Construction of surface HA/TiO2 coating on porous titanium scaffolds and its preliminary biological evaluation

Photothermal Antibacterial and Osteoinductive Polypyrrole@Cu Implants for Biological Tissue Replacement

The treatment of bone defects caused by disease or accidents through the use of implants presents significant clinical challenges. After clinical implantation, these materials attract and accumulate bacteria and hinder the integration of the implant with bone tissue due to the lack of osteoinductive properties, both of which can cause postoperative infection and even lead to the eventual failure of the operation. This work successfully prepared a novel biomaterial coating with multiple antibacterial mechanisms for potent and durable and osteoinductive biological tissue replacement by pulsed PED (electrochemical deposition). By effectively regulating PPy (polypyrrole), the uniform composite coating achieved sound physiological stability. Furthermore, the photothermal analysis showcased exceptional potent photothermal antibacterial activity. The antibacterial assessments revealed a bacterial eradication rate of 100% for the PPy@Cu/PD composite coating following a 24 h incubation. Upon the introduction of NIR (near-infrared) irradiation, the combined effects of multiple antibacterial mechanisms led to bacterial reduction rates of 99% for E. coli and 98% for S. aureus after a 6 h incubation. Additionally, the successful promotion of osteoblast proliferation was confirmed through the application of the osteoinductive drug PD (pamidronate disodium) on the composite coating's surface. Therefore, the antimicrobial Ti-based coatings with osteoinductive properties and potent and durable antibacterial properties could serve as ideal bone implants.

Effect of different HA/β-TCP coated 3D printed bioceramic scaffolds on repairing large bone defects in rabbits

BACKGROUND

Treatment of large segmental bone defects is still a major clinical challenge, and bone grafting is the main method. The development of novel bone graft substitutes will help solve this problem.

METHODS

Porous bioceramics hydroxyapatite (HA) scaffolds coated with different ratios of HA/β-tricalcium phosphate (β-TCP) were prepared by 3D printing. The scaffolds were sampled and tested in large segmental bone defect rabbit models. X-ray, micro-computed tomography (CT), hematoxylin and eosin (HE) staining, Van-Gieson staining, and type I collagen staining were performed to find the best scaffolds for large segmental bone defect treatment.

RESULTS

The average length, diameter, compressive strength, and porosity of the bioceramics scaffolds were 15.05 ± 0.10 mm, 4.98 ± 0.06 mm, 11.11 ± 0.77 MPa, and 54.26 ± 5.38%, respectively. Postoperative lateral radiographs suggested the scaffold group got better bone healing and stability than the blank group. Micro-CT showed new bones grew into the scaffold from the two ends of the fracture along the scaffold and finally achieved bony union. The new bone volume around the scaffolds suggested the 3:7 HA/β-TCP-coated bioceramic scaffolds were more favorable for the healing of large segmental bone defects. The results of HE, Van-Gieson, and type I collagen staining also suggested more new bone formation in 3:7 HA/β-TCP-coated bioceramic scaffolds.

CONCLUSION

3:7 HA/β-TCP-coated porous bioceramics scaffolds are more conducive to the repair of large bone defects in rabbits. The results of this study can provide some reference and theoretical support in this area.

Effect of acid-alkali treatment on serum protein adsorption and bacterial adhesion to porous titanium

Modification of the titanium (Ti) surface is widely known to influence biological reactions such as protein adsorption and bacterial adhesion in vivo, ultimately controlling osseointegration. In this study, we sought to investigate the correlation of protein adsorption and bacterial adhesion with the nanoporous structure of acid-alkali-treated Ti implants, shedding light on the modification of Ti implants to promote osseointegration. We fabricated nontreated porous Ti (NTPT) by powder metallurgy and immersed it in mixed acids and NaOH to obtain acid-alkali-treated porous Ti (AAPT). Nontreated dense sample (NTDT) served as control. Our results showed that nanopores were formed after acid-alkali treatment. AAPT showed a higher specific surface area and became much more hydrophilic than NTPT and NTDT (p < 0.001). Compared to dense samples, porous samples exhibited a lower zeta potential and higher adsorbed protein level at each time point within 120 min (p < 0.001). AAPT formed a thicker protein layer by serum precoating than NTPT and NTDT (p < 0.001). The main adsorbed proteins on AAPT and NTPT were albumin, α1 antitrypsin, transferrin, apolipoprotein A1, complement C3 and haptoglobin α1 chain. The amounts of bacteria adhering to the serum-precoated samples were lower than those adhering to the nonprecoated samples (p < 0.05). Lower-molecular-weight proteins showed higher affinity to porous Ti. In conclusion, acid-alkali treatment facilitated protein adsorption by porous Ti, and the protein coating tended to prevent bacteria from adhering. These findings may be utilized for Ti implant modification aimed at reducing bacterial adhesion and enhancing osseointegration. Graphical abstract.

