Powder metallurgical low-modulus Ti-Mg alloys for biomedical applications

Fabrication and Characterization of Biomedical Ti-Mg Composites via Spark Plasma Sintering

The fabrication of Ti-Mg composite biomaterials was investigated using spark plasma sintering (SPS) with varying Mg contents and sintering pressures. The effects of powder mixing, Mg addition, and sintering pressure on the microstructure and mechanical properties of the composite materials were systematically analyzed. Uniform dispersion of Mg within the Ti matrix was achieved, confirming the efficacy of ethanol-assisted ball milling for consistent mixing. The Young's modulus of the composite materials exhibited a linear decrease with increasing Mg content, with Ti-30vol%Mg and Ti-50vol%Mg demonstrating reduced modulus values compared to pure Ti. Based on density measurements, compression tests, and Young's modulus results, it was determined that the sinterability of Ti-30vol%Mg saturates at a sintering pressure of approximately 50 MPa. Moreover, our immersion tests in physiological saline underscore the profound significance of our findings. Ti-30vol%Mg maintained compressive strength above that of cortical bone for 6-to-10 days, with mechanical integrity improving under higher sintering pressures. These findings mark a significant leap towards the development of Ti-Mg composite biomaterials with tailored mechanical properties, thereby enhancing biocompatibility and osseointegration for a wide range of biomedical applications.

Biomedical Applications of Titanium Alloys: A Comprehensive Review

Titanium alloys have emerged as the most successful metallic material to ever be applied in the field of biomedical engineering. This comprehensive review covers the history of titanium in medicine, the properties of titanium and its alloys, the production technologies used to produce biomedical implants, and the most common uses for titanium and its alloys, ranging from orthopedic implants to dental prosthetics and cardiovascular devices. At the core of this success lies the combination of machinability, mechanical strength, biocompatibility, and corrosion resistance. This unique combination of useful traits has positioned titanium alloys as an indispensable material for biomedical engineering applications, enabling safer, more durable, and more efficient treatments for patients affected by various kinds of pathologies. This review takes an in-depth journey into the inherent properties that define titanium alloys and which of them are advantageous for biomedical use. It explores their production techniques and the fabrication methodologies that are utilized to machine them into their final shape. The biomedical applications of titanium alloys are then categorized and described in detail, focusing on which specific advantages titanium alloys are present when compared to other materials. This review not only captures the current state of the art, but also explores the future possibilities and limitations of titanium alloys applied in the biomedical field.

Recent Advances in Processing of Titanium and Titanium Alloys through Metal Injection Molding for Biomedical Applications: 2013-2022

Metal injection molding (MIM) is one of the most widely used manufacturing processes worldwide as it is a cost-effective way of producing a variety of dental and orthopedic implants, surgical instruments, and other important biomedical products. Titanium (Ti) and Ti alloys are popular modern metallic materials that have revamped the biomedical sector as they have superior biocompatibility, excellent corrosion resistance, and high static and fatigue strength. This paper systematically reviews the MIM process parameters that extant studies have used to produce Ti and Ti alloy components between 2013 and 2022 for the medical industry. Moreover, the effect of sintering temperature on the mechanical properties of the MIM-processed sintered components has been reviewed and discussed. It is concluded that by appropriately selecting and implementing the processing parameters at different stages of the MIM process, defect-free Ti and Ti alloy-based biomedical components can be produced. Therefore, this present study could greatly benefit future studies that examine using MIM to develop products for biomedical applications.

