Anodic oxide films containing Ca and P of titanium biomaterial

Citrus-Fruit-Based Hydroxyapatite Anodization Coatings on Titanium Implants

The increasing demand for titanium implants necessitates improved longevity. Plasma-sprayed hydroxyapatite coatings enhance implant osseointegration but are susceptible to delamination. Alternatively, anodized hydroxyapatite coatings have shown greater adhesion strengths. The present study aimed to develop anodized hydroxyapatite coatings on titanium using commercial calcium-fortified fruit juice as a calcium source. Varying the electrolyte compositions enabled the formation of four oxide groups with different predominate calcium compounds. Each oxide's morphology, crystallinity, chemistry, molecular structure, and adhesion quality were compared and contrasted. Nanoscale SEM images revealed a progression from porous surface oxide to white surface deposits to petal-like hydroxyapatite structures with the changing anodization electrolytes. Oxide thickness evaluations showed progression from a single-layered oxide with low Ca-, P-, and Mg-dopant incorporations to bi-layered oxide structures with increased Ca-, P-, and Mg-dopant incorporation with changing electrolytes. The bi-layered oxide structures exhibited a titanium-dioxide-rich inner layer and calcium-compound-rich outer layers. Furthermore, indentation analyses confirmed good adhesion quality for three oxides. For the predominate hydroxyapatite oxides, FTIR analyses showed carbonate substitutions indicating the presence of bone-like apatite formation, and ICP-OES analyses revealed prolonged Ca and Mg release over 30 days. These Mg-enhanced carbonated apatite coatings show much promise to improve osseointegration and future implant lifetimes.

Influence of Ultrasound on the Characteristics of CaP Coatings Generated Via the Micro-arc Oxidation Process in Relation to Biomedical Engineering

Over the past decade, bone tissue engineering has been at the core of attention because of an increasing number of implant surgeries. The purpose of this study was to obtain coatings on titanium (Ti) implants with improved properties in terms of biomedical applications and to investigate the effect of ultrasound (US) on these properties during the micro-arc oxidation (MAO) process. The influence of various process parameters, such as time and current density, as well as US mode, on the properties of such coatings was evaluated. Novel porous calcium-phosphate-based coatings were obtained on commercially pure Ti. Their microstructure, chemical composition, topography, wettability, nanomechanical properties, thickness, adhesion to the substrate, and corrosion resistance were analyzed. In addition, cytocompatibility evaluation was checked with the human osteoblasts. The properties of the coatings varied significantly, depending on applied process parameters. The US application during the MAO process contributes to the increase of coating thickness, porosity, roughness, and skewness, as well as augmented calcium incorporation. The most advantageous coating was obtained at a current of 136 mA, time 450 s, and unipolar rectangular US, as it exhibits high porosity, adequate wettability, and beneficial skewness, which enabled increased adhesion and proliferation of osteoblasts during in vitro studies. Finally, the conducted research demonstrated the influence of various UMAO process parameters, which allowed for the selection of appropriate Ti implant modification for specific biomedical utilization.

Trabecular structural difference between the superior and inferior regions of the vertebral body: a cadaveric and clinical study

Background

Osteoporotic vertebral compression fractures commonly involve the superior vertebral body; however, their associated causes have not yet been clearly established. This study aimed to determine the trabecular structural differences between the superior and inferior regions of the vertebral body using cadaveric and clinical studies.

Materials and methods

First, five vertebrae were collected from three human cadavers. The trabecular structures of the superior and inferior regions of each vertebral body were analyzed using micro-computed tomography (micro-CT), finite element analysis (FEA), and biomechanical test. Based on the results of the ex vivo study, we conducted a clinical study. Second, spine CT images were retrospectively collected. Bone volume and Hounsfield unit were analyzed for 192 vertebral bodies. Finally, after sample size calculation based on the pilot study, prospectively, 200 participants underwent dual-energy X-ray absorptiometry (DXA) of the lateral spine. The bone mineral densities (BMDs) of the superior and inferior regions of each lumbar vertebral body were measured. The paired t-test and Wilcoxon signed-rank test were used for the statistical analyses, and p-value < 0.05 was considered significant.

Results

Cadaver studies revealed differences between the superior and inferior trabecular bone structures. The bone volume ratio, BMD, and various other trabecular parameters advocated for decreased strength of the superior region. Throughout the biomechanical study, the limitations of the compression force were 3.44 and 4.63 N/m2 for the superior and inferior regions, respectively. In the FEA study, the inferior region had a lower average displacement and higher von Mises stress than the superior region. In the clinical spine CT-based bone volume and BMD study, the bone volume was significantly higher in the inferior region than in the superior region. In the lateral spine DXA, the mean BMD of the superior region of vertebral bodies was significantly lower compared with that of the inferior region.

Conclusion

The superior trabecular structure of the lumbar vertebral bodies possesses more biomechanical susceptibility compared with the inferior trabecular structure, confirming its dominant role in causing osteoporotic vertebral fractures. Physicians should also focus on the BMD values of the superior region of the vertebral body using lateral spine DXA to evaluate osteoporosis.

