Advances in Multifunctional Bioactive Coatings for Metallic Bone Implants

To fix the bone in orthopedics, it is almost always necessary to use implants. Metals provide the needed physical and mechanical properties for load-bearing applications. Although widely used as biomedical materials for the replacement of hard tissue, metallic implants still confront challenges, among which the foremost is their low biocompatibility. Some of them also suffer from excessive wear, low corrosion resistance, infections and shielding stress. To address these issues, various coatings have been applied to enhance their in vitro and in vivo performance. When merged with the beneficial properties of various bio-ceramic or polymer coatings remarkable bioactive, osteogenic, antibacterial, or biodegradable composite implants can be created. In this review, bioactive and high-performance coatings for metallic bone implants are systematically reviewed and their biocompatibility is discussed. Updates in coating materials and formulations for metallic implants, as well as their production routes, have been provided. The ways of improving the bioactive coating performance by incorporating bioactive moieties such as growth factors, osteogenic factors, immunomodulatory factors, antibiotics, or other drugs that are locally released in a controlled manner have also been addressed.

Smart biomaterials and their potential applications in tissue engineering

Smart biomaterials have been rapidly advancing ever since the concept of tissue engineering was proposed. Interacting with human cells, smart biomaterials can play a key role in novel tissue morphogenesis. Various aspects of biomaterials utilized in or being sought for the goal of encouraging bone regeneration, skin graft engineering, and nerve conduits are discussed in this review. Beginning with bone, this study summarizes all the available bioceramics and materials along with their properties used singly or in conjunction with each other to create scaffolds for bone tissue engineering. A quick overview of the skin-based nanocomposite biomaterials possessing antibacterial properties for wound healing is outlined along with skin regeneration therapies using infrared radiation, electrospinning, and piezoelectricity, which aid in wound healing. Furthermore, a brief overview of bioengineered artificial skin grafts made of various natural and synthetic polymers has been presented. Finally, by examining the interactions between natural and synthetic-based biomaterials and the biological environment, their strengths and drawbacks for constructing peripheral nerve conduits are highlighted. The description of the preclinical outcome of nerve regeneration in injury healed with various natural-based conduits receives special attention. The organic and synthetic worlds collide at the interface of nanomaterials and biological systems, producing a new scientific field including nanomaterial design for tissue engineering.

Analytical Techniques for the Characterization of Bioactive Coatings for Orthopaedic Implants

The development of bioactive coatings for orthopedic implants has been of great interest in recent years in order to achieve both early- and long-term osseointegration. Numerous bioactive materials have been investigated for this purpose, along with loading coatings with therapeutic agents (active compounds) that are released into the surrounding media in a controlled manner after surgery. This review initially focuses on the importance and usefulness of characterization techniques for bioactive coatings, allowing the detailed evaluation of coating properties and further improvements. Various advanced analytical techniques that have been used to characterize the structure, interactions, and morphology of the designed bioactive coatings are comprehensively described by means of time-of-flight secondary ion mass spectrometry (ToF-SIMS), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FTIR), atomic force microscopy (AFM), scanning electron microscopy (SEM), transmission electron microscopy (TEM), 3D tomography, quartz crystal microbalance (QCM), coating adhesion, and contact angle (CA) measurements. Secondly, the design of controlled-release systems, the determination of drug release kinetics, and recent advances in drug release from bioactive coatings are addressed as the evaluation thereof is crucial for improving the synthesis parameters in designing optimal bioactive coatings.

Overcoming Multidrug Resistance in Bacteria Through Antibiotics Delivery in Surface-Engineered Nano-Cargos: Recent Developments for Future Nano-Antibiotics

In the recent few decades, the increase in multidrug-resistant (MDR) bacteria has reached an alarming rate and caused serious health problems. The incidence of infections due to MDR bacteria has been accompanied by morbidity and mortality; therefore, tackling bacterial resistance has become an urgent and unmet challenge to be properly addressed. The field of nanomedicine has the potential to design and develop efficient antimicrobials for MDR bacteria using its innovative and alternative approaches. The uniquely constructed nano-sized antimicrobials have a predominance over traditional antibiotics because their small size helps them in better interaction with bacterial cells. Moreover, surface engineering of nanocarriers offers significant advantages of targeting and modulating various resistance mechanisms, thus owe superior qualities for overcoming bacterial resistance. This review covers different mechanisms of antibiotic resistance, application of nanocarrier systems in drug delivery, functionalization of nanocarriers, application of functionalized nanocarriers for overcoming bacterial resistance, possible limitations of nanocarrier-based approach for antibacterial delivery, and future of surface-functionalized antimicrobial delivery systems.

