Addition of Zn to the ternary Mg-Ca-Sr alloys significantly improves their antibacterial property

In Vitro and In Vivo Analysis of the Mg-Ca-Zn Biodegradable Alloys

The objective of this work was to analyze the in vitro and in vivo tests of a novel Mg-based biodegradable alloy-Mg-0.5%Ca-with various amounts of Zn (0.5, 1, 1.5, 2.0, and 3.0 wt.%). In terms of in vitro biocompatibility, MTT and Calcein-AM cell viability assays, performed on the MG-63 cell line through the extract method, revealed that all five alloy extracts are non-cytotoxic at an extraction ratio of 0.025 g alloy per mL of cell culture medium. In the in vivo histological analysis, Mg-0.5Ca-1.5Zn demonstrated exceptional potential for stimulating bone remodeling and showed excellent biocompatibility. It was observed that Mg-0.5Ca-0.5Zn, Mg-0.5Ca-1.5Zn, and Mg-0.5Ca-3Zn displayed good biocompatibility. Furthermore, the histological examination highlighted the differentiation of periosteal cells into chondrocytes and subsequent bone tissue replacement through endochondral ossification. This process highlighted the importance of the initial implant's integrity and the role of the periosteum. In summary, Mg-0.5Ca-1.5Zn stands out as a promising candidate for bone regeneration and osseointegration, supported by both in vitro and in vivo findings.

Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview

Magnesium-based biomaterials hold remarkable promise for various clinical applications, offering advantages such as reduced stress-shielding and enhanced bone strengthening and vascular remodeling compared to traditional materials. However, ensuring the quality of preclinical research is crucial for the development of these implants. To achieve implant success, an understanding of the cellular responses post-implantation, proper model selection, and good study design are crucial. There are several challenges to reaching a safe and effective translation of laboratory findings into clinical practice. The utilization of Mg-based biomedical devices eliminates the need for biomaterial removal surgery post-healing and mitigates adverse effects associated with permanent biomaterial implantation. However, the high corrosion rate of Mg-based implants poses challenges such as unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. The biocompatibility and degradability of materials based on magnesium have been studied by many researchers in vitro; however, evaluations addressing the impact of the material in vivo still need to be improved. Several animal models, including rats, rabbits, dogs, and pigs, have been explored to assess the potential of magnesium-based materials. Moreover, strategies such as alloying and coating have been identified to enhance the degradation rate of magnesium-based materials in vivo to transform these challenges into opportunities. This review aims to explore the utilization of Mg implants across various biomedical applications within cellular (in vitro) and animal (in vivo) models.

Association between dietary calcium intake and severe abdominal aorta calcification among American adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey

BACKGROUND

Evidence regarding the relationship between dietary calcium intake and severe abdominal aortic calcification (AAC) is limited. Therefore, this study aimed to investigate the association between dietary calcium intake and severe AAC in American adults based on data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

The present cross-sectional study utilized data from the NHANES 2013-2014, a population-based dataset. Dietary calcium intake was assessed using two 24-h dietary recall interviews. Quantification of the AAC scores was accomplished utilizing the Kauppila score system, whereby severe AAC was defined as having an AAC score greater than 6. We used multivariable logistic regression models, a restricted cubic spline analysis, and a two-piecewise linear regression model to show the effect of calcium intake on severe AAC.

RESULTS

Out of the 2640 individuals examined, 10.9% had severe AAC. Following the adjustment for confounding variables, an independent association was discovered between an augmented intake of dietary calcium and the incidence of severe AAC. When comparing individuals in the second quartile (Q2) of dietary calcium intake with those in the lowest quartile (Q1), a decrease in the occurrence of severe AAC was observed (odds ratio: 0.66; 95% confidence interval: 0.44-0.99). Furthermore, the relationship between dietary calcium intake and severe AAC demonstrated an L-shaped pattern, with an inflection point observed at 907.259 mg/day. Subgroup analyses revealed no significant interaction effects.

CONCLUSION

The study revealed that the relationship between dietary calcium intake and severe AAC in American adults is L-shaped, with an inflection point of 907.259 mg/day. Further research is required to confirm this association.

Synergetic effects of boron nitride with waste zirconia: Evaluation of instantaneous fingerprint detection and mechanical properties for biomedical applications

Herein, present study mainly focuses on the synthesis and characterizations of boron nitride reinforced waste zirconia (wZrO2) with different concentrations. Composites were prepared via a scalable solid-state reaction method. Various physical parameters such as density, ionic concentration, polaron radius, and field strength were evaluated. XRD results reveal crystalline nature with a major phase of tetragonal zirconia and as boron nitride is reinforced, the tetragonal transforms into a monoclinic zirconia. Interconnected spherical grains and nanosheets were observed using FESEM. Mechanical characterizations revealed the highest compressive strength of 266 MPa. The latent fingerprints were visualized using a composite on different surfaces, implementing the powder dusting and solution techniques. MTT assay was performed and revealed good biocompatible nature. These results reveal that composite is suitable for fabrication of bioceramics with acceptable mechanical and biological performances. The composite can also be utilized for latent fingerprint detection in forensic science.