Minimum 10-year follow-up of micro-arc oxidation coating on a cementless grit-blasted tapered-wedge stem of total hip arthroplasty: a multicentre study

BACKGROUND

Recently, a femoral stem treated with grit-blasting and micro-arc oxidation (MAO) coating has commercialised but medium-term follow-up studies are lacking. The aim of this study was to report the outcome of a grit-blasted and MAO-coated femoral component designed as a straight, double-wedged, tapered stem with a rectangular cross-section with minimum 10 years follow-up.

METHODS

Between March 2006 and December 2008, 309 primary total hip arthroplasties using a grit-blasted and MAO-coated femoral component were performed by 3 experienced hip surgeons in 3 hospitals. At minimum 10 years after index THA, 299 hips were living, 10 hips were deceased, and 65 hips were lost to follow-up or had a follow-up period <10 years. Finally, 234 hips were enrolled in this study.

RESULTS

Mean duration of clinical follow-up was 129.6 months. The mean Harris Hip Score was improved from 46.9 to 88.4 at the final follow-up. 4 hips were revised for 2 aseptic femoral loosening, 1 aseptic acetabular cup loosening and 1 late infection. 3 hips were revised for a periprosthetic femoral fracture requiring a femoral component revision. The average time to revision was 51.6 (range 0-148) months. Kaplan-Meier survivorship analysis with an end point of revision for any reason demonstrated a survival rate of 97.4% at 10 years. Survival was 98.7% with revision for aseptic loosening as the endpoint.

CONCLUSIONS

The outcomes of a cementless grit-blasted and MAO-coated tapered-wedge stem of THA were excellent to satisfactory after a follow-up of at least 10 years.

Surface Modification of Biomedical Ti and Ti Alloys: A Review on Current Advances

Ti is widely used as a material for orthopedic implants. As rapid and effective osseointegration is a key factor for the successful application of implants, biologically inert Ti materials start to show inherent limitations, such as poor surface cell adhesion, bioactivity, and bone-growth-inducing capabilities. Surface modification can be an efficient and effective approach to addressing the biocompatibility, mechanical, and functionality issues of the various Ti implant materials. In this study, we have overviewed more than 140 papers to summarize the recent progress in the surface modification of Ti implants by physical and/or chemical modification approaches, aiming at optimizing their wear resistance, biocompatibility, and antimicrobial properties. As an advanced manufacturing technology for Ti and Ti alloys, additive manufacturing was particularly addressed in this review. We also provide an outlook for future research directions in this field as a contribution to the development of advanced Ti implants for biomedical applications.

Rapid structural regulation, apatite-inducing mechanism and in vivo investigation of microwave-assisted hydrothermally treated titania coating

Owing to the poor bioactivity of microarc oxidation (MAO) coating and the rapid activation ability of the microwave hydrothermal (MH) technique, MH treatment was applied to optimize the in vivo interface status between MAO-treated titanium and bone. In this study, consequently, new outermost layers were prepared using hydroxyapatite (HA) nanorods, HA submicron pillars or sodium titanate nanosheets. The results revealed that the NaOH concentration significantly influenced the surface structure and phase constitution of the MAO samples. Moreover, on enhancing the NaOH concentration, the number of HA phases was decreased. Further, the influence of the NaOH concentration on the interfacial bonding strength was insignificant for concentrations ≤0.5 mol L⁻¹. Transmission electron microscopy (TEM) analysis showed that the induction of apatite was accompanied by the dissolution of the HA crystals and there was excellent crystallographic matching with the HA crystals. The in vitro and in vivo analyses revealed that the MH-treated MAO sample with the HA nanorods possessed superior apatite-formation ability and osseointegration, including a small amount of soft tissue and optimal bone–implant interfacial bonding force, thus signifying strong potential for the optimization of the bone–implant interfacial status.

In this work, the micro/nano scale structures of HA nanorods integrated on a titanium were prepared using MAO and MH treatment. The in vivo results indicate that HA crystals play a crucial role in the improvement of the osseointegration.

Porous tantalum oxide with osteoconductive elements and antibacterial core-shell nanoparticles: A new generation of materials for dental implants

Implant surfaces with cytocompatible and antibacterial properties are extremely desirable for the prevention of implant's infection and the promotion of osseointegration. In this work, both micro-arc oxidation (MAO) and DC magnetron sputtering techniques were combined in order to endow tantalum-based surfaces with osteoblastic cytocompatibility and antibacterial activity. Porous Ta₂O₅ layers containing calcium (Ca) and phosphorous (P) were produced by MAO (TaCaP) to mimic the bone tissue morphology and chemical composition (Ca/P ratio close to 1.67). Furthermore, zinc (Zn) nanoparticles were deposited onto the previous surfaces by DC magnetron sputtering without or with an additional thin carbon layer deposited over the nanoparticles (respectively, TaCaP-Zn and TaCaP-ZnC) to control the Zn ions (Zn²⁺) release. Before osteoblastic cell seeding, the surfaces were leached for three time-points in PBS. All modified samples were cytocompatible. TaCaP-Zn slightly impaired cell adhesion but this was improved in the samples leached for longer immersion times. The initial cell adhesion was clearly improved by the deposition of the carbon layer on the Zn nanoparticles, which also translated to a higher proliferation rate. Both Zn-containing surfaces presented antibacterial activity against S. aureus. The two surfaces were active against planktonic bacteria, and TaCaP-Zn also inhibited sessile bacteria. Attributing to the excellent in vitro performance of the nanostructured Ta surface, with osteoconductive elements by MAO followed by antimicrobial nanoparticles incorporation by magnetron sputtering, this work is clearly a progress on the strategy to develop a new generation of dental implants.