Improving Biocompatibility for Next Generation of Metallic Implants

The increasing need for joint replacement surgeries, musculoskeletal repairs, and orthodontics worldwide prompts emerging technologies to evolve with healthcare's changing landscape. Metallic orthopaedic materials have a shared application history with the aerospace industry, making them only partly efficient in the biomedical domain. However, suitability of metallic materials in bone tissue replacements and regenerative therapies remains unchallenged due to their superior mechanical properties, eventhough they are not perfectly biocompatible. Therefore, exploring ways to improve biocompatibility is the most critical step toward designing the next generation of metallic biomaterials. This review discusses methods of improving biocompatibility of metals used in biomedical devices using surface modification, bulk modification, and incorporation of biologics. Our investigation spans multiple length scales, from bulk metals to the effect of microporosities, surface nanoarchitecture, and biomolecules such as DNA incorporation for enhanced biological response in metallic materials. We examine recent technologies such as 3D printing in alloy design and storing surface charge on nanoarchitecture surfaces, metal-on-metal, and ceramic-on-metal coatings to present a coherent and comprehensive understanding of the subject. Finally, we consider the advantages and challenges of metallic biomaterials and identify future directions.

Simultaneously stimulated osteogenesis and anti-bacteria of physically cross-linked double-network hydrogel loaded with MgO-Ag2O nanocomposites

Hydrogels, with a three-dimensional network of water-soluble polymer and water, could simulate the critical properties of extracellular matrix, which has been widely used in bone tissue engineering. However, most of conventional hydrogels for bone regeneration are fragile and have poor osteogenic activity, which restricts their applications. In this work, a novel nanoparticle-hydrogel composite consisting of physically cross-linked double-network loaded with MgO-Ag₂O nanocomposites was developed by the sol-gel method. The Mg²⁺ released from MgO-Ag₂O nanocomposites was used as an ionic cross-linking site of sodium alginate (SA), while the hydrophobic micelles in the polyacrylamide (PAAM) network is acted as another crosslinking point. The results indicated that the novel nanoparticle-hydrogel composites had good self-recovery ability and excellent mechanical properties compared with the conventional sodium alginate (SA)/polyacrylamide (PAAM) hydrogels. Additionally, it showed a slow release of Mg and Ag ions due to the dual function of the embedding effect of hydrogels and the increasing pH of the solution induced by the hydrolysis of sodium alginate. In terms of in vitro tests, the nanoparticle-hydrogel composites showed significantly stimulatory effects on the proliferation and differentiation of SaOS-2 cells. In addition, the antibacterial effects of the nanoparticle-hydrogel composites were gradually enhanced with the increase of MgO-Ag₂O content.

Biodegradability and Cytocompatibility of 3D-Printed Mg-Ti Interpenetrating Phase Composites

Orthopedic hybrid implants combining both titanium (Ti) and magnesium (Mg) have gained wide attraction nowadays. However, it still remains a huge challenge in the fabrication of Mg-Ti composites because of the different temperatures of Ti melting point and pure Mg volatilization point. In this study, we successfully fabricated a new Mg-Ti composite with bi-continuous interpenetrating phase architecture by infiltrating Mg melt into Ti scaffolds, which were prepared by 3D printing and subsequent acid treatment. We attempted to understand the 7-day degradation process of the Mg-Ti composite and examine the different Mg2+ concentration composite impacts on the MC3T3-E1 cells, including toxicity, morphology, apoptosis, and osteogenic activity. CCK-8 results indicated cytotoxicity and absence of the Mg-Ti composite during 7-day degradation. Moreover, the composite significantly improved the morphology, reduced the apoptosis rate, and enhanced the osteogenic activity of MC3T3-E1 cells. The favorable impacts might be attributed to the appropriate Mg2+ concentration of the extracts. The results on varying Mg2+ concentration tests indicated that Mg2+ showed no cell adverse effect under 10-mM concentration. The 8-mM group exhibited the best cell morphology, minimum apoptosis rate, and maximum osteogenic activity. This work may open a new perspective on the development and biomedical applications for Mg-Ti composites.