Bioactive fluorcanasite reinforced magnesium alloy-based porous bio-nanocomposite scaffolds with tunable mechanical properties

Magnesium (Mg) alloy-based porous bio-nanocomposite bone scaffolds were developed by powder metallurgy route. Selective alloying elements such as calcium (Ca), zinc (Zn) and strontium (Sr) were incorporated to tune the mechanical integrity while, bioactive fluorcanasite nano-particulates were introduced within the alloy system to enhance the bone tissue regeneration. Green compacts containing carbamide were fabricated and sintered using two-stage heat treatment process to achieve the targeted porosities. The microstructure of these fabricated magnesium alloy-based bio-nanocomposites was examined by Field emission scanning electron microscope (FE-SEM) and x-ray micro computed tomography (x-ray μCT), which revealed gradient porosities and distribution of alloying elements. X-ray diffraction (XRD) studies confirmed the presence of major crystalline phases in the fabricated samples and the evolution of the various combinations of intermetallic phases of Ca, Mg, Zn and Sr which were anticipated to enhance the mechanical properties. Further, XRD studies revealed the presence of apatite phase for the immersed samples, a conducive environment for bone regeneration. The fabricated samples were evaluated for their mechanical performance against uniaxial compression load. The tunability of compressive strengths and modulus values could be established with variation in porosities of fabricated samples. The retained compressive strength and Young's modulus of the samples following immersion in phosphate buffered saline (PBS) solution was found to be in line with that of natural human cancellous bone, thereby establishing the potential of the fabricated magnesium-alloy-based nanocomposite as a promising scaffold candidate for bone tissue engineering.

Mg-, Zn-, and Fe-Based Alloys With Antibacterial Properties as Orthopedic Implant Materials

Implant-associated infection (IAI) is one of the major challenges in orthopedic surgery. The development of implants with inherent antibacterial properties is an effective strategy to resolve this issue. In recent years, biodegradable alloy materials have received considerable attention because of their superior comprehensive performance in the field of orthopedic implants. Studies on biodegradable alloy orthopedic implants with antibacterial properties have gradually increased. This review summarizes the recent advances in biodegradable magnesium- (Mg-), iron- (Fe-), and zinc- (Zn-) based alloys with antibacterial properties as orthopedic implant materials. The antibacterial mechanisms of these alloy materials are also outlined, thus providing more basis and insights on the design and application of biodegradable alloys with antibacterial properties as orthopedic implants.

In vitro and in vivo assessment of the effect of biodegradable magnesium alloys on osteogenesis

Magnesium (Mg) and some of its alloys are considered promising biodegradable metallic biomaterials for bone implant applications. The osteogenesis effect of Mg alloys is widely reported; however, the underlying mechanisms are still not clear. In this study, pure Mg, Mg-3Zn, and Mg-2Zn-1Mn were prepared, and their degradation behavior, biocompatibility, and osteogenesis effect were systematically assessed both in vitro and in vivo. Primary rat bone marrow-derived mesenchymal stem cells (BMSCs) were used to evaluate the biocompatibility of the prepared Mg alloys, and a rat femur fracture model was used to assess the stimulating effect of these alloys on bone-tissue formation. Mg-2Zn-1Mn showed higher corrosion resistance and more stable degradation behavior than pure Mg and Mg-3Zn. Extracts of the three materials showed significant stimulating effects on osteogenic differentiation of BMSCs along with non-cytotoxicity. Implantation of Mg-2Zn-1Mn wires into the femur of rats demonstrated superior histocompatibility, stable degradation, and notable promotion of osteogenesis without systemic toxicity. Moreover, the results of both in vitro and in vivo assessments demonstrated that bone morphogenetic proteins and fibroblast growth factor receptors are involved in the stimulating effect of Mg alloys. STATEMENT OF SIGNIFICANCE: This work reports the degradation behavior, biocompatibility, and osteogenic effect of pure Mg and Mg-3Zn and Mg-2Zn-1Mn alloys in both in vitro and in vivo conditions. Mg-2Zn-1Mn showed higher corrosion resistance and more stable degradation behavior than pure Mg and Mg-3Zn. The extracts of the three materials showed a significant stimulating effect on osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells (BMSCs) along with non-cytotoxicity. Mg-2Zn-1Mn wires implanted into the femur of rats showed good histocompatibility, stable degradation, and notable promotion of osteogenesis without systemic toxicity. The results of the present study suggest that bone morphogenetic proteins (BMPs) and fibroblast growth factor receptors (FGFRs) are involved in the stimulating effect of Mg alloys on osteogenesis.