In Vitro Biological Characterization of Silver-Doped Anodic Oxide Coating on Titanium

Despite the high biocompatibility and clinical effectiveness of Ti-based implants, surface functionalization (with complex osteointegrative/antibacterial strategies) is still required. To enhance the dental implant surface and to provide additional osteoinductive and antibacterial properties, plasma electrolytic oxidation of a pure Ti was performed using a nitrilotriacetic acid (NTA)-based Ag nanoparticles (AgNP)-loaded calcium–phosphate solution. Chemical and structural properties of the surface-modified titanium were assessed using scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) and contact angle measurement. A bacterial adhesion test and cell culture biocompatibility with collagen production were performed to evaluate biological effectiveness of the Ti after the plasma electrolytic process. The NTA-based calcium–phosphate solution with Ag nanoparticles (AgNPs) can provide formation of a thick, porous plasma electrolytic oxidation (PEO) layer enriched in silver oxide. Voltage elevation leads to increased porosity and a hydrophilic nature of the newly formed ceramic coating. The silver-enriched PEO layer exhibits an effective antibacterial effect with high biocompatibility and increased collagen production that could be an effective complex strategy for dental and orthopedic implant development.

Oxidation Mechanism of Biomedical Titanium Alloy Surface and Experiment

The biological activity, biocompatibility, and corrosion resistance of implants depend primarily on titanium dioxide (TiO2) film on biomedical titanium alloy (Ti6Al4V). This research is aimed at getting an ideal temperature range for forming a dense titanium dioxide (TiO2) film during titanium alloy cutting. This article is based on Gibbs free energy, entropy changes, and oxygen partial pressure equations to perform thermodynamic calculations on the oxidation reaction of titanium alloys, studies the oxidation reaction history of titanium alloys, and analyzes the formation conditions of titanium dioxide. The heat oxidation experiment was carried out. The chemical composition was analyzed with an energy dispersive spectrometer (EDS). The results revealed that titanium dioxide (TiO2) is the main reaction product on the surface below 900°C. Excellent porous oxidation films can be obtained between 670°C and 750°C, which is helpful to improve the bioactivity and osseointegration of implants.

Effects of Micro-Arc Oxidation Process Parameters on Characteristics of Calcium-Phosphate Containing Oxide Layers on the Selective Laser Melted Ti13Zr13Nb Alloy

Titania-based films on selective laser melted Ti13Zr13Nb have been formed by micro-arc oxidation (MAO) at different process parameters (voltage, current, processing time) in order to evaluate the impact of MAO process parameters in calcium and phosphate (Ca + P) containing electrolyte on surface characteristic, early-stage bioactivity, nanomechanical properties, and adhesion between the oxide coatings and substrate. The surface topography, surface roughness, pore diameter, elemental composition, crystal structure, surface wettability, and the early stage-bioactivity in Hank’s solution were evaluated for all coatings. Hardness, maximum indent depth, Young’s modulus, and Ecoating/Esubstrate, H/E, H3/E2 ratios were determined in the case of nanomechanical evaluation while the MAO coating adhesion properties were estimated by the scratch test. The study indicated that the most important parameter of MAO process influencing the coating characteristic is voltage. Due to the good ratio of structural and nanomechanical properties of the coatings, the optimal conditions of MAO process were found at 300 V during 15 min, at 32 mA or 50 mA of current, which resulted in the predictable structure, high Ca/P ratio, high hydrophilicity, the highest demonstrated early-stage bioactivity, better nanomechanical properties, the elastic modulus and hardness well close to the values characteristic for bones, as compared to specimens treated at a lower voltage (200 V) and uncoated substrate, as well as a higher critical load of adhesion and total delamination.

Comparative Analysis between Short Stem and Conventional Femoral Stem in Patients with Osteonecrosis of Femoral Head: Metha Stem and Excia Stem

Objective

To compare the intraoperative, radiological, and clinical short‐term outcomes of cementless total hip arthroplasties (THA) using a short stem (SS) and a conventional femoral stem (CS) in a randomized prospective control study.

Methods

From June 2011 to October 2017, patients who underwent cementless THA for idiopathic osteonecrosis of the femoral head were recruited. Patients had a minimum 2 years of follow‐up after the operation. The patients were divided into two groups: those who underwent THA using an SS and those who underwent THA using a CS. SS were used in 34 patients (41 hips) and CS were used in 41 patients (45 hips). In both groups, the same cup was used in all cases, and the mean follow‐up periods were 63 (26–101) months in the SS and 64 (26–101) months in the CS groups. Intraoperative, clinical, and radiological evaluations were performed for the two groups.

