A review on nickel-free nitrogen containing austenitic stainless steels for biomedical applications

Microstructural and mechanical characterization of electron beam welded low-nickel nitrogen-strengthened austenitic stainless steel

In this paper, the Electron Beam Welding (EBW) was used to join thin plates of low-nickel nitrogen-strengthened austenitic stainless steel (LNiASS), a material valued for its superior mechanical properties and cost-effectiveness. Traditional welding techniques often lead to issues such as hot cracking, reduced toughness, and undesirable microstructures. The objective was to address these challenges using EB·W., which offers precise control, minimal heat input, and deeper penetration. Methodology included joining LNiASS plates with E.B.W. and analyzing the resulting microstructures and mechanical properties through optical microscopy, tensile testing, microhardness testing, and scanning electron microscopy (SEM). The findings indicated the presence of various ferrite morphologies without significant precipitation of deleterious phases like carbides and sigma phase. The weldment strength was ∼90 % of the base alloy, with fractures occurring near the weld cord due to nitrogen loss and grain coarsening in the (HAZ). Microhardness increased by ∼12.9 %, attributed to microstructural evolution and a fine-grained structure. Impact testing in Charpy V-Notch (CVN) configuration showed the weld absorbed ∼50 % more impact energy than the base material, due to refined Microstructure and enhanced hardness. Longitudinal residual stress analysis indicated compressive nature below mid-thickness, resulting from thermal expansion and contraction during welding. These results demonstrated E.B·W.'s effectiveness in preserving mechanical properties and enhancing the performance of nitrogen-strengthened stainless steel welds.

Optimizing the compression resistance of low-nickel stainless steel coronary stents using finite element and response surface methodology

Considering the high strength and excellent biocompatibility of low-nickel stainless steel, this paper focused on optimizing the design of a vascular stent made from this material using finite element analysis (FEA) combined with the response surface methodology (RSM). The aim is to achieve the desired compressive resistance for the stent while maintaining a thin stent wall thickness. The parameters of the stent's support unit width (H), strut width (W), and thickness (T) were selected as input parameters, while the output parameters obtained from FEA included the compressive load, the equivalent plastic strain (PEEQ), axial shortening rate, radial recoil rate, and metal coverage rate. The mathematical models of input parameters and output parameters were established by using the Box Behnken design (BBD) of RSM. The model equations were solved under constrained conditions, and the optimal structural parameters, namely H, W, and T, were finally determined as 0.770 mm, 0.100 mm, and 0.075 mm respectively. In this situation, the compression load of the stent reached the target value of 0.38 N/mm; the PEEQ resulting from the stent expansion was small; the axial shortening, radial recoil, and metal coverage index were all minimized within the required range.

Design and Development of a Cost-Effective Transnasal Skull Base Bone Wax Applicator: A Technical Note

Bone wax is an important hemostatic agent used in neurosurgical practice from more than a century. It acts by mechanical tamponade effect to stop the oozing from cancellous bone. Bone wax application over the skull surface over the vertex is easy and can be applied with fingers. In deeper areas, one uses dissector to apply the bone wax; however, it becomes difficult at times to apply in transnasal surgery using the same dissectors. Author designed a cost-effective 20-cm-long different angled bone wax applicator for skull base transnasal surgery. This applicator is cost-effective and not described previously in English literature.

Alloplastic temporomandibular joint replacement - past, present, and future: "Learn from the past, prepare for the future, live in the present." Thomas S. Monson

Based on evidence from the orthopaedic, biomedical engineering, and oral and maxillofacial surgical literature, this paper discusses reported successes and failures of past alloplastic temporomandibular joint (TMJ) devices that have led to the development of present total temporomandibular joint replacement (TMJR) devices. The paper concludes with discussion of the ongoing research that will lead to future embodiment (materials, designs, and manufacture) advances in TMJR management of severe and debilitating end-stage TMJ disease, further improving patients' mandibular function, form, and overall quality of life.

Bioactivity, Cytotoxicity, and Tribological Studies of Nickel-Free Austenitic Stainless Steel Obtained via Powder Metallurgy Route

In the present study, the bioactivity, cytotoxicity, and tribological properties of a nickel-free austenitic stainless steel produced via the mechanical alloying of elemental iron, chromium, and manganese nitride powders following by hot isostatic pressing was investigated. Powders after 90 h of mechanical alloying were consolidated via hot isostatic pressing at 1150 °C (1425 K) and heat treated at 1175 °C (1448 K) for 1 h in a vacuum with furnace cooling. Tribological tests were performed to determine the resistance of the as-received nickel-free steel. It was noticed that applying heat treatment after hot isostatic pressing decreases the average friction coefficient and wear rate of the austenitic steel. An immersion test in a simulated body fluid for 28 days at 37 ± 1 °C has been used to determine the biocompatibility of the tested material. The SEM-EDS analysis allowed us to characterise the morphology of the films and the elements of the steel on the thin-film layer. Elements typical of apatite (calcium and phosphorus) were detected on the surface of the sample. Cellular toxicity tests showed no significant toxic side effects for Saos-2 human osteosarcoma cells and the number of Saos-2 human osteosarcoma cells on the nickel-free steel was greater than on the 316LV grade steel.

A study on the effect of bioactive glass and hydroxyapatite-loaded Xanthan dialdehyde-based composite coatings for potential orthopedic applications

The most important challenge faced in designing orthopedic devices is to control the leaching of ions from the substrate material, and to prevent biofilm formation. Accordingly, the surgical grade stainless steel (316L SS) was electrophoretically deposited with functional composition of biopolymers and bioceramics. The composite coating consisted of: Bioglass (BG), hydroxyapatite (HA), and lawsone, that were loaded into a polymeric matrix of Xanthan Dialdehyde/Chondroitin Sulfate (XDA/CS). The parameters and final composition for electrophoretic deposition were optimized through trial-and-error approach. The composite coating exhibited significant adhesion strength of "4B" (ASTM D3359) with the substrate, suitable wettability of contact angle 48°, and an optimum average surface roughness of 0.32 µm. Thus, promoting proliferation and attachment of bone-forming cells, transcription factors, and proteins. Fourier transformed infrared spectroscopic analysis revealed a strong polymeric network formation between XDA and CS. scanning electron microscopy and energy dispersive X-ray spectroscopy analysis displayed a homogenous surface with invariable dispersion of HA and BG particles. The adhesion, hydrant behavior, and topography of said coatings was optimal to design orthopedic implant devices. The said coatings exhibited a clear inhibition zone of 21.65 mm and 21.04 mm with no bacterial growth against Staphylococcus aureus (S. Aureus) and Escherichia coli (E. Coli) respectively, confirming the antibacterial potential. Furthermore, the crystals related to calcium (Ca) and HA were seen after 28 days of submersion in simulated body fluid. The corrosion current density, of the above-mentioned coating was minimal as compared to the bare 316L SS substrate. The results infer that XDA/CS/BG/HA/lawsone based composite coating can be a candidate to design coatings for orthopedic implant devices.