The Influence of Rapid Solidification on Corrosion Behavior of Mg60Zn20Yb15.7Ca2.6Sr1.7 Alloy for Medical Applications

Biodegradable magnesium alloys with Zn, Yb, Ca and Sr additions are potential materials with increased corrosion resistance in physiological fluids that ensure a controlled resorption process in the human body. This article presents the influence of the use of a high cooling rate on the corrosion behavior of Mg₆₀Zn₂₀Yb_15.7Ca_2.6Sr_1.7 alloy proposed for medical applications. The microstructure of the alloy in a form of high-pressure die-casted plates was presented using scanning electron microscopy in the backscattered electrons (BSEs) mode with energy-dispersive X-ray spectrometer (EDX) qualitative analysis of chemical composition. The crystallization mechanism and thermal properties were described on the basis of differential scanning calorimetry (DSC) results. The corrosion behavior of Mg₆₀Zn₂₀Yb_15.7Ca_2.6Sr_1.7 alloy was analyzed by electrochemical studies with open circuit potential (E_OCP) measurements and polarization tests. Moreover, light microscopy and X-ray photoelectron spectroscopy were used to characterize the corrosion products formed on the surface of studied samples. On the basis of the results, the influence of the cooling rate on the improvement in the corrosion resistance was proved. The presented studies are novel and important from the point of view of the impact of the technology of biodegradable materials on corrosion products that come into direct contact with the tissue environment.

In vitro and in vivo degradation assessment and preventive measures of biodegradable Mg alloys for biomedical applications

Magnesium (Mg) and its alloys have been widely explored as a potential biodegradable implant material. However, the fast degradation of Mg-based alloys under physiological environment has hindered their widespread use for implant applications till date. The present review focuses on in vitro and in vivo degradation of biodegradable Mg alloys, and preventive measures for biomedical applications. Initially, the corrosion assessment approaches to predict the degradation behavior of Mg alloys are discussed along with the measures to control rapid corrosion. Furthermore, this review attempts to explore the correlation between in vitro and in vivo corrosion behavior of different Mg alloys. It was found that the corrosion depends on experimental conditions, materials and the results of different assessment procedures hardly matches with each other. It has been demonstrated the corrosion rate of magnesium can be tailored by alloying elements, surface treatments and heat treatments. Various researches also studied different biocompatible coatings such as dicalcium phosphate dihydrate (DCPD), β-tricalcium phosphate (β-TCP), hydroxyapatite (HA), polycaprolactone (PCL), polylactic acid (PLA), and so on, on Mg alloys to suppress rapid degradation and examine their influence on new bone regeneration as well. This review shows the need for a standard method of corrosion assessment to predict the in vivo corrosion rate based on in vitro data, and thus reducing the in vivo experimentation.

Recent Advances in Research on Antibacterial Metals and Alloys as Implant Materials

Implants are widely used in orthopedic surgery and are gaining attention of late. However, their use is restricted by implant-associated infections (IAI), which represent one of the most serious and dangerous complications of implant surgeries. Various strategies have been developed to prevent and treat IAI, among which the closest to clinical translation is designing metal materials with antibacterial functions by alloying methods based on existing materials, including titanium, cobalt, tantalum, and biodegradable metals. This review first discusses the complex interaction between bacteria, host cells, and materials in IAI and the mechanisms underlying the antibacterial effects of biomedical metals and alloys. Then, their applications for the prevention and treatment of IAI are highlighted. Finally, new insights into their clinical translation are provided. This review also provides suggestions for further development of antibacterial metals and alloys.

In vitro and in vivo antibacterial performance of Zr & O PIII magnesium alloys with high concentration of oxygen vacancies

The effects of dual Zr and O plasma immersion ion implantation (Zr & O PIII) on antibacterial properties of ZK60 Mg alloys are systematically investigated. The results show that a hydrophobic, smooth, and ZrO₂-containing graded film is formed. Electrochemical assessment shows that the corrosion rate of the plasma-treated Mg alloy decreases and the decreased degradation rate is attributed to the protection rendered by the surface oxide. In vitro and in vivo antibacterial tests reveal Zr & O PIII ZK60 presents higher antibacterial rate compared to Zr PIII ZK60 and untreated control. The hydrophobic and smooth surface suppresses bacterial adhesion. High concentration of oxygen vacancies in the surface films are determined by X-ray photoelectron spectroscopy (XPS), UV–vis diffuse reflectance spectra (UV–vis DRS) and electron paramagnetic resonance (EPR) and involved in the production of reactive oxygen species (ROS). The higher level of ROS expression inhibits biofilm formation by down-regulating the expression of icaADBC genes but up-regulating the expression of icaR gene. In addition, Zr & O PIII improves cell viability and initial cell adhesion confirming good cytocompatibility. Dual Zr & O PIII is a simple and practical means to expedite clinical acceptance of biodegradable magnesium alloys.

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A ZrO₂-containing graded film with high concentration of oxygen vacancies was formed via PIII.

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S. aureus adhesion was suppressed due to enhanced hydrophobicity and decreased roughness.

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High concentration of oxygen vacancies lead to the upregulation of ROS expression.

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ROS mediates biofilm-associated genes expression to inhibit biofilm formation in vitro and in vivo.

