Effect of nanotubular-micro-roughened titanium surface on cell response in vitro and osseointegration in vivo

Evaluation of cellular response and drug delivery efficacy of nanoporous stainless steel material

OBJECTIVE

Various surface modification techniques that can further improve the function and usability of stainless steel as a medical device have been reported. In the present study, the physical and biological properties of nanoporous stainless steel as well as its usefulness for drug delivery were assessed.

METHODS

The specimen was prepared with a circular disk shape (15 mm in diameter and 1 mm in thickness). The disk was subjected to electropolishing at a constant voltage of 20 V and 10 A for 10 min in an acidic environment (50% H₂SO₄). Everolimus (EVL) was used as a testing drug for drug-loading capacity of the material surface and release kinetics. The physiobiological properties of the material were assessed using platelet adhesion, and smooth muscle cell (SMC) adhesion, migration, and proliferation assays.

RESULTS

The surface roughness of the postpolishing group was greater than that of the nonpolishing group. Platelet adhesion and SMC adhesion and migration were inhibited in the postpolishing group compared to those in the prepolishing group. In the postpolishing group, the total amount of EVL on the surface (i.e., drug storage rate) was higher and the drug release rate was lower, with half the amount of the EVL released within 4 days compared with only 1 day for that of the prepolishing group.

CONCLUSION

Taken together, this stainless steel with a nanoporous surface could be used as a medical device for controlling cellular responses and carrying drugs.

Evolution of anodised titanium for implant applications

Anodised titanium has a long history as a coating structure for implants due to its bioactive and ossified surface, which promotes rapid bone integration. In response to the growing literature on anodised titanium, this article is the first to revisit the evolution of anodised titanium as an implant coating. The review reports the process and mechanisms for the engineering of distinctive anodised titanium structures, the significant factors influencing the mechanisms of its formation, bioactivity, as well as recent pre- and post-surface treatments proposed to improve the performance of anodised titanium. The review then broadens the discussion to include future functional trends of anodised titanium, ranging from the provision of higher surface energy interactions in the design of biocomposite coatings (template stencil interface for mechanical interlock) to techniques for measuring the bone-to-implant contact (BIC), each with their own challenges. Overall, this paper provides up-to-date information on the impacts of the structure and function of anodised titanium as an implant coating in vitro and in/ex vivo tests, as well as the four key future challenges that are important for its clinical translations, namely (i) techniques to enhance the mechanical stability and (ii) testing techniques to measure the mechanical stability of anodised titanium, (iii) real-time/in-situ detection methods for surface reactions, and (iv) cost-effectiveness for anodised titanium and its safety as a bone implant coating.

The Trends of TiZr Alloy Research as a Viable Alternative for Ti and Ti16 Zr Roxolid Dental Implants

Despite many discussions about Ti versus Zr, Ti remains the golden standard for dental implants. With the extended use of implants, their rejection in peri-implantitis due to material properties is going to be an important part of oral health problems. Extended use of implants leading to a statistical increase in implant rejection associated with peri-implantitis raises concerns in selecting better implant materials. In this context, starting in the last decade, investigation and use of TiZr alloys as alternatives for Ti in oral dentistry became increasingly more viable. Based on existing new results for Ti16Zr (Roxolid) implants and Ti50Zr alloy behaviour in oral environments, this paper presents the trends of research concerning the electrochemical stability, mechanical, and biological properties of this alloy with treated and untreated surfaces. The surface treatments were mostly performed by anodizing the alloy in various conditions as a non-sophisticated and cheap procedure, leading to nanostructures such as nanopores and nanotubes. The drug loading and release from nanostructured Ti50Zr as an important perspective in oral implant applications is discussed and promoted as well.

Effects of different sterilization methods on surface characteristics and biofilm formation on zirconia in vitro

OBJECTIVE

The current laboratory study was to investigate the effect of different sterilization treatments on surface characteristics of zirconia, and biofilm formation on zirconia surface after exposure to these sterilization treatments.

METHODS

Commercially available zirconia discs (Cerconbase, Degu-Dent, Hanau, Germany) were prepared and polished to the same value of surface roughness. The discs were treated with one of the following sterilization methods steam autoclave sterilization, dry heat sterilization, ultraviolet C (UVC) irradiation, and gamma (γ) ray irradiation. The characteristics of zirconia surfaces were evaluated by scanning electron microscopy (SEM), surface roughness, surface free energy (SFE), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD) measurements. Then, Staphylococcus aureus (S.a.) and Porphyromonas gingivalis (P.g.) bacteria were used and cultured on the respective sterilized zirconia surfaces. The amount of biofilm formation on zirconia surface was quantified by colony forming unit (CFU) counts.

RESULTS

Significant modifications were detected on the colour and SFE of zirconia. The colour of zirconia samples after UVC irradiation became light yellow whilst dark brown colour was observed after gamma ray irradiation. Moreover, UVC and gamma ray irradiation increased the hydrophilicity of zirconia surface. Overall, dry heat sterilized samples showed the significantly lowest amount of bacteria growth on zirconia, while UVC and gamma ray irradiation resulted in the highest.