Results

There was no difference in the demographics of the two groups. There was one patient with a proximal femoral crack in the SS group and one with a distal femoral crack in the CS group. Clinically, the mean Harris hip score was improved in both groups at 2‐year follow‐up. Radiographically endosteal osseointegrations were found in 40 of 41 cases in the SS group and in 44 of 45 cases in the CS group. There was one case of dislocation in each group. In the SS group, the acetabular cup was changed and repositioned 7 months after the initial operation. Stem loosening, infection, ceramic breakage, and varus/valgus change were not observed. There was a statistically significant lower stress shielding effect in the SS group. There were no differences in vertical/parallel offset and leg length discrepancy.

Conclusion

The intraoperative, radiological, and clinical evaluations in both groups showed good outcomes and there was no statistically significant difference between the two groups.

Effects of calcium and phosphorus incorporation on the properties and bioactivity of TiO2 nanotubes

In this study, we investigate the formation of calcium and phosphorus-doped TiO₂ nanotubes, produced by potentiostatic anodization of Ti in viscous electrolyte-containing HF and Ca/P ions. Characterization of the produced oxide layer was conducted using scanning electron microscopy, glancing-angle X-ray diffraction, X-ray photoelectron spectroscopy, contact angle, and protein adsorption measurements. Adipose-derived stem cells were used to study material cytotoxicity, cell viability and proliferation, and cell morphology and growth. To evaluate the adipose-derived stem-cell differentiation, we investigated the expression of osteocalcin and osteopontin by cells as well as calcium mineralization. Results show that it was possible to produce a superhydrophilic titanium oxide nanotube layer with incorporation of Ca and P ions. The presence of Ca and P in the oxide layer not only improved the cell adhesion and proliferation but also stimulated the production of key marker proteins indicating differentiation of cells.

Surface properties and bioactivity of TiO2 nanotube array prepared by two-step anodic oxidation for biomedical applications

A highly ordered TiO₂ nanotube array has been prepared on a commercial pure titanium substrate in a hydrofluoric (HF) electrolyte using a DC power source through two-step anodic oxidation. The morphology, composition, wettability and surface energy of the nanotube array have been characterized by using a field-emission scanning electron microscope (FE-SEM), a transmission electron microscope (JEM-2010) with energy-dispersive X-ray spectrometer EDX (INCA OXFORD), X-ray diffraction method, an atomic force microscope (AFM), an optical contact angle measuring device and the Owens method with two liquids. The electrochemical behaviours of anodic oxidation films with different structures have been investigated in Sodium Lactate Ringer's Injection at 37±1°C by potentiodynamic polarization curve and electrochemical impedance spectroscopy. The formation mechanism of the nanotube array and the advantages of two-step oxidation have been discussed according to the experimental observation and the characterized results. Meanwhile, the structural changes of nanotubes are analysed according to the results of impedance spectroscopy. Cytotoxicity testing and cell adhesion and proliferation have been studied in order to evaluate the bioactivity of the nanotube array film. The diameters of nanotubes are in the range of 120-140 nm. The nanotube surface shows better wettability and higher surface energy compared to the bare substrate. The nanotube surface exhibits a wide passivation range and good corrosion resistance. The growth of the nanotube array is the result of the combined action of the anodization and field-assisted dissolution. The nanotube array by two-step oxidation becomes more regular and orderly. Moreover, the nanotube array surface is non-toxic and favourable to cell adhesion and proliferation. Such nanotube array films are expected to have significant biomedical applications.

Investigation of Realizing Both Antibacterial Property and Osteogenic Cell Compatibility on Titanium Surface by Simple Electrochemical Treatment

Recently, the problem of infection on implanted devices caused by the formation of biofilms has been recognized. Surface treatment to prevent the initial stages of bacterial adhesion and subsequent bacterial growth is the only possible solution against such infection. In this study, simple electrochemical treatment was used for introducing silver, an antibiotic agent, on the titanium surface. A porous oxide layer containing small amounts of silver was formed on the metal of the substrate. This was done by microarc oxidation using the electrolyte with silver nitrate. The porous oxide layer was almost amorphous with a small fraction of anatase phase. The samples prepared using the electrolyte containing 0.04 mM or a higher concentration of silver nitrate showed an excellent antibacterial effect against both E. coli and S. aureus. However, the proliferation of osteoblast-like cells in the samples was not affected when a concentration of 0.5 mM or lower was used. Moreover, samples containing silver showed no harmful effects on the process of bone differentiation. Furthermore, the calcification process of the cells on the samples treated with and without silver were more promoted than that on untreated Ti. Thus, we found that it is possible to use this optimum concentration of silver to realize the conflicting biofunctions: its antibacterial property and osteogenic cell compatibility.

Polydopamine deposition with anodic oxidation for better connective tissue attachment to transmucosal implants

BACKGROUND AND OBJECTIVE

Nowadays, most designs for the transmucosal surface of implants are machined-smooth. However, connective tissue adhered to the smooth surface of an implant has poor mechanical resistance, which can render separation of tissue from the implant interface and induce epithelial downgrowth. Modification of the transmucosal surface of implants, which can help form a good seal of connective tissue, is therefore desired. We hypothesized that anodic oxidation (AO) and polydopamine (PD) deposition could be used to enhance the attachment between an implant and peri-implant connective tissue. We tested this hypothesis in the mandibles of Beagle dogs.