Antibacterial metals and alloys for potential biomedical implants

Metals and alloys, including stainless steel, titanium and its alloys, cobalt alloys, and other metals and alloys have been widely used clinically as implant materials, but implant-related infection or inflammation is still one of the main causes of implantation failure. The bacterial infection or inflammation that seriously threatens human health has already become a worldwide complaint. Antibacterial metals and alloys recently have attracted wide attention for their long-term stable antibacterial ability, good mechanical properties and good biocompatibility in vitro and in vivo. In this review, common antibacterial alloying elements, antibacterial standards and testing methods were introduced. Recent developments in the design and manufacturing of antibacterial metal alloys containing various antibacterial agents were described in detail, including antibacterial stainless steel, antibacterial titanium alloy, antibacterial zinc and alloy, antibacterial magnesium and alloy, antibacterial cobalt alloy, and other antibacterial metals and alloys. Researches on the antibacterial properties, mechanical properties, corrosion resistance and biocompatibility of antibacterial metals and alloys have been summarized in detail for the first time. It is hoped that this review could help researchers understand the development of antibacterial alloys in a timely manner, thereby could promote the development of antibacterial metal alloys and the clinical application.

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This paper focuses the recent development of several antibacterial metals and alloys as biomedical materials.

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The possible antibacterial mechanisms of antibacterial metals and alloys are summarized in this paper.

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This review discusses the feasibility of antibacterial metals and alloys as biomedical implants in the future.

Nanoscale Zeolitic Imidazolate Framework-8 Activator of Canonical MAPK Signaling for Bone Repair

Zeolitic imidazolate framework-8 (ZIF-8) is an important type of metal organic framework and has found numerous applications in the biomedical field. Our previous studies have demonstrated that nano ZIF-8-based titanium implants could promote osseointegration; however, its osteogenic capacity and the related mechanisms in bone regeneration have not been fully clarified. Presented here is a nanoscale ZIF-8 that could drive rat bone mesenchymal stem cell (rBMSC) differentiation into osteoblasts both in vitro and in vivo, and interestingly, nano ZIF-8 exhibited a better osteogenic effect compared with ionic conditions of Zn at the same concentration of Zn2+. Moreover, the cellular uptake mechanisms of the nanoparticles were thoroughly clarified. Specifically, nano ZIF-8 could enter the rBMSC cytoplasm probably via caveolae-mediated endocytosis and macropinocytosis. The intracellular and extracellular Zn2+ released from nano ZIF-8 and the receptors involved in the endocytosis may play a role in inducing activation of key osteogenic pathways. Furthermore, through transcriptome sequencing, multiple osteogenic pathways were found to be upregulated, among which nano ZIF-8 primarily phosphorylated ERK, thus activating the canonical mitogen-activated protein kinase pathway and promoting the osteogenesis of rBMSCs. Taken together, this study helps to elucidate the mechanism by which nano ZIF-8 regulates osteogenesis and suggests it to be a potential biomaterial for constructing multifunctional composites in bone tissue engineering.

Improvements of Corrosion Resistance and Antibacterial Properties of Hydroxyapatite/Cupric Oxide Doped Titania Composite Coatings on Degradable Magnesium Alloys

The excellent biocompatibility of calcium phosphate (CaP) coatings makes them widely used in magnesium (Mg) alloy orthopedic implant materials. However, the porous morphology of CaP coatings limits their corrosion resistance. A cupric oxide (CuO) doped titania (TiO₂) sol-gel coating is prepared on a porous hydroxyapatite (HA) coating. According to electrochemical test results, the HA/CuO-TiO₂ coating obtains a current density of 6 × 10^-4 mA/cm², lower than that of the Mg alloy (2.6 × 10^-2 mA/cm²). The hydrogen evaluation of the HA/CuO-TiO₂ coating is only 1/12 that of the Mg alloy after immersion for 7 days. In addition, the HA/CuO-TiO₂ coating has an antibacterial rate of 99.5 ± 0.4% against Staphylococcus aureus, significantly higher than that of the HA coating (19.8 ± 0.3%) and HTC0 coating (38.4 ± 0.5%). The CuO doped composite coating has no adverse effect or cytotoxicity on cell proliferation (cell viability ≥79.6%). Hence, the HA/CuO-TiO₂ composite coating is useful for enhancing the corrosion resistance and antibacterial properties of Mg alloys while ensuring cytocompatibility. The HA/CuO-TiO₂ coated AZ60 Mg alloy can meet the requirements of clinical application.

The role of magnesium in biomaterials related infections

Magnesium is currently increasing interest in the field of biomaterials. An extensive bibliography on this material in the last two decades arises from its potential for the development of biodegradable implants. In addition, many researches, motivated by this progress, have analyzed the performance of magnesium in both in vitro and in vivo assays with gram-positive and gram-negative bacteria in a very broad range of conditions. This review explores the extensive literature in recent years on magnesium in biomaterials-related infections, and discusses the mechanisms of the Mg action on bacteria, as well as the competition of Mg²⁺ and/or synergy with other divalent cations in this subject.

