Progress of research on the surface functionalization of tantalum and porous tantalum in bone tissue engineering

Tantalum and porous tantalum are ideal materials for making orthopedic implants due to their stable chemical properties and excellent biocompatibility. However, their utilization is still affected by loosening, infection, and peripheral inflammatory reactions, which sometimes ultimately lead to implant removal. An ideal bone implant should have exceptional biological activity, which can improve the surrounding biological microenvironment to enhance bone repair. Recent advances in surface functionalization have produced various strategies for developing compatibility between either of the two materials and their respective microenvironments. This review provides a systematic overview of state-of-the-art strategies for conferring biological functions to tantalum and porous tantalum implants. Furthermore, the review describes methods for preparing active surfaces and different bioactive substances that are used, summarizing their functions. Finally, this review discusses current challenges in the development of optimal bone implant materials.

Preparation, modification, and clinical application of porous tantalum scaffolds

Porous tantalum (Ta) implants have been developed and clinically applied as high-quality implant biomaterials in the orthopedics field because of their excellent corrosion resistance, biocompatibility, osteointegration, and bone conductivity. Porous Ta allows fine bone ingrowth and new bone formation through the inner space because of its high porosity and interconnected pore structure. It contributes to rapid bone integration and long-term stability of osseointegrated implants. Porous Ta has excellent wetting properties and high surface energy, which facilitate the adhesion, proliferation, and mineralization of osteoblasts. Moreover, porous Ta is superior to classical metallic materials in avoiding the stress shielding effect, minimizing the loss of marginal bone, and improving primary stability because of its low elastic modulus and high friction coefficient. Accordingly, the excellent biological and mechanical properties of porous Ta are primarily responsible for its rising clinical translation trend. Over the past 2 decades, advanced fabrication strategies such as emerging manufacturing technologies, surface modification techniques, and patient-oriented designs have remarkably influenced the microstructural characteristic, bioactive performance, and clinical indications of porous Ta scaffolds. The present review offers an overview of the fabrication methods, modification techniques, and orthopedic applications of porous Ta implants.

A review on in vitro/in vivo response of additively manufactured Ti-6Al-4V alloy

Bone replacement using porous and solid metallic implants, such as Ti-alloy implants, is regarded as one of the most practical therapeutic approaches in biomedical engineering. The bone is a complex tissue with various mechanical properties based on the site of action. Patient-specific Ti-6Al-4V constructs may address the key needs in bone treatment for having customized implants that mimic the complex structure of the natural tissue and diminish the risk of implant failure. This review focuses on the most promising methods of fabricating such patient-specific Ti-6Al-4V implants using additive manufacturing (AM) with a specific emphasis on the popular subcategory, which is powder bed fusion (PBF). Characteristics of the ideal implant to promote optimized tissue-implant interactions, as well as physical, mechanical/chemical treatments and modifications will be discussed. Accordingly, such investigations will be classified into 3B-based approaches (Biofunctionality, Bioactivity, and Biostability), which mainly govern native body response and ultimately the success in implantation.

A Decade of Progress on MAO-Treated Tantalum Surfaces: Advances and Contributions for Biomedical Applications

Micro-structured coatings with functional properties have been investigated due to a wide range of applications. It is known that micro-structures can play an important role in surface interactions determining the materials’ performance. Amongst the other materials, there has been an increasing interest in tantalum oxide (Ta₂O₅). This attention is mainly due to its variety of properties: biocompatibility and bioactivity; high dielectric constant; good thermal and chemical stability; excellent corrosion and mechanical resistance. Moreover, there is a wide range of applications in which the properties can be fitted. Furthermore, according to the final application, these properties can be enhanced or tailored through surface micro-structures manipulation. Due to this purpose, over the past decade, Ta surface modification by micro-arc oxidation (MAO) has been investigated mostly for biomedical applications. Therefore, this review focuses on Ta surface functionalization using the MAO technique. A clear understanding of the micro-discharge phenomena and the formation mechanism of a Ta₂O₅ anodic coating by MAO is supplied. The Ta₂O₅ coating morphology, topography, chemistry, and structure are explored, establishing their correlation with the MAO parameters. Additionally, an understanding of Ta₂O₅’s biological, mechanical, and electrochemical properties is provided and reviewed.

