A review of TiO2 NTs on Ti metal: Electrochemical synthesis, functionalization and potential use as bone implants

Biomaterials Designed to Modulate Reactive Oxygen Species for Enhanced Bone Regeneration in Diabetic Conditions

Diabetes mellitus, characterized by enduring hyperglycemia, precipitates oxidative stress, engendering a spectrum of complications, notably increased bone vulnerability. The genesis of reactive oxygen species (ROS), a byproduct of oxygen metabolism, instigates oxidative detriment and impairs bone metabolism in diabetic conditions. This review delves into the mechanisms of ROS generation and its impact on bone homeostasis within the context of diabetes. Furthermore, the review summarizes the cutting-edge progress in the development of ROS-neutralizing biomaterials tailored for the amelioration of diabetic osteopathy. These biomaterials are engineered to modulate ROS dynamics, thereby mitigating inflammatory responses and facilitating bone repair. Additionally, the challenges and therapeutic prospects of ROS-targeted biomaterials in clinical application of diabetic bone disease treatment is addressed.

Impact of Silicon Carbide Coating and Nanotube Diameter on the Antibacterial Properties of Nanostructured Titanium Surfaces

This study aimed to comprehensively assess the influence of the nanotube diameter and the presence of a silicon carbide (SiC) coating on microbial proliferation on nanostructured titanium surfaces. An experiment used 72 anodized titanium sheets with varying nanotube diameters of 50 and 100 nm. These sheets were divided into four groups: non-coated 50 nm titanium nanotubes, SiC-coated 50 nm titanium nanotubes, non-coated 100 nm titanium nanotubes, and SiC-coated 100 nm titanium nanotubes, totaling 36 samples per group. P. gingivalis and T. denticola reference strains were used to evaluate microbial proliferation. Samples were assessed over 3 and 7 days using fluorescence microscopy with a live/dead viability kit and scanning electron microscopy (SEM). At the 3-day time point, fluorescence and SEM images revealed a lower density of microorganisms in the 50 nm samples than in the 100 nm samples. However, there was a consistently low density of T. denticola across all the groups. Fluorescence images indicated that most bacteria were viable at this time. By the 7th day, there was a decrease in the microorganism density, except for T. denticola in the non-coated samples. Additionally, more dead bacteria were detected at this later time point. These findings suggest that the titanium nanotube diameter and the presence of the SiC coating influenced bacterial proliferation. The results hinted at a potential antibacterial effect on the 50 nm diameter and the coated surfaces. These insights contribute valuable knowledge to dental implantology, paving the way for developing innovative strategies to enhance the antimicrobial properties of dental implant materials and mitigate peri-implant infections.

Nanoporous Titanium Implant Surface Accelerates Osteogenesis via the Piezo1/Acetyl-CoA/β-Catenin Pathway

Osseointegration is the most important factor determining implant success. The surface modification of TiO2 nanotubes prepared by anodic oxidation has remarkable advantages in promoting bone formation. However, the mechanism behind this phenomenon is still unintelligible. Here we show that the nanomorphology exhibited open and clean nanotube structure and strong hydrophilicity, and the nanomorphology significantly facilitated the adhesion, proliferation, and osteogenesis differentiation of stem cells. Exploring the mechanism, we found that the nanomorphology can enhance mitochondrial oxidative phosphorylation (OxPhos) by activating Piezo1 and increasing intracellular Ca2+. The increase in OxPhos can significantly uplift the level of acetyl-CoA in the cytoplasm but not significantly raise the level of acetyl-CoA in the nucleus, which was beneficial for the acetylation and stability of β-catenin and ultimately promoted osteogenesis. This study provides a new interpretation for the regulatory mechanism of stem cell osteogenesis by nanomorphology.

Biocompatible antibiotic-coupled nickel-titanium nanoparticles as a potential coating material for biomedical devices

The challenges facing metallic implants for reconstructive surgery include the leaching of toxic metal ions, a mismatch in elastic modulus between the implant and the treated tissue, and the risk of infection. These problems can be addressed by passivating the metal surface with an organic substrate and incorporating antibiotic molecules. Nitinol (NiTi), a nickel-titanium alloy, is used in devices for biomedical applications due to its shape memory and superelasticity. However, unmodified NiTi carries a risk of localized nickel toxicity and inadequately supports angiogenesis or neuroregeneration due to limited cell adhesion, poor biomineralization, and little antibacterial activity. To address these challenges, NiTi nanoparticles were modified using self-assembled phosphonic acid monolayers and functionalized with the antibiotics ceftriaxone and vancomycin via the formation of an amide. Surface modifications were monitored to confirm that phosphonic acid modifications were present on NiTi nanoparticles and 100% of the samples formed ordered films. Modifications were stable for more than a year. Elemental composition showed the presence of nickel, titanium, and phosphorus (1.9% for each sample) after surface modifications. Dynamic light scattering analysis suggested some agglomeration in solution. However, scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy confirmed a particle size distribution of <100 nm, the even distribution of nanoparticles on coverslips, and elemental composition before and after cell culture. B35 neuroblastoma cells exhibited no inhibition of survival and extended neurites of approximately 100 μm in total length when cultured on coverslips coated with only poly-l-lysine or with phosphonic acid-modified NiTi, indicating high biocompatibility. The ability to support neural cell growth and differentiation makes modified NiTi nanoparticles a promising coating for surfaces in metallic bone and nerve implants. NiTi nanoparticles functionalized with ceftriaxone inhibited Escherichia coli and Serratia marcescens (SM6) at doses of 375 and 750 μg whereas the growth of Bacillus subtilis was inhibited by a dose of only 37.5 μg. NiTi-vancomycin was effective against B. subtilis at all doses even after mammalian cell culture. These are common bacteria associated with infected implants, further supporting the potential use of functionalized NiTi in coating reconstructive implants.

Polydopamine-curcumin coating of titanium for remarkable antibacterial activity via synergistic photodynamic and photothermal properties

Combined photothermal therapy (PTT) and photodynamic therapy (PDT) has emerged as a novel and effective antibacterial strategy. In order to endow titanium (Ti) with antibacterial properties, the Ti-PDA-Cur composite was prepared using the excellent adhesion properties of polydopamine (PDA) to load curcumin (Cur) on the surface of Ti. The Ti-PDA-Cur coating can produce singlet oxygen (1O2) and heat under 405 + 808 nm light irradiation, which can effectively kill Staphylococcus aureus and Escherichia coli. Moreover, the cytotoxicity and hemolysis rate of Ti-PDA-Cur were low, indicating its good biocompatibility. Therefore, this study provided a new strategy for the development of new Ti implants.