In vitro and in vivo degradation behavior of Mg-2Sr-Ca and Mg-2Sr-Zn alloys

Magnesium alloys with integration of degradability and good mechanical performance are desired for orthopedic implants. In this paper, Mg-2Sr-Ca and Mg-2Sr-Zn alloys were prepared and the degradation as well as the bone response were investigated. Compared with the binary Mg-2Sr alloys, the addition of Ca and Zn improved the in vitro and in vivo corrosion resistance. Mg-2Sr-Ca and Mg-2Sr-Zn alloys exhibited more uniform corrosion and maintained the configuration of the implants 4 weeks post-implantation. The in vivo corrosion rates were 0.85 mm/yr for Mg-2Sr-Zn and 1.10 mm/yr for Mg-2Sr-Ca in comparison with 1.37 mm/yr for Mg-2Sr. The in vitro cell tests indicated that Mg-2Sr-Ca and Mg-2Sr-Zn alloys exhibited higher MG63 cell viability than Mg-2Sr alloy. Furthermore, these two alloys can promote the mineralization and new bone formation without inducing any significant adverse effects and this sound osteogenic properties suggest its attractive clinical potential.

Polymeric nanoparticles-based multi-functional coatings on NiTi alloy with nickel ion release control, cytocompatibility, and antibacterial performance

Photo-cross-linked quaternized copolymer coatings on NiTi alloy show prominent inhibition of nickel ion release and antibacterial properties.

Strontium enhances proliferation and osteogenic behavior of periodontal ligament cells in vitro

BACKGROUND AND OBJECTIVE

Strontium (Sr) enhances osteogenic differentiation of certain multipotent cells. Periodontal ligament cells (PDLCs) are known to be multipotent, and Sr might be useful in periodontal bone tissue engineering. This study investigates the effect of high concentration of Sr on the proliferation and osteogenic behavior of PDLCs in vitro.

MATERIAL AND METHODS

Primary human PDLCs were cultured in MEM + 10% FBS without (Ctrl) or with Sr in four diverse concentrations: Sr1, 11.3 × 10^-3  mg/L, human serum physiological level; Sr2, 13 mg/L, typical human serum level after strontium ranelate treatment; Sr3, 130 mg/L, and Sr4, 360 mg/L. The spreading area (2, 4, 6, 24 hours), proliferation rate (1, 3, 7 days), osteogenic behavior (alkaline phosphatase - ALP activity, 7 and 14 days; expression of osteogenic genes, ALP, Runt-related transcription factor 2 - RUNX2, osteopontin - OPN, osteocalcin - OCN, and osteoprotegerin -OPG, 1, 3, 7, 14, 21 days), and formation of mineralized nodules (14 and 21 days) of the PDLCs were assessed. Data were compared group- and period-wise using ANOVA tests.

RESULTS

Periodontal ligament cells cultured with Sr4 showed increased spreading area (after 4 hours), proliferation rate (from 3 days), and OCN and OPN (from 7 days) gene expression as compared to Ctrl, Sr1, Sr2, and Sr3. Sr4 also led to lower ALP activity (from 7 days), ALP (from 3 days), and RUNX2 (at 7 and 14 days) gene expression, together with more evident formation of mineralized nodules, compared to Ctrl, Sr1, Sr2, and Sr3.

CONCLUSION

Periodontal ligament cells responded to Sr4 with increased cellular proliferation and osteogenic behavior in vitro.

Novel high-strength, low-alloys Zn-Mg (<0.1wt% Mg) and their arterial biodegradation

It is still an open challenge to find a biodegradable metallic material exhibiting sufficient mechanical properties and degradation behavior to serve as an arterial stent. In this study, Zn-Mg alloys of 0.002 (Zn-002Mg), 0.005 (Zn-005Mg) and 0.08wt% Mg (Zn-08Mg) content were cast, extruded and drawn to 0.25mm diameter, and evaluated as potential biodegradable stent materials. Structural analysis confirmed formation of Mg₂Zn₁₁ intermetallic in all three alloys with the average grain size decreasing with increasing Mg content. Tensile testing, fractography analysis and micro hardness measurements showed the best integration of strength, ductility and hardness for the Zn-08Mg alloy. Yield strength, tensile strength, and elongation to failure values of >200-300MPa, >300-400MPa, and >30% respectively, were recorded for Zn-08Mg. This metal appears to be the first formulated biodegradable material that satisfies benchmark values desirable for endovascular stenting. Unfortunately, the alloy reveals signs of age hardening and strain rate sensitivity, which need to be addressed before using this metal for stenting. The explants of Zn-08Mg alloy residing in the abdominal aorta of adult male Sprague-Dawley rats for 1.5, 3, 4.5, 6 and 11months demonstrated similar, yet slightly elevated inflammation and neointimal activation for the alloy relative to what was recently reported for pure zinc.

