In vitro investigation of titanium and hydroxyapatite dental implant surfaces using a rat bone marrow stromal cell culture system

Advanced Antimicrobial and Anti-Infective Strategies to Manage Peri-Implant Infection: A Narrative Review

Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms that cause implant infection can be targeted by new prevention and treatment methods which can also lead to the reduction of systemic antibiotic exposure and its associated adverse effects. This review aims to summarize advanced biomaterial strategies applied to implant components based on anti-pathogenic mechanisms and immune balance mechanisms. It emphasizes that modifying the dental implant surface and regulating the early immune response are promising strategies, which may further prevent or slow the development of peri-implant infection, and subsequent failure.

Zirconia based composite scaffolds and their application in bone tissue engineering

In the field of bone tissue engineering, biomimetic scaffold utilization is deemed an immensely promising method. The bio-ceramic material Zirconia (ZrO2) has garnered significant attention in the biomimetic scaffolds realm due to its remarkable biocompatibility, superior mechanical strength, and exceptional chemical stability. Numerous examinations have been conducted to investigate the properties and functions of biomimetic structures built from zirconia. Generally, nano-ZrO2 materials have showcased encouraging applications in bone tissue engineering, providing a blend of mechanical robustness, bioactivity, drug delivery capabilities, and antibacterial properties. This review aims to concentrate on the properties and preparations of ZrO2 and its composite materials, while emphasizing its role along with other materials as scaffolds for bone tissue repair applications. The study also discusses the constraints of materials and technology involved in this domain. Ongoing research and development in this area are anticipated to further augment the potential of nano-ZrO2 for advancing bone regeneration therapies.

An investigational time course study of titanium plasma spray on osseointegration of PEEK and titanium implants: an in vivo ovine model

BACKGROUND CONTEXT

Methods to improve osseointegration of orthopedic spinal implants remains a clinical challenge. Materials composed of poly-ether-ether-ketone (PEEK) and titanium are commonly used in orthopedic applications due to their inherent properties of biocompatibility. Titanium has a clinical reputation for durability and osseous affinity, and PEEK offers advantages of a modulus that approximates osseous structures and is radiolucent. The hypothesis for the current investigation was that a titanium plasma spray (TPS) coating may increase the rate and magnitude of circumferential and appositional trabecular osseointegration of PEEK and titanium implants versus uncoated controls.

PURPOSE

Using an in vivo ovine model, the current investigation compared titanium plasma-sprayed PEEK and titanium dowels versus nonplasma-sprayed dowels. Using a time course study of 6 and 12 weeks postoperatively, experimental assays to quantify osseointegration included micro-computed tomography (microCT), biomechanical testing, and histomorphometry.

STUDY DESIGN/SETTING

In-vivo ovine model.

METHODS

Twelve skeletally mature crossbred sheep were equally randomized into postoperative periods of 6 and 12 weeks. Four types of dowel implants-PEEK, titanium plasma-sprayed PEEK (TPS PEEK), titanium, and titanium plasma-sprayed titanium (TPS titanium) were implanted into cylindrical metaphyseal defects in the distal femurs and proximal humeri (one defect per limb, n=48 sites). Sixteen nonoperative specimens (eight femurs and eight humeri) served as zero time-point controls. Half of the specimens underwent destructive biomechanical pullout testing and the remaining half quantitative microCT to quantify circumferential bone volume within 1 mm and 2 mm of the implant surface and histomorphometry to compute direct trabecular apposition.

RESULTS

There were no intra- or perioperative complications. The TPS-coated implants demonstrated significantly higher peak loads at dowel pullout at 6 and 12 weeks compared with uncoated controls (p<.05). No differences were observed across dowel treatments at the zero time-point (p>.05). MicroCT results exhibited no significant differences in circumferential osseointegration between implants within 1 mm or 2 mm of the dowel surface (p>.05). Direct appositional osseointegration of trabecular bone based on histomorphometry was higher for TPS-coated groups, regardless of base material, compared with uncoated treatments at both time intervals (p<.05).

CONCLUSIONS

The current in vivo study demonstrated the biological and mechanical advantages of plasma spray coatings. TPS improved histological incorporation and peak force required for implant extraction.

CLINICAL SIGNIFICANCE

Plasma spray coatings may offer clinical benefit by improving biological fixation and osseointegration within the first 6 to 12 weeks postoperatively- the critical healing period for implant-based arthrodesis procedures.

The Impact of Mechanical Debridement Techniques on Titanium Implant Surfaces: A Comparison of Sandblasted, Acid-Etched, and Femtosecond Laser-Treated Surfaces

This study evaluated the effects of various mechanical debridement methods on the surface roughness (Ra) of dental implants, comparing femtosecond laser-treated surfaces with conventionally machined and sandblasted with large-grit sand and acid-etched (SLA) implant surfaces. The fabrication of grade 4 titanium (Ti) disks (10 mm in diameter and 1 mm thick) and the SLA process were carried out by a dental implant manufacturer (DENTIS; Daegu, Republic of Korea). Subsequently, disk surfaces were treated with various methods: machined, SLA, and femtosecond laser. Disks of each surface-treated group were post-treated with mechanical debridement methods: Ti curettes, ultrasonic scaler, and Ti brushes. Scanning electron microscopy, Ra, and wettability were evaluated. Statistical analysis was performed using the Kruskal-Wallis H test, with post-hoc analyses conducted using the Bonferroni correction (α = 0.05). In the control group, no significant difference in Ra was observed between the machined and SLA groups. However, femtosecond laser-treated surfaces exhibited higher Ra than SLA surfaces (p < 0.05). The application of Ti curette or brushing further accentuated the roughness of the femtosecond laser-treated surfaces, whereas scaling reduced the Ra in SLA surfaces. Femtosecond laser-treated implant surfaces, with their unique roughness and compositional attributes, are promising alternatives in dental implant surface treatments.