MATERIAL AND METHODS

AO and PD were used to modify the transmucosal region of transmucosal implants (implant neck). The surface microstructure, surface roughness and elemental composition were investigated in vitro. L929 mouse fibroblasts were cultured to test the effect of PD on cell adhesion. Six Beagle dogs were used for the in vivo experiment (n = 6 dogs per group). Three months after building the edentulous animal model, four groups of implants (control, AO, PD and AO + PD) were inserted. After 4 months of healing, samples were harvested for histometric analyses.

RESULTS

The surfaces of anodized implant necks were overlaid with densely distributed pores, 2-7 μm in size. On the PD-modified surfaces, N1s, the chemical bond of nitrogen in PD, was detected using X-ray photoelectron spectroscopy. L929 developed pseudopods more quickly on the PD-modified surfaces than on the surfaces of the control group. The in vivo experiment showed a longer connective tissue seal and a more coronally located peri-implant soft-tissue attachment in the AO + PD group than in the control group (P < .05).

CONCLUSION

The modification of AO + PD on the implant neck yielded better attachment between the implant and peri-implant connective tissue.

Antibacterial Titanium Plate Anodized by being Discharged in NaCl Solution Exhibits Cell Compatibility

Implant surfaces should be modified to achieve excellent cell compatibility as well as antibacterial activity. Our previous study demonstrated that titanium plates anodized by being discharged in NaCl (Ti-Cl) exhibited high antibacterial activity. Since Ti-Cl was prepared with a NaCl solution, we hypothesized that Ti-Cl would exhibit low toxicity toward cells. The aims of this study were to characterize the surface of Ti-Cl and investigate the cell compatibility (MC3T3-E1 and L929 cells) of Ti-Cl. The results demonstrated that, since the TiCl3 formed on the Ti-Cl surface was hydrolyzed into HCl, HClO, and TiOH after immersion in pure distilled water, TiCl3 contributed to the antibacterial activity of Ti-Cl. On the other hand, TiO formed on the Ti-Cl surface enhanced cell extension and cell growth through a larger adsorption of fibronectin compared with the pure titanium control. These findings suggest that antibacterial titanium is a promising material for use in dental implant systems.

The functional response of bioactive titania-modified three-dimensional Ti-6Al-4V mesh structure toward providing a favorable pathway for intercellular communication and osteoincorporation

The objective of the study is to fundamentally elucidate the biological response of 3D printed mesh structures subjected to plasma electrolytic oxidation process through the study of osteoblast functions. The cellular activity of plasma electrolytic-oxidized mesh structure was explored in terms of cell-to-cell communication involving proliferation, synthesis of extracellular and intracellular proteins, and mineralization. Upon plasma electrolytic oxidation of the mesh structure, a thin layer of bioactive titania with pore size 1-3 µm was nucleated on the surface. The combination of microporous bioactive titania and interconnected porous architecture provided the desired pathway for supply of nutrients and oxygen to cells and tissue and a favorable osteogenic microenvironment for tissue on-growth and in-growth, in relation to the unmodified mesh structure. The formation of a confluent layer as envisaged via electron microscopy and quantitative assessment of the expression level of proteins (actin, vinculin, and fibronectin) point toward the determining role of surface-modified mesh structure in modulating osteoblasts functions. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2488-2501, 2016.

Histomorphometric and histologic evaluation of titanium-zirconium (aTiZr) implants with anodized surfaces

The choice of implant surface has a significant influence on osseointegration. Modification of TiZr surface by anodization is reported to have the potential to modulate the osteoblast cell behaviour favouring more rapid bone formation. The aim of this study is to investigate the effect of anodizing the surface of TiZr discs with respect to osseointegration after four weeks implantation in sheep femurs. Titanium (Ti) and TiZr discs were anodized in an electrolyte containing DL-α-glycerophosphate and calcium acetate at 300 V. The surface characteristics were analyzed by scanning electron microscopy, electron dispersive spectroscopy, atomic force microscopy and goniometry. Forty implant discs with thickness of 1.5 and 10 mm diameter (10 of each-titanium, titanium-zirconium, anodized titanium and anodized titanium-zirconium) were placed in the femoral condyles of 10 sheep. Histomorphometric and histologic analysis were performed 4 weeks after implantation. The anodized implants displayed hydrophilic, porous, nano-to-micrometer scale roughened surfaces. Energy dispersive spectroscopy analysis revealed calcium and phosphorous incorporation into the surface of both titanium and titanium-zirconium after anodization. Histologically there was new bone apposition on all implanted discs, slightly more pronounced on anodised discs. The percentage bone-to-implant contact measurements of anodized implants were higher than machined/unmodified implants but there was no significant difference between the two groups with anodized surfaces (P > 0.05, n = 10). The present histomorphometric and histological findings confirm that surface modification of titanium-zirconium by anodization is similar to anodised titanium enhances early osseointegration compared to machined implant surfaces.