SIGNIFICANCE

It is evident that various sterilization methods could change the surface which contribute to different biofilm formation and colour on zirconia.

Synergistic effects of bioactive ions and micro/nano-topography on the attachment, proliferation and differentiation of murine osteoblasts (MC3T3)

Surface topography and chemical nature of biological materials play an important role in regulating cell behaviors. For the intention of improving the biological performance of Ti6Al4V, the hierarchical micro/nano-topographies containing bioactive ions (Ca(2+) and Mg(2+)) were fabricated in this study. Briefly, the hierarchical micro/nano-topography was constructed on Ti6Al4V surface via sandblasting, acid etching and alkali-hydrothermal treatment. Then Na(+) existing in the nano-topography was replaced by Ca(2+) and Mg(2+) through hydrothermal reaction. The surface topographies and chemical nature of native and treated samples were characterized using laser scanning microscope, X-ray Photoelectron Spectroscopy and field emission scanning electron microscopy with the energy-dispersive spectroscopy. Surface wettability was measured with a contact angle goniometer. A series of biological tests were carried out to evaluate the synergistic effects of bioactive ions and micro/nano-topography on the attachment, proliferation and differentiation of murine osteoblastic MC3T3 cells. The results of in vitro tests indicated that Ca(2+) and Mg(2+) in the titanium alloy surface had an affirmative effect on cells attachment, proliferation and differentiation. Cells grown onto micro/nano-structured surface with Ca(2+) implantation exhibited significantly higher differentiation levels of alkaline phosphatase activity and mineralization compared to that on micro/nano-structured surface with Mg(2+) implantation. This study provided a novel method to construct a favorable biological environment between tissues and implants.

Surface modifications and Nano-composite coatings to improve the bonding strength of titanium-porcelain

Surface modifications of Ti and nano-composite coatings were employed to simultaneously improve the surface roughness, corrosion resistance and chemical bonding between porclain-Ti. The specimens were studied by field-emission scanning electron microscopy, surface roughness, differential scanning calorimetry, Fourier transform infrared spectroscopy, corrosion resistance and bonding strength tests. The SEM results showed that hybrid structures with micro-stripes, nano-pores and nano-protuberances were prepared by surface modification of Ti, which significantly enhanced the surface roughness and corrosion resistance of Ti. Porous nano-composite coatings were synthesized on Ti anodized with pre-treatment in 40% HF acid. TiO2 nanoparticles were added into the hybrid coating to increase the solid phase content of the sols and avoid the formation of microcracks. With the TiO2 content increasing from 45 wt% to 60 wt%, the quantities of the microcracks on the coating surface gradually decreased. The optimal TiO2 content for the nanocomposite coatings is 60 wt% in this research. Compared to the uncoated group, the bonding strength of the coated groups showed a bonding strength improvement of 23.96%. The cytotoxicity of the 4# coating group was ranked as zero, which corresponds to non-cytotoxicity.

Conformal coating containing Ca, P, Si and Na with double-level porous surface structure on titanium formed by a three-step microarc oxidation

Development of conformal MAO coating on a Ti plate with a double-level porous surface, followed by characterization and evaluation in SBF.

Porous titania surfaces on titanium with hierarchical macro- and mesoporosities for enhancing cell adhesion, proliferation and mineralization

Titanium received a macroporous titania surface layer by anodization, which contains open pores with average pore diameter around 5 μm. An additional mesoporous titania top layer following the contour of the macropores, of 100-200 nm thickness and with a pore diameter of 10nm, was formed by using the evaporation-induced self-assembly (EISA) method with titanium (IV) tetraethoxide as the precursor. A coherent laminar titania surface layer was thus obtained, creating a hierarchical macro- and mesoporous surface that was characterized by high-resolution electron microscopy. The interfacial bonding between the surface layers and the titanium matrix was characterized by the scratch test that confirmed a stable and strong bonding of titania surface layers on titanium. The wettability to water and the effects on the osteosarcoma cell line (SaOS-2) proliferation and mineralization of the formed titania surface layers were studied systematically by cell culture and scanning electron microscopy. The results proved that the porous titania surface with hierarchical macro- and mesoporosities was hydrophilic that significantly promoted cell attachment and spreading. A synergistic role of the hierarchical macro- and mesoporosities was revealed in terms of enhancing cell adhesion, proliferation and mineralization, compared with the titania surface with solo scale topography.

Synthesis and characterization of hybrid micro/nano-structured NiTi surfaces by a combination of etching and anodizing

The purpose of this study was to generate hybrid micro/nano-structures on biomedical nickel-titanium alloy (NiTi). To achieve this, NiTi surfaces were firstly electrochemically etched and then anodized in fluoride-containing electrolyte. With the etching process, the NiTi surface was micro-roughened through the formation of micropits uniformly distributed over the entire surface. Following the subsequent anodizing process, self-organized nanotube structures enriched in TiO2 could be superimposed on the etched surface under specific conditions. Furthermore, the anodizing treatment significantly reduced water contact angles and increased the surface free energy compared to the surfaces prior to anodizing. The results of this study show for the first time that it is possible to create hybrid micro/nano-structures on biomedical NiTi alloys by combining electrochemical etching and anodizing under controlled conditions. These novel structures are expected to significantly enhance the surface biofunctionality of the material when compared to conventional implant devices with either micro- or nano-structured surfaces.