Anodization as a scalable nanofabrication method to engineer mechanobactericidal nanostructures on complex geometries

Bacterial contamination of implant surfaces is one of the primary causes of their failure, and this threat has been further exacerbated due to the emergence of drug-resistant bacteria. Nanostructured mechanobactericidal surfaces that neutralize bacteria via biophysical forces instead of traditional biochemical routes have emerged as a potential remedy against this issue. Here, we report on the bactericidal activity of titania nanotubes (TNTs) prepared by anodization, a well-established and scalable method. We investigate the differences in bacterial behavior between three different topographies and demonstrate the applicability of this technique on complex three-dimensional (3D) geometries. It was found that the metabolic activity of bacteria on such surfaces was lower, indicative of disturbed intracellular processes. The differences in deformations of the cell wall of Gram-negative and positive bacteria were investigated from electron micrographs Finally, nanoindentation experiments show that the nanotubular topography was durable enough against forces typically experienced in daily life and had minimal deformation under forces exerted by bacteria. Our observations highlight the potential of the anodization technique for fabricating mechanobactericidal surfaces for implants, devices, surgical instruments, and other surfaces in a healthcare setting in a cheap, scalable way.

Surface characterization and antibacterial efficiency of well-ordered TiO2 nanotube surfaces fabricated on titanium foams

Titanium (Ti)-based implants are not compatible enough due to their bio-inert character, insufficient antibacterial capabilities and stress-shielding problem for dental and orthopaedic implant applications. Thus, this work focused to fabricate, analyze and improve antibacterial properties titanium dioxide (TiO2) nanotube array surfaces on Ti foam by anodic oxidation (AO) process. The well-ordered nanotube arrays with approximately 75 nm were successfully fabricated at 40 V for 1 h on Ti foams. Ti and O were observed as major elements on AO-coated Ti foam surfaces. In addition, the existence of TiO2 structure was proved on AO-coated foam Ti surfaces. For potential dental and orthopedic implant application, in vitro antibacterial properties were investigated versus Staphylococcus aureus and Escherichia coli. For both bacteria, antibacterial properties of TiO2 nanotube surface were greater than bare Ti foam. The bacterial inhibition versus Staphylococcus aureus and Escherichia coli of TiO2 nanotube surfaces are improved as 53.3% and 69.4% compared to bare Ti foam.

Cytocompatibility, antibacterial, and corrosion properties of chitosan/polymethacrylates and chitosan/poly(4-vinylpyridine) smart coatings, electrophoretically deposited on nanosilver-decorated titania nanotubes

The development of novel implants subjected to surface modification to achieve high osteointegration properties at simultaneous antimicrobial activity is a highly current problem. This study involved different surface treatments of titanium surface, mainly by electrochemical oxidation to produce a nanotubular oxide layer (TNTs), a subsequent electrochemical reduction of silver nitrate and decoration of a nanotubular surface with silver nanoparticles (AgNPs), and finally electrophoretic deposition (EPD) of a composite of chitosan (CS) and either polymethacrylate-based copolymer Eudragit E 100 (EE100) or poly(4-vinylpyridine) (P4VP) coating. The effects of each stage of this multi-step modification were examined in terms of morphology, roughness, wettability, corrosion resistance, coating-substrate adhesion, antibacterial properties, and osteoblast cell adhesion and proliferation. The results showed that the titanium surface formed nanotubes (inner diameter of 97 ± 12 nm, length of 342 ± 36 nm) subsequently covered with silver nanoparticles (with a diameter of 88 ± 8 nm). Further, the silver-decorated nanotubes were tightly coated with biopolymer films. Most of the applied modifications increased both the roughness and the surface contact angle of the samples. The deposition of biopolymer coatings resulted in reduced burst release of silver. The coated samples revealed potent antimicrobial activity against both Gram-positive and Gram-negative bacteria. Total elimination (99.9%) of E. coli was recorded for a sample with CS/P4VP coating. Cytotoxicity results using hFOB 1.19, a human osteoblast cell line, showed that after 3 days the tested modifications did not affect the cellular growth according to the titanium control. The proposed innovative multilayer antibacterial coatings can be successful for titanium implants as effective postoperative anti-inflammation protection.

Osteoimmune-modulating and BMP-2-eluting anodised 3D printed titanium for accelerated bone regeneration

3D printing of titanium (Ti) metal has potential to transform the field of personalised orthopaedics and dental implants. However, the impacts of controlled surface topographical features of 3D printed Ti implants on their interactions with the cellular microenvironment and incorporation of biological growth factors, which are critical in guiding the integration of implants with bone, are not well studied. In the present study, we explore the role of surface topological features of 3D printed Ti implants using an anodised titania nanotube (TiNT) surface layer in guiding their immune cell interaction and ability to deliver bioactive form of growth factors. TiNT layers with precisely controlled pore diameter (between 21and 130 nm) were anodically grown on 3D printed Ti surfaces to impart a nano-micro rough topology. Immune biomarker profiles at gene and protein levels show that anodised 3D Ti surfaces with smaller pores resulted in classical activation of macrophages (M1-like), while larger pores (i.e., >100 nm) promoted alternate activation of macrophages (M2-like). The in vitro bone mineralisation studies using the conditioned media from the immunomodulatory studies elucidate a clear impact of pore diameter on bone mineralisation. The tubular structure of TiNTs was utilised as a container to incorporate recombinant human bone morphogenetic protein-2 (BMP-2) in the presence of various sugar and polymeric cryoprotectants. Sucrose offered the most sustainable release of preserved BMP-2 from TiNTs. Downstream effects of released BMP-2 on macrophages as well as bone mineralisation were assessed showing bioactivity retention of the released rhBMP-2. Overall, the TiNT surface topography in combination with controlled, sustained, and local release of bioactive growth factors can potentially enhance the osseointegration outcomes of custom 3D printed Ti implants in the clinic.