In Vitro Study of Zirconia Surface Modification for Dental Implants by Atomic Layer Deposition

Zirconia is a promising material for dental implants; however, an appropriate surface modification procedure has not yet been identified. Atomic layer deposition (ALD) is a nanotechnology that deposits thin films of metal oxides or metals on materials. The aim of this study was to deposit thin films of titanium dioxide (TiO₂), aluminum oxide (Al₂O₃), silicon dioxide (SiO₂), and zinc oxide (ZnO) on zirconia disks (ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn, respectively) using ALD and evaluate the cell proliferation abilities of mouse fibroblasts (L929) and mouse osteoblastic cells (MC3T3-E1) on each sample. Zirconia disks (ZR; diameter 10 mm) were fabricated using a computer-aided design/computer-aided manufacturing system. Following the ALD of TiO₂, Al₂O₃, SiO₂, or ZnO thin film, the thin-film thickness, elemental distribution, contact angle, adhesion strength, and elemental elution were determined. The L929 and MC3T3-E1 cell proliferation and morphologies on each sample were observed on days 1, 3, and 5 (L929) and days 1, 4, and 7 (MC3T3-E1). The ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn thin-film thicknesses were 41.97, 42.36, 62.50, and 61.11 nm, respectively, and their average adhesion strengths were 163.5, 140.9, 157.3, and 161.6 mN, respectively. The contact angle on ZR-Si was significantly lower than that on all the other specimens. The eluted Zr, Ti, and Al amounts were below the detection limits, whereas the total Si and Zn elution amounts over two weeks were 0.019 and 0.695 ppm, respectively. For both L929 and MC3T3-E1, the cell numbers increased over time on ZR, ZR-Ti, ZR-Al, and ZR-Si. Particularly, cell proliferation in ZR-Ti exceeded that in the other samples. These results suggest that ALD application to zirconia, particularly for TiO₂ deposition, could be a new surface modification procedure for zirconia dental implants.

Randomized clinical trial to evaluate the efficacy and safety of two types of sandblasted with large-grit and acid-etched surface implants with different surface roughness

Objectives

This study aims to evaluate the efficacy and safety of two types of sandblasted with large-grit and acid-etched (SLA) surface implants with different surface roughness.

Patients and Methods This study was conducted based on a clinical record review of 55 patients (mean age, 53.00 years). A total of 80 SLA surface implants was placed. Among the 80 implants, 38 implants placed in 29 subjects had surface roughness (Ra) of 3.09 µm (test group, TG), while the other 42 implants placed in 31 subjects had a surface roughness (Ra) of 2.50 µm (control group, CG). A comparison was made of implant primary/secondary stability; success and survival rates; marginal bone loss; and soft tissue assessment including probing pocket depth (PPD), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) between the groups at 1 year after implant placement.

Results

Among the implants that were initially registered, 1 from the TG and 4 from the CG dropped out, leaving 37 implants in the TG and 38 implants in the CG to be traced and analyzed. Although 1 TG case showed unstable primary stability, all cases showed stable secondary stability. Success and survival rates at 1 year after implant placement were 100% in both groups. Marginal bone loss was 0.07 mm and 0.00 mm for the TG and CG, respectively, but the difference was not significant. Among the several parameters for evaluation of soft tissue, the TG showed lower PI at 1 year after implant placement (TG=0.00, CG=0.29; P=0.0004), while the remaining categories showed no significant difference between the groups.

Conclusion

This study shows that the two types of SLA implants with different surface roughness have no difference in efficacy or safety. Therefore, both of the implants can be used safely and with promising outcomes.

Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications

An increase in the world population and its life expectancy, as well as the ongoing concern about our physical appearance, have elevated the relevance of dental implantology in recent decades. Engineering strategies to improve the survival rate of dental implants have been widely investigated, focusing on implant material composition, geometry (usually guided to reduce stiffness), and interface surrounding tissues. Although efforts to develop different implant surface modifications are being applied in commercial dental prostheses today, the inclusion of surface coatings has gained special interest, as they can be tailored to efficiently enhance osseointegration, as well as to reduce bacterial-related infection, minimizing peri-implantitis appearance and its associated risks. The use of biomaterials to replace teeth has highlighted the need for the development of reliable analytical methods to assess the therapeutic benefits of implants. This literature review considers the state-of-the-art strategies for surface modification or coating and analytical methodologies for increasing the survival rate for teeth restoration.