Adhesion and friction behaviors of a γ-Fe/diamond heterogeneous contact interface: a density functional theory study

Diamond tools play a vital role in precision machining. However, the adhesive wear restricts their application when Fe-based workpieces are cut by diamond tools. Thus, it is significant to theoretically explain the interface binding mechanism between the diamond and Fe alloy matrix. In this study, the adhesion and friction behaviors of a γ-Fe/diamond (denoted as Fe/C) heterogeneous contact interface were investigated employing density functional theory (DFT). The results show that the transfer of the Fe atom to C atom occurs when the interaction energy for a given configuration is larger than the separation energy of the corresponding Fe surface layers. The energy barriers of the Fe/C(100), (110) and (111) sliding interfaces along the minimum energy path are 1.45, 0.48 and 0.42 J m-2, respectively, indicating that the Fe/C(111) interface is the easiest to slide. Furthermore, the friction potential barrier increases with an increase in the load (1-5 nN) according to the potential energy curves. Moreover, the friction coefficient of the Fe/C interface is larger than 0.2 and provides a theoretical minimum friction coefficient for the Fe/C sliding interface.

Improving the Surface Integrity of 316L Steel in the Context of Bioimplant Applications

Bioimplants should meet important surface integrity criteria, with the main goal of the manufacturing process to improve wear and corrosion resistance properties. This requires a special approach at the cutting stage. During this research, the impact of the cutting parameters on improving the surface integrity of AISI 316L steel was evaluated. In this context of bioimplant applications, the mean roughness Sa value was obtained in the range of 0.73-4.19 μm. On the basis of the results obtained, a significant effect was observed of both the cutting speed and the feed rate on changes in the microstructure of the near-surface layer. At a cutting speed of 150 m/min, the average grain size was approximately 31 μm. By increasing the cutting speed to 200 m/min, the average grain size increased to approximately 52 μm. The basic austenitic microstructure of AISI 316L steel with typical precipitation of carbides on the grain boundaries was refined at the near-surface layer after the machining process. Changing the cutting speed determined the hardness of the treated and near-surface layers. The maximum value of hardness is reached at a depth of 20 μm and decreases with the depth of measurement. It was also noted that at a depth of up to 240 μm, the maximum hardness of 270-305 HV1 was reached, hence the height of the machining impact zone can be determined, which is approximately 240 μm for almost all machining conditions.

Novel Bioactive Magnesium-Hopeite composite by friction stir processing for orthopedic implant applications

Magnesium (Mg) shows excellent potential for orthopedic implant applications owing to its equivalent mechanical properties compared to cortical bone and its biocompatibility. However, the rapid degradation rate of magnesium and its alloys in the physiological environment results in losing their mechanical integrity before complete bone healing. In light of this, friction stir processing (FSP), a solid-state process, is used to fabricate Hopeite (Zn(PO₄)₂.4H₂O) reinforced novel magnesium composite. As a result of the novel composite fabricated by FSP, grain refinement of the matrix phase occurs significantly. The samples were immersed in simulated body fluid (SBF) for in-vitro bioactivity and biodegradability tests. The corrosion behavior of pure Mg, FSP Mg, and FSP Mg-Hopeite composite samples was compared using electrochemical and immersion tests in SBF. It found that Mg-Hopeite composite has better corrosion resistance than FSP Mg and pure Mg. Because of grain refinement and the presence of secondary phase Hopeite in the composite, the mechanical properties and corrosion resistance improved. The bioactivity test was performed in the SBF environment, and a rapid apatite layer was formed on the surface of Mg-Hopeite composite samples during the test. Osteoblast-like MG63 cells were exposed to samples, and the MTT assay confirmed the non-toxicity of the FSP Mg-Hopeite composite. The wettability of the Mg-Hopeite composite was improved than pure Mg. The present research findings showed that the novel Mg-Hopeite composite fabricated by FSP is a promising candidate for orthopedic implant applications, unreported in the literature.

Effect of Sintering Temperature and Solution Treatment on Phase Changes and Mechanical Properties of High-Nitrogen Stainless Steel Prepared by MIM

High-nitrogen stainless steel (HNSS) has been widely concerned and studied owing to its excellent mechanical, corrosion resistance, and biocompatibility properties. A series of HNSS was prepared by metal injection molding (MIM) using gas atomized Fe-Cr-Mn-Mo-0.3 N duplex stainless steel powders. Both sintering and solution treatments were carried out in an N₂ atmosphere. The effects of nitrogen distribution and phase transformation on the mechanical properties of MIM HNSS during sintering and solution were studied. The results show that as the sintering temperature increased, the sample density increased, but the total nitrogen content decreased. Nitrogen and Cr₂N concentration gradients along the cross-section of as-sintered samples were formed after cooling. The high nitrogen content promotes the decomposition of γ: γ_saturated translated to γ and Cr₂N. Meanwhile, the low Mn content in austenite also decomposes γ: γ translated to α and Cr₂N. After solution treatment, a single γ phase was obtained for samples sintered at 1200 to 1320 °C. For solution treatment samples sintered at 1320 and 1350 °C, their tensile strength was 988.76 and 1036.12 MPa; yield strength was 615.61 and 636.14 MPa, and elongation was 42.58 and 40.08%, respectively. These values vastly exceeded the published MIM HNSS values.