Antibacterial activity and biofilm inhibition by surface modified titanium alloy medical implants following application of silver, titanium dioxide and hydroxyapatite nanocoatings

One of the most common causes of implant failure is peri-implantitis, which is caused by bacterial biofilm formation on the surfaces of dental implants. Modification of the surface nanotopography has been suggested to affect bacterial adherence to implants. Silver nanoparticles are also known for their antibacterial properties. In this study, titanium alloy implants were surface modified following silver plating, anodisation and sintering techniques to create a combination of silver, titanium dioxide and hydroxyapatite (HA) nanocoatings. Their antibacterial performance was quantitatively assessed by measuring the growth of Streptococcus sanguinis, proportion of live/dead cells and lactate production by the microbes over 24 h. Application of a dual layered silver-HA nanocoating to the surface of implants successfully inhibited bacterial growth in the surrounding media (100% mortality), whereas the formation of bacterial biofilm on the implant surfaces was reduced by 97.5%. Uncoated controls and titanium dioxide nanocoatings showed no antibacterial effect. Both silver and HA nanocoatings were found to be very stable in biological fluids with material loss, as a result of dissolution, to be less than 0.07% for the silver nanocoatings after 24 h in a modified Krebs-Ringer bicarbonate buffer. No dissolution was detected for the HA nanocoatings. Thus, application of a dual layered silver-HA nanocoating to titanium alloy implants creates a surface with antibiofilm properties without compromising the HA biocompatibility required for successful osseointegration and accelerated bone healing.

ZnO quantum dots modified bioactive glass nanoparticles with pH-sensitive release of Zn ions, fluorescence, antibacterial and osteogenic properties

Zinc (Zn)-containing materials have osteogenic and antibacterial activities while bioactive glass nanoparticles (BGN) show bone-bonding ability, as well as osteoconductive and osteoinductive properties. Zn-containing BGN are therefore considered to be promising materials for various biomedical applications, particularly in bone regeneration. In this study, we report a convenient method to prepare Zn-containing BGN by coating ZnO quantum dots (QDs) on BGN via electrostatic interactions. The synthesized ZnO-BGN nanocomposite particles are spherical and highly dispersed, and exhibit a unique fluorescence behavior under UV excitation, emitting three wavelengths in the violet, blue and green range. ZnO-BGN showed apatite-forming ability upon immersion in simulated body fluid, but their apatite formation was delayed compared to BGN. Interestingly, ZnO-BGN showed a rapid release of Zn ions at pH 4 but a far slower release at pH 7.4. ZnO-BGN also exhibited antibacterial effects on both Gram-positive and Gram-negative bacteria at the concentrations of 1, 0.1, and 0.01 mg mL^-1. Higher concentrations could lead to stronger antibacterial effects. The LDH and live/dead assays indicated that ZnO-BGN had no significant cytotoxicity towards human mesenchymal stem cells (hMSC) at concentration of 0.1 and 0.01 mg mL^-1, but ZnO-BGN inhibited the relative proliferation of hMSC compared to BGN and the control according to the MTT assay. Notably ZnO-BGN improved the osteogenic differentiation of hMSC as indicated by the determination of the alkaline phosphatase activity. In conclusion, coating quantum dots on BGN is a promising strategy to produce Zn-containing BGN. The synthesized ZnO-BGN are potential materials for bone regeneration, considering their apatite-forming ability, unique ion-release behavior, effective antibacterial activity, non-cytotoxicity, and osteogenic potential.

Electrophoretic deposition of colloidal particles on Mg with cytocompatibility, antibacterial performance, and corrosion resistance

Magnesium (Mg) has recently received increasing attention due to its unique biological performance, including cytocompatibility, antibacterial and biodegradable properties. However, rapid corrosion in physiological environment and potential toxicity limits its clinical applications. To improve the corrosion resistance meanwhile not compromise other excellent performance, self-assembled colloidal particles were deposited onto magnesium surfaces in ethanol by a simple and effective electrophoretic deposition (EPD) method. The fabricated functional nanostructured coatings were investigated using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) analyses, and scanning electron microscopy (SEM). The electrochemical test, pH value, and Mg ion concentration data show that the corrosion resistance of Mg samples is enhanced appreciably after surface treatment. In vitro cellular response and antibacterial capability of the modified Mg substrates are performed. Significantly increased cell adhesion and viability are observed from the coated Mg samples, and the amounts of adherent bacteria on the treated Mg surfaces diminish remarkably compared to the bare Mg. Furthermore, the bare and coated Mg samples were implanted in New Zealand white rabbits for 12 weeks to examine the in vivo long-term corrosion performance and in situ inflammation behavior. The experiment results confirmed that compared with bare Mg substrate the corrosion and foreign-body reactions of the coated Mg samples were suppressed. The above results suggested that our coatings, which effectively enhance the biocompatibility, antimicrobial properties, and corrosion resistance of Mg substrate, provide a simple and practical strategy to expedite clinical acceptance of biodegradableMg and its alloys.

