The influence of sterilization on nitrogen-included ultrananocrystalline diamond for biomedical applications

Adhesion of biofilm, surface characteristics, and mechanical properties of antimicrobial denture base resin

PURPOSE

This study incorporated the nanomaterial, nanostructured silver vanadate decorated with silver nanoparticles (AgVO₃), into heat-cured resin (HT) at concentrations of 2.5%, 5%, and 10% and compared the adhesion of multispecies biofilms, surface characteristics, and mechanical properties with conventional heat-cured (HT 0%) and printed resins.

MATERIALS AND METHODS

AgVO₃ was incorporated in mass into HT powder. A denture base resin was used to obtain printed samples. Adhesion of a multispecies biofilm of Candida albicans, Candida glabrata, and Streptococcus mutans was evaluated by colony-forming units per milliliter (CFU/mL) and metabolic activity. Wettability, roughness, and scanning electron microscopy (SEM) were used to assess the physical characteristics of the surface. The mechanical properties of flexural strength and elastic modulus were tested.

RESULTS

HT 10%-AgVO₃ showed efficacy against S. mutans; however, it favored C. albicans CFU/mL (P < .05). The printed resin showed a higher metabolically active biofilm than HT 0% (P < .05). There was no difference in wettability or roughness between groups (P > .05). Irregularities on the printed resin surface and pores in HT 5%-AgVO₃ were observed by SEM. HT 0% showed the highest flexural strength, and the resins incorporated with AgVO₃ had the highest elastic modulus (P < .05).

CONCLUSION

The incorporation of 10% AgVO₃ into heat-cured resin provided antimicrobial activity against S. mutans in a multispecies biofilm did not affect the roughness or wettability but reduced flexural strength and increased elastic modulus. Printed resin showed higher irregularity, an active biofilm, and lower flexural strength and elastic modulus than heat-cured resin.

The Gemstone Cyborg: How Diamond Films Are Creating New Platforms for Cell Regeneration and Biointerfacing

Diamond is a promising material for the biomedical field, mainly due to its set of characteristics such as biocompatibility, strength, and electrical conductivity. Diamond can be synthesised in the laboratory by different methods, is available in the form of plates or films deposited on foreign substrates, and its morphology varies from microcrystalline diamond to ultrananocrystalline diamond. In this review, we summarise some of the most relevant studies regarding the adhesion of cells onto diamond surfaces, the consequent cell growth, and, in some very interesting cases, the differentiation of cells into neurons and oligodendrocytes. We discuss how different morphologies can affect cell adhesion and how surface termination can influence the surface hydrophilicity and consequent attachment of adherent proteins. At the end of the review, we present a brief perspective on how the results from cell adhesion and biocompatibility can make way for the use of diamond as biointerface.

Key Challenges in Diamond Coating of Titanium Implants: Current Status and Future Prospects

Over past years, the fabrication of Ti-based permanent implants for fracture fixation, joint replacement and bone or tooth substitution, has become a routine task. However, it has been found that some degradation phenomena occurring on the Ti surface limits the life or the efficiency of the artificial constructs. The task of avoiding such adverse effects, to prevent microbial colonization and to accelerate osteointegration, is being faced by a variety of approaches in order to adapt Ti surfaces to the needs of osseous tissues. Among the large set of biocompatible materials proposed as an interface between Ti and the hosting tissue, diamond has been proven to offer bioactive and mechanical properties able to match the specific requirements of osteoblasts. Advances in material science and implant engineering are now enabling us to produce micro- or nano-crystalline diamond coatings on a variety of differently shaped Ti constructs. The aim of this paper is to provide an overview of the research currently ongoing in the field of diamond-coated orthopedic Ti implants and to examine the evolution of the concepts that are accelerating the full transition of such technology from the laboratory to clinical applications.

A Biocompatible Ultrananocrystalline Diamond (UNCD) Coating for a New Generation of Dental Implants

Implant therapy using osseointegratable titanium (Ti) dental implants has revolutionized clinical dental practice and has shown a high rate of success. However, because a metallic implant is in contact with body tissues and fluids in vivo, ions/particles can be released into the biological milieu as a result of corrosion or biotribocorrosion. Ultrananocrystalline diamond (UNCD) coatings possess a synergistic combination of mechanical, tribological, and chemical properties, which makes UNCD highly biocompatible. In addition, because the UNCD coating is made of carbon (C), a component of human DNA, cells, and molecules, it is potentially a highly biocompatible coating for medical implant devices. The aim of the present research was to evaluate tissue response to UNCD-coated titanium micro-implants using a murine model designed to evaluate biocompatibility. Non-coated (n = 10) and UNCD-coated (n = 10) orthodontic Ti micro-implants were placed in the hematopoietic bone marrow of the tibia of male Wistar rats. The animals were euthanized 30 days post implantation. The tibiae were resected, and ground histologic sections were obtained and stained with toluidine blue. Histologically, both groups showed lamellar bone tissue in contact with the implants (osseointegration). No inflammatory or multinucleated giant cells were observed. Histomorphometric evaluation showed no statistically significant differences in the percentage of BIC between groups (C: 53.40 ± 13% vs. UNCD: 58.82 ± 9%, p > 0.05). UNCD showed good biocompatibility properties. Although the percentage of BIC (osseointegration) was similar in UNCD-coated and control Ti micro-implants, the documented tribological properties of UNCD make it a superior implant coating material. Given the current surge in the use of nano-coatings, nanofilms, and nanostructured surfaces to enhance the biocompatibility of biomedical implants, the results of the present study contribute valuable data for the manufacture of UNCD coatings as a new generation of superior dental implants.