Tissue Integration and Biological Cellular Response of SLM-Manufactured Titanium Scaffolds

Background: SLM (Selective Laser Melting)–manufactured Titanium (Ti) scaffolds have a significant value for bone reconstructions in the oral and maxillofacial surgery field. While their mechanical properties and biocompatibility have been analysed, there is still no adequate information regarding tissue integration. Therefore, the aim of this study is a comprehensive systematic assessment of the essential parameters (porosity, pore dimension, surface treatment, shape) required to provide the long-term performance of Ti SLM medical implants. Materials and methods: A systematic literature search was conducted via electronic databases PubMed, Medline and Cochrane, using a selection of relevant search MeSH terms. The literature review was conducted using the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Results: Within the total of 11 in vitro design studies, 9 in vivo studies, and 4 that had both in vitro and in vivo designs, the results indicated that SLM-generated Ti scaffolds presented no cytotoxicity, their tissue integration being assured by pore dimensions of 400 to 600 µm, high porosity (75–88%), hydroxyapatite or SiO2–TiO2 coating, and bioactive treatment. The shape of the scaffold did not seem to have significant importance. Conclusions: The SLM technique used to fabricate the implants offers exceptional control over the structure of the base. It is anticipated that with this technique, and a better understanding of the physical interaction between the scaffold and bone tissue, porous bases can be tailored to optimize the graft’s integrative and mechanical properties in order to obtain structures able to sustain osseous tissue on Ti.

Design of dental implants at materials level: An overview

Due to the excellent restoration of masticatory function, satisfaction on aesthetics and other superiorities, dental implants represent an effective method to resolve tooth losing and damaging. Current dental implant systems still have problems waiting to be addressed, and problems are centralized on the materials of implant bodies. This review aims to summarize major developments in the field of dental implant materials, starting with an overview on structures, procedures of dental implants and challenges of implant materials. Next, implant materials are examined in three categories, that is, metals, ceramics, and polymers, their mechanical properties, biocompatibility, and bioactivity are summarized. And as an important aspect, strategies of surface modification are also reviewed, along with some finite element analysis to guiding the research direction of implant materials. Finally, the conclusive remarks are outlined to provide an outlook on the future research directions and prospects of dental implants.

Production of High Silicon-Doped Hydroxyapatite Thin Film Coatings via Magnetron Sputtering: Deposition, Characterisation, and In Vitro Biocompatibility

In recent years, it has been found that small weight percent additions of silicon to HA can be used to enhance the initial response between bone tissue and HA. A large amount of research has been concerned with bulk materials, however, only recently has the attention moved to the use of these doped materials as coatings. This paper focusses on the development of a co-RF and pulsed DC magnetron sputtering methodology to produce a high percentage Si containing HA (SiHA) thin films (from 1.8 to 13.4 wt.%; one of the highest recorded in the literature to date). As deposited thin films were found to be amorphous, but crystallised at different annealing temperatures employed, dependent on silicon content, which also lowered surface energy profiles destabilising the films. X-ray photoelectron spectroscopy (XPS) was used to explore the structure of silicon within the films which were found to be in a polymeric (SiO2; Q4) state. However, after annealing, the films transformed to a SiO44−, Q0, state, indicating that silicon had substituted into the HA lattice at higher concentrations than previously reported. A loss of hydroxyl groups and the maintenance of a single-phase HA crystal structure further provided evidence for silicon substitution. Furthermore, a human osteoblast cell (HOB) model was used to explore the in vitro cellular response. The cells appeared to prefer the HA surfaces compared to SiHA surfaces, which was thought to be due to the higher solubility of SiHA surfaces inhibiting protein mediated cell attachment. The extent of this effect was found to be dependent on film crystallinity and silicon content.

Treatments for enhancing the biocompatibility of titanium implants

Titanium surface treatment is a crucial process for achieving sufficient osseointegration of an implant into the bone. If the implant does not heal sufficiently, serious complications may occur, e.g. infection, inflammation, aseptic loosening of the implant, or the stress-shielding effect, as a result of which the implant may need to be reoperated. After a titanium graft has been implanted, several interactions are crucial in order to create a strong bone-implant connection. It is essential that cells adhere to the surface of the implant. Surface roughness has a significant influence on cell adhesion, and also on improving and accelerating osseointegration. Other highly important factors are biocompatibility and resistance to bacterial contamination. Bio-inertness of titanium is ensured by the protective film of titanium oxides that forms spontaneously on its surface. This film prevents the penetration of metal compounds, and it is well-adhesive for calcium and phosphate ions, which are necessary for the formation of the mineralized bone structure. Since the presence of the film alone is not sufficient for the biocompatibility of titanium, a suitable surface finish is required to create a firm bone-implant connection. In this review, we explain and compare the most widely-used methods for modulating the surface roughness of titanium implants in order to enhance cell adhesion on the surface of the implant, e.g. plasma spraying, sandblasting, acid etching, laser treatment, sol-gel etc., The methods are divided into three overlapping groups, according to the type of modification.

A review of nanostructured surfaces and materials for dental implants: surface coating, patterning and functionalization for improved performance

The emerging field of nanostructured implants has enormous scope in the areas of medical science and dental implants. Surface nanofeatures provide significant potential solutions to medical problems by the introduction of better biomaterials, improved implant design, and surface engineering techniques such as coating, patterning, functionalization and molecular grafting at the nanoscale. This review is of an interdisciplinary nature, addressing the history and development of dental implants and the emerging area of nanotechnology in dental implants. After a brief introduction to nanotechnology in dental implants and the main classes of dental implants, an overview of different types of nanomaterials (i.e. metals, metal oxides, ceramics, polymers and hydrides) used in dental implant together with their unique properties, the influence of elemental compositions, and surface morphologies and possible applications are presented from a chemical point of view. In the core of this review, the dental implant materials, physical and chemical fabrication techniques and the role of nanotechnology in achieving ideal dental implants have been discussed. Finally, the critical parameters in dental implant design and available data on the current dental implant surfaces that use nanotopography in clinical dentistry have been discussed.