Structural and Material Determinants Influencing the Behavior of Porous Ti and Its Alloys Made by Additive Manufacturing Techniques for Biomedical Applications

One of the biggest challenges in tissue engineering is the manufacturing of porous structures that are customized in size and shape and that mimic natural bone structure. Additive manufacturing is known as a sufficient method to produce 3D porous structures used as bone substitutes in large segmental bone defects. The literature indicates that the mechanical and biological properties of scaffolds highly depend on geometrical features of structure (pore size, pore shape, porosity), surface morphology, and chemistry. The objective of this review is to present the latest advances and trends in the development of titanium scaffolds concerning the relationships between applied materials, manufacturing methods, and interior architecture determined by porosity, pore shape, and size, and the mechanical, biological, chemical, and physical properties. Such a review is assumed to show the real achievements and, on the other side, shortages in so far research.

The morphological effect of nanostructured hydroxyapatite coatings on the osteoinduction and osteogenic capacity of porous titanium

Weak osteogenic activity affects the long-term fixation and lifespan of titanium (Ti) implants. Surface modification along with a built-in porous structure is a highly considerable approach to improve the osteoinduction and osseointegration capacity of Ti. Herein, the osteoinduction and osteogenic activities of electrochemically deposited (ED) nanoplate-like, nanorod-like and nanoneedle-like hydroxyapatite (HA) coatings (named EDHA-P, EDHA-R, and EDHA-N, respectively) were evaluated in vitro and in vivo by comparison with those of acid/alkali (AA) treatment. The results revealed that the apatite forming ability of all nanostructured EDHA coatings was excellent, and only 12 h of soaking in SBF was needed to induce a complete layer of apatite. More serum proteins adsorbed on EDHA-P than others. In cellular experiments, different from those on EDHA-R and EDHA-N, the cells on EDHA-P presented a polygonal shape with lamellipodia extension, and thus exhibited a relatively larger spreading area. Furthermore, EDHA-P was more favorable for the enhancement of the proliferation and ALP activity of BMSCs, and the up-regulation of OPN gene expression. Based on the good biological performance in vitro, EDHA-P was selected to further evaluate its osteoinduction and osteogenic activities in vivo by comparison with AA treatment. Interestingly, a greater ability of ectopic osteoinduction was observed in the EDHA-P group compared to that in the AA group. At the osseous site, EDHA-P promoted more bone on/ingrowth, and had a higher area percentage of newly formed bone in the bone-implant interface and inner pores of the implants than in the AA group. Thus, a nanoplate-like HA coating has good potential in improving the osteoinductivity and osteogenic activity of porous Ti implants in clinical applications.

3D printed titanium scaffolds with homogeneous diamond-like structures mimicking that of the osteocyte microenvironment and its bone regeneration study

Biofabrication of personalized titanium scaffold mimicking that of the osteocyte microenvironment is challenging due to its complex geometrical cues. The effect of scaffolds geometrical cues and implantation sites on osteogenesis is still not clear. In this study, personalized titanium scaffolds with homogeneous diamond-like structures mimicking that of the osteocyte microenvironment were precisely designed and fabricated by selected laser melting method. The effects of different geometric cues, including porosity, pore sizes and interconnection properties, on cellular behavior were investigated. Biomimetic mechanical properties of porous titanium alloy scaffold were predesigned and simulated by finite element analysis. In vitro experiment revealed that homogeneous diamond-like structures mimicking that of the osteocyte microenvironment triggered osteocyte adhesion and migration behavior. Typical implantation sites, including rabbit femur, beagle femur, and beagle skull, were used to study the implantation sites effects on bone regeneration. In vivo experimental results indicated that different implantation sites showed significant differences. This study helps to understand the scaffolds geometrical microenvironment and implantation sites effects on osteogenesis mechanism. And it is beneficial to the development of bone implants with better bone regeneration ability.

