarsal bone area. Anonymized patient-specific data of the right feet were captured by computer tomography, which were then digitally processed to generate a surface file format (standard tessellation language, STL) ready for additive manufacturing. Physical realization by selective laser melting in titanium using optimized parameter settings and post-processing by stress relief annealing results in a customized osteosynthesis plate with superior properties fulfilling medical demands. High fitting accuracy was demonstrated by applying the osteosynthesis plate to an equally good 3D printed bone model, which likewise was generated using the patient-specific computer tomography (CT) data employing selective laser sintering and polyamid 12. Proper fixation has been achieved without any further manipulation of the plate using standard screws, proving that based on CT data, individualized implants well adapted to the anatomical conditions can be accomplished without the need for additional steps, such as bending, cutting and shape trimming of precast bone plates during the surgical intervention. Beyond parameter optimization for selective laser melting, this exemplified digital to physical process chain highlights the potential of additive manufacturing for individualized osteosynthesis.
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Affiliation(s)
- André Edelmann
- Applied Laser and Photonics Group, University of Applied Sciences Aschaffenburg, 63743 Aschaffenburg, Germany; (M.D.); (R.H.)
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Ginestra P, Ferraro RM, Zohar-Hauber K, Abeni A, Giliani S, Ceretti E. Selective Laser Melting and Electron Beam Melting of Ti6Al4V for Orthopedic Applications: A Comparative Study on the Applied Building Direction. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5584. [PMID: 33297551 PMCID: PMC7729448 DOI: 10.3390/ma13235584] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/13/2022]
Abstract
The 3D printing process offers several advantages to the medical industry by producing complex and bespoke devices that accurately reproduce customized patient geometries. Despite the recent developments that strongly enhanced the dominance of additive manufacturing (AM) techniques over conventional methods, processes need to be continually optimized and controlled to obtain implants that can fulfill all the requirements of the surgical procedure and the anatomical district of interest. The best outcomes of an implant derive from optimal compromise and balance between a good interaction with the surrounding tissue through cell attachment and reduced inflammatory response mainly caused by a weak interface with the native tissue or bacteria colonization of the implant surface. For these reasons, the chemical, morphological, and mechanical properties of a device need to be designed in order to assure the best performances considering the in vivo environment components. In particular, complex 3D geometries can be produced with high dimensional accuracy but inadequate surface properties due to the layer manufacturing process that always entails the use of post-processing techniques to improve the surface quality, increasing the lead times of the whole process despite the reduction of the supply chain. The goal of this work was to provide a comparison between Ti6Al4V samples fabricated by selective laser melting (SLM) and electron beam melting (EBM) with different building directions in relation to the building plate. The results highlighted the influence of the process technique on osteoblast attachment and mineralization compared with the building orientation that showed a limited effect in promoting a proper osseointegration over a long-term period.
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Affiliation(s)
- Paola Ginestra
- Department of Mechanical and Industrial Engineering, University of Brescia, via Branze 38, 25123 Brescia, Italy; (A.A.); (E.C.)
| | - Rosalba Monica Ferraro
- Institute of Molecular Medicine “Angelo Nocivelli”, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy; (R.M.F.); (S.G.)
| | - Keren Zohar-Hauber
- Metallurgical and Powders Technologies Lab, Institute of Metals, Technion City, Haifa 320003, Israel;
| | - Andrea Abeni
- Department of Mechanical and Industrial Engineering, University of Brescia, via Branze 38, 25123 Brescia, Italy; (A.A.); (E.C.)
| | - Silvia Giliani
- Institute of Molecular Medicine “Angelo Nocivelli”, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy; (R.M.F.); (S.G.)
| | - Elisabetta Ceretti
- Department of Mechanical and Industrial Engineering, University of Brescia, via Branze 38, 25123 Brescia, Italy; (A.A.); (E.C.)
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