Biological Activity and Thrombogenic Properties of Oxide Nanotubes on the Ti-13Nb-13Zr Biomedical Alloy

The success of implant treatment is dependent on the osseointegration of the implant. The main goal of this work was to improve the biofunctionality of the Ti-13Nb-13Zr implant alloy by the production of oxide nanotubes (ONTs) layers for better anchoring in the bone and use as an intelligent carrier in drug delivery systems. Anodization of the Ti-13Nb-13Zr alloy was carried out in 0.5% HF, 1 M (NH₄)₂SO₄ + 2% NH₄F, and 1 M ethylene glycol + 4 wt.% NH₄F electrolytes. Physicochemical characteristics of ONTs were performed by high-resolution electron microscopy (HREM), X-ray photoelectron spectroscopy (XPS), and scanning Kelvin probe (SKP). Water contact angle studies were conducted using the sitting airdrop method. In vitro biological properties and release kinetics of ibuprofen were investigated. The results of TEM and XPS studies confirmed the formation of the single-walled ONTs of three generations on the bi-phase (α + β) Ti-13Nb-13Zr alloy. The ONTs were composed of oxides of the alloying elements. The proposed surface modification method ensured good hemolytic properties, no cytotoxity for L-929 mouse cells, good adhesion, increased surface wettability, and improved athrombogenic properties of the Ti-13Nb-13Zr alloy. Nanotubular surfaces allowed ibuprofen to be released from the polymer matrix according to the Gallagher-Corrigan model.

Controlled Delivery of Celecoxib-β-Cyclodextrin Complexes from the Nanostructured Titanium Dioxide Layers

Considering the potential of nanostructured titanium dioxide layers as drug delivery systems, it is advisable to indicate the possibility of creating a functional drug delivery system based on anodic TiO₂ for celecoxib as an alternative anti-inflammatory drug and its inclusion complex with β-cyclodextrin. First, the optimal composition of celecoxib-β-cyclodextrin complexes was synthesized and determined. The effectiveness of the complexation was quantified using isothermal titration calorimetry (ITC), differential scanning calorimetry (DSC), infrared spectroscopy (FT-IR) nuclear magnetic resonance (¹H NMR), and scanning electron microscopy (SEM). Then, nanostructured titanium dioxide layers (TiO₂) were synthesized using the electrochemical oxidation technique. The TiO₂ layers with pore diameters of 60 nm and layer thickness of 1.60 µm were used as drug delivery systems. The samples were modified with pure celecoxib and the β-cyclodextrin-celecoxib complex. The release profiles shown effective drug release from such layers during 24 h. After the initial burst release, the drug was continuously released from the pores. The presented results confirm that the use of nanostructured TiO₂ as a drug delivery system can be effectively used in more complicated systems composed of β-cyclodextrin-celecoxib complexes, making such drugs available for pain treatment, e.g., for orthopedic surgeries.

Characterization and investigation of electrochemical and biological properties of antibacterial silver nanoparticle-deposited TiO2 nanotube array surfaces

The one of main reasons of the premature failure of Ti-based implants is infections. The metal- and metal oxide-based nanoparticles have very high potential on controlling of infections. In this work, the randomly distributed AgNPs-deposited onto well-ordered TiO₂ nanotube surfaces were fabricated on titanium by anodic oxidation (AO) and electrochemical deposition (ED) processes. AgNPs-deposited nanotube surfaces, which is beneficial for bone tissue growth exhibited hydrophilic behaviors. Moreover, the AgNPs-deposited nanotube surfaces, which prevent the leaching of metallic Ti ions from the implant surface, indicated great corrosion resistance under SBF conditions. The electrochemical corrosion resistance of AgNPs-deposited nanotube surfaces was improved up to about 145% compared to bare Gr2 surface. The cell viability of AgNPs-deposited nanotube surfaces was improved. Importantly, the AgNPs-deposited nanotube surfaces exhibited antibacterial activity for Gram-positive and Gram-negative bacteria. Eventually, it can be concluded that the AgNPs-deposited nanotube surfaces possess high stability for long-term usage of implant applications.

Dual-functional composite scaffolds for inhibiting infection and promoting bone regeneration

The treatment of infected bone defects is an intractable problem in orthopedics. It comprises two critical parts, namely that of infection control and bone defect repair. According to these two core tasks during treatment, the ideal approach of simultaneously controlling infection and repairing bone defects is promising treatment strategy. Several engineered biomaterials and drug delivery systems with dual functions of anti-bacterial action and ostogenesis-promotion have been developed and demonstrated excellent therapeutic effects. Compared with the conventional treatment method, the dual-functional composite scaffold can provide one-stage treatment avoiding multiple surgeries, thereby remarkably simplifying the treatment process and reducing the treatment time, overcoming the disadvantages of conventional bone transplantation. In this review, the impaired bone repair ability and its specific mechanisms in the microenvironment of pathogen infection and excessive inflammation were analyzed, providing a theoretical basis for the treatment of infectious bone defects. Furthermore, we discussed the composite dual-functional scaffold composed of a combination of antibacterial and osteogenic material. Finally, a series of advanced drug delivery systems with antibacterial and bone-promoting capabilities were summarized and discussed. This review provides a comprehensive understanding for the microenvironment of infectious bone defects and leading-edge design strategies for the antibacterial and bone-promoting dual-function scaffold, thus providing clinically significant treatment methods for infectious bone defects.

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Antibacterial and bone-promoting dual-function scaffolds are ideal strategies for treatment of infectious bone defects.

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The effect of infection on bone repair was summarized in detail from four important aspects.

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A variety of dual-function scaffolds based on antibacterial and osteogenic materials were discussed.

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Dual-function drug delivery systems promoting repair of infectious bone defects by locally releasing functional agents.

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Leading-edge design strategies, challenges and prospects for dual-functional biomaterials were provided.

Early Antimicrobial Evaluation of Nanostructured Surfaces Based on Bacterial Biological Properties

Nanostructured physical antibacterial surfaces are of great interest due to the increasing antibiotic resistance. In this work, the titania nanotube (TNT) array, a potential physical antibacterial surface, was used for antimicrobial evaluation. The early antibacterial properties of TNTs were assessed based on three growth phases of Staphylococcus aureus (S. aureus), and the physical factors influencing the antibacterial properties were comprehensively discussed. The results show apparent early antibacterial effects of TNTs, including the anti-initial attachment during the lag phase, the inhibition of proliferation and bactericidal effect during the logarithmic phase, and the inhibition of biofilm formation during the stationary phase. These antimicrobial effects are closely related to the combined influence of various physical properties of TNTs, such as diameter, hydrophilicity, roughness, and charge. The present work suggests that the evaluation of the early antimicrobial behavior of biomaterials should pay more attention on the biological characteristics of bacteria.

