Biomaterials: a primer for surgeons

Characterization and Evaluation of Silver Concentrations in Hydroxyapatite Powders

The goal of this study is to evaluate the influence of the concentration of silver on the structural and antimicrobial in vitro properties of silver-doped hydroxyapatite powders obtained using the precipitation method. Different concentrations of silver were evaluated to assess the antimicrobial properties. X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, scanning electron microscopy (SEM), and dispersive energy spectroscopy (EDS) were used to characterize the powders. XRD and FTIR showed that the hydroxyapatite structure is not affected by the incorporation of silver; on the other hand, EDS showed the presence of silver in the powders. Antibacterial studies showed the efficiency of hydroxyapatite powders in inhibiting bacterial growth as silver concentration increases. According to the results, silver-doped hydroxyapatite powders are suggested for use in the prevention and treatment of infections in bone and dental tissues.

Advances in Biodegradable Polymers and Biomaterials for Medical Applications-A Review

The introduction of new materials for the production of various types of constructs that can connect directly to tissues has enabled the development of such fields of science as medicine, tissue, and regenerative engineering. The implementation of these types of materials, called biomaterials, has contributed to a significant improvement in the quality of human life in terms of health. This is due to the constantly growing availability of new implants, prostheses, tools, and surgical equipment, which, thanks to their specific features such as biocompatibility, appropriate mechanical properties, ease of sterilization, and high porosity, ensure an improvement of living. Biodegradation ensures, among other things, the ideal rate of development for regenerated tissue. Current tissue engineering and regenerative medicine strategies aim to restore the function of damaged tissues. The current gold standard is autografts (using the patient's tissue to accelerate healing), but limitations such as limited procurement of certain tissues, long operative time, and donor site morbidity have warranted the search for alternative options. The use of biomaterials for this purpose is an attractive option and the number of biomaterials being developed and tested is growing rapidly.

Clinical Applications of Poly-Methyl-Methacrylate in Neurosurgery: The In Vivo Cranial Bone Reconstruction

Background: Biomaterials and biotechnology are becoming increasingly important fields in modern medicine. For cranial bone defects of various aetiologies, artificial materials, such as poly-methyl-methacrylate, are often used. We report our clinical experience with poly-methyl-methacrylate for a novel in vivo bone defect closure and artificial bone flap development in various neurosurgical operations. Methods: The experimental study included 12 patients at a single centre in 2018. They presented with cranial bone defects after various neurosurgical procedures, including tumour, traumatic brain injury and vascular pathologies. The patients underwent an in vivo bone reconstruction from poly-methyl-methacrylate, which was performed immediately after the tumour removal in the tumour group, whereas the trauma and vascular patients required a second surgery for cranial bone reconstruction due to the bone decompression. The artificial bone flap was modelled in vivo just before the skin closure. Clinical and surgical data were reviewed. Results: All patients had significant bony destruction or unusable bone flap. The tumour group included five patients with meningiomas destruction and the trauma group comprised four patients, all with severe traumatic brain injury. In the vascular group, there were three patients. The average modelling time for the artificial flap modelling was approximately 10 min. The convenient location of the bone defect enabled a relatively straightforward and fast reconstruction procedure. No deformations of flaps or other complications were encountered, except in one patient, who suffered a postoperative infection. Conclusions: Poly-methyl-methacrylate can be used as a suitable material to deliver good cranioplasty cosmesis. It offers an optimal dural covering and brain protection and allows fast intraoperative reconstruction with excellent cosmetic effect during the one-stage procedure. The observations of our study support the use of poly-methyl-methacrylate for the ad hoc reconstruction of cranial bone defects.

Diamond-like Carbon Coatings in the Biomedical Field: Properties, Applications and Future Development

Repairment and replacement of organs and tissues are part of the history of struggle against human diseases, in addition to the research and development (R&D) of drugs. Acquisition and processing of specific substances and physiological signals are very important to understand the effects of pathology and treatment. These depend on the available biomedical materials. The family of diamond-like carbon coatings (DLCs) has been extensively applied in many industrial fields. DLCs have also been demonstrated to be biocompatible, both in vivo and in vitro. In many cases, the performance of biomedical devices can be effectively enhanced by coating them with DLCs, such as vascular stents, prosthetic heart valves and surgical instruments. However, the feasibility of the application of DLC in biomedicine remains under discussion. This review introduces the current state of research and application of DLCs in biomedical devices, their potential application in biosensors and urgent problems to be solved. It will be useful to build a bridge between DLC R&D workers and biomedical workers in order to develop high-performance DLC films/coatings, promote their practical use and develop their potential applications in the biomedical field.

