Core-Shell NiS@SrTiO3 Nanorods on Titanium for Enhanced Osseointegration via Programmed Regulation of Bacterial Infection, Angiogenesis, and Osteogenesis

Developing bone implants with dynamic self-adjustment of antibacterial, angiogenic, and osteogenic functions in line with a bone regenerative cascade is highly required in orthopedics. Herein, a unique core-shell nanorods array featuring a thin layer of NiS coated on each SrTiO3 nanorod (NiS@SrTiO3) was in situ constructed on titanium (Ti) through a two-step hydrothermal treatment. Under near-infrared (NIR) irradiation, the photoresponsive effect of NiS layer in synergy with the physical perforation of SrTiO3 nanorods initially enabled in vitro antibacterial rates of 96.5% to Escherichia coli and 93.1% to Staphylococcus aureus. With the degradation of the NiS layer, trace amounts of Ni ions were released, which accelerated angiogenesis by upregulating the expression of vascular regeneration-related factors, while the gradual exposure of SrTiO3 nanorods could simultaneously enhance the surface hydrophilicity in favor of cell adhesion and slowly release Sr ions to promote the proliferation and differentiation of MC3T3-E1 cells. The in vivo assessment verified not only the satisfactory antibacterial effect but also the superior osteogenic ability of the NiS@SrTiO3/Ti group with the aid of NIR irradiation, finally promoting the osseointegration of the Ti implant. The modification method endowing Ti implant with antibacterial, angiogenic, and osteogenic functions provides a new strategy to improve the long-term reliability of Ti-based devices.

Strontium Ion-Functionalized Nano-Hydroxyapatite/Chitosan Composite Microspheres Promote Osteogenesis and Angiogenesis for Bone Regeneration

Critical-size bone defects are an important problem in clinical practice, which usually occurs in severe trauma, or tumor resection, and cannot heal completely and autonomously. Implantation of grafts is often required to promote the regeneration of critical-size bone defects. Metal ions play an important role in human health, as they affect the body's metabolism and the tissue function. Strontium ions (Sr²⁺) can promote osteogenesis and angiogenesis. Herein, we prepared nano-hydroxyapatite (nHA)/chitosan (CS) composite microspheres with a uniform particle size distribution and an extracellular matrix-like nanofiber structure using microfluidic technology and direct alkali-induced gelation. Strontium ions were stably added into the microspheres by using polydopamine (PDA) to chelate metal ions forming a bone repair material (nHA/CS@PDA-Sr) with good bioactivity. The coordination reaction of PDA can effectively control the release of strontium ions and avoid the negative effects caused by the high strontium concentration. Our in vitro experiments showed that the composite microspheres had good biocompatibility and that the PDA coating promotes cell adhesion. The slow release of strontium ions can effectively promote mesenchymal stem cells osteogenic differentiation and the vascularization of endothelial cells. In addition, we injected composite microspheres into cranial defects of rats to evaluate osseointegration in vivo. The results showed that nHA/CS@PDA-Sr could effectively promote bone regeneration in the defect area. This study demonstrates that composite microspheres stimulate bone repair providing a promising way for bone-defect regeneration.

Effects of Zinc Ions Released From Ti-NW-Zn Surface on Osteogenesis and Angiogenesis In Vitro and in an In Vivo Zebrafish Model

Zinc-modified titanium materials have been widely applied in oral implants. Among them, our previous studies have also successfully prepared a novel acid-etched microstructured titanium surface modified with zinc-containing nanowires (Ti-NW-Zn) and proved its excellent biocompatibility. It is well known that the functional regulation between angiogenesis and osteogenesis is of great importance for bone remodeling around implants. However, there are few reports concerning the biological safety of zinc ions released from materials and the appropriate concentration of released zinc ions which was more conducive to angiogenesis and bone regeneration. In this study, we investigated the effects of zinc ions released from Ti-NW-Zn surfaces on angiogenesis and osteogenesis using the zebrafish model and revealed the relationship between angiogenesis and osteogenesis via HUVECs and MC3T3-E1s in vitro. We found that the zinc ions released from Ti-NW-Zn surfaces, with a concentration lower than median lethal concentrations (LCs) of zebrafish, were biologically safe and promote osteogenesis and angiogenesis in vivo. Moreover, the proper concentration of zinc ions could induce the proliferation of HUVECs and osteogenic differentiation. The positive effects of the appropriate concentration of zinc ions on osteoblast behaviors might be regulated by activating the MAPK/ERK signaling pathway. These aspects may provide new sights into the mechanisms underlying zinc-modified titanium surfaces between osteogenesis and angiogenesis, to lay the foundation for further improving the materials, meanwhile, promoting the applications in dentistry.