Dental Implants: Enhancing Biological Response Through Surface Modifications

Surface characteristics are an important factor for long-term clinical success of dental implants. Alterations of implant surface characteristics accelerate or improve osseointegration by interacting with the physiology of bone healing. Dental implant surfaces have been traditionally modified at the microlevel. Recently, researchers have actively investigated nano-modifications in dental implants. This review explores implant surface modifications that enhance biological response at the interface between a bone and the implant.

Construction of a Hierarchical Micro-/Submicro-/Nanostructured 3D-Printed Ti6Al4V Surface Feature to Promote Osteogenesis: Involvement of Sema7A through the ITGB1/FAK/ERK Signaling Pathway

Constructing hierarchical hybrid structures is considered a facile method to improve the osseointegration of implants. Herein, a hierarchical micro-/submicro-/nanostructured surface feature of Ti6Al4V implants (3DAT group) was successfully constructed by combining the inherently formed three-dimensional (3D)-printed microscale topography, acid-etched sub-micropits, and anodized nanotubes. Compared with the classical SLA surface, the microscale topography and sub-micropits increased the three-dimensional space for the cell growth and mechanical stability of implants, while the modification of nanotubes dramatically improved the surface hydrophilicity, protein adsorption, and biomineralization. Most importantly, the 3DAT surface feature possessed excellent osteogenic performance in vitro and in vivo, with the involvement of semaphorin 7A (Sema7A) as revealed by RNA-seq through the ITGB1/FAK/ERK signaling pathway. The present study suggested that the hierarchically structured surface design strategy could accelerate the osseointegration rate of 3D-printed Ti6Al4V implants, promising personalized reconstruction of bone defects.

The Investigation of New Phosphate–Titanite Glasses According to Optical, Physical, and Shielding Properties

The melt-quenching approach was used to prepare phosphate–titanite glasses with the composition P2O5-Na2O-CaO-8KF-CaCl2-xTiO2 (where x = 2, 4, and 6) in a mol %. The optical, physical, and shielding properties, such as the mass attenuation coefficient (MAC), half-value layer (HVL), effective electron density (Neff), and effective atomic number (Zeff), of the glasses were investigated at energies ranging between 15 and 200 keV. The shielding parameters were investigated using recently developed software (MIKE). The optical properties were examined using devices such as UV-Vis-NIR spectroscopy over wavelengths ranging between 190 and 2500 nm. The reported results showed that increasing the concentration of TiO2 led to an increase in the density from 2.657 to 2.682 g/cm3 and an increase in the OPD from 66.055 to 67.262 mol/L, while the molar volume (VM) and oxygen molar volume (VO) decreased from 39.21 to 39.101 cm3/mol and from 15.139 to 14.867 cm3/mol, respectively. The energy gap was found to decrease from 3.403 to 3.279 eV when the TiO2 concentration increased. Furthermore, as the surface plasmon resonance of TiO2 increases, so does its third-order susceptibility, non-linear refractive indices, linear attenuation, and mass attenuation. The shielding performance evaluation indicates that the most suitable energy range is between 15 and 50 keV. Based on the results, the PCKNT3 glass sample exhibits the highest attenuation performance of all of the samples tested.

Effect of bone-shaped nanotube-hydrogel drug delivery system for enhanced osseointegration

Anodic titanium dioxide nanotubes (TNT) have a range of beneficial theranostic properties. However, a lack of effective osseointegration is a problem frequently associated with the titanium dental implant surface. Here, we investigated whether bone-shaped nanotube titanium implants could enhance osseointegration via promoting initial release of vascular endothelial growth factor 165 (VEGF165) and dual release of recombinant human bone morphogenetic protein-2 (rhBMP-2). Thus, we generated cylindrical-shaped nanotubes (TNT1) and bone-shaped nanotubes (TNT2) through voltage-varying and time-varying electrochemical anodization methods, respectively. Additionally, we prepared rhBMP-2-loaded cylindrical-shaped nanotubes/VEGF165-loaded hydrogel (TNT-F1) and rhBMP-2-loaded bone-shaped nanotubes/VEGF165-loaded hydrogel (TNT-F2) drug delivery systems. We evaluated the characteristics and release kinetics of the drug delivery systems, and then analyzed the cytocompatibility and osteogenic differentiation of these specimens with mesenchymal stem cells (MSCs) in vitro. Finally, we utilized a rat femur defect model to test the bone formation capacity of nanotube-hydrogel drug delivery system in vivo. Among these different nanotubes structures, the bone-shaped one was the optimum structure for growth factor release.

A Critical Review of Additive Manufacturing Techniques and Associated Biomaterials Used in Bone Tissue Engineering

With the ability to fabricate complex structures while meeting individual needs, additive manufacturing (AM) offers unprecedented opportunities for bone tissue engineering in the biomedical field. However, traditional metal implants have many adverse effects due to their poor integration with host tissues, and therefore new material implants with porous structures are gradually being developed that are suitable for clinical medical applications. From the perspectives of additive manufacturing technology and materials, this article discusses a suitable manufacturing process for ideal materials for biological bone tissue engineering. It begins with a review of the methods and applicable materials in existing additive manufacturing technologies and their applications in biomedicine, introducing the advantages and disadvantages of various AM technologies. The properties of materials including metals and polymers, commonly used AM technologies, recent developments, and their applications in bone tissue engineering are discussed in detail and summarized. In addition, the main challenges for different metallic and polymer materials, such as biodegradability, anisotropy, growth factors to promote the osteogenic capacity, and enhancement of mechanical properties are also introduced. Finally, the development prospects for AM technologies and biomaterials in bone tissue engineering are considered.