HA-hybrid matrix composite coating on Ti-Cp for biomedical application

Calcium phosphate coatings have been applied to titanium metal substrates and their alloys as a synergistic alternative capable of combining the mechanical properties of metals and the excellent bioactive properties provided by ceramic materials. However, the unsatisfactory adhesion of hydroxyapatite coatings on metallic substrates, as well as their limitation when subjected to mechanical stresses have been reported as a limitation. Biofunctional coatings have been proposed as an alternative to single ceramic coatings, aiming at optimizing the long-term clinical success of biomaterials such as Ti. This work aims at evaluating the morphological properties and biological behavior of Ti-cp coated with matrix composite coating hydroxyapatite-containing hybrid. The hybrid matrix was obtained from TEOS and MTES silicon precursors, with dispersed hydroxyapatite suspended by dip coating. For the morphological characterization FTIR, SEM/FEG, AFM and contact angle measurement were used. Biological behavior was evaluated for toxicity, cell viability and the osteogenic differentiation capacity of mesenchymal stem cells. The composite coatings obtained showed regular dispersion of hydroxyapatite particles in the hybrid matrix, with uniform coating adhering to the Ti-Cp substrate. Nevertheless, although they provided similar viability behavior of mesenchymal stem cells to the Ti-Cp substrate, the evaluated coatings did not present osteoinductive properties. This result is probably due to the pronounced hydrophobic behavior caused by the incorporation of HA.

Electrochemical Deposition of Nanostructured Hydroxyapatite Coating on Titanium with Enhanced Early Stage Osteogenic Activity and Osseointegration

Purpose

The aim of research is to fabricate nanostructured hydroxyapatite (HA) coatings on the titanium via electrochemical deposition (ED). Additionally, the biological properties of the ED-produced HA (EDHA) coatings with a plate-like nanostructure were evaluated in vitro and in vivo by undertaking comparisons with those prepared by acid/alkali (AA) treatment and by plasma spray-produced HA (PSHA) nanotopography-free coatings.

Materials and Methods

Nanoplate-like HA coatings were prepared through ED, and nanotopography-free PSHA coatings were fabricated. The surface morphology, phase composition, roughness, and wettability of these samples were investigated. Furthermore, the growth, proliferation, and osteogenic differentiation of MC3T3-E1 cells cultured on each sample were evaluated via in vitro experiments. Histological assessment and push-out tests for the bone–implant interface were performed to explore the effect of the EDHA coatings on the interfacial osseointegration in vivo.

Results

XRD analysis showed that the strongest intensity for the EDHA coatings was at the (002) plane rather than at the regular (211) plane. Relatively higher surface roughness and greater wettability were observed for the EDHA coatings. Cellular experiments revealed that the plate-like nanostructured EDHA coatings not only possessed an ability, similar to that of PSHA coatings, to promote the adhesion and proliferation of MC3T3-E1 cells but also demonstrated significantly enhanced early or intermediate markers of osteogenic differentiation. Significant osseointegration enhancement in the early stage of implantation period and great bonding strength were observed at the interface of bone and EDHA samples. In comparison, relatively weak osseointegration and bonding strength of the bone–implant interface were observed for the AA treatment.

Conclusion

The biological performance of the plate-like nanostructured EDHA coating, which was comparable with that of the PSHA, improves early-stage osteogenic differentiation and osseointegration abilities and has great potential for enhancing the initial stability and long-term survival of uncemented or 3D porous titanium implants.

In-Situ Synthesis and Characterization of Chitosan/Hydroxyapatite Nanocomposite Coatings to Improve the Bioactive Properties of Ti6Al4V Substrates

Ti6Al4V alloy is still attracting great interest because of its application as an implant material for hard tissue repair. This research aims to produce and investigate in-situ chitosan/hydroxyapatite (CS/HA) nanocomposite coatings based on different amounts of HA (10, 50 and 60 wt.%) on alkali-treated Ti6Al4V substrate through the sol-gel process to enhance in vitro bioactivity. The influence of different contents of HA on the morphology, contact angle, roughness, adhesion strength, and in vitro bioactivity of the CS/HA coatings was studied. Results confirmed that, with increasing the HA content, the surface morphology of crack-free CS/HA coatings changed for nucleation modification and HA nanocrystals growth, and consequently, the surface roughness of the coatings increased. Furthermore, the bioactivity of the CS/HA nanocomposite coatings enhanced bone-like apatite layer formation on the material surface with increasing HA content. Moreover, CS/HA nanocomposite coatings were biocompatible and, in particular, CS/10 wt.% HA composition significantly promoted human mesenchymal stem cells (hMSCs) proliferation. In particular, these results demonstrate that the treatment strategy used during the bioprocess was able to improve in vitro properties enough to meet the clinical performance. Indeed, it is predicted that the dense and crack-free CS/HA nanocomposite coatings suggest good potential application as dental implants.

