Histological reaction to hydroxyapatite in the middle ear of rats

Advanced Strategies for Enhancing the Biocompatibility and Antibacterial Properties of Implantable Structures

This review explores the latest advancements in enhancing the biocompatibility and antibacterial properties of implantable structures, with a focus on titanium (Ti) and its alloys. Titanium implants, widely used in dental and orthopedic applications, demonstrate excellent mechanical strength and biocompatibility, yet face challenges such as peri-implantitis, a bacterial infection that can lead to implant failure. To address these issues, both passive and active surface modification strategies have been developed. Passive modifications, such as altering surface texture and chemistry, aim to prevent bacterial adhesion, while active approaches incorporate antimicrobial agents for sustained infection control. Nanotechnology has emerged as a transformative tool, enabling the creation of nanoscale materials and coatings like TiO2 and ZnO that promote osseointegration and inhibit biofilm formation. Techniques such as plasma spraying, ion implantation, and plasma electrolytic oxidation (PEO) show promising results in improving implant integration and durability. Despite significant progress, further research is needed to refine these technologies, optimize surface properties, and address the clinical challenges associated with implant longevity and safety. This review highlights the intersection of surface engineering, nanotechnology, and biomedical innovation, paving the way for the next generation of implantable devices.

Hydroxyapatite-based composites: Excellent materials for environmental remediation and biomedical applications

Given their unique characteristics and properties, Hydroxyapatite (HAp) nanomaterials and nanocomposites have been used in diverse advanced catalytic technologies and in the field of biomedicine, such as drug and protein carriers. This paper examines the structure and properties of the manufactured HAp as well as a variety of synthesis methods, including hydrothermal, microwave-assisted, co-precipitation, sol-gel, and solid-state approaches. Additionally, the benefits and drawbacks of various synthesis techniques and ways to get around them to spur more research are also covered. This literature discusses the various applications, including photocatalytic degradation, adsorptions, and protein and drug carriers. The photocatalytic activity is mainly focused on single-phase, doped-phase, and multi-phase HAp, while the adsorption of dyes, heavy metals, and emerging pollutants by HAp are discussed in the manuscript. Furthermore, the use of HAp in treating bone disorders, drug carriers, and protein carriers is also conferred. In light of this, the development of HAp-based nanocomposites will inspire the next generation of chemists to improve upon and create stable nanoparticles and nanocomposites capable of successfully addressing major environmental concerns. This overview's conclusion offers potential directions for future study into HAp synthesis and its numerous applications.

In vitro characterization of hydroxyapatite and cobalt ferrite nanoparticles compounds and their biocompatibility in vivo

Bioactive materials in combination with antibiotics have been widely developed for the treatment of bone infection. Thus, this work aims to characterize six biomaterials formulated with different concentrations of hydroxyapatite and cobalt ferrite nanoparticles, in addition to the antibiotic ciprofloxacin, using X-ray diffraction (XRD), scanning electron microscopy (SEM), and the antibiotic diffusion test on agar. Furthermore, in vivo biocompatibility and the reabsorption process of these materials were analyzed. XRD showed that both hydroxyapatite and cobalt ferrite present high crystallinity. The photomicrographs obtained by SEM revealed that composites have a complex surface, evidenced by the irregular arrangement of the hydroxyapatite and cobalt ferrite granules, besides demonstrating the interaction between their components. The antibiotic-diffusion test showed that all biomaterials produced an inhibition halo in Staphylococcus aureus cultures. For the biocompatibility study, composites were surgically implanted in the dorsal region of rabbits. At 15, 30, 70, and 100 days, biopsies of the implanted regions were performed. The biomaterials were easily identified during histological analysis and no significant inflammatory process, nor histological signs of toxicity or rejection by the adjacent tissue were observed. We can conclude that the biomaterials analyzed are biocompatible, degradable, and effective in inhibiting the in vitro growth of Staphylococcus aureus. Graphical abstract.