Evaluation of Biodegradable Alloy Fe30Mn0.6N in Rabbit Femur and Cartilage through Detecting Osteogenesis and Autophagy

Biodegradable iron alloy implants have become one of the most ideal possible candidates because of their biocompatibility and comprehensive mechanical properties. Iron alloy's impact on chondrocytes is still unknown, though. This investigation looked at the biocompatibility and degradation of the Fe30Mn0.6N alloy as well as how it affected bone formation and chondrocyte autophagy. In vivo implantation of Fe30Mn0.6N and Ti6Al4V rods into rabbit femoral cartilage and femoral shaft was carried out to evaluate the degradation of the alloy and the cartilage and bone response at different intervals. After 8 weeks of implantation, the cross-sectional area of the Fe30Mn0.6N alloys lowered by 50.79 ± 9.59%. More Ca and P element deposition was found on the surface Fe30Mn0.6N rods by using energy dispersive spectroscopy (EDS) and scanning electron microscopy (P < 0.05). After 2, 4, and 8 weeks of implantation, no evident inflammatory infiltration was seen in peri-implant cartilage and bone tissue of Fe30Mn0.6N and Ti6Al4V alloys. Also, implantation of Fe30Mn0.6N alloy promoted autophagy in cartilage by detecting expression of LC3-II compared with Ti6Al4V after implantation (P < 0.05). Fe30Mn0.6N alloy also stimulated early osteogenesis at the peri-implant interface compared with Ti6Al4V after implantation (P < 0.05). In the in vitro test, we found that low concentrations of Fe30Mn0.6N extracts had no influence on cell viability. 15% and 30% extracts of Fe30Mn0.6N could upregulate autophagy compared to the control group by detecting beclin-1, LC3, Atg3, and P62 on the basis of WB and IHC (P < 0.05). Also, the PI3K-AKT-mTOR signaling pathway mediated in the upregulation of autophagy of chondrocytes resulting in exposure to extract of Fe30Mn0.6N alloy. It is concluded that Fe30Mn0.6N showed degradability and biocompatibility in vivo and upregulated autophagy activity in chondrocytes.

Alloplastic temporomandibular joint replacement: present status and future perspectives of the elements of embodiment

Medical device embodiment involves the following elements: materials, design, and manufacturing. Failure of any one of these elements can result in failure of the device, despite the others being satisfactory. The abundance of clinical and basic science literature published since 1986, demonstrates the safety and efficacy of alloplastic temporomandibular joint replacement (TMJR). Currently, there are 19 countries producing 41 TMJR devices. More than 75% are custom designed, and 27% are additively manufactured. In light of the increasing number of TMJR devices being designed and manufactured around the world, this paper will discuss TMJR embodiment so that clinicians understand their present status as well as the prospects for the future of new and/or improved TMJR devices, to ensure that these devices continue to be safe and effective long-term surgical options for the management of end-stage TMJ pathologies.

Microstructure and Mechanical Properties of Modified 316L Stainless Steel Alloy for Biomedical Applications Using Powder Metallurgy

AISI 316L stainless steel (SS) is one of the extensively used biomaterials to produce implants and medical devices. It provides a low-cost solution with ample mechanical properties, corrosion resistance, and biocompatibility compared to its counterpart materials. However, the implants made of this material are subjected to a short life span in human physiological conditions leading to the leaching of metal ions, thus limiting its use as a biomaterial. In this research, the addition of boron, titanium, and niobium with varying concentrations in the SS matrix has been explored. This paper explores the impact of material composition on modified SS alloy’s physical and mechanical properties. The study’s outcomes specify that the microhardness increases for all the alloy compositions, with a maximum increase of 64.68% for the 2 wt.% niobium added SS alloy. On the other hand, the tensile strength decreased to 297.40 MPa for the alloy containing 0.25 wt.% boron and 2 wt.% titanium additions compared to a tensile strength of 572.50 MPa for pure SS. The compression strength increased from 776 MPa for pure SS to 1408 MPa for the alloy containing niobium and titanium additions in equal concentrations.

Main Applications and Recent Research Progresses of Additive Manufacturing in Dentistry

In recent ten years, with the fast development of digital and engineering manufacturing technology, additive manufacturing has already been more and more widely used in the field of dentistry, from the first personalized surgical guides to the latest personalized restoration crowns and root implants. In particular, the bioprinting of teeth and tissue is of great potential to realize organ regeneration and finally improve the life quality. In this review paper, we firstly presented the workflow of additive manufacturing technology. Then, we summarized the main applications and recent research progresses of additive manufacturing in dentistry. Lastly, we sketched out some challenges and future directions of additive manufacturing technology in dentistry.

The “Expanded” Phases in the Low-Temperature Treated Stainless Steels: A Review

Low-temperature treatments have become a valuable method for improving the surface hardness of stainless steels, and thus their tribological properties, without impairing their corrosion resistance. By using treatment temperatures lower than those usually employed for nitriding or carburizing of low alloy steels or tool steels, it is possible to obtain a fairly fast (interstitial) diffusion of nitrogen and/or carbon atoms; on the contrary, the diffusion of substitutional atoms, as chromium atoms, has significantly slowed down, therefore the formation of chromium compounds is hindered, and corrosion resistance can be maintained. As a consequence, nitrogen and carbon atoms can be retained in solid solutions in an iron lattice well beyond their maximum solubility, and supersaturated solid solutions are produced. Depending on the iron lattice structure present in the stainless steel, the so-called “expanded austenite” or “S-phase”, “expanded ferrite”, and “expanded martensite” have been reported to be formed. This review summarizes the main studies on the characteristics and properties of these “expanded” phases and of the modified surface layers in which these phases form by using low-temperature treatments. A particular focus is on expanded martensite and expanded ferrite. Expanded austenite–S-phase is also discussed, with particular reference to the most recent studies.

Biomedical Alloys and Physical Surface Modifications: A Mini-Review

Biomedical alloys are essential parts of modern biomedical applications. However, they cannot satisfy the increasing requirements for large-scale production owing to the degradation of metals. Physical surface modification could be an effective way to enhance their biofunctionality. The main goal of this review is to emphasize the importance of the physical surface modification of biomedical alloys. In this review, we compare the properties of several common biomedical alloys, including stainless steel, Co-Cr, and Ti alloys. Then, we introduce the principle and applications of some popular physical surface modifications, such as thermal spraying, glow discharge plasma, ion implantation, ultrasonic nanocrystal surface modification, and physical vapor deposition. The importance of physical surface modifications in improving the biofunctionality of biomedical alloys is revealed. Future studies could focus on the development of novel coating materials and the integration of various approaches.