Production of a biofunctional titanium surface using plasma electrolytic oxidation and glow-discharge plasma for biomedical applications

In this study, the authors tested the hypotheses that plasma electrolytic oxidation (PEO) and glow-discharge plasma (GDP) would improve the electrochemical, physical, chemical, and mechanical properties of commercially pure titanium (cpTi), and that blood protein adsorption on plasma-treated surfaces would increase. Machined and sandblasted surfaces were used as controls. Standard electrochemical tests were conducted in artificial saliva (pHs of 3.0, 6.5, and 9.0) and simulated body fluid. Surfaces were characterized by scanning electron microscopy, energy-dispersive spectroscopy, x-ray photoelectron spectroscopy, atomic force microscopy, x-ray diffraction, profilometry, Vickers microhardness, and surface energy. For biological assay, the adsorption of blood serum proteins (i.e., albumin, fibrinogen, and fibronectin) was tested. Higher values of polarization resistance and lower values of capacitance were noted for the PEO and GDP groups (p < 0.05). Acidic artificial saliva reduced the corrosion resistance of cpTi (p < 0.05). PEO and GDP treatments improved the surface properties by enrichment of the surface chemistry with bioactive elements and increased surface energy. PEO produced a porous oxide layer (5-μm thickness), while GDP created a very thin oxide layer (0.76-μm thickness). For the PEO group, the authors noted rutile and anatase crystalline structures that may be responsible for the corrosion barrier improvement and increased microhardness values. Plasma treatments were able to enhance the surface properties and electrochemical stability of titanium, while increasing protein adsorption levels.

Spark anodization of titanium-zirconium alloy: surface characterization and bioactivity assessment

Titanium (Ti) and its alloys have been popularly used as implant biomaterial for decades. Recently, titanium-zirconium (TiZr) alloy has been developed as an alternative implant material with improved strength in load bearing areas. Surface modification is one of the key factors to alter the surface properties to hasten osseointegration. Spark anodic oxidation (anodization) is one such method that is reported to enhance the bone formation around implants. This study aims to anodize TiZr and study its surface characteristics and cytocompatibility by cell culture experiments using osteoblast-like cells. Titanium (Ti) and TiZr discs were anodized in an electrolyte containing DL-α-glycerophosphate and calcium acetate (CA) at 300 V. The surface characteristics were analyzed by scanning electron microscopy, electron dispersive spectroscopy, X-ray diffraction (XRD), atomic force microscopy and goniometry. Using osteoblast-like cells viability, proliferation, differentiation and mineralization was assessed. The anodized surfaces demonstrated increased oxygen, entrapped calcium and phosphorous from the electrolyte used. XRD analysis confirmed the presence of anatase in the oxide layer. Average roughness increased and there was a significant decrease in contact angle (P < 0.01) following anodization. The anodized TiZr (aTiZr) surfaces were more nano-porous compared to anodized Ti (aTi). No significant difference was found in the viability of cells, but after 24 h the total number of cells was significantly higher (P < 0.01). Proliferation, alkaline phosphatase activity and calcium deposits were significantly higher on anodized surfaces compared to machined surfaces (P < 0.05, ANOVA). Anodization of TiZr resulted in a more nanoporous and hydrophilic surface than aTi, and osteoblast biocompatibility appeared comparable to aTi.

Fabrication and bioactivity evaluation of porous anodised TiO2 films in vitro

This study aims to find an optimal method for modifying the neck of dental implants for gingival attachment through in vitro investigations of the biological features of various anodised TiO2 films. The titanium sheets were divided into four groups: a control group and three test groups classified according to the anodisation voltage (Group 150 V, Group 180 V or Group 200 V).The surface microstructure and crystal structure were observed using scanning electron microscopy and X-ray diffraction. The protein adsorption ability, antibacterial activity and cell adhesion ability were tested to examine the biological properties of the materials in vitro. Microscopic grooves were observed in the control group, whereas the test groups contained numerous pores. Group 180 V and Group 200 V showed higher protein adsorption ability (p < 0.05), whereas Group 150 V and Group 180 V exhibited better antibacterial activity (p < 0.05). Higher cell concentrations of L929 were observed in Group 180V and Group 200 V than in the other two groups (p < 0.05), which indicated that the TiO2 films formed at 180 V promote protein adsorption and enhance fibroblast growth while inhibiting bacterial adhesion. These results indicate that anodisation positively affects the formation of a biological seal in the neck region of dental implants.

Osseointegration improvement by plasma electrolytic oxidation of modified titanium alloys surfaces

Titanium (Ti) is a material frequently used in orthopedic applications, due to its good mechanical properties and high corrosion resistance. However, formation of a non-adherent fibrous tissue between material and bone drastically could affect the osseointegration process and, therefore, the mechanical stability of the implant. Modifications of topography and configuration of the tissue/material interface is one of the mechanisms to improve that process by manipulating parameters such as morphology and roughness. There are different techniques that can be used to modify the titanium surface; plasma electrolytic oxidation (PEO) is one of those alternatives, which consists of obtaining porous anodic coatings by controlling parameters such as voltage, current, anodizing solution and time of the reaction. From all of the above factors, and based on previous studies that demonstrated that bone cells sense substrates features to grow new tissue, in this work commercially pure Ti (c.p Ti) and Ti6Al4V alloy samples were modified at their surface by PEO in different anodizing solutions composed of H2SO4 and H3PO4 mixtures. Treated surfaces were characterized and used as platforms to grow osteoblasts; subsequently, cell behavior parameters like adhesion, proliferation and differentiation were also studied. Although the results showed no significant differences in proliferation, differentiation and cell biological activity, overall results showed an important influence of topography of the modified surfaces compared with polished untreated surfaces. Finally, this study offers an alternative protocol to modify surfaces of Ti and their alloys in a controlled and reproducible way in which biocompatibility of the material is not compromised and osseointegration would be improved.