Three interfaces of the dental implant system and their clinical effects on hard and soft tissues

Anatomically, the human tooth has structures both embedded within and forming part of the exterior surface of the human body. When a tooth is lost, it is often replaced by a dental implant, to facilitate the chewing of food and for esthetic purposes. For successful substitution of the lost tooth, hard tissue should be integrated into the implant surface. The microtopography and chemistry of the implant surface have been explored with the aim of enhancing osseointegration. Additionally, clinical implant success is dependent on ensuring that a barrier, comprising strong gingival attachment to an abutment, does not allow the infiltration of oral bacteria into the bone-integrated surface. Epithelial and connective tissue cells respond to the abutment surface, depending on its surface characteristics and the materials from which it is made. In particular, the biomechanics of the implant-abutment connection structure (i.e., the biomechanics of the interface between implant and abutment surfaces, and the screw mechanics of the implant-abutment assembly) are critical for both the soft tissue seal and hard tissue integration. Herein, we discuss the clinical importance of these three interfaces: bone-implant, gingiva-abutment, and implant-abutment.

Nanostructured Titanium Implant Surface Facilitating Osseointegration from Protein Adsorption to Osteogenesis: The Example of TiO2 NTAs

Titanium implants have been widely applied in dentistry and orthopedics due to their biocompatibility and resistance to mechanical fatigue. TiO₂ nanotube arrays (TiO₂ NTAs) on titanium implant surfaces have exhibited excellent biocompatibility, bioactivity, and adjustability, which can significantly promote osseointegration and participate in its entire path. In this review, to give a comprehensive understanding of the osseointegration process, four stages have been divided according to pivotal biological processes, including protein adsorption, inflammatory cell adhesion/inflammatory response, additional relevant cell adhesion and angiogenesis/osteogenesis. The impact of TiO₂ NTAs on osseointegration is clarified in detail from the four stages. The nanotubular layer can manipulate the quantity, the species and the conformation of adsorbed protein. For inflammatory cells adhesion and inflammatory response, TiO₂ NTAs improve macrophage adhesion on the surface and induce M2-polarization. TiO₂ NTAs also facilitate the repairment-related cells adhesion and filopodia formation for additional relevant cells adhesion. In the angiogenesis and osteogenesis stage, TiO₂ NTAs show the ability to induce osteogenic differentiation and the potential for blood vessel formation. In the end, we propose the multi-dimensional regulation of TiO₂ NTAs on titanium implants to achieve highly efficient manipulation of osseointegration, which may provide views on the rational design and development of titanium implants.

Modified TiO₂ nanotubes-zeolite composite photocatalyst: Characteristics, microstructure and applicability for degrading triclocarban

The study explored the characteristics and effectiveness of modified TiO₂ nanotubes with zeolite as a composite photocatalyst (MTNZC) for the degradation of triclocarban (TCC) from the aqueous solution. MTNZC samples have been produced via electrochemical anodisation (ECA) followed by electrophoretic deposition (EPD). Three independent factors selected include MTNZC size (0.5-1 cm²), pH (3-10), and irradiation time (10-60 min). The observation revealed that the surface of Ti substrate by the 40 V of anodisation and 3 h of calcination was covered with the array ordered, smooth and optimum elongated nanotubes with average tube length was approximately 5.1 μm. EDS analysis proved the presence of Si, Mg, Al, and Na on MTNZC due to the chemical composition present in the zeolite. The average crystallite size of TiO₂ nanotubes increased from 2.07 to 3.95 nm by increasing anodisation voltage (10, 40, and 60 V) followed by 450 °C of calcination for 1, 3, and 6 h, respectively. The optimisation by RSM shows the F-value (36.12), the p-value of all responses were less than 0.0001, and the 95% confidence level of the model by all the responses indicated the model was significant. The R² in the range of 0.9433-0.9906 showed the suitability of the model to represent the actual relationship among the parameters. The photocatalytic degradation rate of TCC from the first and the fifth cycles were 94.2 and 77.4%, indicating the applicability of MTNZC to be used for several cycles.

Development of sea urchin type silica stabilised zirconia nanospheres with enhanced antimicrobial and osteoactivity properties

Zirconia based ceramics are giving new hope in hard tissues replacement and implants application. Among the three forms of zirconia (ZrO2), tetragonal form ( t-ZrO2) possess high mechanical stability in comparison with the other two which makes it suitable for fabricating biomedical implants with enhanced osteo activity. Here, tetragonal phase nanospheres consisting of silica stabilised zirconia (1:1) were prepared via sol gel method. The nanospheres exhibit sea urchin type morphology as observed from FESEM analysis. XRD patterns confirm the formation of t -SiO2-ZrO2 binary phase after high temperature calcination at 650°C. The immersion studies in SBF help in the formation of a layer of apatite in a gradual manner over the pallets for the period of 7, 14, 21 and 28 days which was confirmed by XRD, FTIR analysis. Moreover, t- SiO2 – ZrO2 samples were subjected to cytotoxicity tests through MTT assay on MG-63 cell lines. Antibacterial properties were investigated quantitatively using colony forming unit method against both gram positive as well as gram-negative bacteria.

Characterization and Properties of Titanium(IV) Oxide, Synthesized by Different Routes

The article considers the influence of precursor type and sol-gel synthesis conditions of TiO2 on its properties. The obtained TiO2 samples were characterized by X-ray diffraction methods, electron microscopy, as a result of which it was found that all the obtained TiO2 powders have the crystallite size in a nanorange of 2.5–17 nm. It was shown that sorption-photocatalytic properties of TiO2 significantly depend on a phase composition, surface acidity, specific surface area and porosity. It was found that the amorphous TiO2 has improved adsorption properties, while crystalline TiO2 is characterized by enhanced photocatalytic properties. Determined acidic nature of the TiO2 surface explains the better sorption and photocatalysis relative to the cationic dye.

The Deposition of a Lectin from Oreochromis niloticus on the Surface of Titanium Dioxide Nanotubes Improved the Cell Adhesion, Proliferation, and Osteogenic Activity of Osteoblast-like Cells

Titanium and its alloys are used as biomaterials for medical and dental applications, due to their mechanical and physical properties. Surface modifications of titanium with bioactive molecules can increase the osseointegration by improving the interface between the bone and implant. In this work, titanium dioxide nanotubes (TiO2NTs) were functionalized with a lectin from the plasma of the fish Oreochromis niloticus aiming to favor the adhesion and proliferation of osteoblast-like cells, improving its biocompatibility. The TiO2NTs were obtained by anodization of titanium and annealed at 400 °C for 3 h. The resulting TiO2NTs were characterized by high-resolution scanning electron microscopy. The successful incorporation of OniL on the surface of TiO2NTs, by spin coating, was demonstrated by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIE), and attenuated total reflection-Fourier transform infrared spectrum (ATR-FTIR). Our results showed that TiO2NTs were successfully synthesized in a regular and well-distributed way. The modification of TiO2NTs with OniL favored adhesion, proliferation, and the osteogenic activity of osteoblast-like cells, suggesting its use to improve the quality and biocompatibility of titanium-based biomaterials.