Synthesis, Surface Nitriding and Characterization of Ti-Nb Modified 316L Stainless Steel Alloy Using Powder Metallurgy

The powder metallurgy (PM) technique has been widely used for producing different alloy compositions by the addition of suitable reinforcements. PM is also capable of producing desireable mechanical and physical properties of the material by varying process parameters. This research investigates the addition of titanium and niobium in a 316L stainless steel matrix for potential use in the biomedical field. The increase of sintering dwell time resulted in simultaneous sintering and surface nitriding of compositions, using nitrogen as the sintering atmosphere. The developed alloy compositions were characterized using OM, FESEM, XRD and XPS techniques for quantification of the surface nitride layer and the nitrogen absorbed during sintering. The corrosion resistance and cytotoxicity assessments of the developed compositions were carried out in artificial saliva solution and human oral fibroblast cell culture, respectively. The results indicated that the nitride layer produced during sintering increased the corrosion resistance of the alloy and the developed compositions are non-cytotoxic. This newly developed alloy composition and processing technique is expected to provide a low-cost solution to implant manufacturing.

Microstructure/Mechanical Characterization of Plasma Nitrided Fine-Grain Austenitic Stainless Steels in Low Temperature

Fine-grained austenitic stainless steels (FGSS) were plasma nitrided below 700 K to describe their microstructure evolution during the nitrogen supersaturation process and to investigate the post-stressing effect on the microstructure and mechanical properties of nitrided FGSS. Normal- and fine-grained AISI304 plates were nitrided at 623 K and 673 K to investigate the grain size effect on the nitrogen supersaturation process as well as the microstructure evolution during the nitriding process. Fine-grained AISI316 (FGSS316) wires were nitrided at 623 K to demonstrate that their outer surfaces were uniformly nitrided to have the same two-phase, refined microstructure with high nitrogen solute content. This nitrided FGSS316 wire had a core structure where the original FGSS316 core matrix was bound by the nitrided FGSS316 layer. The nitrided wire had higher stiffness, ultimate strength, and elongation in the uniaxial tensile testing than its un-nitrided wires. The core microstructure was refined and homogenized by this applied loading together with an increase of nitrided layer hardness.

Corrosion resistance assessment of nickel-titanium endodontic files with and without heat treatment

Objectives

The aim of this study was to evaluate the corrosion resistance of heat-treated (Reciproc and WaveOne) and non-heat-treated (ProTaper and Mtwo) superelastic nickel-titanium endodontic files when immersed in a 5.25% sodium hypochlorite solution.

Materials and Methods

Anodic polarization curves were obtained with potential sweeps that began at the open circuit potential or corrosion potential (E_corr). The pitting potential (E_pit) was identified on the anodic polarization curve as the potential at which a sudden increase in current was observed. The micromorphology of the 28 tested files was analyzed before and after the electrochemical assay using scanning electron microscope (SEM). The data were analyzed using 1-way analysis of variance with the post hoc Bonferroni test (for E_corr) and the Student t-test for independent samples (for E_pit).

Results

The mean E_corr values were 0.506 V for ProTaper, 0.348 V for Mtwo, 0.542 V for Reciproc, and 0.321 V for WaveOne files. Only WaveOne and Protaper files exhibited pitting corrosion, with E_pit values of 0.879 V and 0.904 V, respectively. On the SEM images of the ProTaper and WaveOne files, cavities suggestive of pitting corrosion were detected.

Conclusions

Signs of corrosion were observed in both heat-treated and non-heat-treated files. Of the evaluated files, WaveOne (a heat-treated file) and ProTaper (a non-heat-treated file) exhibited the lowest corrosion resistance.

3D and 4D printing in dentistry and maxillofacial surgery: Printing techniques, materials, and applications

3D and 4D printing are cutting-edge technologies for precise and expedited manufacturing of objects ranging from plastic to metal. Recent advances in 3D and 4D printing technologies in dentistry and maxillofacial surgery enable dentists to custom design and print surgical drill guides, temporary and permanent crowns and bridges, orthodontic appliances and orthotics, implants, mouthguards for drug delivery. In the present review, different 3D printing technologies available for use in dentistry are highlighted together with a critique on the materials available for printing. Recent reports of the application of these printed platformed are highlighted to enable readers appreciate the progress in 3D/4D printing in dentistry.

Effect of Intercritical Annealing on the Microstructure and Mechanical Properties of 0.1C-13Cr-3Ni Martensitic Stainless Steel

Standard heat treatment of martensitic stainless steel consists of quenching and tempering. However, this results in high strength and hardness, while Charpy impact toughness shows lower values and a large deviation in its values. Therefore, a modified heat treatment of 0.1C-13Cr-3Ni martensitic stainless steel (PK993/1CH13N3) with intercritical annealing between Ac1 and Ac3 was introduced before tempering to study its effect on the microstructure and mechanical properties (yield strength, tensile strength, hardness and Charpy impact toughness). The temperatures of intercritical annealing were 740, 760, 780 and 800 °C. ThermoCalc was used for thermodynamic calculations. Microstructure characterization was performed on an optical and scanning electron microscope, while XRD was used for the determination of retained austenite. Results show that intercritical annealing improves impact toughness and lowers deviation of its values. This can be attributed to the dissolution of the thin carbide film along prior austenite grain boundaries and prevention of its re-occurrence during tempering. On the other hand, lower carbon concentration in martensite that was quenching from the intercritical region resulted in lower strength and hardness. Intercritical annealing refines the martensitic microstructure creating a lamellar morphology.