Rational design of hollow mesoporous titania nanoparticles loaded with curcumin for UV-controlled release and targeted drug delivery

Curcumin (Cur), appeared to provide huge potential in biomedical application. However, its therapeutic efficacy was greatly limited as the result of poor solubility and instability. To address these limitations, we create a new type of hollow mesoporous titania nanoparticle (HMTN) to encapsulate Cur. HMTN was decorated with a layer of hydrophilic polyethylenimine (PEI), which controlled the release rate of Cur inside the pore due to its dendritic structure. Combined with the folic acid (FA) mediated targeting effect, the potential multifunctional Cur loaded titania nanoparticle (Cur-FA-PEI-HMTN) showed excellent biocompatibility and bioavailability, as well as the UV-responsive drug release properties. The operating parameters to prepare hollow structure were studied and the Cur-FA-PEI-HMTN nanosystem had been fully characterized by Brunauer-Emmet-Teller, Fourier transform infrared spectroscopy, transmission electron microscope, thermal gravity analysis, differential thermal analysis, x-ray diffraction, dynamic light scattering and zeta potential. In addition, the hemolytic test, as well as CCK8, flow cytometry, Hoechst 33342 staining experiment, were carried out to confirm the low cytotoxity and high biocompatibility. The confocal microscopy analysis results also revealed the increasing uptake of Cur@FA-PEI-HMTN by MCF-7 cells. The synthesized nanoparticles displayed great potential as drug nanovehicles with high biocompatibility.

Titanium dioxide nanotubes as drug carriers for infection control and osteogenesis of bone implants

Titanium implants have been widely used as one of the most effective treatments of bone defects. However, the lack of osteogenesis and bacteria-resistant activities result in high infection and loosening rates of titanium implants. Anodic oxidation could easily construct titanium dioxide nanotubes (TNTs) array on the surface of titanium, and the rough surface of TNTs is beneficial to the growth of osteoblast-related cells on the surface. And TNTs could be excellent drug carriers because of their single-entry tubular hollow structure. In this review, we aim at detailing the application of TNTs as drug carriers in the field of bone implants. Starting from the topography of TNTs, we illustrated the biological activity of the TNTs surface, the drugs for loading in TNTs, and the controlled and responsive release strategies of drug-loaded TNTs, respectively. At the end of this review, the shortcomings of TNTs as the drug carrier in the field of bone implants are discussed, and the development direction of this research field is also prospected.

Nanostructured Biomaterials for Bone Regeneration

This review article addresses the various aspects of nano-biomaterials used in or being pursued for the purpose of promoting bone regeneration. In the last decade, significant growth in the fields of polymer sciences, nanotechnology, and biotechnology has resulted in the development of new nano-biomaterials. These are extensively explored as drug delivery carriers and as implantable devices. At the interface of nanomaterials and biological systems, the organic and synthetic worlds have merged over the past two decades, forming a new scientific field incorporating nano-material design for biological applications. For this field to evolve, there is a need to understand the dynamic forces and molecular components that shape these interactions and influence function, while also considering safety. While there is still much to learn about the bio-physicochemical interactions at the interface, we are at a point where pockets of accumulated knowledge can provide a conceptual framework to guide further exploration and inform future product development. This review is intended as a resource for academics, scientists, and physicians working in the field of orthopedics and bone repair.