Albumin adsorption on microwave-treated titanium dioxide for dental implant materials

Surface modification of biomedical implants is an established strategy to improve osseointegration. TiO₂ nanoflowers (TNF) were deposited on a titanium substrate by hydrothermal technique followed by microwave radiation at 700 W for 5-15 min. Microwave-treated samples were analyzed by X-ray diffraction (XRD), scanning electron microscopy, and Raman spectroscopy to determine their physicochemical characteristics. The XRD and Raman results showed crystalline rutile TiO₂. The surfaces of microwave-treated TNF were hydrophilic with split hierarchical structure. The Sips isotherm was used to analyze BSA adsorption on microwave treated TNF samples. The microwave treatment enhances protein adsorption capacity.

Porous Nanomaterials Targeting Autophagy in Bone Regeneration

Porous nanomaterials (PNMs) are nanosized materials with specially designed porous structures that have been widely used in the bone tissue engineering field due to the fact of their excellent physical and chemical properties such as high porosity, high specific surface area, and ideal biodegradability. Currently, PNMs are mainly used in the following four aspects: (1) as an excellent cargo to deliver bone regenerative growth factors/drugs; (2) as a fluorescent material to trace cell differentiation and bone formation; (3) as a raw material to synthesize or modify tissue engineering scaffolds; (4) as a bio-active substance to regulate cell behavior. Recent advances in the interaction between nanomaterials and cells have revealed that autophagy, a cellular survival mechanism that regulates intracellular activity by degrading/recycling intracellular metabolites, providing energy/nutrients, clearing protein aggregates, destroying organelles, and destroying intracellular pathogens, is associated with the phagocytosis and clearance of nanomaterials as well as material-induced cell differentiation and stress. Autophagy regulates bone remodeling balance via directly participating in the differentiation of osteoclasts and osteoblasts. Moreover, autophagy can regulate bone regeneration by modulating immune cell response, thereby modulating the osteogenic microenvironment. Therefore, autophagy may serve as an effective target for nanomaterials to facilitate the bone regeneration process. Increasingly, studies have shown that PNMs can modulate autophagy to regulate bone regeneration in recent years. This paper summarizes the current advances on the main application of PNMs in bone regeneration, the critical role of autophagy in bone regeneration, and the mechanism of PNMs regulating bone regeneration by targeting autophagy.

RhBMP-2-Loaded PLGA/Titanium Nanotube Delivery System Synergistically Enhances Osseointegration

Although Ti-based implants have been widely used, osseointegration failure can also be found between implants and the surrounding bone tissue, especially in aged patients or in patients with certain systemic diseases. Therefore, in this research, we establish a sustained rhBMP-2 delivery system on a titanium implant surface, an anodic oxidation TiO2 nanotube layer combined with the PLGA film, to enhance osseointegration. This designed system was characterized as follows: surface topography characterization by SEM and AFM; rhBMP-2 release; and the ability to influence MC3T3 cell adhesion, proliferation, and osteogenic differentiation in vitro. Additionally, we evaluated the ability of this system to generate new bone around implants in rabbit tibias by the histological assay and removal torque test. SEM and AFM showed that PLGA membranes were formed on the surfaces of TiO2 nanotube arrays using 1, 3, and 10% PLGA solutions. The 3% PLGA group showed a perfect sustained release of rhBMP-2, lasting for 28 days. Meanwhile, the 3% PLGA group showed improved cell proliferation and osteogenic mRNA expression levels. In the in vivo experiments, the 3% PLGA group had the ability to promote osteogenesis in experimental animals. The anodized TiO2 nanotube coated with a certain thickness of the PLGA layer was an ideal and suitable rhBMP-2 carrier. This modified surface enhances osseointegration and could be useful in clinical dental implant treatment.

Inorganic Agents for Enhanced Angiogenesis of Orthopedic Biomaterials

Aseptic loosening of a permanent prosthesis remains one of the most common reasons for bone implant failure. To improve the fixation between implant and bone tissue as well as enhance blood vessel formation, bioactive agents are incorporated into the surface of the biomaterial. This study reviews and compares five bioactive elements (copper, magnesium, silicon, strontium, and zinc) with respect to their effect on the angiogenic behavior of endothelial cells (ECs) when incorporated on the surface of biomaterials. Moreover, it provides an overview of the state-of-the-art methodologies used for the in vitro assessment of the angiogenic properties of these elements. Two databases are searched using keywords containing ECs and copper, magnesium, silicon, strontium, and zinc. After applying the defined inclusion and exclusion criteria, 59 articles are retained for the final assessment. An overview of the angiogenic properties of five bioactive elements and the methods used for assessment of their in vitro angiogenic potential is presented. The findings show that silicon and strontium can effectively enhance osseointegration through the simultaneous promotion of both angiogenesis and osteogenesis. Therefore, their integration onto the surface of biomaterials can ultimately decrease the incidence of implant failure due to aseptic loosening.

Surface Characterization and Biocompatibility of Hydroxyapatite Coating on Anodized TiO2 Nanotubes via PVD Magnetron Sputtering

Hydroxyapatite (HA) coating has received significant attention in the scientific community for the development of implants, and HA coating on titanium oxide (TiO₂) nanotubes has shown potential benefits in the improvement of cell proliferation, adhesion, and differentiation. In this study, a HA coating on a TiO₂ nanotubular surface was developed to improve the biocompatibility of the titanium (Ti) surface via magnetron sputtering. Scanning electron microscopy (SEM), surface profilometry, and water contact goniometry revealed that HA-coated TiO₂ nanotubes influenced the surface roughness (R_a) and hydrophilicity. The XRD and FTIR peaks indicated the presence of crystalline phases of TiO₂ (anatase) and HA-coated TiO₂ nanotubes after annealing at 500 °C for 120 min. The HA-coated TiO₂ nanotubes showed significantly increased R_a and decreased water contact angle (θ) compared to the as-anodized TiO₂ nanotubular and bare CP-Ti surfaces. MTS assay using osteoblast-like cells confirmed that the HA-coated TiO₂ nanotubular surface provided an enhanced cell attachment and growth when compared to as-anodized TiO₂ nanotubular and pure CP-Ti surfaces.