Insights on Spark Plasma Sintering of Magnesium Composites: A Review

This review paper gives an insight into the microstructural, mechanical, biological, and corrosion resistance of spark plasma sintered magnesium (Mg) composites. Mg has a mechanical property similar to natural human bones as well as biodegradable and biocompatible properties. Furthermore, Mg is considered a potential material for structural and biomedical applications. However, its high affinity toward oxygen leads to oxidation of the material. Various researchers optimize the material composition, processing techniques, and surface modifications to overcome this issue. In this review, effort has been made to explore the role of process techniques, especially applying a typical powder metallurgy process and the sintering technique called spark plasma sintering (SPS) in the processing of Mg composites. The effect of reinforcement material on Mg composites is illustrated well. The reinforcement’s homogeneity, size, and shape affect the mechanical properties of Mg composites. The evidence shows that Mg composites exhibit better corrosion resistance, as the reinforcement act as a cathode in a Mg matrix. However, in most cases, a localized corrosion phenomenon is observed. The Mg composite’s high corrosion rate has adversely affected cell viability and promotes cytotoxicity. The reinforcement of bioactive material to the Mg matrix is a potential method to enhance the corrosion resistance and biocompatibility of the materials. However, the impact of SPS process parameters on the final quality of the Mg composite needs to be explored.

Recent Progress on Nanocrystalline Metallic Materials for Biomedical Applications

Nanocrystalline (NC) metallic materials have better mechanical properties, corrosion behavior and biocompatibility compared with their coarse-grained (CG) counterparts. Recently, nanocrystalline metallic materials are receiving increasing attention for biomedical applications. In this review, we have summarized the mechanical properties, corrosion behavior, biocompatibility, and clinical applications of different types of NC metallic materials. Nanocrystalline materials, such as Ti and Ti alloys, shape memory alloys (SMAs), stainless steels (SS), and biodegradable Fe and Mg alloys prepared by high-pressure torsion, equiangular extrusion techniques, etc., have better mechanical properties, superior corrosion resistance and biocompatibility properties due to their special nanostructures. Moreover, future research directions of NC metallic materials are elaborated. This review can provide guidance and reference for future research on nanocrystalline metallic materials for biomedical applications.

Sequential activation of M1 and M2 phenotypes in macrophages by Mg degradation from Ti-Mg alloy for enhanced osteogenesis

BACKGROUND

Even though the modulatory effects of Magnisum (Mg) and its alloys on bone-healing cells have been widely investigated during the last two decades, relatively limited attention has been paid on their inflammation-modulatory properties. Understanding the activation process of macrophages in response to the dynamic degradation process of Mg as well as the relationship between macrophage phenotypes and their osteogenic potential is critical for the design and development of advanced Mg-based or Mg-incorporated biomaterials.

METHODS

In this work, a Ti-0.625 Mg (wt.%) alloy fabricated by mechanical alloying (MA) and subsequent spark plasma sintering (SPS) was employed as a material model to explore the inflammatory response and osteogenic performance in vitro and in vivo by taking pure Ti as the control. The data analysis was performed following Student's t-test.

RESULTS

The results revealed that the macrophages grown on the Ti-0.625 Mg alloy underwent sequential activation of M1 and M2 phenotypes during a culture period of 5 days. The initially increased environmental pH (~ 8.03) was responsible for the activation of M1 macrophages, while accumulated Mg²⁺ within cells contributed to the lateral M2 phenotype activation. Both M1 and M2 macrophages promoted osteoblast-like SaOS-2 cell maturation. In vivo experiment further showed the better anti-inflammatory response, regenerative potentiality and thinner fibrous tissue layer for the Ti-0.625 Mg alloy than pure Ti.

CONCLUSION

The results highlighted the roles of Mg degradation in the Ti-0.625 Mg alloy on the sequential activation of macrophage phenotypes and the importance of modulating M1-to-M2 transition in macrophage phenotypes for the design and development of inflammation-modulatory biomaterials.