Anodic formation and biomedical properties of hafnium-oxide nanofilms

Hafnium dioxide (HfO₂) is attracting attention for bio-related applications due to its good cytocompatibility, high density, and resistance to corrosion and mechanical damage. Here we synthesize two types of hafnium-oxide thin films on substrates via self-organized electrochemical anodization: (1) an array of hierarchically structured nanorods anchored to a thin oxide layer and (2) a microscopically flat oxide film. The nanostructured film is composed of a unique mixture of HfO₂, suboxide Hf₂O₃, and oxide-hydroxide compound HfO₂·nH₂O whereas the flat film is mainly HfO₂. In vitro interaction of the two films with MG-63 osteoblast-like cells and Gram-negative E. coli bacteria is studied for the first time to assess the potential of the films for biomedical application. Both films reveal good cytocompatibility and affinity for proteins, represented by fibronectin and especially albumin, which is absorbed in a nine times larger amount. The morphology and specific surface chemistry of the nanostructured film cause a two-fold enhanced antibacterial effect, better cell attachment, significantly improved proliferation of cells, five-fold rise in the cellular Young's modulus, slightly stronger production of reactive oxygen species, and formation of cell clusters. Compared with the flat film, the nanostructured one features the weakening of AFM-measured adhesion force at the cell/surface interface, probably caused by partially lifting the nanorods from the substrate due to the strong contact with cells. The present findings deepen the understanding of biological processes at the living cell/metal-oxide interface, underlying the role of surface chemistry and the impact of nanostructuring at the nanoscale.

Progress in TiO2 nanotube coatings for biomedical applications: a review

Titanium dioxide nanotubes (TNTs) have drawn wide attention and been extensively applied in the field of biomedicine, due to their large specific surface area, good corrosion resistance, excellent biocompatibility, and enhanced bioactivity. This review describes the preparation of TNTs and the surface modification that entrust the nanotubes with better antibacterial property and enhanced osteoblast adhesion, proliferation, and differentiation. Considering the contact between TNTs' surface and surrounding tissues after implantation, the interactions between TNTs (with properties including their diameter, length, wettability, and crystalline phase) and proteins, platelets, bacteria, and cells are illustrated. The state of the art in the applications of TNTs in dentistry, orthopedic implants, and cardiovascular stents are introduced. In particular, the application of TNTs in biosensing has attracted much attention due to its ability for the rapid diagnosis of diseases. Finally, the difficulties and challenges in the practical application of TNTs are also discussed.

Calcium-MicroRNA Complex-Functionalized Nanotubular Implant Surface for Highly Efficient Transfection and Enhanced Osteogenesis of Mesenchymal Stem Cells

Controlling mesenchymal stem cell (MSC) differentiation by RNA interference (RNAi) is a promising approach for next-generation regenerative medicine. However, efficient delivery of RNAi therapeutics is still a limiting factor. In this study, we have developed a simple, biocompatible, and highly effective delivery method of small RNA therapeutics into human MSCs (hMSCs) from an implant surface by calcium ions. First, we demonstrated that simple Ca/siRNA targeting green fluorescent protein (GFP) nanocomplexes were able to efficiently silence GFP in GFP-expressing hMSCs with adequate Ca²⁺ concentration (>5 mM). In addition, a single transfection could obtain a long-lasting silencing effect for more than 2 weeks. All three of the main endocytosis pathways (clathrin- and caveolin-mediated endocytosis and macropinocytosis) were involved in the internalization of the Ca/siRNA complexes by MSCs, and macropinocytosis plays the most dominant role. Furthermore, the Ca/siRNA complexes could be efficiently loaded onto the titanium implant surface when pretreated with anodization to create a nanotube (NT) layer. Because of the hydrophilic property of the NT surface, the Ca/siRNA was quickly loaded (less than 4 h) with high efficiency (nearly 100%), forming an even amorphous coating. The Ca/siRNA-coated NT surface showed an initial burst release of 80% of the siRNA complexes over 2 h, which is adequate to achieve robust gene silencing of attached hMSCs. To demonstrate the therapeutic potential of our Ca/siRNA coating technology, Ca/antimiR-138 complexes were loaded on to the NT surface, which strongly enhanced the osteogenic differentiation of hMSCs. In conclusion, our findings suggest that Ca²⁺ is an effective and biocompatible carrier to deliver small RNA therapeutics into hMSCs, both in solution and from functionalized surfaces, which provides a novel approach to control the MSC differentiation and tissue regeneration.

Antibiotic delivery by nanobioceramics

The role of nanotechnology has evinced remarkable interest in the field of drug delivery. Bioceramics are inorganic biomaterials which are frequently used as bone substitutes. They have been explored in drug delivery as carriers for antibiotics, anti-osteoporotic drugs and anticancer drugs. Bioceramic nanoparticles are excellent alternatives to polymers due to their bioactivity, pH and temperature stability, multifunctionality, biocompatibility and tunable biodegradability. The use of bioceramics for local drug delivery in the field of orthopedics offer an efficient, safe mode of drug delivery directly to the surgical site thereby overcoming the limitations of systemic drug delivery. This review focuses on the development and applications of various nanobioceramics employed as drug delivery systems for the treatment of bone infections.