The Impacts of Crystalline Structure and Different Surface Functional Groups on Drug Release and the Osseointegration Process of Nanostructured TiO2

In implantable materials, surface topography and chemistry are the most important in the effective osseointegration and interaction with drug molecules. Therefore, structural and surface modifications of nanostructured titanium dioxide (TiO2) layers are reported in the present work. In particular, the modification of annealed TiO2 samples with -OH groups and silane derivatives, confirmed by X-ray photoelectron spectroscopy, is shown. Moreover, the ibuprofen release process was studied regarding the desorption-desorption-diffusion (DDD) kinetic model. The results proved that the most significant impact on the release profile is annealing, and further surface modifications did not change its kinetics. Additionally, the cell adhesion and proliferation were examined based on the MTS test and immunofluorescent staining. The obtained data showed that the proposed changes in the surface chemistry enhance the samples' hydrophilicity. Moreover, improvements in the adhesion and proliferation of the MG-63 cells were observed.

A Simple Cerium Coating Strategy for Titanium Oxide Nano-tubes' Bioactivity Enhancement

Despite the well-known favorable chemical and mechanical properties of titanium-based materials for orthopedic and dental applications, poor osseointegration of the implants, bacteria adhesion, and excessive inflammatory response from the host remain major problems to be solved. Here, the antioxidant and anti-inflammatory enzyme-like abilities of ceria (CeO_x) were coupled to the advantageous features of titanium nanotubes (TiNTs). Cost-effective and fast methods, such as electrochemical anodization and drop casting, were used to build active surfaces with enhanced bioactivity. Surface composition, electrochemical response, and in vitro ability to induce hydroxyapatite (HA) precipitation were evaluated. The amount of cerium in the coating did not significantly affect wettability, yet a growing ability to induce early HA precipitation from simulated body fluid (SBF) was observed as the oxide content at the surface increased. The presence of 4%wt CeO_x was also able to stimulate rapid HA maturation in a (poorly) crystalline form, indicating an interesting potential to induce rapid in vivo osseointegration process.

The Use of Anodic Oxides in Practical and Sustainable Devices for Energy Conversion and Storage

This review addresses the main contributions of anodic oxide films synthesized and designed to overcome the current limitations of practical applications in energy conversion and storage devices. We present some strategies adopted to improve the efficiency, stability, and overall performance of these sustainable technologies operating via photo, photoelectrochemical, and electrochemical processes. The facile and scalable synthesis with strict control of the properties combined with the low-cost, high surface area, chemical stability, and unidirectional orientation of these nanostructures make the anodized oxides attractive for these applications. Assuming different functionalities, TiO2-NT is the widely explored anodic oxide in dye-sensitized solar cells, PEC water-splitting systems, fuel cells, supercapacitors, and batteries. However, other nanostructured anodic films based on WO3, CuxO, ZnO, NiO, SnO, Fe2O3, ZrO2, Nb2O5, and Ta2O5 are also explored and act as the respective active layers in several devices. The use of AAO as a structural material to guide the synthesis is also reported. Although in the development stage, the proof-of-concept of these devices demonstrates the feasibility of using the anodic oxide as a component and opens up new perspectives for the industrial and commercial utilization of these technologies.

Silver-Deposited Nanoparticles on the Titanium Nanotubes Surface as a Promising Antibacterial Material into Implants

The main disadvantage of the implants is the associated infections. Therefore, in the long term, the possibility of improving the antibacterial capacity of different types of implants (dental, orthopedic) is being researched. The severity of the problem lies in the increasing bacterial resistance and finding appropriate alternative treatments for infectious diseases, which is an important research field nowadays. The purpose of this review is to draw a parallel between different studies analyzing the antibacterial activity and mechanism of silver nanoparticles (NP Ag) deposited on the titanium nanotubes (NTT), as well as the analysis of the NP Ag toxicity. This review also provides an overview of the synthesis and characterization of TiO2-derived nanotubes (NT). Thus, the analysis aims to present the existing knowledge to better understand the NP Ag implants benefits and their antibacterial activity.

3D Printed Ti-6Al-4V Implant with a Micro/Nanostructured Surface and Its Cellular Responses

Three-dimensional (3D) printing technology has been proved to be a powerful tool for the free-form fabrication of titanium (Ti) implants. However, the surface quality of 3D printed Ti implants is not suitable for clinical application directly. Therefore, surface modification of 3D printed Ti implants is required in order to achieve good biocompatibility and osseointegration. In this study, a novel surface modification method of 3D printed Ti-6Al-4V implants has been proposed, which combined acid etching with hydrothermal treatment to construct micro/nanostructures. Polished TC4 sheets (P), electron beam melting Ti sheets (AE), and micro/nanostructured Ti sheets (AMH) were used in this study to evaluate the effects of different surface morphologies on cellular responses. The surface morphology and 3D topography after treatment were detected via scanning electron microscopy and laser scanning microscopy. The results illustrated that a hierarchical structure comprising micro-valleys and nanowires with a surface roughness of 14.388 μm was successfully constructed. Compared with group P samples, the hydrophilicity of group AMH samples significantly increased with a reduced water contact angle from 54.9° to 4.5°. Cell culture experiments indicated that the micro/nanostructures on the material surface could enhance the cell adhesion and proliferation of MC3T3s. The microstructure could enhance bone-to-implant contact, and the nanostructure could directly interact with some cell membrane receptors. Overall, this study proposes a new strategy to construct micro/nanostructures on the surface of 3D printed Ti-6Al-4V implants and may further serve as a potential modification method for better osteogenesis ability.

Effect of size and crystalline phase of TiO2 nanotubes on cell behaviors: A high throughput study using gradient TiO2 nanotubes

The research of TiO2 nanotubes (TNTs) in the field of biomedicine has been increasingly active. However, given the diversity of the nanoscale dimension and controversial reports, our understanding of the structure-property relationships of TNTs is not yet complete. In this paper, gradient TNTs with a wide diameter range of 20-350 nm were achieved by bipolar electrochemistry and utilized for a thorough high-throughput study of the effect of nanotube dimension and crystalline phase on protein adsorption and cell behaviors. Results indicated that protein adsorption escalated with nanotube dimension whereas cell proliferation and differentiation are preferred on small diameter (<70 nm) nanotubes. Large diameter anatase nanotubes had higher adsorption of serum proteins than as-prepared ones. But only as-prepared small diameter nanotubes presented slightly higher cell proliferation than corresponding annealed nanotubes whereas there was no discernible difference between as-prepared and annealed nanotubes on cell differentiation for the entire gradient. Those findings replenish previous research about how cell responses to TNTs with a wide diameter range and provide scientific guidance for the optimal design of biomedical materials.