Insight Into Corrosion of Dental Implants: From Biochemical Mechanisms to Designing Corrosion-Resistant Materials

Purpose of Review

Despite advanced technologies to avoid corrosion of dental implants, the mechanisms toward the release of metals and their role in the onset of peri-implant diseases are still under-investigated. Effective knowledge on the etiopathogenesis of corrosive products and preventive strategies mitigating the risks for surface degradation are thus in dire need. This review aimed to summarize evidence toward biocorrosion in the oral environment and discuss the current strategies targeting the improvement of dental implants and focusing on the methodological and electrochemical aspects of surface treatments and titanium-based alloys.

Recent Findings

Recent studies suggest the existence of wear/corrosion products may correlate with peri-implantitis progress by triggering microbial dysbiosis, the release of pro-inflammatory cytokines, and animal bone resorption. Furthermore, current clinical evidence demonstrating the presence of metal-like particles in diseased tissues supports their possible role as a risk factor for peri-implantitis. For instance, to overcome the drawback of titanium corrosion, researchers are primarily focusing on developing corrosion-resistant alloys and coatings for dental implants by changing their physicochemical features.

Summary

The current state-of-art discussed in this review found corrosion products effective in affecting biofilm virulence and inflammatory factors in vitro. Controversial and unstandardized data are limitations, making the premise of corrosion products being essential for peri-implantitis onset. On the other hand, when it comes to the strategies toward reducing implant corrosion rate, it is evident that the chemical and physical properties are crucial for the in vitro electrochemical behavior of the implant material. For instance, it is foreseeable that the formation of films/coatings and the incorporation of some functional compounds into the substrate may enhance the material’s corrosion resistance and biological response. Nevertheless, the utmost challenge of research in this field is to achieve adequate stimulation of the biological tissues without weakening its protective behavior against corrosion. In addition, the translatability from in vitro findings to clinical studies is still in its infancy. Therefore, further accumulation of high-level evidence on the role of corrosion products on peri-implant tissues is expected to confirm the findings of the present review besides the development of better methods to improve the corrosion resistance of dental implants. Furthermore, such knowledge could further develop safe and long-term implant rehabilitation therapy.

Design of patient specific bone stiffness mimicking scaffold

The difference in stiffness of a patient's bone and bone implant causes stress shielding. Thus, implants which match the stiffness of bone of the patient result in better bone growth and osseointegration. Variation in porosity is one of the methods to obtain implants with different stiffness values. This study proposes a novel method to design biomimetic bone graft implant based on computed tomography (CT) scan data, that creates similar pre- and post-implant mechanical environment on peri-implant bone. The design methodology is demonstrated by taking three different sections of human femur bone, greater trochanter, diaphysis and epicondyle, with two different implant materials, Ti-6Al-4V and Ti-Mg. Bones from these three sections were replaced with porous implants of effective stiffness of replaced bone, as would have been required after a resection surgery. Models were simulated with physiological loading condition using finite element (FE) method. Variation of maximum von Mises stress and average strain on peri-prosthetic bone were found to be in the range of -6% to 10.7% and -7% to -17.9% for porous implants and 26% to 50% and -36% to -59% for solid implant respectively compared to natural bone. The results revealed that the porous implants, which have been designed based on CT scan data, can effectively produce mechanical response at peri-implant bone, which is very close to pre-implanted condition. Following this methodology, more osseointegration friendly mechanical environment can be achieved at peri-implant bone for any anatomical location independent of implant materials.

Using MgO nanoparticles as a potential platform to precisely load and steadily release Ag ions for enhanced osteogenesis and bacterial killing