Mussel-inspired surface modification of titania nanotubes as a novel drug delivery system

Titania nanotubes (TNT_s) have attracted considerable attention for the development of new devices for local drug delivery applications. In this study TNT_s were synthesized by hydrothermal method from titania nanoparticles and then the surface of TNT_s were functionalized by in situ polymerization of bioinspired polydopamine (PDA). The proposed strategies emphasized on remarkable properties of these materials and their unique combination to design local drug delivery system with advanced performance. The samples were characterized using Transmission Electron Microscope (TEM), Field Emission Scanning Electron Microscope (FESEM), X-ray diffraction pattern (XRD), Fourier-transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA) and surface area analysis (BET). The results showed that the specific surface area significantly is increased by creating tubular nanostructure. TGA results indicated Surface functionalization of TNT_s with PDA (TNT_s-PDA) about 19.3% that led to increase biocompatibility and bioactivity of TNT_s as well as improve drug loading and release properties. It is attributed to the effect of NH₂ groups which immobilize drug molecules on the TNT_s. According to the obtained release profiles for the samples, the release profiles followed from a Hill model. Thus, PDA modified TNT_s can be excellent candidate as specific drug delivery systems.

Enhancement in Sustained Release of Antimicrobial Peptide from Dual-Diameter-Structured TiO2 Nanotubes for Long-Lasting Antibacterial Activity and Cytocompatibility

Novel films on Ti-based orthopedic implants for localized antimicrobial delivery, which comprises dual-diameter TiO₂ nanotubes with the inner layers of compact and fluorine-free oxide tightly bonding to Ti, were formed by voltage-increased anodization with F^- sedimentation procedure. The nanotubes were closely aligned and structured with upper 35 and 70 nm diametric tubes as nanocaps, respectively, and the underlying 140 nm diametric tubes as nanoreservoirs. Followed by loading ponericin G1 (a kind of antimicrobial peptide (AMP)) into the dual-diameter nanotubes with vacuum-assisted physisorption, the resultant films were investigated for loading efficiency and release kinetics of AMP, antibacterial activity against Staphylococcus aureus, and osteoblastic compatibility, together with the AMP-loaded single-diameter (140 nm) nanotube film. The loaded films had no statistical difference in the loading efficiency of AMP and revealed burst release within 6 h followed by steady release of AMP in phosphate-buffered solution. At day 42, almost all of AMP was released from the single-diameter nanotube film. However, the dual-diameter nanotube films loaded with AMP still showed sustained release at least up to 60 days, and the sustained efficacy was enhanced with decreasing diameter of nanocaps. In the case of nominal AMP loading amount of 125 μg, the resultant 35 nm capped dual-diameter nanotube film exhibited significant short- and long-term (even for 49 days) antibacterial activity not only against planktonic bacteria, which is ascribed to the release-killing efficacy of AMP, but also against adhered bacteria, which is ascribed to the AMP-derived killing efficacy and the nanocaps-derived adhesion resistance. Moreover, this loaded film presented cytocompatibility comparative to that of Ti but higher than that of the other AMP-loaded films. Increasing the nominal loading amount of AMP to 200 μg improved antibacterial activity but gave rise to obvious cytotoxicity of the loaded films.

Formulation of benzoxaborole drugs in PLLA: from materials preparation to in vitro release kinetics and cellular assays

A complete investigation on the incorporation of simple benzoxaboroles into PLLA-based films was carried out.

Novel drug delivery nanosystems based on out-inside bifunctionalized mesoporous silica yolk–shell magnetic nanostars used as nanocarriers for curcumin

Bifunctionalized yolk–shell magnetic mesoporous silica is used as a curcumin nanocarrier with magnetic response and increased cellular uptake.

Titanium dioxide nanotube arrays coated with laminin enhance C2C12 skeletal myoblast adhesion and differentiation

TiO₂ nanotube arrays of various topography/surface chemistry are tested with C2C12 cells. Improved cell adhesion and differentiation are shown on 10 nm diameter nanotube arrays coated with laminin, encouraging array use for skeletal muscle tissue engineering and stimulation.

Titania nanostructures: a biomedical perspective

A systematic and comprehensive summary of various TNS-based biomedical research with a special emphasis on drug-delivery, tissue engineering, biosensor, and anti-bacterial applications.