Molecular Response to Nanopatterned Implants in the Human Jaw Bone

The Effects of Surface Patterning and Photobiomodulation on the Osseointegration of Titanium Implants in Osteoporotic Long Bones: An In Vivo Study in Rats

This study aimed to assess the impact of titanium surface patterning used in combination with photobiomodulation therapy on enhancing osseointegration in osteoporotic bone fractures. C.p. titanium implants were employed, half with an unmodified surface and half with a modified one, showing a nanostructured cellular surface. Surface patterning aimed to obtain a complex morphology designed for better osseointegration, using a selective anodization process after photoresist coating. A total of 52 rats were used, of which 4 were sacrificed 12 weeks after ovariectomy to evaluate bone density. A total of 48 rats received titanium implants in both tibiae and underwent surgery for implant placement and bone fracture. Half of the rats were subjected to photobiomodulation. The times of sacrifice were 2, 4, and 6 weeks after finalizing LASER therapy. The evaluation methods were micro-CT scanning, the mechanical pull-force test, and morphology. Mechanical tests revealed a significant difference in the surface-patterned titanium with the LASER group at 2 weeks, but not at 4 and 6 weeks. This group outperformed regular titanium and titanium/LASER groups. Micro-CT showed no significant differences, while the morphology indicated better bone quality at 4 weeks in all LASER-treated groups. The effect of surface patterning and photobiomodulation leads to better osseointegration, especially in the earlier stages.

Nanotextured porous titanium scaffolds by argon ion irradiation: Toward conformal nanopatterning and improved implant osseointegration

Stress shielding and osseointegration are two main challenges in bone regeneration, which have been targeted successfully by chemical and physical surface modification methods. Direct irradiation synthesis (DIS) is an energetic ion irradiation method that generates self-organized nanopatterns conformal to the surface of materials with complex geometries (e.g., pores on a material surface). This work exposes porous titanium samples to energetic argon ions generating nanopatterning between and inside pores. The unique porous architected titanium (Ti) structure is achieved by mixing Ti powder with given amounts of spacer NaCl particles (vol % equal to 30%, 40%, 50%, 60%, and 70%), compacted and sintered, and combined with DIS to generate a porous Ti with bone-like mechanical properties and hierarchical topography to enhance Ti osseointegration. The porosity percentages range between 25% and 30% using 30 vol % NaCl space-holder (SH) volume percentages to porosity rates of 63%-68% with SH volume of 70 vol % NaCl. Stable and reproducible nanopatterning on the flat surface between pores, inside pits, and along the internal pore walls are achieved, for the first time on any porous biomaterial. Nanoscale features were observed in the form of nanowalls and nanopeaks of lengths between 100 and 500 nm, thicknesses of 35-nm and heights between 100 and 200 nm on average. Bulk mechanical properties that mimic bone-like structures were observed along with increased wettability (by reducing contact values). Nano features were cell biocompatible and enhanced in vitro pre-osteoblast differentiation and mineralization. Higher alkaline phosphatase levels and increased calcium deposits were observed on irradiated 50 vol % NaCl samples at 7 and 14 days. After 24 h, nanopatterned porous samples decreased the number of attached macrophages and the formation of foreign body giant cells, confirming nanoscale tunability of M1-M2 immuno-activation with enhanced osseointegration.

Topography-mediated immunomodulation in osseointegration; Ally or Enemy

Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.

Effect of Smoke Exposure on Gene Expression in Bone Healing around Implants Coated with Nanohydroxyapatite

This study evaluated the effect of smoke exposure on the expression of genes related to bone metabolism in implants coated with nanohydroxyapatite (NHA). A total of 36 rats were exposed to cigarette smoke for 60 days. The animals were allocated into three groups: machined implants (MAC), dual acid-etched implants (DAE), and NHA-coated implants (NHA). Implants were installed in the left tibia of the rats after 30 days of smoke exposure. The implants were retrieved 7 and 30 days after implantation, and the adjacent bone analyzed using a real-time polymerase chain reaction for gene expression of alkaline phosphatase (ALP), osteopontin (OPN), receptor activator of the nuclear factor kappa ligand (RANKL), osteoprotegerin (OPG), the RANKL/OPG ratio, osteocalcin (OCN) and runt-related transcription factor 2 (Runx2). After 7 days, Runx2, OPN and OPG expression demonstrated significantly higher levels for the NHA surface treatment relative to DAE and MAC surfaces. NHA presented the lowest RANKL and RANKL/OPG levels. After 30 days, NHA-coated implants showed significantly higher levels of Runx2, ALP, OPN, OPG, OC, RANKL and RANKL/OPG relative to DAE and MAC implants. The results indicated a greater osteogenic and high osteoclastic activity around NHA implants, in comparison to DAE and MAC implants.

An update of nanotopographical surfaces in modulating stem cell fate: a narrative review

Stem cells have been one of the ideal sources for tissue regeneration owing to their capability of self-renewal and differentiation. In vivo, the extracellular microenvironment plays a vital role in modulating stem cell fate. When developing biomaterials for regenerative medicine, incorporating biochemical and biophysical cues to mimic extracellular matrix can enhance stem cell lineage differentiation. More specifically, modulating the stem cell fate can be achieved by controlling the nanotopographic features on synthetic surfaces. Optimization of nanotopographical features leads to desirable stem cell functions, which can maximize the effectiveness of regenerative treatment. In this review, nanotopographical surfaces, including static patterned surface, dynamic patterned surface, and roughness are summarized, and their fabrication, as well as the impact on stem cell behaviour, are discussed. Later, the recent progress of applying nanotopographical featured biomaterials for altering different types of stem cells is presented, which directs the design and fabrication of functional biomaterial. Last, the perspective in fundamental research and for clinical application in this field is discussed.