Effects of Nanotopography Regulation and Silicon Doping on Angiogenic and Osteogenic Activities of Hydroxyapatite Coating on Titanium Implant

Background

Angiogenic and osteogenic activities are two major problems with biomedical titanium (Ti) and other orthopedic implants used to repair large bone defects.

Purpose

The aim of this study is to prepare hydroxyapatite (HA) coatings on the surface of Ti by using electrochemical deposition (ED), and to evaluate the effects of nanotopography and silicon (Si) doping on the angiogenic and osteogenic activities of the coating in vitro.

Materials and Methods

HA coating and Si-doped HA (HS) coatings with varying nanotopographies were fabricated using two ED modes, ie, the pulsive current (PC) and cyclic voltammetry (CV) methods. The coatings were characterized through scanning electron microscope (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), X-ray photoelectron spectrometer (XPS), and atomic force microscopy (AFM), and their in vitro bioactivity and protein adsorption were assessed. Using MC3T3-E1 pre-osteoblasts and HUVECs as cell models, the osteogenic and angiogenic capabilities of the coatings were evaluated through in vitro cellular experiments.

Results

By controlling Si content in ~0.8 wt.%, the coatings resulting from the PC mode (HA-PC and HS-PC) and CV mode (HA-CV and HS-CV) had nanosheet and nanorod topographies, respectively. At lower crystallinity, higher ionic dissolution, smaller contact angle, higher surface roughness, and more negative zeta potential, the HS and PC samples exhibited quicker apatite deposition and higher BSA adsorption capacity. The in vitro cell study showed that Si doping was more favorable for enhancing the viability of the MC3T3-E1 cells, but nanosheet coating increased the area for cell spreading. Of the four coatings, HS-PC with Si doping and nanosheet topography exhibited the best effect in terms of up-regulating the expressions of the osteogenic genes (ALP, Col-I, OSX, OPN and OCN) in the MC3T3-E1 cells. Moreover, all leach liquors of the surface-coated Ti disks promoted the growth of the HUVECs, and the HS samples played a more significant role in promoting cell migration and tube formation than the HA samples. Of the four leach liquors, only the two HS samples up-regulated NO content and expressions of the angiogenesis-related genes (VEGF, bFGF and eNOS) in the HUVECs, and the HS-PC yielded a better effect.

Conclusion

The results show that Si doping while regulating the topography of the coating can help enhance the bone regeneration and vascularization of HA-coated Ti implants.

The optimized preparation of HA/L-TiO2/D-TiO2 composite coating on porous titanium and its effect on the behavior osteoblasts

Various surface bioactivation technology has been confirmed to improve the osteogenic ability of porous titanium (pTi) implants effectively. In this study, a three-layered composite coating, i.e. outer layer of hydroxyapatite (HA), middle layer of loose titanium dioxide (L-TiO₂) and inner layer of dense TiO₂ (D-TiO₂), was fabricated on pTi by a combined processing procedure of pickling, alkali heat (AH), anodic oxidation (AO), electrochemical deposition (ED) and hydrothermal treatment (HT). After soaking in simulated body fluid for 48 h, the surface of the AHAOEDHT-treated pTi was completely covered by a homogeneous apatite layer. Using MC3T3-E1 pro-osteoblasts as cell model, the cell culture revealed that both the pTi without surface treatment and the AHAOEDHT sample could support the attachment, growth and proliferation of the cells. Compared to the pTi sample, the AHAOEDHT one induced higher expressions of osteogenesis-related genes in the cells, including alkaline phosphatase, Type I collagen, osteopontin, osteoclast inhibitor, osteocalcin and zinc finger structure transcription factor. As thus, besides the good corrosion resistance, the HA/L-TiO₂/D-TiO₂-coated pTi had good osteogenic activity, showing good potential in practical application for bone defect repair.

Porous Tantalum and Titanium in Orthopedics: A Review

Porous metal is metal with special porous structures, which can offer high biocompatibility and low Young's modulus to satisfy the need for orthopedic applications. Titanium and tantalum are the most widely used porous metals in orthopedics due to their excellent biomechanical properties and biocompatibility. Porous titanium and tantalum have been studied and applied for a long history until now. Here in this review, various manufacturing methods of titanium and tantalum porous metals are introduced. Application of these porous metals in different parts of the body are summarized, and strengths and weaknesses of these porous metal implants in clinical practice are discussed frankly for future improvement from the viewpoint of orthopedic surgeons. Then according to the requirements from clinics, progress in research for clinical use is illustrated in four aspects. Various creative designs of microporous and functionally gradient structure, surface modification, and functional compound systems of porous metal are exhibited as reference for future research. Finally, the directions of orthopedic porous metal development were proposed from the clinical view based on the rapid progress of additive manufacturing. Controllable design of both macroscopic anatomical bionic shape and microscopic functional bionic gradient porous metal, which could meet the rigorous mechanical demand of bone reconstruction, should be developed as the focus. The modification of a porous metal surface and construction of a functional porous metal compound system, empowering stronger cell proliferation and antimicrobial and antineoplastic property to the porous metal implant, also should be taken into consideration.