Comparison of subcutaneous inflammatory response to commercial and engineered zinc hydroxyapatite implants in rabbits

ABSTRACT Hydroxyapatite (HA) is widely used as a biomaterial for bone repair and metallic prostheses coating. The main limitations of the current commercial synthetic hydroxyapatite compounds include high cost and decreased availability, especially for veterinary medicine purposes. Additionally, it is thought that HA biocompatibility and bioactivity could be enhanced by the addition of metal compounds. The objective of this work was to compare the subcutaneous tissue response of commercial and engineered hydroxyapatite obtained from the bovine femur diaphysis mixed with different concentrations of hexa-hydrated Zinc Nitrate in rabbits. Twenty-Five New Zealand female rabbits were used. Five treatments were done according to HA composition (commercial HA, no Zn-HA, 0.1M Zn, 0.2M Zn, and 0.3M Zn). Each treatment was evaluated at five time-points (8, 15, 30, 60 and 90 days post-implantation). Histopathologic analysis was performed to assess inflammation by polymorphonuclear cells infiltration, neovascularization, and fibrosis. Results obtained in this work suggest that general inflammation decreased after 60 days of implantation regardless of Zn concentration. Fibrosis score was increased in the commercial HP compared to control and Zn-hydrated HA. This paper shows that bovine hydroxyapatite is a biocompatible material regardless of nitrate Zinc concentration and has the same properties of commercial hydroxyapatite.

Application of hydroxyapatite and its modified forms as adsorbents for water defluoridation: an insight into process synthesis

Fluorosis is a major scourge in many countries caused by prolonged consumption of drinking water with high fluoride content found in groundwater resources. Hydroxyapatite (Hap) and its composite forms are excellent biomaterials that recently gained attention as efficient adsorbents, owing to its physical and chemical nature as it can substitute both cationic and anionic complexes present in an aqueous solution in its atomic arrangement. Its biological nature, biocompatibility and biodegradability along with its chemical characteristics such as crystallinity, stability, ion adsorption capability and highly specific catalytic activity make it suitable for a variety of applications especially in water treatment for fluoride removal. This review describes various techniques for synthesis of a wide variety of biogenic, synthetic, composite and modified forms of Hap for application in water defluoridation. Hap derived from natural sources or synthesized using conventional methods, hydrothermal, sol-gel or advanced sonication-cum-precipitation technique varied in terms of its crystallinity, structure, size, etc., which affect the fluoride removal capacity. The advantage and disadvantages of various synthesis methods, process parameters and product characteristics have been compiled, which may help to identify a suitable synthesis method for a desired Hap product for potential application and future perspectives in water treatment.

Recent progress on fabrication and drug delivery applications of nanostructured hydroxyapatite

Through this brief review, we provide a comprehensive historical background of the development of nanostructured hydroxyapatite (nHAp), and its application potentials for controlled drug delivery, drug conjugation, and other biomedical treatments. Aspects associated with efficient utilization of hydroxyapatite (HAp) nanostructures such as their synthesis, interaction with drug molecules, and other concerns, which need to be resolved before they could be used as a potential drug carrier in body system, are discussed. This review focuses on the evolution of perceptions, practices, and accomplishments in providing improved delivery systems for drugs until date. The pioneering developments that have presaged today's fascinating state of the art drug delivery systems based on HAp and HAp-based composite nanostructures are also discussed. Special emphasis has been given to describe the application and effectiveness of modified HAp as drug carrier agent for different diseases such as bone-related disorders, carriers for antibiotics, anti-inflammatory, carcinogenic drugs, medical imaging, and protein delivery agents. As only a very few published works made comprehensive evaluation of HAp nanostructures for drug delivery applications, we try to cover the three major areas: concepts, practices and achievements, and applications, which have been consolidated and patented for their practical usage. The review covers a broad spectrum of nHAp and HAp modified inorganic drug carriers, emphasizing some of their specific aspects those needed to be considered for future drug delivery applications. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Respiratory Disease Nanotechnology Approaches to Biology > Cells at the Nanoscale.