Designing Better Cardiovascular Stent Materials - A Learning Curve

Cardiovascular stents are life-saving devices and one of the top 10 medical breakthroughs of the 21st century. Decades of research and clinical trials have taught us about the effects of material (metal or polymer), design (geometry, strut thickness, and the number of connectors), and drug-elution on vasculature mechanics, hemocompatibility, biocompatibility, and patient health. Recently developed novel bioresorbable stents are intended to overcome common issues of chronic inflammation, in-stent restenosis, and stent thrombosis associated with permanent stents, but there is still much to learn. Increased knowledge and advanced methods in material processing have led to new stent formulations aimed at improving the performance of their predecessors but often comes with potential tradeoffs. This review aims to discuss the advantages and disadvantages of stent material interactions with the host within five areas of contrasting characteristics, such as 1) metal or polymer, 2) bioresorbable or permanent, 3) drug elution or no drug elution, 4) bare or surface-modified, and 5) self-expanding or balloon-expanding perspectives, as they relate to pre-clinical and clinical outcomes and concludes with directions for future studies.

Fatigue Crack Growth and Fracture of Internal Fixation Materials in In Vivo Environments-A Review

The development of crack patterns is a serious problem affecting the durability of orthopedic implants and the prognosis of patients. This issue has gained considerable attention in the medical community in recent years. This literature focuses on the five primary aspects relevant to the evaluation of the surface cracking patterns, i.e., inappropriate use, design flaws, inconsistent elastic modulus, allergic reaction, poor compatibility, and anti-corrosiveness. The hope is that increased understanding will open doors to optimize fabrication for biomedical applications. The latest technological issues and potential capabilities of implants that combine absorbable materials and shape memory alloys are also discussed. This article will act as a roadmap to be employed in the realm of orthopedic. Fatigue crack growth and the challenges associated with materials must be recognized to help make new implant technologies viable for wider clinical adoption. This review presents a summary of recent findings on the fatigue mechanisms and fracture of implant in the initial period after surgery. We propose solutions to common problems. The recognition of essential complications and technical problems related to various approaches and material choices while satisfying clinical requirements is crucial. Additional investigation will be needed to surmount these challenges and reduce the likelihood of fatigue crack growth after implantation.

In-vivo comparison of the Ni-free steel X13CrMnMoN18-14-3 and titanium alloy implants in rabbit femora - A promising steel for orthopedic surgery

A variety of metallic biomaterials is used for fracture fixation. Allergic reactions towards nickel-containing steels urge the need for alternatives. The present study investigated the suitability of the nickel-free stainless steel P2000 in comparison to titanium alloy implants for bone surgical applications in a rabbit femora defect model. Thirty-six rabbits received two different cylindrical implants press-fit inserted into the distal femoral metaphysis. At day 0, 28, and 56, implant ingrowth was monitored by radiography; implant stability was assessed by pull-out torque measurements while bone-to-implant contact (BIC) was determined histomorphometrically. Radiography revealed comparable implant ingrowth after 1 and 2 months for both implant materials. The pull-out force of P2000 tended to be higher than that for titanium at day 28 (p = .076) but the values were comparable at day 56 (p = .905). At day 56, implant fixation was significantly increased compared to the day of surgery for both, P2000 (p = .030) and for titanium alloy (p = .026). Microscopic examination revealed that both implant types appeared to be well integrated and firmly anchored in the bone. BIC ratio of titanium alloy tended to be higher at day 28 (p = .079) but they did not differ significantly at day 56 (p = .711). In the present rabbit femora defect model, the nickel-free stainless steel P2000 provides primary stability and osseointegration comparable to that of titanium alloy implants.

Corrosion resistance of the nickel-free high-nitrogen steel FeCrMnMoN0.9 under simulated inflammatory conditions

Nickel-free, high-nitrogen austenitic steels (AHNS) have been introduced for biomedical applications, with encouraging results in terms of mechanical and corrosion properties. Here, we tested the corrosion resistance of a nickel-free high nitrogen steel (FeCrMnMoN0.9) in bovine serum solutions containing 0 or 3 g/L hyaluronic acid (HA), and 0, 3, or 30 mM hydrogen peroxide (H₂ O₂ ) simulating no, moderate, or strong inflammatory conditions, respectively. Nondestructive electrochemical measurements (open circuit potential [OCP], linear polarization resistance "R_P ", and electrochemical impedance spectroscopy) were run in triplicate over 10 hr. The presence of HA had no significant effect either on the stabilized OCP values, or on the corrosion resistance of FeCrMnMoN0.9. Increasing H₂ O₂ concentrations shifted the OCP to more electropositive values; the corrosion resistance decreased only at a 30 mM H₂ O₂ . Final R_P values at 0, 3, and 30 mM H₂ O₂ resulted in 1598 ± 276, 1746 ± 308, and 439 ± 47 kΩ cm² , respectively. These values were 4-14 times higher, than the R_P values measured on LC-CoCrMo in our previous study, conducted under identical conditions. While these findings are encouraging, future studies need to focus on tribocorrosive properties of the AHNS to evaluate its applicability in joint replacement.

Nanoscale light element identification using machine learning aided STEM-EDS

Light element identification is necessary in materials research to obtain detailed insight into various material properties. However, reported techniques, such as scanning transmission electron microscopy (STEM)-energy dispersive X-ray spectroscopy (EDS) have inadequate detection limits, which impairs identification. In this study, we achieved light element identification with nanoscale spatial resolution in a multi-component metal alloy through unsupervised machine learning algorithms of singular value decomposition (SVD) and independent component analysis (ICA). Improvement of the signal-to-noise ratio (SNR) in the STEM-EDS spectrum images was achieved by combining SVD and ICA, leading to the identification of a nanoscale N-depleted region that was not observed in as-measured STEM-EDS. Additionally, the formation of the nanoscale N-depleted region was validated using STEM–electron energy loss spectroscopy and multicomponent diffusional transformation simulation. The enhancement of SNR in STEM-EDS spectrum images by machine learning algorithms can provide an efficient, economical chemical analysis method to identify light elements at the nanoscale.