STATEMENT OF SIGNIFICANCE

Biomedical Mg metals have been considered as promising biodegradable implants because of their intended functions, such as cytocompatibility, antibacterial, and biodegradable properties. However, rapid corrosion in physiological environment limits their clinical applications. Alloying and surface coatings have been used to reduce the degradation rate. But this would compromise other excellent performance of Mg samples, including antibacterial and anti-inflammatory activity. Thus, while the rapid degradation of Mg samples must be solved, good antibacterial property and acceptable cytocompatibility are also necessary. In this study, polymer-based coatings were fabricated on Mg surfaces by electrophoretic deposition of poly(isobornyl acrylate-co-dimethylaminoethyl methacrylate)/tannic acid (P(ISA-co-DMA)/TA) colloidal particles. It suggested that the coating materials effectively improved the biocompatibility, antimicrobial behavior, and corrosion resistance of biomedical Mg.

Good Biocompatibility and Sintering Properties of Zirconia Nanoparticles Synthesized via Vapor-phase Hydrolysis

ZrO2 nanoparticles were synthesized by a vapor-phase hydrolysis process, and characterized in terms of crystalline structures, hardness and microstructures by X-ray diffraction, Vickers hardness test method, and atomic force microscopy (AFM) measurements. Moreover, in vitro cytotoxicity evaluation and hemolysis assay showed that the nanoparticles possessed good biocompatibility. Hardness investigations and AFM measurements indicated that both the sintering temperature and compression force played an important role in determining the physical behaviors (hardness, roughness and density) of flakes of the ZrO2 nanoparticles. When ZrO2 nanoparticles synthesized at 500 °C were pressed into flakes under 6 MPa and sintered at 1400 °C, the resulting flakes exhibited an optimal combination of hardness (534.58 gf·mm-2), roughness (0.07 μm) and density (4.41 g·cm-3). As the Vickers hardness value of human bones is of 315~535 gf·mm-2 and the density of adult femuris about 1.3~1.7 g·cm-3, the experimental results showed that the ZrO2 flakes were comparable to human bones with a higher density. As a result, the synthesized ZrO2 NPs may be useful for biomedical applications, especially for bone repair and replacement in future.

Stimulatory effects of the degradation products from Mg-Ca-Sr alloy on the osteogenesis through regulating ERK signaling pathway

The influence of Mg-1Ca-xwt.% Sr (x = 0.2, 0.5, 1.0, 2.0) alloys on the osteogenic differentiation and mineralization of pre-osteoblast MC3T3-E1 were studied through typical differentiation markers, such as intracellular alkaline phosphatase (ALP) activity, extracellular collagen secretion and calcium nodule formation. It was shown that Mg-1Ca alloys with different content of Sr promoted cell viability and enhanced the differentiation and mineralization levels of osteoblasts, and Mg-1Ca-2.0Sr alloy had the most remarkable and significant effect among all. To further investigate the underlying mechanisms, RT-PCR and Western Blotting assays were taken to analyze the mRNA expression level of osteogenesis-related genes and intracellular signaling pathways involved in osteogenesis, respectively. RT-PCR results showed that Mg-1Ca-2.0Sr alloy significantly up-regulated the expressions of the transcription factors of Runt-related transcription factor 2 (RUNX2) and Osterix (OSX), Integrin subunits, as well as alkaline phosphatase (ALP), Bone sialoprotein (BSP), Collagen I (COL I), Osteocalcin (OCN) and Osteopontin (OPN). Western Blotting results suggested that Mg-1Ca-2.0Sr alloy rapidly induced extracellular signal-regulated kinase (ERK) activation but showed no obvious effects on c-Jun N terminal kinase (JNK) and p38 kinase of MAPK. Taken together, our results demonstrated that Mg-1Ca-2.0Sr alloy had excellent biocompatibility and osteogenesis via the ERK pathway and is expected to be promising as orthopedic implants and bone repair materials.

On the Determination of Magnesium Degradation Rates under Physiological Conditions

The current physiological in vitro tests of Mg degradation follow the procedure stated according to the ASTM standard. This standard, although useful in predicting the initial degradation behavior of an alloy, has its limitations in interpreting the same for longer periods of immersion in cell culture media. This is an important consequence as the alloy's degradation is time dependent. Even if two different alloys show similar corrosion rates in a short term experiment, their degradation characteristics might differ with increased immersion times. Furthermore, studies concerning Mg corrosion extrapolate the corrosion rate from a single time point measurement to the order of a year (mm/y), which might not be appropriate because of time dependent degradation behavior. In this work, the above issues are addressed and a new methodology of performing long-term immersion tests in determining the degradation rates of Mg alloys was put forth. For this purpose, cast and extruded Mg-2Ag and powder pressed and sintered Mg-0.3Ca alloy systems were chosen. DMEM Glutamax +10% FBS (Fetal Bovine Serum) +1% Penicillin streptomycin was used as cell culture medium. The advantages of such a method in predicting the degradation rates in vivo deduced from in vitro experiments are discussed.