Surface characterization and corrosion behavior of calcium phosphate-base composite layer on titanium and its alloys via plasma electrolytic oxidation: A review paper

In recent years, calcium phosphate-base composites, such as hydroxyapatite (HA) and carbonate apatite (CA) have been considered desirable and biocompatible coating layers in clinical and biomedical applications such as implants because of the high resistance of the composites. This review focuses on the effects of voltage, time and electrolytes on a calcium phosphate-base composite layer in case of pure titanium and other biomedical grade titanium alloys via the plasma electrolytic oxidation (PEO) method. Remarkably, these parameters changed the structure, morphology, pH, thickness and crystallinity of the obtained coating for various engineering and biomedical applications. Hence, the structured layer caused improvement of the biocompatibility, corrosion resistance and assignment of extra benefits for Osseo integration. The fabricated layer with a thickness range of 10 to 20 μm was evaluated for physical, chemical, mechanical and tribological characteristics via XRD, FESEM, EDS, EIS and corrosion analysis respectively, to determine the effects of the applied parameters and various electrolytes on morphology and phase transition. Moreover, it was observed that during PEO, the concentration of calcium, phosphor and titanium shifts upward, which leads to an enhanced bioactivity by altering the thickness. The results confirm that the crystallinity, thickness and contents of composite layer can be changed by applying thermal treatments. The corrosion behavior was investigated via the potentiodynamic polarization test in a body-simulated environment. Here, the optimum corrosion resistance was obtained for the coating process condition at 500 V for 15 min in Ringer solution. This review has been summarized, aiming at the further development of PEO by producing more adequate titanium-base implants along with desired mechanical and biomedical features.

Synthesis methods for nanosized hydroxyapatite with diverse structures

Hydroxyapatite (HAp) is the major mineral constituent of vertebrate bones and teeth. It has been well documented that HAp nanoparticles can significantly increase the biocompatibility and bioactivity of man-made biomaterials. Over the past decade, HAp nanoparticles have therefore increasingly been in demand, and extensive efforts have been devoted to develop many synthetic routes, involving both scientifically and economically new features. Several investigations have also been made to determine how critical properties of HAp can be effectively controlled by varying the processing parameters. With such a wide variety of methods for the preparation of HAp nanoparticles, choosing a specific procedure to synthesize a well-defined powder can be laborious; accordingly, in the present review, we have summarized all the available information on the preparation methodologies of HAp, and highlighted the inherent advantages and disadvantages involved in each method. This article is focused on nanosized HAp, although recent articles on microsized particles, especially those assembled from nanoparticles and/or nanocrystals, have also been reviewed for comparison. We have also provided several scientific figures and discussed a number of critical issues and challenges which require further research and development.

Effects of NasoPore Packing in the Middle Ear Cavity of the Guinea Pig

Objective. To evaluate the effects of NasoPore after packing of the middle ear in guinea pigs.

Study Design. A randomized, prospective, controlled animal study.

Setting. University laboratory.

Subjects and Methods. Forty-one guinea pigs were divided into 3 groups. In group 1 (n = 12), the middle ears of animals were unilaterally implanted with NasoPore, leaving the contralateral middle ears packed with absorbable gelatin sponge soaked in a solution containing kanamycin and furosemide as an ototoxicity-positive control; group 2 (n = 17) underwent the same experimental protocol as group 1, except the gelatin sponge was unsoaked; in group 3 (n = 12), NasoPore was inserted unilaterally and no packing material was placed into the contralateral ear. Auditory brainstem responses (ABRs) were performed preoperatively and 3 months after the procedure. The surface preparation and scanning electron microscopy (SEM) were assessed 3 months postoperatively, whereas pathology of middle ear was analyzed in 5 samples of group 2.

Results. ABR thresholds of the contralateral ear significantly increased in group 1 and were slightly shifted in group 2 compared with the NasoPore-packed and nonpacked ears 3 months postoperatively. The NasoPore-packed middle ears were found to have less fibrosis and inflammation and less thickened bone and tympanic membranes than Gelfoam-packed ears. Surface preparations and SEM showed no ototoxicity in the inner ear of NasoPore-packed ears.