In vitro evaluation of an yttria-stabilized zirconia reinforced nano-hydroxyapatite/polyamide 66 ternary biomaterial: biomechanics, biocompatibility and bioactivity

The characterization of a novel ternary biomaterial composed of nano-hydroxyapatite/polyamide 66/yttria-stabilized tetragonal zirconia.

Surface Modifications and Their Effects on Titanium Dental Implants

This review covers several basic methodologies of surface treatment and their effects on titanium (Ti) implants. The importance of each treatment and its effects will be discussed in detail in order to compare their effectiveness in promoting osseointegration. Published literature for the last 18 years was selected with the use of keywords like titanium dental implant, surface roughness, coating, and osseointegration. Significant surface roughness played an important role in providing effective surface for bone implant contact, cell proliferation, and removal torque, despite having good mechanical properties. Overall, published studies indicated that an acid etched surface-modified and a coating application on commercial pure titanium implant was most preferable in producing the good surface roughness. Thus, a combination of a good surface roughness and mechanical properties of titanium could lead to successful dental implants.

Comparison of the osteogenic potential of titanium- and modified zirconia-based bioceramics

Zirconia is now favored over titanium for use in dental implant materials because of its superior aesthetic qualities. However, zirconia is susceptible to degradation at lower temperatures. In order to address this issue, we have developed modified zirconia implants that contain tantalum oxide or niobium oxide. Cells attached as efficiently to the zirconia implants as to titanium-based materials, irrespective of surface roughness. Cell proliferation on the polished surface was higher than that on the rough surfaces, but the converse was true for the osteogenic response. Cells on yttrium oxide (Y₂O₃)/tantalum oxide (Ta₂O₅)- and yttrium oxide (Y₂O₃)/niobium oxide (Nb₂O₅)-containing tetragonal zirconia polycrystals (TZP) discs ((Y, Ta)-TZP and (Y, Nb)-TZP, respectively) had a similar proliferative potential as those grown on anodized titanium. The osteogenic potential of MC3T3-E1 pre-osteoblast cells on (Y, Ta)-TZP and (Y, Nb)-TZP was similar to that of cells grown on rough-surface titanium. These data demonstrate that improved zirconia implants, which are resistant to temperature-induced degradation, retain the desirable clinical properties of structural stability and support of an osteogenic response.

Mg ion implantation on SLA-treated titanium surface and its effects on the behavior of mesenchymal stem cell

Magnesium (Mg) is one of the most important ions associated with bone osseointegration. The aim of this study was to evaluate the cellular effects of Mg implantation in titanium (Ti) surfaces treated with sand blast using large grit and acid etching (SLA). Mg ions were implanted into the surface via vacuum arc source ion implantation. The surface morphology, chemical properties, and the amount of Mg ion release were evaluated by scanning electron microscopy (SEM), Auger electron spectroscopy (AES), Rutherford backscattering spectroscopy (RBS), and inductively coupled plasma-optical emission spectrometer (ICP-OES). Human mesenchymal stem cells (hMSCs) were used to evaluate cellular parameters such as proliferation, cytotoxicity, and adhesion morphology by MTS assay, live/dead assay, and SEM. Furthermore, osteoblast differentiation was determined on the basis of alkaline phosphatase (ALP) activity and the degree of calcium accumulation. In the Mg ion-implanted disk, 2.3×10(16) ions/cm(2) was retained. However, after Mg ion implantation, the surface morphology did not change. Implanted Mg ions were rapidly released during the first 7 days in vitro. The MTS assay, live/dead assay, and SEM demonstrated increased cell attachment and growth on the Mg ion-implanted surface. In particular, Mg ion implantation increased the initial cell adhesion, and in an osteoblast differentiation assay, ALP activity and calcium accumulation. These findings suggest that Mg ion implantation using the plasma source ion implantation (PSII) technique may be useful for SLA-treated Ti dental implants to improve their osseointegration capacity.

Osteophilic multilayer coatings for accelerated bone tissue growth

Osteophilic modular nanostructured multilayers containing hydroxyapatite nanoparticles complexed with a natural polymer chitosan create an osteoconductive surface for mesenchymal stem cells (MSCs). Coupled with the sustained release of physiological amounts of osteoinductive bone morphogenetic protein over several days from degradable poly(β-amino ester) based multilayers, this single coating results in a synergistic accelerated and upregulated differentiation of MSCs into osteoblasts laying down new bone tissue on orthopedic implants.

Zirconia-hydroxyapatite composite material with micro porous structure

OBJECTIVES

Titanium plates and apatite blocks are commonly used for restoring large osseous defects in dental and orthopedic surgery. However, several cases of allergies against titanium have been recently reported. Also, sintered apatite block does not possess sufficient mechanical strength. In this study, we attempted to fabricate a composite material that has mechanical properties similar to biocortical bone and high bioaffinity by compounding hydroxyapatite (HAp) with the base material zirconia (ZrO(2)), which possesses high mechanical properties and low toxicity toward living organisms.