Optimization of Sintering Parameters of 316L Stainless Steel for In-Situ Nitrogen Absorption and Surface Nitriding Using Response Surface Methodology

This research investigates the simultaneous sintering and surface nitriding of 316L stainless steel alloy using powder metallurgy method. The influence of sintering temperature and dwell time are investigated for maximum nitrogen absorption, densification and increased microhardness using response surface methodology (RSM). In this study, 316L stainless steel powder was compacted at 800 MPa and sintered at two different temperatures of 1150 and 1200 °C with varying dwell times of 1, 3, 5 and 8 h in nitrogen atmosphere. The sintered compacts were then characterized for their microstructure, densification, microhardness and nitrogen absorption. The results revealed that increased dwell time assisted nitrogen to diffuse into stainless steel matrix along with the creation of nitride layer onto the sample surface. The microhardness and density also increased with increasing dwell time. A densification of 7.575 g/cm3 and microhardness of 235 HV were obtained for the samples sintered at 1200 °C temperature with 8 h dwell time. The simultaneous sintering and surface nitriding technique developed in this research work can help in improving corrosion resistance of this material and controlling leaching of metal ions for its potential use in biomedical applications.

From Austenitic Stainless Steel to Expanded Austenite-S Phase: Formation, Characteristics and Properties of an Elusive Metastable Phase

Austenitic stainless steels are employed in many industrial fields, due to their excellent corrosion resistance, easy formability and weldability. However, their low hardness, poor tribological properties and the possibility of localized corrosion in specific environments may limit their use. Conventional thermochemical surface treatments, such as nitriding or carburizing, are able to enhance surface hardness, but at the expense of corrosion resistance, owing to the formation of chromium-containing precipitates. An effective alternative is the so called low temperature treatments, which are performed with nitrogen- and/or carbon-containing media at temperatures, at which chromium mobility is low and the formation of precipitates is hindered. As a consequence, interstitial atoms are retained in solid solution in austenite, and a metastable supersaturated phase forms, named expanded austenite or S phase. Since the first studies, dating 1980s, the S phase has demonstrated to have high hardness and good corrosion resistance, but also other interesting properties and an elusive structure. In this review the main studies on the formation and characteristics of S phase are summarized and the results of the more recent research are also discussed. Together with mechanical, fatigue, tribological and corrosion resistance properties of this phase, electric and magnetic properties, wettability and biocompatibility are overviewed.

Heat Transfer Characteristics of Nitrogen in Supercritical Region Using Redlich-Kwong Equation of State

The present paper studies through numerical methods, the thermodynamic heat transfer characteristics of free convection flow of supercritical nitrogen over a vertical cylinder. In the present analysis, the values of volumetric thermal expansion coefficient ($\beta$) are evaluated based on Redlich-Kwong equation of state (RK-EOS) and Van der Waals equation of state (VW-EOS). The calculated analytical thermal expansion coefficient values using RK-EOS are very close to NIST data values in comparison with VW-EOS. A set of coupled nonlinear partial differential equations (PDEs) governing the supercritical fluid (SCF) flow are derived, converted into non-dimensional form with the help of suitable dimensionless quantities and solved using Crank-Nicolson implicit finite difference method. The simulations are carried out for nitrogen in the supercritical region. The obtained numerical data is expressed in terms of graphs and tables for various values of physical parameters. The increasing value of reduced temperature decreases the average Nusselt number and skin-friction coefficient, whereas amplifying value of reduced pressure enhance the heat transfer rate and wall shear stress in the SCF region. Present results are compared with the previous results and the two are found to be in good agreement, i. e. the numerically generated results found to be in agreement with existing results.

Microstructure, Mechanical, and Corrosion Properties of Ni-Free Austenitic Stainless Steel Prepared by Mechanical Alloying and HIPping

An influence of the powder metallurgy route on the phase structure, mechanical properties, and corrosion resistance of Fe–18%Cr–12%Mn–N nickel-free austenitic stainless steel as a potential material for medical applications were studied. The powder was mechanically alloyed in a high purity nitrogen atmosphere for 90 h followed by Hot Isostatic Pressing at 1150 °C (1423 K) and heat treatment at 1175 °C (1423 K) for 1 h in a vacuum with furnace cooling and water quenching. More than 96% of theoretical density was obtained for the samples after Hot Isostatic Pressing that had a direct influence on the tensile strength of the tested samples (Ultimate Tensile Strength is 935 MPa) with the total elongation of 0.5%. Heat treatment did not affect the tensile strength of the tested material, however, an elongation was improved by up to 3.5%. Corrosion properties of the tested austenitic stainless steel in various stages of the manufacturing process were evaluated applying the anodic polarization measurements and compared with the austenitic 316LV stainless steel. In general, the heat treatment applied after Hot Isostatic Pressing improved the corrosion resistance. The Hot Isostatic Pressing sample shows dissolution, while heat treatment causes a passivity range, the noblest corrosion potential, and lower current density of this sample.

Magnesium matrix nanocomposites for orthopedic applications: A review from mechanical, corrosion, and biological perspectives

Magnesium (Mg) and some of its alloys have attracted extensive interests for biomedical applications as they exhibit biodegradability and low elastic modulus that is closer to natural bones than the currently used metallic implant materials such as titanium (Ti) and its alloys, stainless steels, and cobalt-chromium (Co-Cr) alloys. However, the rapid degradation of Mg alloys and loss of their mechanical integrity before sufficient bone healing impede their clinical application. Our literature review shows that magnesium matrix nanocomposites (MMNCs) reinforced with nanoparticles possess enhanced strength, high corrosion resistance, and good biocompatibility. This article provides a detailed analysis of the effects of nanoparticle reinforcements on the mechanical properties, corrosion behavior, and biocompatibility of MMNCs as promising biodegradable implant materials. The governing equations to quantitatively predict the mechanical properties and underlying synergistic strengthening mechanisms in MMNCs are elucidated. The potential, recent advances, challenges and future research directions in relation to nanoparticles reinforced MMNCs are highlighted. STATEMENT OF SIGNIFICANCE: Critically reviewing magnesium metal matrix nanocomposites (MMNCs) for the biomedical application. Clear definitions of strengthening mechanisms using reinforcement particle in the magnesium matrix, as there were controversial in governing equations of strengthening parameters. Providing better understanding of the effect of particle size, volume fraction, interfacial bonding, and uniform dispersion of reinforcement particles on MMNCs.

Bioactive Glass and Silicate-Based Ceramic Coatings on Metallic Implants: Open Challenge or Outdated Topic?