Integrin-mediated osteoblastic adhesion on a porous manganese-incorporated TiO2 coating prepared by plasma electrolytic oxidation

This study was conducted to evaluate the bioactivity of manganese-incorporated TiO₂ (Mn-TiO₂) coating prepared on titanium (Ti) plate by plasma electrolytic oxidation (PEO) technique in Ca-, P- and Mn-containing electrolytes. The surface topography, phase and element compositions of the coatings were investigated using scanning electron microscopy (SEM), X-ray diffraction (XRD) and energy dispersive spectrometry (EDS), respectively. The adhesion of osteoblast-like MG63 cells onto Ti, TiO₂ and Mn-TiO₂ surfaces was evaluated, and the signal transduction pathway involved was confirmed by the sequential expression of the genes for integrins β₁, β₃, α₁ and α₃, focal adhesion kinase (FAK), and the extracellular regulated kinases (ERKs), including ERK1 and ERK2. The results obtained indicated that Mn was successfully incorporated into the porous nanostructured TiO₂ coating, and did not alter the surface topography or the phase composition of the coating. The adhesion of the MG63 cells onto the Mn-incorporated TiO₂ coating was significantly enhanced compared with that on the Mn-free TiO₂ coating and the pure Ti plates. In addition, the enhanced cell adhesion on the Mn-TiO₂ coatings may have been mediated by the binding of the integrin subunits, β₁ and α₁, and the subsequent signal transduction pathway, involving FAK and ERK2. The study indicated that the novel Mn-TiO₂ coating has potential for orthopedic implant applications, and that further investigations are required.

Mechanical Properties of Nanotextured Titanium Orthopedic Screws for Clinical Applications

In this work, we modified the topography of commercial titanium orthopedic screws using electrochemical anodization in a 0.4 wt% hydrofluoric acid solution to produce titanium dioxide nanotube layers. The morphology of the nanotube layers were characterized using scanning electron microscopy. The mechanical properties of the nanotube layers were investigated by screwing and unscrewing an anodized screw into several different types of human bone while the torsional force applied to the screwdriver was measured using a torque screwdriver. The range of torsional force applied to the screwdriver was between 5 and [Formula: see text]. Independent assessment of the mechanical properties of the same surfaces was performed on simple anodized titanium foils using a triboindenter. Results showed that the fabricated nanotube layers can resist mechanical stresses close to those found in clinical situations.

Effects of different sterilization techniques and varying anodized TiO₂ nanotube dimensions on bacteria growth

Infection of titanium (Ti)-based orthopedic implants is a growing problem due to the ability of bacteria to develop a resistance to today's antibiotics. As an attempt to develop a new strategy to combat bacteria functions, Ti was anodized in the present study to possess different diameters of nanotubes. It is reported here for the first time that Ti anodized to possess 20 nm tubes then followed by heat treatment to remove fluorine deposited from the HF anodization electrolyte solution significantly reduced both S. aureus and S. epidermidis growth compared to unanodized Ti controls. It was further found that the sterilization method used for both anodized nanotubular Ti and conventional Ti played an important role in the degree of bacteria growth on these substrates. Overall, UV light and ethanol sterilized samples decreased bacteria growth, while autoclaving resulted in the highest amount of bacteria growth. In summary, this study indicated that through a simple and inexpensive process, Ti can be anodized to possess 20 nm tubes that no matter how sterilized (UV light, ethanol soaking, or autoclaving) reduces bacteria growth and, thus, shows great promise as an antibacterial implant material.

Surface modification of titanium by hydrothermal treatment in Mg-containing solution and early osteoblast responses

Surface modification on titanium was carried out in order to improve its bioactivity. Pure titanium was hydrothermally treated in distilled water and 0.1 M MgCl(2) solutions at 200°C for 24 h. Surface morphology, roughness, wettability and chemical composition were characterized before and after treatment. Bovine serum albumin was used as model to study protein adsorption. MC3T3-E1 cells were cultured and initial cell attachment, morphology, proliferation were evaluated. After hydrothermal treatment, nano-sized precipitations were observed and samples showed superhydrophilicity. Magnesium (Mg) was immobilized into titanium surface by hydrothermal treatment. Protein adsorption was significantly increased on Mg-containing samples. Cell attachment was improved and cell spreading was enhanced on Mg-containing samples compared with untreated or those treated in distilled water. Increased early cellular attachment on the MgTi surface resulted in subsequent increase of number of proliferated cells. Hydrothermal treatment in MgCl(2) solution was expected to be an effective method to fabricate titanium implant with good bioactivity.