Polycrystalline diamond coating on 3D printed titanium scaffolds: Surface characterisation and foreign body response

Titanium-based implants are the leading material for orthopaedic surgery, due to their strength, versatility, fabrication via additive manufacturing and invoked biological response. However, the interface between the implant and the host tissue requires improvement to better integrate the implant material and mitigate foreign body response. The interface can be manipulated by changing the surface energy, chemistry, and topography of the Titanium-based implant. Recently, polycrystalline diamond (PCD) has emerged as an exciting coating material for 3D printed titanium scaffolds showing enhanced mammalian cell functions while inhibiting bacterial attachment in vitro. In this study, we performed in-depth characterisation of PCD coatings investigating the surface topography, thickness, surface energy, and compared its foreign body response in vivo with uncoated titanium scaffold. Coating PCD onto titanium scaffolds resulted in a similar microscale surface roughness (RMS_(PCD-coated) = 24 μm; RMS_(SLM-Ti) = 28 μm), increased nanoscale roughness (RMS_(PCD-coated) = 35 nm; RMS_(SLM-Ti) = 66 nm) and a considerable decrease in surface free energy (E_(PCD-coated) = 4 mN m^-1; E_(SLM-Ti) = 16 mN m^-1). These surface property changes were supported by X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy as corresponding to observed surface chemistry changes induced by the coating. The underlying mechanism of how the diamond coatings chemical and physical properties changes the wettability of implants was examined. In vivo, the coated scaffolds induced similar level of fibrous encapsulation with uncoated scaffolds. This study thus provides further insight into the physicochemical characteristics of PCD coatings, adding evidence to the promising potential of PCD-coatings of medical implants.

Osteoblast Cell Response on Polycrystalline Diamond-Coated Additively Manufactured Scaffolds

Additive manufacturing of metals using selective laser melting can create customized parts with various degrees of complexity and geometry for medical implants. However, challenges remain in accepting orthopedic implants due to the bio-inert surface of metal scaffolds, resulting in a lack of osseointegration. Here, we show that polycrystalline diamond (PCD) coatings on selective laser melted titanium (SLM-Ti) scaffolds can improve the cell-to-material interaction of osteoblasts. The results show that by controlling the uniformity of the diamond coatings, we can mediate the biological response of osteoblasts, such as cell adhesion, proliferation, and spreading. The osteoblasts show favorable cell adhesion and spreading on non-planar PCD-coated scaffolds compared to the un-coated SLM-Ti scaffold. This study plays an important role in understanding the key physicochemical behavior of bone cell growth on customized orthopedic implant materials.

Polycrystalline Diamond Coating of Additively Manufactured Titanium for Biomedical Applications

Additive manufacturing using selective laser melted titanium (SLM-Ti) is used to create bespoke items across many diverse fields such as medicine, defense, and aerospace. Despite great progress in orthopedic implant applications, such as for "just in time" implants, significant challenges remain with regards to material osseointegration and the susceptibility to bacterial colonization on the implant. Here, we show that polycrystalline diamond coatings on these titanium samples can enhance biological scaffold interaction improving medical implant applicability. The highly conformable coating exhibited excellent bonding to the substrate. Relative to uncoated SLM-Ti, the diamond coated samples showed enhanced mammalian cell growth, enriched apatite deposition, and reduced microbial S. aureus activity. These results open new opportunities for novel coatings on SLM-Ti devices in general and especially show promise for improved biomedical implants.

Diamond thin films: giving biomedical applications a new shine

Progress made in the last two decades in chemical vapour deposition technology has enabled the production of inexpensive, high-quality coatings made from diamond to become a scientific and commercial reality. Two properties of diamond make it a highly desirable candidate material for biomedical applications: first, it is bioinert, meaning that there is minimal immune response when diamond is implanted into the body, and second, its electrical conductivity can be altered in a controlled manner, from insulating to near-metallic. In vitro, diamond can be used as a substrate upon which a range of biological cells can be cultured. In vivo, diamond thin films have been proposed as coatings for implants and prostheses. Here, we review a large body of data regarding the use of diamond substrates for in vitro cell culture. We also detail more recent work exploring diamond-coated implants with the main targets being bone and neural tissue. We conclude that diamond emerges as one of the major new biomaterials of the twenty-first century that could shape the way medical treatment will be performed, especially when invasive procedures are required.

Optimizing growth and post treatment of diamond for high capacitance neural interfaces

Electrochemical and biological properties are two crucial criteria in the selection of the materials to be used as electrodes for neural interfaces. For neural stimulation, materials are required to exhibit high capacitance and to form intimate contact with neurons for eliciting effective neural responses at acceptably low voltages. Here we report on a new high capacitance material fabricated using nitrogen included ultrananocrystalline diamond (N-UNCD). After exposure to oxygen plasma for 3 h, the activated N-UNCD exhibited extremely high electrochemical capacitance greater than 1 mF/cm(2), which originates from the special hybrid sp(2)/sp(3) structure of N-UNCD. The in vitro biocompatibility of the activated N-UNCD was then assessed using rat cortical neurons and surface roughness was found to be critical for healthy neuron growth, with best results observed on surfaces with a roughness of approximately 20 nm. Therefore, by using oxygen plasma activated N-UNCD with appropriate surface roughness, and considering the chemical and mechanical stability of diamond, the fabricated neural interfaces are expected to exhibit high efficacy, long-term stability and a healthy neuron/electrode interface.