Application of hydroxyapatite nanoparticles in tumor-associated bone segmental defect

Hydroxyapatite (HA) has been widely applied in bone repair because of its superior biocompatibility. Recently, a proliferation-suppressive effect of HA nanoparticles (n-HA) against various cancer cells was reported. This study was aimed at assessing the translational value of n-HA both as a bone-regenerating material and as an antitumor agent. Inhibition of tumor growth, prevention of metastasis, and enhancement of the survival rate of tumor-bearing rabbits treated with n-HA were demonstrated. Activated mitochondrial-dependent apoptosis in vivo was confirmed, and we observed that a stimulated immune response was involved in the n-HA-induced antitumor effect. A porous titanium scaffold loaded with n-HA was fabricated and implanted into a critical-sized segmental bone defect in a rabbit tumor model. The n-HA-releasing scaffold not only showed a prominent effect in suppressing tumor growth and osteolytic lesion but also promoted bone regeneration. These findings provide a rationale for using n-HA in tumor-associated bone segmental defects.

Dual modulation of crystallinity and macro-/microstructures of 3D printed porous titanium implants to enhance stability and osseointegration

The macro architecture and micro surface topological morphology of implants play essential roles in bone tissue regeneration.

Evaluation and regulation of the corrosion resistance of macroporous titanium scaffolds with bioactive surface films for biomedical applications

A three-layer bioactive film on porous titanium was constructed and evaluated for its corrosion resistance via electrochemical analysis.

Additive manufacturing of bone scaffolds

Additive manufacturing (AM) can obtain not only customized external shape but also porous internal structure for scaffolds, both of which are of great importance for repairing large segmental bone defects. The scaffold fabrication process generally involves scaffold design, AM, and post-treatments. Thus, this article firstly reviews the state-of-the-art of scaffold design, including computer-aided design, reverse modeling, topology optimization, and mathematical modeling. In addition, the current characteristics of several typical AM techniques, including selective laser sintering, fused deposition modeling (FDM), and electron beam melting (EBM), especially their advantages and limitations are presented. In particular, selective laser sintering is able to obtain scaffolds with nanoscale grains, due to its high heating rate and a short holding time. However, this character usually results in insufficient densification. FDM can fabricate scaffolds with a relative high accuracy of pore structure but with a relative low mechanical strength. EBM with a high beam-material coupling efficiency can process high melting point metals, but it exhibits a low-resolution and poor surface quality. Furthermore, the common post-treatments, with main focus on heat and surface treatments, which are applied to improve the comprehensive performance are also discussed. Finally, this review also discusses the future directions for AM scaffolds for bone tissue engineering.

Osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with nano-hydroxyapatite particles

Background

The aim of this study was to evaluate osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with hydroxy apatite used to augment large boney defects in a dog model.

Methods

Surgical defects were made bilaterally on the lower jaw of 12 Beagle dogs. Cone beam CT images were used to create three dimensional images of the healed defects. Porous zirconia scaffolds were fabricated by milling custom made CAD/CAM blocks into the desired shape. After sintering, the pores of half of the scaffolds were filled with a nano-hydroxy apatite (HA) powder while the other half served as control. The scaffolds were inserted bilaterally in the healed mandibular jaw defects and were secured in position by resorbable fixation screws. After a healing time of 6 weeks, bone-scaffold interface was subjected to histomorphometric analysis to detect the amount of new bone formation. Stained histological sections were analyzed using a computer software (n=12, α=0.05). Mercury porosimetery was used to measure pore sizes, chemical composition was analyzed using energy dispersive x-ray analysis (EDX), and the crystal structure was identified using x-ray diffraction micro-analysis (XRD).

Results

HA enriched zirconia scaffolds revealed significantly higher volume of new bone formation (33% ± 14) compared to the controls (21% ± 11). New bone deposition started by coating the pore cavity walls and proceeded by filling the entire pore volume. Bone in-growth started from the surface of the scaffold and propagated towards the scaffold core. Islands of entrapped hydroxy apatite particles were observed in mineralized bone matrix.

Conclusions

Within the limitations of this study, hydroxy apatite enhanced osteogenesis ability of porous zirconia scaffolds.