Potassium Titanate Assembled Titanium Dioxide Nanotube Arrays Endow Titanium Implants Excellent Osseointegration Performance and Nerve Formation Potential

Titanium based materials have been widely applied in bone-tissue engineering. However, inefficient bone repair remains to be solved due to the lack of neural network reconstruction at the bone-implant interface. Herein, we propose a functional surface modification approach to promote neurogenesis. Using an electrochemical technique and a hydrothermal approach, a potassium titanate nanorod-decorated titanium oxide (K₂Ti₆O₁₃-TiO₂) nanotube array is constructed on the surface of titanium implants. The K₂Ti₆O₁₃-TiO₂ hybrid nanotube array on titanium implants can enhance the osteogenic differentiation of mesenchymal stem cells due to the special nanostructures of titanium oxide nanorods. Meanwhile, the release of potassium ions is able to accelerate the neural differentiation of neural stem cells. This study provides a new approach to promote neuralization on the surface of implants, which is promising for future applications in constructing a fully functional interface in bone repair.

Strontium-Loaded Nanotubes of Ti-24Nb-4Zr-8Sn Alloys for Biomedical Implantation

Ti-24Nb-4Zr-8Sn (Ti2448) alloys, with a relatively low elastic modulus and unique mechanical properties, are desirable materials for oral implantation. In the current study, a multifaceted strontium-incorporating nanotube coating was fabricated on a Ti2448 alloy (Ti2-NTSr) through anodization and hydrothermal procedures. In vitro, the Ti2-NTSr specimens demonstrated better osteogenic properties and more favorable osteoimmunomodulatory abilities. Moreover, macrophages on Ti2-NTSr specimens could improve the recruitment and osteogenic differentiation of osteoblasts. In vivo, dense clots with highly branched, thin fibrins and small pores existed on the Ti2-NTSr implant in the early stage after surgery. Analysis of the deposition of Ca and P elements, hard tissue slices and the bone-implant contact rate (BIC%) of the Ti2-NTSr implants also showed superior osseointegration. Taken together, these results demonstrate that the Ti2-NTSr coating may maximize the clinical outcomes of Ti2448 alloys for implantation applications.

Inorganic Agents for Enhanced Angiogenesis of Orthopedic Biomaterials

Aseptic loosening of a permanent prosthesis remains one of the most common reasons for bone implant failure. To improve the fixation between implant and bone tissue as well as enhance blood vessel formation, bioactive agents are incorporated into the surface of the biomaterial. This study reviews and compares five bioactive elements (copper, magnesium, silicon, strontium, and zinc) with respect to their effect on the angiogenic behavior of endothelial cells (ECs) when incorporated on the surface of biomaterials. Moreover, it provides an overview of the state-of-the-art methodologies used for the in vitro assessment of the angiogenic properties of these elements. Two databases are searched using keywords containing ECs and copper, magnesium, silicon, strontium, and zinc. After applying the defined inclusion and exclusion criteria, 59 articles are retained for the final assessment. An overview of the angiogenic properties of five bioactive elements and the methods used for assessment of their in vitro angiogenic potential is presented. The findings show that silicon and strontium can effectively enhance osseointegration through the simultaneous promotion of both angiogenesis and osteogenesis. Therefore, their integration onto the surface of biomaterials can ultimately decrease the incidence of implant failure due to aseptic loosening.

Novel Bionic Topography with MiR-21 Coating for Improving Bone-Implant Integration through Regulating Cell Adhesion and Angiogenesis

Implant loosening is still the major form of the failure of artificial joints. Herein, inspired by the operculum of the river snail, we prepared a novel bionic micro/nanoscale topography on a titanium surface. This bionic topography promoted early cell adhesion through up-regulating the expression of ITG α5β1 and thus accelerated the following cell spreading, proliferation, and differentiation. Moreover, a miR-21 coating, which promoted the angiogenic differentiation of MSCs, was fabricated on the bionic topography. Benefiting from both bionic micro/nanoscale topography and miR-21, blood vessel growth and bone formation and mineralization around the implant, as well as bone-implant bonding strength, were significantly improved. Collectively, the present study highlights the combination of the bionic micro/nanoscale topography and miR-21 on promoting cell adhesion and angiogenic differentiation and improving in vivo angiogenesis and bone-implant osseointegration. This work provides a new train of thought propelling the development of implants for potential application in the orthopedics field.

Effect of Strontium Substitution on the Physicochemical Properties and Bone Regeneration Potential of 3D Printed Calcium Silicate Scaffolds

In this study, we synthesized strontium-contained calcium silicate (SrCS) powder and fabricated SrCS scaffolds with controlled precise structures using 3D printing techniques. SrCS scaffolds were shown to possess increased mechanical properties as compared to calcium silicate (CS) scaffolds. Our results showed that SrCS scaffolds had uniform interconnected macropores (~500 µm) with a compressive strength 2-times higher than that of CS scaffolds. The biological behaviors of SrCS scaffolds were assessed using the following characteristics: apatite-precipitating ability, cytocompatibility, proliferation, and osteogenic differentiation of human mesenchymal stem cells (MSCs). With CS scaffolds as controls, our results indicated that SrCS scaffolds demonstrated good apatite-forming bioactivity with sustained release of Si and Sr ions. The in vitro tests demonstrated that SrCS scaffolds possessed excellent biocompatibility which in turn stimulated adhesion, proliferation, and differentiation of MSCs. In addition, the SrCS scaffolds were able to enhance MSCs synthesis of osteoprotegerin (OPG) and suppress macrophage colony-stimulating factor (M-CSF) thus disrupting normal bone homeostasis which led to enhanced bone formation over bone resorption. Implanted SrCS scaffolds were able to promote new blood vessel growth and new bone regeneration within 4 weeks after implantation in critical-sized rabbit femur defects. Therefore, it was shown that 3D printed SrCS scaffolds with specific controllable structures can be fabricated and SrCS scaffolds had enhanced mechanical property and osteogenesis behavior which makes it a suitable potential candidate for bone regeneration.