METHODS

After mixing the raw material powders at several different ZrO(2)/HAp mixing ratios, the material was compressed in a metal mold (8 mm in diameter) at 5 MPa. Subsequently, it was sintered for 5 h at 1500°C to obtain the ZrO(2)/HAp composite. The mechanical property and biocompatibility of materials were investigated. Furthermore, osteoconductivity of materials was investigated by animal studies.

RESULTS

A composite material with a minute porous structure was successfully created using ZrO(2)/HAp powders, having different particle sizes, as the starting material. The material also showed high protein adsorption and a favorable cellular affinity. When the mixing ratio was ZrO(2)/HAp=70/30, the strength was equal to cortical bone. Furthermore, in vivo experiments confirmed its high osteoconductivity.

SIGNIFICANCE

The composite material had strength similar to biocortical bones with high cell and tissue affinities by compounding ZrO(2) and HAp. The ZrO(2)/HAp composite material having micro porous structure would be a promising bone restorative material.

Calcium phosphate coated electrospun fiber matrices as scaffolds for bone tissue engineering

Electrospun polymeric scaffolds are used for various tissue engineering applications. In this study, we applied a biomimetic coating method to provide electrospun scaffolds from a block copolymer-poly(ethylene oxide terephthalate)-poly(buthylene terephthalate), with a calcium phosphate layer to improve their bioactivity in bone tissue engineering. The in vitro studies with human mesenchymal stem cells demonstrated cell proliferation on both uncoated and coated samples. No significant effect of calcium phosphate coating was observed on the expression of alkaline phosphatase in vitro. Implantation of scaffold-goat mesenchymal stem cells constructs subcutaneously in nude mice resulted in bone formation in the calcium phosphate coated samples, in contrast to the uncoated ones, where no new bone formation was observed. The results of this study showed that the biomimetic method can successfully be used to coat electrospun scaffolds with a calcium phosphate layer, which improved the in vivo bioactivity of the polymer.

Design of dental implants, influence on the osteogenesis and fixation

The fixation and the bone ingrowth at the interface of porous cylindrical implants (total porosity of 37% and average pores diameter of 480 microm) were compared in vivo to rough cylindrical implants (R (a) = 5.3 microm), both of commercially pure titanium, made by powder metallurgy. The implants were inserted into the tibias of 20 rabbits and the animals were sacrificed 4 and 8 weeks after surgery. The percentage of bone-implant contact observed in porous implant was significantly larger than in the rough ones for all of sacrifice periods, respectively, 57% vs. 46% after 4 weeks, and 59% vs. 50% after 8 weeks. The mechanical tests showed a significant increase in the shear strength of the porous implants for the two analyzed periods, 4 and 8 weeks (14 and 20 MPa), when compared with rough ones (4 and 13 MPa). These results suggest that porous implants improve the contact at the implant-bone interface and increase the fixation to the bone, improving the osseointegration. Thus, the porous implant might be an alternative to dental implant in less favorable conditions, and appear to be better fixed to bone, offering promising alternatives.

In vitro investigation of orthopedic titanium-coated and brushite-coated surfaces using human osteoblasts in the presence of gentamycin

Anti-infective coatings have been developed to protect the surfaces of cementless implants from bacterial colonization that is known to be a prerequisite for device-related infection. The aim of this study is to investigate the effect of brushite-coated arthroplasty surfaces on human osteoblasts and to evaluate the impact of concomitant exposure to gentamycin. We cultured human osteoblasts (hFOB 1.19) on brushite-coated and uncoated titanium alloy in the presence of gentamycin and analyzed cell function and vitality. Our results show that brushite-coated titanium alloy surfaces supported the function of osteoblasts and the expression of extracellular matrix even in the presence of highly dosed gentamycin. Brushite-coated titanium alloy surfaces supported osteogenic function, indicating that this coating could enhance implant osteointegration in vivo. Concomitant exposure to gentamycin slightly decreased osteoblastic activity in vitro, suggesting that there might also be negative effects in vivo. However, in vivo studies are necessary to validate these in vitro findings.

Biocompatibility evaluation of a novel hydroxyapatite-polymer coating for medical implants (in vitro tests)

Nanocomposites consisting of hydroxyapatite (HA) and a sodium maleate copolymer (maleic polyelectrolyte), synthesized by hydrothermal method and deposited on titanium substrates by Matrix Assisted Pulsed Laser Evaporation (MAPLE) technique were tested for the biological properties. Coating bioanalysis was carried out by triple staining of actin, microtubules and nuclei followed by immunofluorescence microscopy. Within 24 h cells that occupied the biomaterial surface displayed the morphology and cytoskeleton pattern similar to the controls. Cells grown on nanocomposite coated surfaces had a higher proliferation rate than their counterparts grown on Ti coated with HA alone, indicating that maleic polyelectrolyte improved surface bio-adhesive characteristics. The capacity to induce cell attachment, spreading and proliferation demonstrated the potential of Ti coated with HA-polymer nanocomposites to be used as scaffolds in dental or orthopedic implantology.