Titania nanotubes from weak organic acid electrolyte: fabrication, characterization and oxide film properties

In this study, TiO2 nanotubes were fabricated using anodic oxidation in fluoride containing weak organic acid for different durations (0.5h, 1h, 2h and 3h). Scanning electron microscope (SEM) micrographs reveal that the morphology of titanium oxide varies with anodization time. Raman spectroscopy and X-ray diffraction (XRD) results indicate that the as-formed oxide nanotubes were amorphous in nature, yet transform into crystalline phases (anatase and rutile) upon annealing at 600°C. Wettability measurements show that both as-formed and annealed nanotubes exhibited hydrophilic behavior. The electrochemical behavior was ascertained by DC polarization and AC electrochemical impedance spectroscopy (EIS) measurements in 0.9% NaCl solution. The results suggest that the annealed nanotubes showed higher impedance (10(5)-10(6)Ωcm(2)) and lower passive current density (10(-7)Acm(-2)) than the as-formed nanotubes. In addition, we investigated the influence of post heat treatment on the semiconducting properties of the oxides by capacitance measurements. In vitro bioactivity test in simulated body fluid (SBF) showed that precipitation of Ca/P is easier in crystallized nanotubes than the amorphous structure. Our study uses a simple strategy to prepare nano-structured titania films and hints the feasibility of tailoring the oxide properties by thermal treatment, producing surfaces with better bioactivity.

Effects of micro-arc oxidation coating on outcomes of a cementless grit-blasted tapered-wedge stem in total hip arthroplasty

To evaluate the effects of micro-arc oxidation (MAO) coating on the outcomes of a grit-blasted tapered-wedge stem in total hip arthroplasty (THA), we performed a retrospective review of 141 THAs using MAO coated stem for a minimum of 5years and compared them to 219 THAs using the same geometry stem without MAO coating. Harris hip score improved from 43.7 points preoperatively to 93.9 points postoperatively. No hips were revised for aseptic loosening. Complications included one squeaking hip, one iliopsoas tendonitis, and one deep vein thrombosis. Postoperative Harris hip scores, WOMAC scores, UCLA activity scores, stem stabilities, and complication rates did not differ between the groups. After medium-term follow-up, our findings did not support the use of MAO coating on grit-blasted tapered-wedge stem to improve clinical outcomes.

Characterization of hydroxyapatite containing a titania layer formed by anodization coupled with blasting

OBJECTIVES

The modification of dental implant surface by increasing the surface roughness or/and altering chemical composition have been attempted. Among them, hydroxyapatite (HA) coatings are typically bioactive. On the other hand, titania coatings have good corrosion resistance and biocompatibility. Therefore, the objective of this study was to fabricate HA containing a titania layer using an HA blasting and anodization method to benefit from the advantages of both, followed by surface characterization and biocompatibility.

MATERIALS AND METHODS

HA blasting was performed followed by microarc oxidation (MAO) using various applied voltages (100, 150, 200, 250 V). For surface characterization, the microstructure of the surface, surface phase and surface roughness were observed. Bonding strength was measured using a universal testing machine and potentiodynamic corrosion testing was performed. Biocompatibility was evaluated based on bioactivity and cell proliferation test.

RESULTS

The porous titanium oxide-containing HA was formed at 150 and 200 V. These surfaces were a lower corrosion current compared to the titanium treated only with HA blasting. In addition, composite treated titanium showed a rougher surface and tighter bonding strength compared to the titanium treated only with MAO. Biocompatibility demonstrated that HA/Titania composite layer on titanium showed a rapid HA precipitation and also enhanced cell proliferation.

CONCLUSIONS

These results suggested that HA containing titania layer on titanium had not only excellent physicochemical, mechanical and electrochemical properties, but also improved bioactivity and biological properties that could be applied as material for a dental implant system.

Biotribocorrosion (tribo-electrochemical) characterization of anodized titanium biomaterial containing calcium and phosphorus before and after osteoblastic cell culture

The purpose of this study was to investigate the relationship between the osteoblastic cells behavior and biotribocorrosion phenomena on bioactive titanium (Ti). Ti substrates submitted to bioactive anodic oxidation and etching treatments were cultured up to 28 days with MG63 osteoblast-like cells. Important parameters of in vitro bone-like tissue formation were assessed. Although no major differences were observed between the surfaces topography (both rough) and wettability (both hydrophobic), a significant increase in cell attachment and differentiation was detected on the anodized substrates as product of favorable surface morphology and chemical composition. Alkaline phosphatase production has increased (≈20 nmol/min/mg of protein) on the anodized materials, while phosphate concentration has reached the double of the etched material and calcium production increased (over 20 µg/mL). The mechanical and biological stability of the anodic surfaces were also put to test through biotribocorrosion sliding solicitations, putting in evidence the resistance of the anodic layer and the cells capacity of regeneration after implant degradation. The Ti osteointegration abilities were also confirmed by the development of strong cell-biomaterial bonds at the interface, on both substrates. By combining the biological and mechanical results, the anodized Ti can be considered a viable option for dentistry.