Bio-functional fillers including bio-ceramic, degradable metallic and composite particles are commonly introduced into bone tissue engineering (BTE) scaffolds to endow the materials with specific biological functions for enhanced bone defect therapy. In this work, MgO nanoparticles (NPs) were employed as a potential platform for precise loading and sustained release of Ag⁺. The results showed that MgO NPs possessed strong adsorption capacity (almost 100%) towards Ag⁺ in AgNO₃ solutions with different concentrations (0.1, 1 and 10 mM). After the adsorption of Ag⁺ in AgNO₃ solutions, cube-shaped MgO NPs transformed to lamella-structured nano-composites (NCs) composed of Mg(OH)₂ and Ag₂O, which were referred as MgO-xAg (x = 0.1, 1 or 10) NCs depending on the employed concentration of AgNO₃ solution. After being suspended in distilled water, as-prepared positively charged NCs underwent a fast degradation process during the initial 4 days. From day 4 and 14, steady release behaviors of Mg²⁺ and/or Ag⁺ from the NCs were noticed. With the lowest loading amount of Ag⁺, MgO-0.1Ag NCs did not exhibit significant modulatory effect on SaOS-2 cell response. On the contrary, MgO-10Ag NCs loaded with the highest amount of Ag⁺ showed significant cyto-toxicity towards SaOS-2 cells. With appropriate amount of Ag⁺ loading, MgO-1Ag NCs showed significantly stimulatory effects on SaOS-2 cell proliferation and differentiation. This is evidenced by the enhanced cell viability, alkaline phosphatase (ALP) activity and collagen (COL) production as well as the gene expressions of ALP, COL and osteoprotegerin (OPG) in MgO-1Ag group. Moreover, MgO-1Ag exhibited strong bactericidal capacity against both Escherichia coli and Staphylococcus aureus. Together, the results indicate that MgO could be employed as a potential platform for precise loading and sustained release of Ag⁺. MgO-1Ag NCs are promising to be used as bio-functional fillers in BTE scaffolds for simultaneously promoted osteogenesis and bacterial killing.

A study of Titanium and Magnesium particle-induced oxidative stress and toxicity to human osteoblasts

Hybrid implants combine both Titanium (Ti) and Magnesium (Mg) are prevalent nowadays. The long-term implications of Ti and Mg implants within the human body are not yet fully understood. Many implant failure cases due to inflammation, allergic responses, and aspect loosening have been reported frequently. Particles generated through daily wear and tear of implants may worsen the situation by causing acute complications. An in-depth understanding of the behavior of metal particles with human osteoblasts is necessary. In this study, a novel and systematic attempt was made to understand the effects of different concentrations of Ti and Mg particles to the osteoblastic SAOS2 cell: toxicity, alterations to mitochondria, and changes to the specific gene and protein expression. Ti particles were found toxic to SAOS2 cells at different dosages, while Mg particles at lower concentrations could improve cell viability. To understand this phenomenon better, we have measured cellular reactive oxygen species (ROS) production and cell apoptosis & necrosis percentage. We also have checked the mitochondrial structure with transmission electron microscope (TEM), and mitochondrial function using Tetramethyl rhodamine, ethyl ester staining (TMRE). NDUFB6, SDHC, and ATP5F1 were the essential mitochondrial genes involved in the ROS production and ATP production. Immunocytochemistry (ICC) and real-time polymerase chain reaction (qPCR) were implemented to check the regulations of these related genes.

Laser-Based Ablation of Titanium-Graphite Composite for Dental Application

Biocompatible materials with excellent mechanical properties as well as sophisticated surface morphology and chemistry are required to satisfy the requirements of modern dental implantology. In the study described in this article, an industrial-grade fibre nanosecond laser working at 1064 nm wavelength was used to micromachine a new type of a biocompatible material, Ti-graphite composite prepared by vacuum low-temperature extrusion of hydrogenated-dehydrogenated (HDH) titanium powder mixed with graphite flakes. The effect of the total laser energy delivered to the material per area on the machined surface morphology, roughness, surface element composition and phases transformations was investigated and evaluated by means of scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), confocal laser-scanning microscopy (CLSM) and X-ray diffraction analysis (XRD). The findings illustrate that the amount of thermal energy put to the working material has a remarkable effect on the machined surface properties, which is discussed from the aspect of the contact properties of dental implants.

Influence of chemical composition on cell viability on titanium surfaces: A systematic review

STATEMENT OF PROBLEM

A consensus on which dental implant alloy and surface treatment provide the best cell viability is unclear.