Surface Modification Techniques of Titanium and its Alloys to Functionally Optimize Their Biomedical Properties: Thematic Review

Depending on the requirements of specific applications, implanted materials including metals, ceramics, and polymers have been used in various disciplines of medicine. Titanium and its alloys as implant materials play a critical role in the orthopedic and dental procedures. However, they still require the utilization of surface modification technologies to not only achieve the robust osteointegration but also to increase the antibacterial properties, which can avoid the implant-related infections. This article aims to provide a summary of the latest advances in surface modification techniques, of titanium and its alloys, specifically in biomedical applications. These surface techniques include plasma spray, physical vapor deposition, sol-gel, micro-arc oxidation, etc. Moreover, the microstructure evolution is comprehensively discussed, which is followed by enhanced mechanical properties, osseointegration, antibacterial properties, and clinical outcomes. Future researches should focus on the combination of multiple methods or improving the structure and composition of the composite coating to further enhance the coating performance.

Nanointeraction: The profound influence of nanostructured and nano-drug delivery biomedical implant surfaces on cell behavior

Nanostructured surfaces feature promising biological properties on biomaterials attracting large interest at basic research, implant industry development, and bioengineering applications. Thou, nanoscale interactions at a molecular and cellular level are not yet completely understood and its biological and clinical implications need to be further elucidated. As follows, the aim of this comprehensive review was to evaluate nanostructured surfaces at biomedical implants focusing on surface development, nanostructuration, and nanoengineered drug delivery systems that can induce specific cell interactions in all relevant aspects of biological, reparative, anti-bacterial, anti-inflammatory and clinical processes. The methods and the physio-chemical properties involved in nanotopography performance, the main cellular characteristics involved at surface/cell interaction, and a summary of results and outlooks reported in studies applying nanostructured surfaces and nano-drug delivery systems is presented. The future prospects and commercial translation of this developing field, particularly concerning multifunctional nanostructured surfaces and its clinical implications are further discussed. At a cellular level, nanostructured biomedical implant surfaces can enhance osteogenesis by targeting osteoblasts, osteocytes, and mesenchymal cells, stimulate fibroblast/epithelial cells proliferation and adherence, inhibit bacterial cell proliferation and biofilm accumulation, and act as immune-modulating surfaces targeting macrophages and reducing pro-inflammatory cytokine expression. Moreover, several methodological options to create drug-delivery systems on metallic implant surfaces are available, however, the clinical translation is yet incomplete. The efficiency of which nanostructured/nano-delivery surfaces may target specific cell interactions and favor clinical outcomes needs to be further elucidated in pre-clinical and clinical studies, along with engineering solutions for commercial translation and approval of controlling agencies.

Canonical, deprotonated, or zwitterionic? II. A computational study on amino acid interaction with the TiO2(110) rutile surface: comparison with the anatase (101) surface

The adsorption of 11 amino acids (Gly, Leu, Met, Phe, Ser, Cys, Glu, Gln, Arg, Lys, and His) on the TiO₂(110) rutile surface is investigated adopting a theoretical approach, using the PBE-D2* functional as implemented in the periodic VASP code. The adsorption of the amino acids is considered in their canonical, deprotonated and zwitterionic forms. For all cases, the most stable adsorption mode adopts a bidentate (O,O) binding with surface undercoordinated Ti atoms, in agreement with previous experimental and computational studies using glycine as a test case. Such a binding mode is possible due to the surface morphology, because the Ti-Ti distances match very well with the carboxylic O-O distance. The most stable adsorption states are the deprotonated and the zwitterionic ones, the canonical one lying significantly above in energy. The relative stability between the deprotonated and the zwitterionic states results in a delicate trade-off among dative interactions (O, N, and S atoms of the amino acids with Ti atoms of the surface), H-bond interactions, dispersive forces and, to a lesser extent, steric hindrance of the amino acidic lateral chains. Finally, the difference in the amino acid adsorption between the (110) rutile and the (101) anatase surfaces is discussed both from the energetic and surface morphological standpoints, highlighting the larger reactivity of the rutile polymorph in adsorbing and deprotonating the amino acids compared with the anatase one.

In vitro evaluation of a novel nanostructured Ti-36Nb-6Ta alloy for orthopedic applications

Aim: To evaluate the impact of a nanostructured surface created on β-titanium alloy, Ti-36Nb-6Ta, on the growth and differentiation of human mesenchymal stem cells. Materials & methods: The nanotubes, with average diameters 18, 36 and 46 nm, were prepared by anodic oxidation. Morphology, hydrophilicity and mechanical properties of the nanotube layers were characterized. The biocompatibility and osteogenic potential of the nanostructured surfaces were established using various in vitro assays, scanning electron microscopy and confocal microscopy. Results: The nanotubes lowered elastic modulus close to that of bone, positively influenced cell adhesion, improved ALP activity, synthesis of type I collagen and osteocalcin expression, but diminished early cell proliferation. Conclusion: Nanostructured Ti-36Nb-6Ta with nanotube diameters 36 nm was the most promising material for bone implantation.

Biomimetic titanium implant coated with extracellular matrix enhances and accelerates osteogenesis

Aim: To evaluate the biological function of titanium implants coated with cell-derived mineralized extracellular matrix, which mimics a bony microenvironment. Materials & methods: A biomimetic titanium implant was fabricated primarily by modifying the titanium surface with TiO₂ nanotubes or sand-blasted, acid-etched topography, then was coated with mineralized extracellular matrix constructed by culturing bone marrow mesenchymal stromal cells. The osteogenic ability of biomimetic titanium surface in vitro and in vivo were evaluated. Results: In vitro and in vivo studies revealed that the biomimetic titanium implant enhanced and accelerated osteogenesis of bone marrow stromal cells by increasing cell proliferation and calcium deposition. Conclusion: By combining surface topography modification with biological coating, the results provided a valuable method to produce biomimetic titanium implants with excellent osteogenic ability.