Strontium/adiponectin co-decoration modulates the osteogenic activity of nano-morphologic polyetheretherketone implant

Polyetheretherketone (PEEK)-based implants have become popular in hard tissue orthopedic and dental field. However, its inherent bio-inertness limited its applications for bone repair/substitution of osteoporosis patients, with poor osteogenesis capability. In order to ameliorate their bioactivity, the 3D porous PEEK substrate was created by sulfonate processing, and the substrate was subsequently incorporated with strontium (Sr) through a hydrothermal reaction in Sr(OH)₂ solutions. The adiponectin (APN) protein membrane was deposited on the substrate via polydopamine-assisted deposition. Surface characterization results disclosed that the nanostructures had been formed on sPEEK-Sr-APN surafces, and APN coatings on the substrates could adjust Sr release rate and further mediate cell-material interactions. in vitro experiments indicated that the cellular effects (proliferation and differentiation) of MC3T3-E1 were significantly increased with Sr/APN coordinated regulation. This study provides bioactive Sr and APN as promising active components for bio-functional bone regeneration/substitution, and optimizes the osteointegration of PEEK implants in clinic.

Deferoxamine loaded titania nanotubes substrates regulate osteogenic and angiogenic differentiation of MSCs via activation of HIF-1α signaling

To develop biomaterials for inducing osteogenic and angiogenic differentiation of mesenchymal stem cells (MSCs) is crucial for bone repair. In this study, we employed titania nanotubes (TNT) as drug nanoreservoirs to load deferoxamine (DFO), and then deposited chitosan (Chi) and gelatin (Gel) multilayer as coverage structure via layer-by-layer (LBL) assembly technique, resulting in TNT-DFO-LBL substrates. Scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS) and contact angle measurements were employed to characterize the physical and chemical properties of the substrates. The results proved the successful fabrication of multilayer coating on TNT array. DFO released from the TNT arrays in a sustained manner. The drug-device combination titanium (Ti) substrates positively improved the adhesion, proliferation, osteogenic/angiogenic differentiation of MSCs and mediated the growth behavior of human umbilical vein endothelial cells (HUVECs). Moreover, the TNT-DFO-LBL substrates up-regulated osteogenic and angiogenic differentiation related genes expression of MSCs by activating HIF-1α signaling pathway. The approach presents here has a potential impact on the development of high quality Ti-based orthopedic implants.

Design, synthesis and characterization of doped-titanium oxide nanomaterials with environmental and angiogenic applications

Since the last decade, the metal composite nanostructures have evolved as promising candidates in regard to their wide applications in the fields of science and engineering. Recently, several investigators identified the titanium based nanomaterials as excellent agents for multifunctional environmental and biomedical applications. In this perspective, we have developed a series of zinc-doped (2 and 5%) titanium oxide-based nanomaterials using various reaction conditions and calcination temperatures (TZ1-TZ3: calcined at 500°C, TZ4-TZ6: calcined at 600°C and TZ7-TZ9: calcined at 700°C). The calcined materials (TZ1 to TZ9) were thoroughly analyzed by several physico-chemical characterization methods. The increase of the calcination temperature results in significant changes of the textural properties of the nanostructured materials. In addition, the increase of the calcination temperature leads to the formation of anatase/rutile mixtures with higher quantity of rutile. Furthermore, incorporation of zinc changes the morphology of the obtained nanoparticles. The materials were studied in the photodegradation of methylene blue observing that materials calcined at lower temperatures (TZ1-TZ3) have higher photocatalytic activity than those of the materials calcined at 600°C (TZ4-TZ6), rutile-based systems TZ7-TZ9 are not active. Based on the background literature of titanium and zinc based nanostructures in therapeutic angiogenesis, we have explored the pro-angiogenic properties of these materials using various in vitro and in vivo assays. The zinc-doped titanium dioxide nanostructures (TZ5 and TZ6) exhibited increased cell viability, proliferation, enhanced S-phase cell population, increased pro-angiogenic messengers (ROS: reactive oxygen species and NO: nitric oxide) production and promoted in vivo blood vessel formation in a plausible mechanistic p38/STAT3 dependent signaling cascade. Altogether, the results of the present study showcase these zinc doped-titanium oxide nanoparticles as promising candidates for environmental (water-remediation) and therapeutic angiogenic applications.