PLD bioactive ceramic films: the influence of CaO-P2O5 glass additions to hydroxyapatite on the proliferation and morphology of osteblastic like-cells

This work consists on the evaluation of the in vitro performance of Ti6Al4V samples PLD (pulsed laser deposition) coated with hydroxyapatite, both pure and mixed with a CaO-P2O5 glass. Previous studies on immersion of PLD coatings in SBF, showed that the immersion apatite films did not present the usual cauliflower morphology but replicated the original columnar structure and exhibited good bioactivity. However, the influence of glass associated to hydroxyapatite concerning adhesion, proliferation and morphology of MG63 cells on the films surface was unclear. In this study, the performance of these PLD coated samples was evaluated, not only following the physical-chemical transformations resulting from the SBF immersion, but also evaluating the cytocompatibility in contact with osteoblast-like MG63 cells. SEM and AFM confirmed that the bioactive ceramic PLD films reproduce the substrate's surface topography and that the films presented good adherence and uniform surface roughness. Physical-chemical phenomena occurring during immersion in SBF did not modify the original columnar structure. In contact with MG63 cells, coated samples exhibited very good acceptance and cytocompatibility when compared to control. The glass mixed with hydroxyapatite induced higher cellular proliferation. Cells grown on these samples presented many filipodia and granular structures, typical features of osteoblasts.

A Novel Piezoelectric Immunosensor for CA125 Using a Hydroxyapatite/Chitosan Nanocomposite-Based Biomolecular Immobilization Method

The ideal immobilization methods that are suitable for binding immunoactive materials with high efficiency onto a sensing surface are the key target to pursue in current biosensor design. In the present paper, the formation of a hydroxyapatite/chitosan (HA/CS) hybrid nanocomposite is described and a general design strategy for immunosensing platforms is proposed on the basis of HA/CS nanocomposite and nanogold particle adsorption of antibodies. A quartz crystal microbalance used as a model transducer and the detection performances of the resulting immunosensor were investigated by using the immuno-system of CA125, an important indicator in the diagnosis of clinical cancers. The hybrid nanocomposite was characterized by scanning electron microscopy and transmission electron microscopy measurements. The frequency response characteristics for the processes of immobilization and immunoreaction of anchored anti-CA125 antibodies were studied in detail. It was found that the developed sensing interface has some advantages, such as activation-free immobilization and high antigen-binding activities of antibodies. The as-prepared immunosensor can allow the determination of CA125 in the concentration range 15.3–440.0 U mL–1. Such an interface design with the hybrid nanocomposite could be tailored as a new alternative used for biosensor design.

Cytocompatibility of calcium phosphate coatings deposited by an ArF pulsed laser

In the current studies, we deposited ultra-thin hydroxyapatite films on a pure titanium substrate by pulsed laser deposition, and we examined the effects of these surfaces on rat bone marrow (RBM) cells. This method allowed deposition of 500-, 2,000-, and 5,000-A-thick hydroxyapatite films. X-ray diffraction showed that the amorphous films recrystallized to a hydroxyapatite crystal structure after annealing. The proliferation of RBM cells was unaffected by the hydroxyapatite films, but osteocalsin and alkaline phosphatase mRNA and protein levels were elevated in cells grown on 2,000- and 5,000-A-thick films. These results indicate that ultra-thin hydroxyapatite films generated by pulsed laser deposition are better at promoting osteogenesis than pure titanium surfaces.

Cytocompatibility of calcium phosphate coatings deposited by an ArF pulsed laser

In the current studies, we deposited ultra-thin hydroxyapatite films on a pure titanium substrate by pulsed laser deposition, and we examined the effects of these surfaces on rat bone marrow (RBM) cells. This method allowed deposition of 500-, 2000-, and 5000-Angstrom-thick hydroxyapatite films. X-ray diffraction showed that the amorphous films recrystallized to a hydroxyapatite crystal structure after annealing. The proliferation of RBM cells was unaffected by the hydroxyapatite films, but osteocalsin and alkaline phosphatase mRNA and protein levels were elevated in cells grown on 2000- and 5000-Angstrom-thick films. These results indicate that ultra-thin hydroxyapatite films generated by pulsed laser deposition are better at promoting osteogenesis than pure titanium surfaces.

In vitro andin vivo biological responses of plasma-sprayed hydroxyapatite coatings with posthydrothermal treatment

This study was undertaken to evaluate the effect of post-hydrothermal treatment on the biological responses of the plasma-sprayed hydroxyapatite (HA)-coated Ti-6Al-4V implant system both in vitro and in vivo. After hydrothermal treatment, the HA coating (HAC) shows the high mechanical strength and indices-of-crystallinity, denser microstructure, lower concentrations of amorphous and impurity phases, when compared with the as-sprayed HAC. The in vitro cell-culture studies, using UMR106 osteoblast-like cell, demonstrated no signifiacnt cell growth on both surface of as-sprayed and hydrothermal-treated HACs during 10-day culture. The in vivo studies, using the transcortical implant model in the femora of goats, evaluated the histological responses of two coatings. After 6 week of implantation, using backscattered electron images, no substantial histological variations in the extents of new bone apposition and new bone healing between the two HACs were observed. However, the as-sprayed HAC, owing to the dissolution induced the granular particles dissociated from the HAC, showed the statically lower extent of new bone apposition than hydrothermal-treated HAC at 12 weeks. The results suggest that hydrothermal treatment could be used to improve the mechanical strength, crystallinity, and phase composition of HAC, which are important factors of long-term fixation and stability of implant. Besides, the treated HAC could also achieve the initial fixation of implant in clinical use.