A study of the physical, chemical and biological properties of TiO2 coatings produced by micro-arc oxidation in a Ca-P-based electrolyte

In this work, a porous and homogeneous titanium dioxide layer was grown on commercially pure titanium substrate using a micro-arc oxidation (MAO) process and Ca-P-based electrolyte. The structure and morphology of the TiO2 coatings were characterized by X-ray diffraction, scanning electron microscopy (SEM), transmission electron microscopy, and profilometry. The chemical properties were studied using electron dispersive X-ray spectroscopy (SEM-EDS) and X-ray photoelectron spectroscopy. The wettability of the coating was evaluated using contact angle measurements. During the MAO process, Ca and P ions were incorporated into the oxide layer. The TiO2 coating was composed of a mixture of crystalline and amorphous structures. The crystalline part of the sample consisted of a major anatase phase and a minor rutile phase. A cross-sectional image of the coating-substrate interface reveals the presence of voids elongated along the interface. An osteoblast culture was performed to verify the cytocompatibility of the anodized surface. The results of the cytotoxicity tests show satisfactory cell viability of the titanium dioxide films produced in this study.

Osseointegration of bioactive microarc oxidized amorphous phase/TiO2 nanocrystals composited coatings on titanium after implantation into rabbit tibia

The amorphous phase/TiO2 nanocrystals (APTN) composited coatings were prepared on Ti implants for biomedical applications. The Ti implants without and with the APTN composited coatings both do not cause any adverse effects after implantation into the rabbit tibia. The osseointegration of Ti implants after covering the APTN coatings is improved pronouncedly, greatly increasing the interface bonding strength between the implants and newly formed bones. In addition, it is interesting that the newly formed bone tissues appear in the micro-pores of the APTN coatings, promoting the interface bonding between the implants and new bones by the mechanical interlock. Moreover, the Ti implant with the APTN coatings formed at higher applied voltage exhibit higher shear strength and displacement during the pushing out experiment probably due to its better osseointegration.

Increased efficiency of direct nanoimprinting on planar and curved bulk titanium through surface modification

In this work the direct transfer of nanopatterns into titanium is demonstrated. The nanofeatures are imprinted at room temperature using diamond stamps in a single step. We also show that the imprint properties of the titanium surface can be altered by anodisation yielding a significant reduction in the required imprint force for pattern transfer. The anodisation process is also utilised for curved titanium surfaces where a reduced imprint force is preferable to avoid sample deformation and damage. We finally demonstrate that our process can be applied directly to titanium rods.

Effects of the surface characteristics of nanoporous titanium oxide films on Ti-24Nb-4Zr-8Sn alloy on the initial adhesion of osteoblast-like MG-63 cells

The aim of the present study was to investigate the effects of the surface characteristics of nanoporous titanium oxide films, formed by anodization on Ti-24Nb-4Zr-8Sn (Ti2448) alloy, on the early adhesion of osteoblast-like MG-63 cells. Nanoporous titanium oxide films with two different pore sizes (30 and 90 nm) were formed by anodization in NH₄F solution on Ti2448 alloy. The surface roughness of the nanoporous titanium oxide films was determined using a Surftest Formtracer and field emission scanning electron microscopy (FESEM). Cell viability was evaluated at different time points using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. To investigate the regulatory mechanisms involved in the focal adhesion of osteoblasts to Ti2448 alloy, we quantified the expression levels of integrin β1 and paxillin mRNAs on the nanoporous titanium oxide films during early osteoblast adhesion using real-time RT-PCR. Samples with a 30-nm nanoporous film exhibited a greater number of overlapping microporous structures with microprojections compared with the 90-nm nanoporous film samples. The MTT assay indicated that cell viability on the 30-nm nanoporous surface following 24 and 48 h of cell culture was higher than those observed on the unanodized control and 90-nm nanoporous surfaces. Integrin β1 mRNA expression levels on the 30-nm nanoporous surface following cell culture for 48 h were also significantly higher compared with those on the unanodized control and 90-nm nanoporous surfaces. The results demonstrated that a 30-nm nanoporous titanium oxide film on Ti2448 alloy may provide the optimum bioactive implant surface for the initial adhesion of osteoblasts.

Simvastatin-activated implant surface promotes osteoblast differentiation in vitro

The bone growth promoting effects of statins suggest that these bioactive molecules can be used to improve the integration of bone-anchored implants. This study aimed at the application of simvastatin with dental implants for use in patients with low bone density. Coin-shaped titanium zirconium samples with grit-blasted and acid-etched surface were coated with simvastatin, using a novel anodic oxidation setup under alkaline conditions. The presence of intact simvastatin attached to the surface was confirmed by infrared spectroscopy. A binding site on the aliphatic O-H group was discovered and the integration of (1)H, (18)O and (12)C in the depth of the surface were observed by secondary ion mass spectroscopy. A simvastatin concentration of about 60 g/cm(2) was found in a release study over 72 h. The simvastatin-coated surfaces promoted alkaline phosphatase, collagen type I and osteocalcin gene expression of MC3T3-E1 cells. This suggested that the demonstrated coating holds potential for use in patients with compromised bone.