Immediate soft-tissue adhesion and the mechanical properties of the Ti-6Al-4V alloy after long-term acid treatment

In Vitro Molecular Study of Titanium-Niobium Alloy Biocompatibility

Titanium dental implants have common clinical applications due to their biocompatibility, biophysical and biochemical characteristics. Although current titanium is thought to be safe and beneficial for patients, there are several indications that it may release toxic metal ions or metal nanoparticles from its alloys into the surrounding environment, which could lead to clinically relevant complications including toxic reactions as well as immune dysfunctions. Hence, an adequate selection and testing of medical biomaterial with outstanding properties are warranted. This study was designed to explore the biocompatibility of smooth titanium-niobium alloy (S_TiNb) versus smooth titanium commercially pure (S_TiCp)—a reference in implantology. All experiments were performed in vitro using human osteoblast-like SaOs-2 and monocyte THP-1 cell lines as models. Cell adhesion and growth morphology were determined by scanning electron microscopy, while cell viability was evaluated using WST-1 assay. Because niobate anions or niobium nanoparticles can be released from implants during biomaterial-cell interaction, potential immunotoxicity of potassium niobate (KNbO₃₎ salt was evaluated by examining both metabolic activity and transcriptomic profiling of treated THP-1 monocytes. The main findings of this study are that S_TiCp and S_TiNb discs do not show an impact on the proliferation and viability of SaOs-2 cells compared to polystyrene surfaces, whereas a significant decrease in THP-1 cells’ viability and metabolic activity was observed in the presence of S_TiNb discs compared to the control group. However, no significant changes were found neither at the metabolic activity nor at the transcriptomic level of THP-1 monocytes exposed to KNbO₃ salt, suggesting that niobium has no effect on the immune system. Overall, these data imply a possible toxicity of S_TiNb discs toward THP-1 cells, which may not be directly related to niobium but perhaps to the manufacturing process of titanium-niobium alloy. Thus, this limitation must be overcome to make titanium alloy an excellent material for medical applications.

Effect of a Nanostructured Titanium Surface on Gingival Cell Adhesion, Viability and Properties against P. gingivalis

OBJECTIVES

The transgingival part of titanium implants is either machined or polished. Cell-surface interactions as a result of nano-modified surfaces could help gingival fibroblast adhesion and support antibacterial properties by means of the physico-mechanical aspects of the surfaces. The aim of the present study was to determine how a nanocavity titanium surface affects the viability and adhesion of human gingival fibroblasts (HGF-1). Additionally, its properties against Porphyromonas gingivalis were tested.

MATERIAL AND METHODS

Two different specimens were evaluated: commercially available machined titanium discs (MD) and nanostructured discs (ND). To obtain ND, machined titanium discs with a diameter of 15 mm were etched with a 1:1 mixture of 98% H₂SO₄ and 30% H₂O₂ (piranha etching) for 5 h at room temperature. Surface topography characterization was performed via scanning electron microscopy (SEM) and atomic force microscopy (AFM). Samples were exposed to HGF-1 to assess the effect on cell viability and adhesion, which were compared between the two groups by means of MTT assay, immunofluorescence and flow cytometry. After incubation with P. gingivalis, antibacterial properties of MD and ND were determined by conventional culturing, live/dead staining and SEM. Results: The present study successfully created a nanostructured surface on commercially available machined titanium discs. The etching process created cavities with a 10-20 nm edge-to-edge diameter. MD and ND show similar adhesion forces equal to about 10-30 nN. The achieved nanostructuration reduced the cell alignment along machining structures and did not negatively affect the proliferation of gingival fibroblasts when compared to MD. No differences in the expression levels of both actin and vinculin proteins, after incubation on MD or ND, were observed. However, the novel ND surface failed to show antibacterial effects against P. gingivalis.

CONCLUSION

Antibacterial effects against P. gingivalis cannot be achieved with nanocavities within a range of 10-20 nm and based on the piranha etching procedure. The proliferation of HGF-1 and the expression levels and localization of the structural proteins actin and vinculin were not influenced by the surface nanostructuration. Further studies on the strength of the gingival cell adhesion should be performed in the future.

CLINICAL RELEVANCE

Since osseointegration is well investigated, mucointegration is an important part of future research and developments. Little is known about how nanostructures on the machined transgingival part of an implant could possibly influence the surrounding tissue. Targeting titanium surfaces with improved antimicrobial properties requires extensive preclinical basic research to gain clinical relevance.

Self-adhering implantable device of titanium: Enhanced soft-tissue adhesion by sandblast pretreatment

Self-adhering implantable devices, which can be immobilized inside the bodies without suturing nor organic glues, made of metallic biomaterials would be optimal devices for preventing device-related complications such as device migration after implantation. We reported previously that acid-treated commercially-pure titanium (CpTi) adhered directly and immediately on hydrous non-keratinized soft tissues. Herein, we investigated the influence of sandblasting as pretreatment for acid-treated CpTi to increase its soft tissue adhesiveness. First, the effects of sandblasting conditions (i.e., pressure, distance and time) were investigated in terms of the sandblasted surface area and the degree of deformation (i.e., internal stress formation) of CpTi films. The effect of the sandblasting on the immediate soft tissue adhesion of acid-treated CpTi was investigated using an ex vivo shear adhesion test with mouse dermal tissues. The optimal sandblasting pretreatment remarkably improved the soft tissue adhesion strength of acid-treated CpTi (102 ± 19 kPa) compared with the non-sandblasted counterparts (41 ± 2 kPa). Finally, the CpTi adhesive was applied for immobilizing a near field communication (NFC) device in vivo, and was shown to have strong immediate adhesion to muscle fascia.