Bio-piezoelectricity: fundamentals and applications in tissue engineering and regenerative medicine

In recent years, smart materials have piqued the interest of scientists and physicians in the biomedical community owing to their ability to modify their properties in response to an external stimulation or changes in their surroundings. Biocompatible piezoelectric materials are an interesting group of smart materials due to their ability to produce electrical charges without an external power source. Electric signals produced by piezoelectric scaffolds can renew and regenerate tissues through special pathways like that found in the extracellular matrix. This review summarizes the piezoelectric phenomenon, piezoelectric effects generated within biological tissues, piezoelectric biomaterials, and their applications in tissue engineering and their use as biosensors.

Corrosion Behavior of Zn, Fe and Fe-Zn Powder Materials Prepared via Uniaxial Compression

Powder metallurgy is one of the most prevalent ways for metallic degradable materials preparation. Knowledge of the properties of initial powders used during this procedure is therefore of great importance. Two different metals, iron and zinc, were selected and studied in this paper due to their promising properties in the field of biodegradable implants. Raw powders were studied using scanning electron microscopy (SEM) coupled with energy dispersive spectrometry (EDX). Powders (Fe, Zn and Fe-Zn in a weight ratio of 1:1) were then compressed at the pressure of 545 MPa to the form of pellets with a diameter of 1.7 cm. Surface morphology and degradation behavior in the Hanks´ solution were studied and evaluated. Electrochemical polarization tests along with the static immersion tests carried out for 21 days were employed for corrosion behavior characterization. The highest corrosion rate was observed for pure Zn powder followed by the Fe-Zn and Fe, respectively. A mixed Fe-Zn sample showed similar properties as pure zinc with no signs of iron degradation after 21 days due to the effect of galvanic protection secured by the zinc acting as a sacrificial anode.

Cobalt-chromium versus titanium alloy rods for correction of adolescent idiopathic scoliosis based on 1-year follow-up: a multicenter randomized controlled clinical trial

OBJECTIVE

For instrumented correction surgery for adolescent idiopathic scoliosis (AIS), surgeons are increasingly switching from titanium (Ti) alloy rods to stiffer cobalt-chromium (CoCr) rods. The authors conducted the first multicenter randomized controlled clinical trial to investigate whether these materials affect the outcomes in terms of spine correction and quality of life (QOL). This trial was registered at UMIN Clinical Trials Registry on September 3, 2012, under the identifier UMIN000008838 (level of evidence 1).

METHODS

Female AIS patients (Lenke types 1-3, patient age 10-19 years) were recruited at 5 Japanese institutions and randomized into two cohorts: 6.0-mm-diameter Ti rods were placed in one group, and 6.0-mm-diameter CoCr rods were placed in the other. Patients were followed up at 2 weeks and 3, 6, and 12 months with radiographic examination to quantify the sagittal and coronal correction (Cobb angle, thoracic kyphosis, rib hump, and apical vertebral rotation). Patients completed questionnaires (Scoliosis Research Society-22r, 12-Item Short-Form Health Survey, and Scoliosis Japanese Questionnaire-27) at 6 and 12 months to assess QOL.

RESULTS

A total of 69 AIS patients were randomized to the demographically similar Ti (n = 37) or CoCr (n = 32) cohort. Four adverse events were recorded, two in each cohort, but these were not related to the rod material. At the final follow-up, both Ti and CoCr cohorts showed significant improvement in spinal correction, including the Cobb angle, thoracic kyphosis, and rib hump size. The correction rates were 68.4% and 67.1% for the Ti and CoCr cohorts, respectively. No parameters differed significantly between the cohorts at any time. Survey data showed improved but similar outcomes in both cohorts.

CONCLUSIONS

Both treatments (Ti and CoCr) produced similar results and were efficient in engendering clinically significant spine corrections. Clinical trial registration no.: UMIN000008838 (UMIN Clinical Trials Registry).

Bioinspired Modifications of PEEK Implants for Bone Tissue Engineering

In recent years, polyetheretherketone (PEEK) has been increasingly employed as an implant material in clinical applications. Although PEEK is biocompatible, chemically stable, and radiolucent and has an elastic modulus similar to that of natural bone, it suffers from poor integration with surrounding bone tissue after implantation. To improve the bioactivity of PEEK, numerous strategies for functionalizing the PEEK surface and changing the PEEK structure have been proposed. Inspired by the components, structure, and function of bone tissue, this review discusses strategies to enhance the biocompatibility of PEEK implants and provides direction for fabricating multifunctional implants in the future.