In vitro assays for adhesion and migration of osteoblastic cells (Saos-2) on titanium surfaces

The first event occurring at the boundary between a metal implant and living tissue is the attachment of cells onto the metal surface of the implant. The attachment characteristics of the metal in this situation are critical in determining its biocompatibility and usefulness as artificial bone and tooth implants. Using the human osteosarcoma cell line Saos-2, we attempted to establish simple and reliable methods for evaluating the attachment of cultured osteoblastic cells onto titanium samples that had been subjected to various surface treatments. Fluorescence actin imaging showed that cells cultured on titanium with hydrofluoric acid etching (HF-Ti) exhibited delayed spreading of their cytoplasm, as compared to cells cultured for the same length of time on nitrided titanium or physically polished titanium. The HF-Ti-cultured cells also exhibited poor assembly of focal contacts, as visualized by vinculin immunofluorescence. Furthermore, in motility assays based on an in vitro wound model, cells cultured on HF-Ti migrated more slowly than cells cultured on other titanium surfaces. These data suggest that Saos-2 cells attach less effectively to the HF-Ti surface. The methods described in this study should be useful for assessing the initial interactions of cultured cells with various materials, including metals.

[Osteoblast reaction on SLA and microgrooved implant surfaces]

The osseointegration process of dental implants depends on the tissue reaction at the tissue-implant interface. Osteoblasts are the main cells responsible for the regulation of osteoinduction. The manner and kinetics of the tissue reaction crucially depend on the interaction between osteoblasts and the morphology of the implant surface. The aim of this study was to investigate osteoblast behaviour on different implant surfaces (smooth, microgrooved, SLA) under standardized conditions. For this in vitro investigation we used primary bovine osteoblasts. Attachment kinetics, proliferation rate and synthesis of bone-associated proteins were used as parameters for cell reaction. The results demonstrate that both attachment and adhesion strength of the primary cell surface interaction was higher on the microgrooved surfaces than on SLA surfaces. The proliferation rate of cells and the synthesis of bone-specific proteins were higher on microgrooved surfaces in contrast to SLA surfaces. Ultrastructural analysis revealed phenotypic osteoblast-like cells on smooth and microgrooved surfaces, whereas cells on SLA surfaces showed a more fibroblastic appearance. This study demonstrates that the morphology of the implant surface determined the subsequent osteoblast reaction. An optimal cell reaction was found at surfaces which are smooth in the microenvironment of osteoblasts.

Mononuclear Titanium(IV)−Citrate Complexes from Aqueous Solutions: pH-Specific Synthesis and Structural and Spectroscopic Studies in Relevance to Aqueous Titanium(IV)−Citrate Speciation

Titanium is a metal frequently employed in a plethora of materials supporting medical applications. In an effort to comprehend the involvement of titanium in requisite biological interactions with physiological ligands, synthetic efforts were launched targeting aqueous soluble species of Ti(IV). To this end, aqueous reactions of TiCl(4) with citric acid afforded expediently, under pH-specific conditions, the colorless crystalline materials Na(6)[Ti(C(6)H(4.5)O(7))(2)(C(6)H(5)O(7))].16H(2)O (1) and Na(3)(NH(4))(3)[Ti(C(6)H(4.5)O(7))(2)(C(6)H(5)O(7))].9H(2)O (2). Complexes 1 and 2 were characterized by elemental analysis, FT-IR, (13)C-MAS solid state and solution NMR, cyclic voltammetry, and X-ray crystallography. 1 crystallizes in the triclinic space group P, with a = 15.511(9) A, b = 15.58(1) A, c = 9.848(5) A, alpha = 85.35(2) degrees, beta = 76.53(2) degrees, gamma = 61.97(2) degrees, V = 2042(2) A(3), and Z = 2. 2 crystallizes in the triclinic space group P, with a = 12.437(5) A, b = 12.440(5) A, c = 12.041(5) A, alpha = 83.08(2) degrees, beta = 81.43(2) degrees, gamma = 67.45(2) degrees, V = 1697(2) A(3), and Z = 2. The X-ray structures of 1 and 2 reveal the presence of a mononuclear complex, with Ti(IV) coordinated to three citrate ligands in a distorted octahedral geometry around Ti(IV). The citrates employ their central alkoxide and carboxylate groups to bind Ti(V), while the terminal carboxylates stay away from the Ti(IV)O(6) core. Worth noting in 1 and 2 is the similar mode of coordination but variable degree of protonation of the bound citrates, with the locus of (de)protonation being the noncoordinating terminal carboxylates. As a result, this work suggests the presence of a number of different Ti(IV)-citrate species of the same nuclearity and coordination geometry as a function of pH. This is consistent with the so far existing pool of mononuclear Ti(IV)-citrate species and provides a logical account of the aqueous speciation in the requisite binary system. Such information is vital in trying to delineate the interactions of soluble and bioavailable Ti(IV) forms promoting biological interactions in humans. To this end, chemical properties, structural attributes, and speciation links to potential ensuing biological effects are dwelled on.

Effects of surface undulations of biphasic calcium phosphate tablets on human osteoblast behavior

In this work, the in vitro behavior of human osteoblast cells on the undulated surfaces of biphasic calcium phosphate tablets was investigated. The tablets were produced by uniaxial pressing with convex cylindrical undulations occupying only half of the surface area; the other half was flat. Chemical and physical characterization was performed by scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). XRD and FTIR analyses revealed the presence of hydroxyapatite (HA) and alpha-tricalcium phosphate (alpha-TCP) in a well-defined ratio. Moreover, microtopography, evaluated by SEM and AFM, was similar on the flat region and on that with undulations. However, surface undulations induced different cellular arrangements, confirming the influence of the macrotopography on the cells orientation.

