A cytocompatible micro/nano-textured surface with Si-doped titania mesoporous arrays fabricated by a one-step anodization

Tubular nanomaterials for bone tissue engineering

Nanomaterial composition, morphology, and mechanical performance are critical parameters for tissue engineering. Within this rapidly expanding space, tubular nanomaterials (TNs), including carbon nanotubes (CNTs), titanium oxide nanotubes (TNTs), halloysite nanotubes (HNTs), silica nanotubes (SiNTs), and hydroxyapatite nanotubes (HANTs) have shown significant potential across a broad range of applications due to their high surface area, versatile surface chemistry, well-defined mechanical properties, excellent biocompatibility, and monodispersity. These include drug delivery vectors, imaging contrast agents, and scaffolds for bone tissue engineering. This review is centered on the recent developments in TN-based biomaterials for structural tissue engineering, with a strong focus on bone tissue regeneration. It includes a detailed literature review on TN-based orthopedic coatings for metallic implants and composite scaffolds to enhance in vivo bone regeneration.

Advancing of Additive-Manufactured Titanium Implants with Bioinspired Micro- to Nanotopographies

There is an increasing demand for low-cost and more efficient titanium (Ti) medical implants that will provide improved osseointegration and at the same time reduce the likelihood of infection. In the past decade, additive manufacturing (AM) using metal selective laser melting (SLM) or three-dimensional (3D) printing techniques has emerged to enable novel implant geometries or properties to overcome such potential challenges. This study presents a new surface engineering approach to create bioinspired multistructured surfaces on SLM-printed Ti alloy (Ti6Al4V) implants by combining SLM technology, electrochemical anodization, and hydrothermal (HT) processes. The resulting implants display unique surfaces with a distinctive dual micro- to nano-topography composed of micron-sized spherical features, fabricated by SLM and vertically aligned nanoscale pillar structures as a result of combining anodization and HT treatment. The fabricated implants enhanced hydroxyapatite-like mineral deposition from simulated body fluid (SBF) compared to control. In addition, normal human osteoblast-like cells (NHBCs) showed strong adhesion to the nano-/microstructures and displayed greater propensity to mineralize compared to control surfaces. This engineering approach and the resulting nature-inspired multiscale-structured surface offers desired features for improving osseointegration and antibacterial performance toward the development of next-generation orthopedic and dental implants.

Biofunctional Elements Incorporated Nano/Microstructured Coatings on Titanium Implants with Enhanced Osteogenic and Antibacterial Performance

Bone fracture is prevalent among athletes and senior citizens and may require surgical insertion of bone implants. Titanium (Ti) and its alloys are widely used in orthopedics due to its high corrosion resistance, good biocompatibility, and modulus compatible with natural bone tissues. However, bone repair and regrowth are impeded by the insufficient intrinsic osteogenetic capability of Ti and Ti alloys and potential bacterial infection. The physicochemical properties of the materials and nano/microstructures on the implant surface are crucial for clinical success and loading with biofunctional elements such as Sr, Zn, Cu, Si, and Ag into nano/microstructured TiO2 coating has been demonstrated to enhance bone repair/regeneration and bacterial resistance of Ti implants. In this review, recent advances in biofunctional element-incorporated nano/microstructured coatings on Ti and Ti alloy implants are described and the prospects and limitations are discussed.

Osteogenic activity of a titanium surface modified with silicon-doped titanium dioxide

Titanium and its alloys are the most widely used implants in clinical practice. However, their bioactivity is unsatisfactory, and the effect of osteogenesis on the bonding interface between the implant and bone needs to be further improved. In this study, a coating consisting of microporous titanium doped with silicon (Si-TiO₂) was successfully created by microarc oxidation (MAO), and Si was evenly distributed on the surface of the coating. The surface morphology, roughness, and phase composition of the Si-TiO₂ microporous coating were similar to those of the Si-free doped MAO coatings. The Si-TiO₂ microporous coating can promote osteoblast adhesion, spreading, proliferation and differentiation. More importantly, the integrin β1-FAK signaling pathway may be involved in the regulatory effect of the coating on osteoblasts. Further studies in vivo indicated that the Si-TiO₂ microporous coating could improve early stage osseointegration. In conclusion, the Si-TiO₂ microporous coating is a feasible way to improve the osteogenic abilities of Ti implants to potentially promote clinical performance.

Engineered titanium implants for localized drug delivery: recent advances and perspectives of Titania nanotubes arrays

INTRODUCTION

Therapeutics delivery to bones to treat skeletal diseases or prevent postsurgical infections is challenging due to complex and solid bone structure that limits blood supply and diffusion of therapeutics administered by systemic routes to reach effective concentration. Titanium (Ti) and their alloys are employed as mainstream implant materials in orthopedics and dentistry; having superior mechanical/biocompatibility properties which could provide an alternative solution to address this problem.