The overall success and long-term life of the medical implants are decisively based on the convenient osseointegration at the hosting tissue-implant interface. Therefore, various surface modifications and different coating approaches have been utilized to the implants to enhance the bone formation and speed up the interaction with the surrounding hosting tissues, thereby enabling the successful fixation of implants. In this review, we will briefly present the main metallic implants and discuss their biocompatibility and osseointegration ability depending on their chemical and mechanical properties. In addition, as the main goal of this review, we explore the main properties of bioactive glasses and silica-based ceramics that are used as coating materials for both orthopedic and dental implants. The current review provides an overview of these bioactive coatings, with a particular emphasis on deposition methods, coating adhesion to the substrates and apatite formation ability tested by immersion in Simulated Body Fluid (SBF). In vitro and in vivo performances in terms of biocompatibility, biodegradability and improved osseointegration are examined as well.

Corrosion performance of cold deformed austenitic stainless steels for biomedical applications

Austenitic stainless steels possess an excellent balance of strength and ductility along with the high ability to further raise their strength during cold deformation (CD). Corrosion resistance of austenitic stainless steels (SSs) is affected by cold deformation because passive films on the surface of steels are expected to be modified. A low level of CD enhances the surface diffusion, which results in the formation of a stable passive film leading to an increase in the corrosion resistance in neutral chloride solutions. The chromium content in the passive film on a deformed steel surface is usually richer, with a higher Cr/Fe ratio than that formed on annealed steels. A higher chromium content makes surface films more stable, which improves the corrosion resistance. However, severe CD results in the formation of strain-induced martensite phase and deformation twins, which decreases the localized corrosion resistance by increasing the number of active anodic sites on the surface. The corrosion resistance, especially the pitting resistance, in SSs is diminished with increasing volume fraction of the martensite. In this review, we highlighted the failure modes of corrosion of stainless steel implants, factors affecting corrosion, and effect of CD on mechanical properties and emphatically on the corrosion resistance of SSs for biomedical applications.

Laser Powder Bed Fusion of Stainless Steel Grades: A Review

In this paper, the capability of laser powder bed fusion (L-PBF) systems to process stainless steel alloys is reviewed. Several classes of stainless steels are analyzed (i.e., austenitic, martensitic, precipitation hardening and duplex), showing the possibility of satisfactorily processing this class of materials and suggesting an enlargement of the list of alloys that can be manufactured, targeting different applications. In particular, it is reported that stainless steel alloys can be satisfactorily processed, and their mechanical performances allow them to be put into service. Porosities inside manufactured components are extremely low, and are comparable to conventionally processed materials. Mechanical performances are even higher than standard requirements. Micro surface roughness typical of the as-built material can act as a crack initiator, reducing the strength in both quasi-static and dynamic conditions.

On the Evaluation of Surface Fatigue Strength of a Stainless-Steel Aeronautical Component

In this paper, a novel method for the evaluation of the surface fatigue strength of a stainless-steel component is proposed. The use of stainless steel is necessary indeed, whenever a component has to work in a particularly aggressive environment that may cause an oxidation of the component itself. One of the major problems that affect stainless-steel components is the possible wear of the antioxidant film that reduces the antioxidant properties of the component itself. One of the main causes that can lead to wear is related to the surface corrosion that occurs every time two evolving bodies are forced to work against each other. If the antioxidant film is affected by surface fatigue problems, such as pitting or spalling, the antioxidant capacities of this type of steel may be lost. In this context, it is, therefore, necessary to verify, at least, by calculation that no corrosion problems exist. The method proposed in this activity is a hybrid method, numerical-theoretical, which allows to estimate the surface fatigue strength in a very short time without having to resort to finite element models that often are so complex to be in contrast with industrial purposes.

Disposable stainless steel-based electrochemical microsensor for in vivo determination of indole-3-acetic acid in soybean seedlings

In vivo detecting of plants signal molecules is of great importance for the precision farming, crop management and plant phenotyping. In this work, for in vivo detecting indole-3-acetic acid (IAA), one of phytohormones, fine stainless steel (SS) wire was used as electrode material. Highly ordered nanopores, popcorn-like Au nanostructures, Pt nanoparticles and reduced graphene oxide (ERGO) nanocomposite films, and polymerized ST film (PST) were fabricated on the SS microelectrode in turn for improving the detection effect. Using the as-prepared SS microelectrode as working electrode, two untreated SS wires as reference electrode and counter electrode respectively, a disposable electrochemical microsensor for IAA were developed. The microsensor exhibited excellent selectivity and high sensitivity with low detection limit (LOD) of 43 pg mL-1. The limit of quantity (LOQ) is 143 pg mL-1. The RSD was 7% for 12 different PST/Pt-ERGO/Au/a-SS microsensors in presence of 100 µg mL-1 IAA. Using this microsensor, IAA of the stem of soybean seedlings was detected in vivo under salt stress. Our result was also confirmed by ultra-performance liquid chromatography-mass spectrum (UPLC-MS). This is the first report for the in vivo detection of IAA in plants using SS-based electrochemical microsensor. Our sensor provides an excellent sensing platform for detecting IAA in plants in vivo.

Surface modification of stainless steel for biomedical applications: Revisiting a century-old material

Stainless steel (SS) has been widely used as a material for fabricating cardiovascular stents/valves, orthopedic prosthesis, and other devices and implants used in biomedicine due to its malleability and resistance to corrosion and fatigue. Despite its good mechanical properties, SS (as other metals) lacks biofunctionality. To be successfully used as a biomaterial, SS must be made resistant to the biological environment by increasing its anti-fouling properties, preventing biofilm formation (passive surface modification), and imparting functionality for eluting a specific drug or capturing selected cells (active surface modification); these features depend on the final application. Various physico-chemical techniques, including plasma vapor deposition, electrochemical treatment, and attachment of different linkers that add functional groups, are used to obtain SS with increased corrosion resistance, improved osseointegration capabilities, added hemocompatibility, and enhanced antibacterial properties. Existing literature on this topic is extensive and has not been covered in an integrated way in previous reviews. This review aims to fill this gap, by surveying the literature on SS surface modification methods, as well as modification routes tailored for specific biomedical applications.