Plasma Electrolytic Oxidation (PEO) Process-Processing, Properties, and Applications

Plasma electrolytic oxidation (PEO) is a novel surface treatment process to produce thick, dense metal oxide coatings, especially on light metals, primarily to improve their wear and corrosion resistance. The coating manufactured from the PEO process is relatively superior to normal anodic oxidation. It is widely employed in the fields of mechanical, petrochemical, and biomedical industries, to name a few. Several investigations have been carried out to study the coating performance developed through the PEO process in the past. This review attempts to summarize and explain some of the fundamental aspects of the PEO process, mechanism of coating formation, the processing conditions that impact the process, the main characteristics of the process, the microstructures evolved in the coating, the mechanical and tribological properties of the coating, and the influence of environmental conditions on the coating process. Recently, the PEO process has also been employed to produce nanocomposite coatings by incorporating nanoparticles in the electrolyte. This review also narrates some of the recent developments in the field of nanocomposite coatings with examples and their applications. Additionally, some of the applications of the PEO coatings have been demonstrated. Moreover, the significance of the PEO process, its current trends, and its scope of future work are highlighted.

The Clinical Application of Porous Tantalum and Its New Development for Bone Tissue Engineering

Porous tantalum (Ta) is a promising biomaterial and has been applied in orthopedics and dentistry for nearly two decades. The high porosity and interconnected pore structure of porous Ta promise fine bone ingrowth and new bone formation within the inner space, which further guarantee rapid osteointegration and bone-implant stability in the long term. Porous Ta has high wettability and surface energy that can facilitate adherence, proliferation and mineralization of osteoblasts. Meanwhile, the low elastic modulus and high friction coefficient of porous Ta allow it to effectively avoid the stress shield effect, minimize marginal bone loss and ensure primary stability. Accordingly, the satisfactory clinical application of porous Ta-based implants or prostheses is mainly derived from its excellent biological and mechanical properties. With the advent of additive manufacturing, personalized porous Ta-based implants or prostheses have shown their clinical value in the treatment of individual patients who need specially designed implants or prosthesis. In addition, many modification methods have been introduced to enhance the bioactivity and antibacterial property of porous Ta with promising in vitro and in vivo research results. In any case, choosing suitable patients is of great importance to guarantee surgical success after porous Ta insertion.

Functionalization of 3D-printed titanium alloy orthopedic implants: a literature review

Titanium alloy orthopedic implants produced by 3D printing combine the dual advantages of having a complex structure that cannot be manufactured by traditional techniques and the excellent physical and chemical properties of titanium and its alloys; they have been widely used in the field of orthopedics in recent years. The inherent porous structure of 3D-printed implants and the original modification processes for titanium alloys provide conditions for the functionalization of implants. To meet the needs of orthopedic surgeons and patients, functionalized implants with long-term stability and anti-infection or anti-tumor properties have been developed. The various methods of functionalization deserve to be summarized, compared and analyzed. Therefore, in this review, we will collect and discuss existing knowledge on the functionalization of 3D-printed titanium alloy orthopedic implants.

Influences of sodium tantalite submicro-particles in polyetheretherketone based composites on behaviors of rBMSCs/HGE-1 cells for dental application

Dental implanted materials require excellent mechanical properties, biocompatibility as well as integration with bone tissue and gingival tissue to achieve early loading and long-term stability. In this study, cubic shape sodium tantalite (ST) submicro-particles with the size of around 180 nm were synthesized by a hydrothermal method, and ST/polyetheretherketone (PEEK) composites (TPC) with ST content of 20 w% (TPC20) and 40 w% (TPC40) were prepared by melting blend. The results showed that the compressive strength, thermal properties, surface roughness, hydrophilicity and surface energy as well as adsorption of proteins on TPC40 were also significantly enhanced compared with TPC20 and PEEK. Moreover, the responses (adhesion and proliferation as well as differentiation) of rat bone marrow mesenchymal stem cells (rBMSCs), and responses (adhesion, and proliferation) of human gingival epithelial (HGE-1) cells to TPC40 were significantly promoted compared with TPC20 and PEEK. The results demonstrated that ST content in TPC had remarkable effects on the surface properties, which played key roles in stimulating the responses of both rBMSCs and HGE-1 cells. TPC40 with increased surface properties and excellent cytocompatibility might have great potential as an implanted material for dental application.