AREAS COVERED

This review presents an overview of recent development of Ti drug-releasing implants, with emphasis on nanoengineered Titania nanotubes (TNTs) structures, for solving key problems to improve implants osseointegration, overcome inflammation and infection together with providing localized drug delivery (LDD) for bone diseases including cancer. Critical analysis of the advantages/disadvantages of developed concepts is discussed, their drug loading/releasing performances and specific applications.

EXPERT OPINION

LDD to bones can address many disorders and postsurgical conditions such as inflammation, implants rejection and infection. To this end, TNTs-Ti implants represent a potential promise for the development of new generation of multifunctional implants with drug release functions. Even this concept is extensively explored recently, there is a strong need for more preclinical studies using animal models to confirm the long-term safety and stability of TNTs-Ti implants for real-life medical applications.

Effects of aspirin-loaded graphene oxide coating of a titanium surface on proliferation and osteogenic differentiation of MC3T3-E1 cells

Graphene oxide (GO) has attracted considerable attention for biomedical applications such as drug delivery because of its two-dimensional structure, which provides a large surface area on both sides of the nanosheet. Here, a new method for titanium (Ti) surface modification involving a GO coating and aspirin (A) loading (A/Ti-GO) was developed, and the bioactive effects on mouse osteoblastic MC3T3-E1 cells were preliminarily studied. The X-ray photoelectron spectrometry indicated new C-O-N, C-Si-O-C, and C-N=C bond formation upon GO coating. Remarkably, the torsion test results showed stable bonding between the GO coating and Ti under a torsional shear force found in clinical settings, in that, there was no tearing or falling off of GO coating from the sample surface. More importantly, through π-π stacking interactions, the release of aspirin loaded on the surface of Ti-GO could sustain for 3 days. Furthermore, the A/Ti-GO surface displayed a significantly higher proliferation rate and differentiation of MC3T3-E1 cells into osteoblasts, which was confirmed by a water-soluble tetrazolium salt-8 (WST-8) assay and alkaline phosphatase activity test. Consequently, Ti surface modification involving GO coating and aspirin loading might be a useful contribution to improve the success rate of Ti implants in patients, especially in bone conditions.

Titanium-based implant comprising a porous microstructure assembled with nanoleaves and controllable silicon-ion release for enhanced osseointegration

Osseointegration is crucial for early fixation as well as for long-term implantation success, hence numerous efforts have been made to tune the surface topography or chemical composition of biomedical implants to improve osseointegration. In this work, various nanostructures, including nanoflocs, nanobundles, nanorods, and nanoleaves, were introduced to the surface of silicon (Si)-incorporated microporous structure to form Si-incorporated micro-nano hierarchical structures on titanium (Ti)-based implants. The osseointegration of the implants were systemically assessed in vivo and in vitro. The in vitro evaluations showed that the nanostructures promoted the protein adsorption, thus modulating the early cellular responses, including the attachment and spreading of osteoblasts and human endothelial cells (HUVECs), and subsequent cell proliferation and differentiation. Furthermore, compared with the single microporous structure, the nanostructures located over the microporous structure protected the Si ions from quick release and allowed the long-term sustained Si-ions release, which further contributed to the proliferation and differentiation of osteoblasts and vascular endothelial growth factor (VEGF) secretion as well as the tube formation of HUVECs. Collectively, the favorable nano-surface structures, especially the nanoleaves structure, and the constant Si-ion release together led to robust osteogenic and angiogenic activities. More importantly, in vivo micro-CT evaluation and histological observations further verified that the Si-incorporated micro-nano hierarchical implant with nanoleaves structure could efficiently promote new bone formation, thus indicating it was an attractive candidate as a next-generation bone-implant material.

Engineering of Micro- to Nanostructured 3D-Printed Drug-Releasing Titanium Implants for Enhanced Osseointegration and Localized Delivery of Anticancer Drugs

Primary and secondary bone cancers are major causes of pathological bone fractures which are usually treated through implant fixation and chemotherapy. However, both approaches face many limitations. On one hand, implants may suffer from poor osseointegration, and their rejection results in repeated surgery, patient's suffering, and extensive expenses. On the other hand, there are severe systemic adverse effects of toxic chemotherapeutics which are administrated systemically. In this paper, in order to address these two problems, we present a new type of localized drug-releasing titanium implants with enhanced implants' biointegration and drug release capabilities that could provide a high concentration of anticancer drugs locally to treat bone cancers. The implants are fabricated by 3D printing of Ti alloy followed by an anodization process featuring unique micro- (particles) and nanosurface (tubular arrays) topography. We successfully demonstrate their enhanced bone osseointegration and drug loading capabilities using two types of anticancer drugs, doxorubicin (DOX) and apoptosis-inducing ligand (Apo2L/TRAIL). In vitro study showed strong anticancer efficacy against cancer cells (MDA-MB-231-TXSA), confirming that these drug-releasing implants can be used for localized chemotherapy for treatment of primary and secondary bone cancers together with fracture support.