The dead space after extirpation of rectum. Current management and searching for new materials for filling

Pelvic surgeries such as extirpation of the rectum or pelvic exenteration lead to a creation of a dead space, which can be cause of complication, such as bowel obstruction, perineal hernia, abscess or hematoma. A growing incidence of complication is expected in connection with the increasing use of laparoscopic and robotic approaches or ELAPE method. Since the bone structures do not allow compression, the only way to deal with the dead space is to fill it in. Present methods provide the filling with omental or myofascial flaps. The length and the mobility of the omental flap can be the limitation. Myofascial flaps are technically more demanding and bring the complications of a donor place. Synthetic or biological meshes do not deal with dead space problematic. Modern technologies using nanomaterials offer the possibility to produce a material with specific properties for example shape, inner structure, surface, or time of degradation. The modified material could also satisfy the requirements for filling the dead space after surgeries.

Comparative Analysis of NF-κB in the MyD88-Mediated Pathway After Implantation of Titanium Alloy and Stainless Steel and the Role of Regulatory T Cells

OBJECTIVE

Development of immunologically smart implants, integrated to biological systems, is a key aim to minimize the inflammatory response of the host to biomaterial implants.

METHODS

The aim of this study is to investigate the influence of titanium alloy and stainless steel implants on immunological responses in rats by comparative analysis of nuclear factor kappa B (NF-κB) profiles in the activation of inflammatory signaling pathways and the role of CD4+CD25+Foxp3+.

RESULTS

Both Ti alloy and stainless steel alloy group implantation affect Toll-like receptors-4 pathways and CD4+CD25+ regulatory T cells in different ways.

CONCLUSIONS

Results show that NF-κB/p65 and NF-κB1/p50 possess potential as a therapeutic target in the prevention of adverse reactions to metal, especially for controlling inflammation after the implantation.

Comparison of surgical correction rates between titanium and cobalt-chrome-alloy as rod materials in adolescent idiopathic scoliosis

Numerous biomechanical studies comparing titanium (Ti) and cobalt-chrome-alloy (CCM) rods are described in the literature. However, there is a dearth of literature comparing the two rod materials in adolescent idiopathic scoliosis (AIS). Therefore, the purpose of this study is to compare the correction rates of Ti and CCM rods in the treatment of AIS with double major curves. We enrolled 45 patients with AIS who underwent surgery between 2009 and 2012. We divided patients into two groups, Group A (n = 29) treated with six-millimeter Ti rods and Group B (n = 16) treated with six-millimeter CCM rods. The rod-derotation maneuver was used for correction. We measured pre- and postoperative indices of coronal alignment (Cobb's angle, coronal balance, T1-tilt, clavicle angle) and sagittal alignment (sagittal vertical axis, thoracic kyphosis, lumbar lordosis). In our study, there were no significant differences between the two groups with respect to demographics or curve characteristics (P > 0.05). In Group A, thoracic and lumbar curvature correction rates were 71.2% and 66.8% respectively, and in Group B they were 71.2% and 73.3%, respectively (P = 0.664 and 0.09). There were no significant differences between the two groups in coronal or sagittal factors (P > 0.05) except for greater postoperative lumbar lordosis in the CCM group (P < 0.001). In conclusion, Ti and CCM rods showed similar correction rates in the sagittal and coronal planes for the surgical correction of AIS with double major curves. Biomechanical studies of Ti and CCM rods in vitro is different in biological condition.

Post-implantation Deformation of Titanium Rod and Cobalt Chrome Rod in Adolescent Idiopathic Scoliosis