The modulation of osteogenesis in vitro by calcium titanium phosphate coatings

Calcium phosphate coated titanium and titanium alloy are widely used as dental and orthopaedic implants. This study examines the effect of novel calcium titanium and calcium titanium zirconium phosphates suitable for plasma-spraying onto titanium substrata on the expression of bone-related genes and proteins by human bone-derived cells (HBDC) and compares this behavior to that on native titanium and hydroxyapatite-coated titanium. Test materials were an acid etched and sand-blasted titanium surface (Ti-DPS), a plasma-sprayed hydroxyapatite coating (HA), and five materials which were created from CaTi(4)(PO(4))(6) (CTP) and CaZr(4)(PO(4))(6) (CZP): sintered CaTi(4)(PO(4))(6) (CTP-S1), sintered 46CaO.23TiO(2).31P(2)O(5) (CTP-S2), sintered CaTiZr(3)(PO(4))(6), (CTZP-S1), sintered 46CaO.23ZrO(2).31P(2)O(5) (CTZP-S2) and sintered 55CaO.20TiO(2).31P(2)O(5) (CTP-S3). HBDC were grown on the substrata for 3, 7, 14 and 21 d, counted and probed for various mRNAs and proteins (type I collagen, osteocalcin, osteopontin, osteonectin, alkaline phosphatase and bone sialoprotein). All substrates significantly affected cellular growth and the temporal expression of an array of bone-related genes and proteins. At 14 and 21 d, cells on CTP-S3 displayed significantly enhanced expression of all osteogenic mRNAs. Surfaces of CTP-S1 and CTP-S3 had the most effect on osteoblastic differentiation inducing a greater expression of an array of osteogenic markers than recorded for cells grown on Ti-DPS and HA, suggesting that these novel materials may possess a higher potency to enhance osteogenesis.

The effect of different titanium and hydroxyapatite-coated dental implant surfaces on phenotypic expression of human bone-derived cells

Roughened titanium (Ti) surfaces have been widely used for dental implants. In recent years, there has been the tendency to replace Ti plasma-sprayed surfaces by sandblasted and acid-etched surfaces in order to enhance osseous apposition. Another approach has been the utilization of hydroxyapatite (HA)-coated implants. This study examines the effect of two roughened Ti dental implant surfaces on the osteoblastic phenotype of human bone-derived cells (HBDC) and compares this behavior to that for cells on an HA-coated surface. Test materials were an acid-etched and sandblasted Ti surface (Ti-DPS), a porous Ti plasma-sprayed coating (Ti-TPS), and a plasma-sprayed porous HA coating (HA). Smooth Ti machined surfaces served as control (Ti-ma). HBDC were grown on the substrata for 3, 7, 14, and 21 days, counted and probed for various bone-related mRNAs and proteins (type I collagen, osteocalcin, osteopontin, osteonectin, alkaline phosphatase, and bone sialoprotein). All dental implant surfaces significantly affected cellular growth and the temporal expression of an array of bone-related genes and proteins. HA-coated Ti had the most effect on osteoblastic differentiation inducing a greater expression of an array of osteogenic markers than recorded for cells grown on Ti-DPS and Ti-TPS, thus suggesting that the HA-coated surface may possess a higher potency to enhance osteogenesis. Furthermore, Ti-DPS surfaces induced greater osteoblast proliferation and differentiation than Ti-TPS.

A new dinuclear Ti(IV)-peroxo-citrate complex from aqueous solutions. Synthetic, structural, and spectroscopic studies in relevance to aqueous titanium(IV)-peroxo-citrate speciation

The wide use of titanium in applied materials has prompted pertinent studies targeting the requisite chemistry of that metal's biological interactions. In order to understand such interactions as well as the requisite titanium aqueous speciation, we launched investigations on the synthesis and spectroscopic and structural characterization of Ti(IV) species with the physiological citric acid. Aqueous reactions of TiCl(4) with citric acid in the presence of H(2)O(2) and neutralizing ammonia afforded expediently the red crystalline material (NH(4))(4)[Ti(2)(O(2))(2)(C(6)H(4)O(7))(2)].2H(2)O (1). Complex 1 was further characterized by UV-vis, FT-IR, FT- and laser-Raman, NMR, and finally by X-ray crystallography. Compound 1 crystallizes in the monoclinic space group P2(1)/n, with a = 10.360(4) A, b = 10.226(4) A, c = 11.478(6) A, beta = 107.99(2) degrees, V = 1156.6(9) A(3), and Z = 2. The X-ray structure of 1 reveals a dinuclear anionic complex containing a Ti(IV)(2)O(2) core. In that central unit, two fully deprotonated citrate ligands are coordinated to the metal ions through their carboxylate moieties in a monodentate fashion. The central alkoxides serve as bridges to the two titanium ions. Also attached to the Ti(IV)(2)O(2) core are two peroxo ligands each bound in a side-on fashion to the respective metal ions. NH(4)(+) ions neutralize the 4- charge of the anion in 1, further contributing to the stability of the derived lattice through H-bond formation. The structural similarities and differences with congener vanadium(V)-peroxo-citrate complexes may point out potential implications in the chemistry of titanium with physiological ligands, when the former is present in a biologically relevant medium.