Systematic Study of Inherent Antibacterial Properties of Magnesium-based Biomaterials

Magnesium-based materials are preferred in temporary orthopedic implants because of their biodegradability, mechanical properties, and intrinsic antibacterial properties. However, the fundamental mechanism of bacteria killing and roles of various factors are not clearly understood. In this study, we performed a systematic study of the antibacterial properties of two common Mg-based materials using a biofilm forming bacterium. Complete annihilation of the initial 3 × 10(4) bacteria is achieved with both materials in 0.1 mL LB medium in 24 h, whereas in the control, they proliferate to 10(10). The bacteria are killed more effectively in the solution than on the surface, and the bacteria killing efficiency depends more on the concentrations of the magnesium ions and hydroxyl ions than the corrosion rate. The killing process is reproduced using formula solutions, and killing is revealed to stem from the synergetic effects of alkalinity and magnesium ions instead of either one of them or Mg(OH)2 precipitate. Reactive oxygen species (ROS) are detected from the bacteria during the killing process but are not likely produced by the redox reaction directly, because they are detected at least 3 h after the reaction has commenced. The average cell size increases during the killing process, suggesting that the bacteria have difficulty with normal division which also contributes to the reduced bacteria population.

Ag-Incorporated FHA Coating on Pure Mg: Degradation and in Vitro Antibacterial Properties

Fluoridated hydroxyapatite (FHA) coating can help retard the degradation of magnesium, and possess good biocompatibility. However, the antibacterial property of FHA is very limited. In this work, we aimed to incorporate silver into FHA structure to fabricate biocompatible and antibacterial coatings with enhanced anticorrosion property. The results showed that the Ag-FHA coating prepared by electrochemical deposition and subsequent immersion in AgNO3 solution was superior to the Ag-FHA coating prepared by coelectrodeposition in terms of crystal structure, surface morphology and corrosion resistance. The release of Ag(+) ion causing high antiplanktonic bacterial rate and excellent antiadherence property to MRSA. Meanwhile, good cell compatibility of MC3T3-E1 including cell viability, cell adhesion, and cell morphology was achieved under the controlled degradation. The balance of degradation and antimicrobial property of Ag-incorporated FHA coating made it an alternative in the application of surface modification for biodegradable Mg.

Controlling the Biomimetic Implant Interface: Modulating Antimicrobial Activity by Spacer Design

Surgical site infection is a common cause of post-operative morbidity, often leading to implant loosening, ultimately requiring revision surgery, increased costs and worse surgical outcomes. Since implant failure starts at the implant surface, creating and controlling the bio-material interface will play a critical role in reducing infection while improving host cell-to-implant interaction. Here, we engineered a biomimetic interface based upon a chimeric peptide that incorporates a titanium binding peptide (TiBP) with an antimicrobial peptide (AMP) into a single molecule to direct binding to the implant surface and deliver an antimicrobial activity against S. mutans and S. epidermidis, two bacteria which are linked with clinical implant infections. To optimize antimicrobial activity, we investigated the design of the spacer domain separating the two functional domains of the chimeric peptide. Lengthening and changing the amino acid composition of the spacer resulted in an improvement of minimum inhibitory concentration by a three-fold against S. mutans. Surfaces coated with the chimeric peptide reduced dramatically the number of bacteria, with up to a nine-fold reduction for S. mutans and a 48-fold reduction for S. epidermidis. Ab initio predictions of antimicrobial activity based on structural features were confirmed. Host cell attachment and viability at the biomimetic interface were also improved compared to the untreated implant surface. Biomimetic interfaces formed with this chimeric peptide offer interminable potential by coupling antimicrobial and improved host cell responses to implantable titanium materials, and this peptide based approach can be extended to various biomaterials surfaces.

Unique antitumor property of the Mg-Ca-Sr alloys with addition of Zn

In clinical practice, tumor recurrence and metastasis after orthopedic prosthesis implantation is an intensely troublesome matter. Therefore, to develop implant materials with antitumor property is extremely necessary and meaningful. Magnesium (Mg) alloys possess superb biocompatibility, mechanical property and biodegradability in orthopedic applications. However, whether they possess antitumor property had seldom been reported. In recent years, it showed that zinc (Zn) not only promote the osteogenic activity but also exhibit good antitumor property. In our present study, Zn was selected as an alloying element for the Mg-1Ca-0.5Sr alloy to develop a multifunctional material with antitumor property. We investigated the influence of the Mg-1Ca-0.5Sr-xZn (x = 0, 2, 4, 6 wt%) alloys extracts on the proliferation rate, cell apoptosis, migration and invasion of the U2OS cell line. Our results show that Zn containing Mg alloys extracts inhibit the cell proliferation by alteration the cell cycle and inducing cell apoptosis via the activation of the mitochondria pathway. The cell migration and invasion property were also suppressed by the activation of MAPK (mitogen-activated protein kinase) pathway. Our work suggests that the Mg-1Ca-0.5Sr-6Zn alloy is expected to be a promising orthopedic implant in osteosarcoma limb-salvage surgery for avoiding tumor recurrence and metastasis.

Development of a novel biomimetic micro/nano-hierarchical interface for enhancement of osseointegration

In the present study, a novel biomimetic micro/nano-hierarchical interface was obtained and an unexpected trabecular bone-like interface was given.