Nanolamellar Tantalum Interfaces in the Osteoblast Adhesion

The design of topographically patterned surfaces is considered to be a preferable approach for influencing cellular behavior in a controllable manner, in particular to improve the osteogenic ability of bone regeneration. In this study, we fabricated nanolamellar tantalum (Ta) surfaces with lamellar wall thicknesses of 40 and 70 nm. The cells attached to nanolamellar Ta surfaces exhibited higher protein adsorption and expression of β1 integrin, as compared to the nonstructured bulk Ta, which facilitated the initial cell attachment and spreading. We thus, as expected, observed significantly enhanced osteoblast adhesion, growth, and alkaline phosphatase activity on nanolamellar Ta surfaces. However, the beneficial effects of nanolamellar structures on osteogenesis became weaker as the lamellar wall thickness increased. The interaction between cells and Ta surfaces was examined through adhesion forces using atomic force microscopy. Our findings indicated that the Ta surface with a lamellar wall thickness of 40 nm exhibited the strongest stimulatory effect. The observed strongest adhesion force between the cell-attached tip and the Ta surface with a 40 nm thick lamellar wall encouraged the much stronger binding of cells with the surface and thus well-attached, -stretched, and -grown cells. We attributed this to the increase in the available contact area of cells with the thinner nanolamellar Ta surface. The increased contact area allowed the enhancement of the cell surface interaction strength and, thus, improved osteoblast adhesion. This study suggests that the thin nanolamellar topography shows immense potential in improving the clinical performance of dental and orthopedic implants.

Additive manufacturing technique-designed metallic porous implants for clinical application in orthopedics

Traditional metallic scaffold prostheses, as vastly applied implants in clinical orthopedic operations, have achieved great success in rebuilding limb function. However, mismatch of bone defects and additional coating requirements limit the long-term survival of traditional prostheses. Recently, additive manufacturing (AM) has opened up unprecedented possibilities for producing complicated structures in prosthesis shapes and microporous surface designs of customized prostheses, which can solve the drawback of traditional prostheses mentioned above. This review presents the most commonly used metallic additive manufacturing techniques, the microporous structure design of metallic scaffolds, and novel applications of customized prostheses in the orthopedic field. Challenges and future perspectives on AM fabricated scaffolds are also summarized.

Tailored Surface Treatment of 3D Printed Porous Ti6Al4V by Microarc Oxidation for Enhanced Osseointegration via Optimized Bone In-Growth Patterns and Interlocked Bone/Implant Interface

3D printed porous titanium (Ti) holds enormous potential for load-bearing orthopedic applications. Although the 3D printing technique has good control over the macro-sturctures of porous Ti, the surface properties that affect tissue response are beyond its control, adding the need for tailored surface treatment to improve its osseointegration capacity. Here, the one step microarc oxidation (MAO) process was applied to a 3D printed porous Ti6Al4V (Ti64) scaffold to endow the scaffold with a homogeneous layer of microporous TiO2 and significant amounts of amorphous calcium-phosphate. Following the treatment, the porous Ti64 scaffolds exhibited a drastically improved apatite forming ability, cyto-compatibility, and alkaline phosphatase activity. In vivo test in a rabbit model showed that the bone in-growth at the untreated scaffold was in a pattern of distance osteogenesis by which bone formed only at the periphery of the scaffold. In contrast, the bone in-growth at the MAO-treated scaffold exhibited a pattern of contact osteogenesis by which bone formed in situ on the entire surface of the scaffold. This pattern of bone in-growth significantly increased bone formation both in and around the scaffold possibly through enhancement of bone formation and disruption of bone remodeling. Moreover, the implant surface of the MAO-treated scaffold interlocked with the bone tissues through the fabricated microporous topographies to generate a stronger bone/implant interface. The increased osteoinetegration strength was further proven by a push out test. MAO exhibits a high efficiency in the enhancement of osteointegration of porous Ti64 via optimizing the patterns of bone in-growth and bone/implant interlocking. Therefore, post-treatment of 3D printed porous Ti64 with MAO technology might open up several possibilities for the development of bioactive customized implants in orthopedic applications.

Formation and osteoblast behavior of HA nano-rod/fiber patterned coatings on tantalum in porous and compact forms

Osteoblast survival and proliferation are enhanced on quasi-upright HA nanorods but inhibited on paralleled HA nanofibers compared to Ta.

Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats

Strontium-substituted hierarchical Ti surface can enhance the osseointegration by both increasing new bone formation and reducing bone resorption under osteoporotic conditions.