STATEMENT OF SIGNIFICANCE

Stainless steel (SS) is widely used in many biomedical applications including bone implants and cardiovascular stents due to its good mechanical properties, biocompatibility and low price. Surface modification allows improving its characteristics without compromising its important bulk properties. SS with improved blood compatibility (blood contacting implants), enhanced ability to resist bacterial infection (long-term devices), better integration with a tissue (bone implants) are examples of successful SS surface modifications. Existing literature on this topic is extensive and has not been covered in an integrated way in previous reviews. This review paper aims to fill this gap, by surveying the literature on SS surface modification methods, as well as to provide guidance for selecting appropriate modification routes tailored for specific biomedical applications.

Surface Functionalization of Ti6Al4V via Self-assembled Monolayers for Improved Protein Adsorption and Fibroblast Adhesion

Although metallic biomaterials find numerous biomedical applications, their inherent low bioactivity and poor osteointegration had been a great challenge for decades. Surface modification via silanization can serve as an attractive method for improving the aforementioned properties of such substrates. However, its effect on protein adsorption/conformation and subsequent cell adhesion and spreading has rarely been investigated. This work reports the in-depth study of the effect of Ti6Al4V surface functionalization on protein adsorption and cell behavior. We prepared self-assembled monolayers (SAMs) of five different surfaces (amine, octyl, mixed [1:1 ratio of amine:octyl], hybrid, and COOH). Synthesized surfaces were characterized by Fourier transform infrared-attenuated total reflection (FTIR-ATR) spectroscopy, contact angle goniometry, profilometry, and field emission scanning electron microscopy (FESEM). Quantification of adsorbed mass of bovine serum albumin (BSA) and fibronectin (FN) was determined on different surfaces along with secondary structure analysis. The adsorbed amount of BSA was found to increase with an increase in surface hydrophobicity with the maximum adsorption on the octyl surface while the reverse trend was detected for FN adsorption, having the maximum adsorbed mass on the COOH surface. The α-helix content of adsorbed BSA increased on amine and COOH surfaces while it decreased for other surfaces. Whereas increasing β-turn content of the adsorbed FN with the increase in the surface hydrophobicity was observed. In FN, RGD loops are located in the β-turn and consequently the increase in Δ adhered cells (%) was predominantly increased with the increasing Δ β-turn content (%). We found hybrid surfaces to be the most promising surface modifier due to maximum cell adhesion (%) and proliferation, larger nuclei area, and the least cell circularity. Bacterial density increased with the increasing hydrophobicity and was found maximum for the amine surface (θ = 63 ± 1°) which further decreased with the increasing hydrophobicity. Overall, modified surfaces (in particular hybrid surface) showed better protein adsorption and cell adhesion properties as compared to unmodified Ti6Al4V and can be potentially used for tissue engineering applications.

A review of biocompatible metal injection moulding process parameters for biomedical applications

Biocompatible metals have been revolutionizing the biomedical field, predominantly in human implant applications, where these metals widely used as a substitute to or as function restoration of degenerated tissues or organs. Powder metallurgy techniques, in specific the metal injection moulding (MIM) process, have been employed for the fabrication of controlled porous structures used for dental and orthopaedic surgical implants. The porous metal implant allows bony tissue ingrowth on the implant surface, thereby enhancing fixation and recovery. This paper elaborates a systematic classification of various biocompatible metals from the aspect of MIM process as used in medical industries. In this study, three biocompatible metals are reviewed-stainless steels, cobalt alloys, and titanium alloys. The applications of MIM technology in biomedicine focusing primarily on the MIM process setting parameters discussed thoroughly. This paper should be of value to investigators who are interested in state of the art of metal powder metallurgy, particularly the MIM technology for biocompatible metal implant design and development.

Design and characterization of a novel nickel-free cobalt-base alloy for intravascular stents

Co-Cr-W-Ni alloy (L605) with high tensile strength is used in coronary stents. The thickness of individual strut of the stent is reduced which can decrease the stent restenosis rate. However, about 10% Ni element content in L605 is found to cause allergic reactions and pulmonary embolism, similar to the traditional 316L stainless steel. In this study, a novel nickel-free cobalt-base alloy Co-20Cr-12Fe-18Mn-2Mo-4W-N (wt%) was designed and fabricated in order to efficiently avoid the potential hazards of Ni element. Fe and Mn, essential elements of human body, were added in the alloy to substitute part of Co element. In comparison to L605 alloy, the tensile strength of the new alloy was higher than 1000MPa while elongation was above 55%. The pitting potential of the new alloy was measured close to 1000mV, also higher than that of L605 alloy. CCK-8 test indicated that the cytotoxicity of the new alloy is grade 1, reflecting that Co-20Cr-12Fe-18Mn-2Mo-4W-N alloy has no cytotoxic effects. There was no significant difference in the apoptosis rates between Co-20Cr-12Fe-18Mn-2Mo-4W-N and L605 alloy. The newly developed cobalt-base alloy showed excellent mechanical, corrosion resistance and biological properties, which could make it a desirable material for future clinical investigations.

Improved antifouling properties and selective biofunctionalization of stainless steel by employing heterobifunctional silane-polyethylene glycol overlayers and avidin-biotin technology

A straightforward solution-based method to modify the biofunctionality of stainless steel (SS) using heterobifunctional silane-polyethylene glycol (silane-PEG) overlayers is reported. Reduced nonspecific biofouling of both proteins and bacteria onto SS and further selective biofunctionalization of the modified surface were achieved. According to photoelectron spectroscopy analyses, the silane-PEGs formed less than 10 Å thick overlayers with close to 90% surface coverage and reproducible chemical compositions. Consequently, the surfaces also became more hydrophilic, and the observed non-specific biofouling of proteins was reduced by approximately 70%. In addition, the attachment of E. coli was reduced by more than 65%. Moreover, the potential of the overlayer to be further modified was demonstrated by successfully coupling biotinylated alkaline phosphatase (bAP) to a silane-PEG-biotin overlayer via avidin-biotin bridges. The activity of the immobilized enzyme was shown to be well preserved without compromising the achieved antifouling properties. Overall, the simple solution-based approach enables the tailoring of SS to enhance its activity for biomedical and biotechnological applications.