PURPOSE

The purpose of this systematic review was to provide information on the influence of surface and intrinsic titanium alloy chemical components on cell viability.

MATERIAL AND METHODS

The PubMed, LILACS, COCHRANE library, and Science Direct databases were electronically searched for the terms dental implants AND titanium AND cytotoxicity. Inclusion criteria were research articles that studied titanium or its alloys for chemical composition and cell viability and were published in English between 1999 and 2019. Articles that did not study titanium and its alloys, articles with nondental or biomedical implants, and articles that were not found in their entirety were excluded.

RESULTS

A total of 1226 articles selected by title or abstract according to the inclusion and exclusion criteria resulted in 51 articles that were reduced to 27 after reading in full. The treatments analyzed were arc fusion, electron beam physical deposition, plasma electrolytic oxidation, coating addition, micro arc oxidation, anodization, thermochemical process, BMP-2 immobilization, pressure-assisted sintering, and alkali heat treatment.

CONCLUSIONS

The evaluated literature did not allow a determination of the best surface treatment for cell viability because of the heterogeneity of the studies regarding the type of alloy, cell used in the MTT assay, study, and implant purpose (biomedical or dental). The cytotoxic effect of chemical components was dependent on dose, time, size, temperature, and cell type. The niobium, tantalum, zirconium, and molybdenum elements have been most often added in the development of less toxic Ti alloys with lower modulus of elasticity and increased strength.

Fabrication of Ti + Mg composites by three-dimensional printing of porous Ti and subsequent pressureless infiltration of biodegradable Mg

A semi-degradable Ti + Mg composite with superior compression and cytotoxicity properties have been successfully fabricated using ink jet 3D printing followed by capillary mediated pressureless infiltration technique targeting orthopaedic implant applications. The composite exhibited low modulus (~5.2 GPa) and high ultimate compressive strength (~418 MPa) properties matching that of the human cortical bone. Ti + Mg composites with stronger 3D interconnected open-porous Ti networks are possible to be fabricated via 3D printing. Corrosion rate of samples measured through immersion testing using 0.9%NaCl solution at 37 °C indicate almost negligible corrosion rate for porous Ti (~1.14 μm/year) and <1 mm/year for Ti + Mg composites for 5 days of immersion, respectively. The composite significantly increased the SAOS-2 osteoblastic bone cell proliferation rate when compared to the 3D printed porous Ti samples and the increase is attributed to the exogenous Mg²⁺ ions originating from the Ti + Mg samples. The cell viability results indicated absent to mild cytotoxicity. An attempt is made to discuss the key considerations for net-shape fabrication of Ti + Mg implants using ink jet 3D printing followed by infiltration approach.

Powder metallurgical Ti-Mg metal-metal composites facilitate osteoconduction and osseointegration for orthopedic application

In this work, Ti—Mg metal-metal composites (MMCs) were successfully fabricated by spark plasma sintering (SPS). In vitro, the proliferation and differentiation of SaOS-2 cells in response to Ti—Mg metal-metal composites (MMCs) were investigated. In vivo, a rat model with femur condyle defect was employed, and Ti—Mg MMCs implants were embedded into the femur condyles. Results showed that Ti—Mg MMCs exhibited enhanced cytocompatibility to SaOS-2 cells than pure Ti. The micro-computed tomography (Micro-CT) results showed that the volume of bone trabecula was significantly more abundant around Ti—Mg implants than around Ti implants, indicating that more active new-bone formed around Ti—Mg MMCs implants. Hematoxylin-eosin (H&E) staining analysis revealed significantly greater osteointegration around Ti—Mg implants than that around Ti implants.

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Bioactive Ti—Mg metal-metal composites (MMCs) were successfully fabricated by spark plasma sintering.

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The proliferation and ALP activity of SaOS-2 cells were promoted by Ti—Mg MMCs extraction medium.

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In vivo results showed that Ti—Mg MMCs exhibited enhanced osseointegration compared to pure Ti.

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.