Conclusion. NasoPore appears to be effective for use in otosurgery. It caused less fibrosis in the middle ear than conventional packing agents and no ototoxicity to the inner ear.

Histologic analysis of the effects of three different support materials within rat middle ear

Objective: To investigate histologic changes in the mucosa of rat middle ear after implantation of three different support materials.

Study Design: A prospective, controlled animal study.

Subjects and Methods: Three types of absorbable materials were implanted into the middle ear cavity of rats: (1) Gelfoam (purified gelatin) (Pharmacia & Upjohn Company, New York, NY), (2) Sepragel (viscoelastic gel composed of cross-linked polymers of hyaluronan) (GENZYME Corp, Ridgefield, NJ), and (3) Nasopore (a biodegradable/fragmentable, synthetic polyurethane foam) (Polyganics, Groningen, The Netherlands). Rats were sacrificed after 3 and 20 days to ascertain early and late histologic changes. The bulla of each rat was excised and prepared for microscopic examination. The histologic changes were evaluated by observation of the middle ear cavity and mucosa in terms of polymorphonuclear leucocytes (PMNL), macrophages, giant cells, fibroblasts and other cells, fibrosis, and remnant materials.

Results: The histologic appearance of gelfoam-treated middle ears was characterized by more severe acute inflammation in the short-term and prominent fibrosis in the long-term in comparison with sepragel- and nasopore-treated groups. Nasopore appeared to be prone to remnant formation and reorganization by means of fibroblastic activity.

Conclusion: Compared with gelfoam, both sepragel and nasopore caused less histologic alterations.

In vivo and in vitro response to electrochemically anodized Ti-6Al-4V alloy

Tissues' reactions to metals depend on a variety of properties of the metal, most notably surface structure. Anodizing has been shown to alter the surface properties of metal, thus eliciting a change in the biocompatibility of the metal. In order to evaluate the biocompatibility of unoxidized titanium alloy (Ti-6Al-4V) and anodized titanium alloy samples, the samples were implanted in murine abdominal subcutaneous tissues, and maintained for 2 and 4 weeks. The reaction of the abdominal subcutaneous connective tissues to the samples was then assessed. Fibrous connective tissue capsules were observed around the vicinity of the sample, and these capsules were shown to harbor fibroblasts, fibrocytes, and other cells, including neutrophils, macrophages, and giant multinucleated cells. The average thickness of the fibrous capsules observed around the anodized alloy samples was less than that of the capsules seen around samples of the unoxidized titanium alloy. Blood was obtained from the tails of the experimental mice, and blood cell analyses were conducted in order to assess the levels of leukocytes, red blood cells, and thrombocytes. The blood analysis results of the unoxidized control group and treatment group were all within normal ranges. In addition, the biocompatibility of the titanium alloy samples was evaluated using cell culture techniques. The numbers of MG-63 cells cultured on oxidized samples tended to be greater than those in the controls; however, these increases were not statistically significant. The alkaline phosphatase activity of the sample oxidized at 310 V evidenced significantly higher activity than was observed in the control group. These results indicate that the anodized Ti-6Al-4V alloy will be of considerable utility in biomedical applications.

Endoscopic Subureteral Urocol Injection for the Treatment of Vesicoureteral Reflux

PURPOSE

We evaluated the effect of Urocol injection for the endoscopic treatment of VUR in children.

MATERIALS AND METHODS

A total of 208 children (62 boys and 146 girls, mean age 4.78 years) with 346 refluxing ureters underwent subureteral injection of Urocol between January 2000 and February 2002. VCUG was performed at 6 months, and ultrasound was performed at 1 week and 3 months postoperatively.

RESULTS

Followup VCUG showed no evidence of reflux in 240 ureters (69%), significant decrease in reflux grade in 62 (18%) and no change in 44 (13%). Ultrasound revealed no obstruction or hydronephrosis.

CONCLUSIONS

The results of this study demonstrate that subureteral injection of Urocol was effective for the treatment of VUR. We conclude that Urocol represents a new, safe, simple, less expensive and repeatable technique in treating VUR.