Introduction: Post-implantation rod deformation is anticipated in scoliosis surgery but the difference in rod deformation between titanium and cobalt chrome rod has not been elucidated. This study aims to compare the difference in rod deformation between two groups. Materials and Methods: Twenty-one adolescent idiopathic scoliosis (AIS) patients were recruited from a single center. The over-contoured concave rods were traced prior to insertion. Post-operative sagittal rod shape was determined from lateral radiographs. Rod deformation was determined using maximal rod deflection and angle of the tangents to rod end points. The differences between pre- and post-operative rod contour were analysed statistically. Rod deformation and thoracic kyphosis between two types of implants were analysed. Results: Both rods exhibited significant change of rod angle and deflection post-operatively. Curvature of the titanium rod and cobalt chrome rod decreased from 60.5° to 37°, and 51° to 28° respectively. Deflection of titanium rod and cobalt chrome rod reduced from 28mm to 23.5mm and 30mm to 17mm respectively. There was no significant difference between titanium and cobalt chrome groups with regard to rod angle (p=0.173) and deflection (p=0.654). Thoracic kyphosis was increased from 20° to 26° in titanium group but a reduction from 25° to 23° was noticed in cobalt chrome group, but these findings were not statistically significant. Conclusion: There was no statistical difference in rod deformation between the two groups. Thus, the use of titanium rod in correction of sagittal profile is not inferior in outcome compared with cobalt chrome but with lower cost.

Histological and radiological evaluation of subcutaneous implants in mouse of a 3D-printable material (Fulcure 720) and experimental application in mandibular reconstruction

INTRODUCTION

The aim of this study was to evaluate the bioactivity of Fullcure compared to porous polyethylene implants (Medpor) in rats prior to custom-made scaffold support manufacturing for mandible segmental defects (MSD) reconstruction in sheep.

METHODS

Twelve Fullcure and Medpor laminaes were implanted in the left and right dorsum respectively of six wistar rats. Toxicity was assessed by skin, kidney and liver histopathology three months post-implantation. Computed Tomography (CT) was carried out in order to assess radiological differences between implants. Fullcure containers were subsequently manufactured by CAD/CAM to hold scaffold cylinders for MSD reconstruction in sheep.

RESULTS

No statistical differences were observed in tissue response between implants. Fullcure radiodensity was higher than Medpor (P<0.05). Fullcure manufactured support was successfully used for mandible repair in sheep. Nevertheless, the manufactured container did not accomplish the goal of guiding new bone formation according to the mandible shape.

CONCLUSIONS

Fullcure showed similar biocompatibility and stronger radiodensity than Medpor. Despite its cheaper price and endless 3D-printing possibilities as scaffold holder for mandible reconstruction, further animal studies are needed to ensure Fullcure biocompatibility as implantable biomaterial.

Fiber-reinforced silicone for tracheobronchial stents: An experimental study

A trachea is a tubular structure composed of smooth muscle that is reinforced with cartilage rings. Some diseases can cause sagging in smooth muscle and cartilaginous tissue. The end result is reduction (narrowing) of the trachea diameter. A solution to this problem is the use of tracheal stents, which are small tubular devices made of silicone. One is inserted into the trachea to prevent or correct its constriction. The purpose of tracheal stent use is to maintain cartilage support that would otherwise be lost in the airway. Current tracheal stent models present limitations in terms of shape and characteristics of the silicone used in their production. One of the most important is the large thickness of the wall, which makes its placement difficult; this mainly applies to pediatric patients. The wall thickness of the stent is closely related to the mechanical properties of the material. This study aims to test the reinforcement of silicone with three kinds of fibers, and then stents that were produced using fiber with the best compressive strength characteristics. Silicone samples were reinforced with polypropylene (PP), polyamide (PA), and carbon fiber (CF) at concentrations of 2% and 4% (vol%), which then underwent tensile strength and Shore A hardness testing. Samples with fiber showed good characteristics; surface analyses were carried out and they were used to produce stents with an internal diameter of 11 or 13mm and a length of 50mm. Stents underwent compression tests for qualitative evaluation. Samples with 2% and 4% CF blends showed the best mechanical performance, and they were used to produce stents. These samples presented similar compressive strengths at low deformation, but stents with a 4% CF blend exhibited improved compressive strength at deformations greater than 30-50% of their diameter (P ≤ 0.05). The addition of 2% and 4% CF blends conferred greater mechanical strength and resistance to the silicone matrix. This is particularly true at low deformation, which is the condition where the stent is used when implanted. In the finite element compression strength tests, the stent composite showed greater compression strength with the addition of fiber, and the results were in accordance with mechanical compression tests performed on the stents. In vivo tests showed that, after 30 days of post-implantation in sheep trachea, an inflammatory process occurred in the region of the trachea in contact with the stent composite and with the stent without fiber (WF). This response is a common process during the first few days of implantation.

Nanofibrillar cellulose-alginate hydrogel coated surgical sutures as cell-carrier systems

Hydrogel nanomaterials, especially those that are of non-human and non-animal origins, have great potential in biomedical and pharmaceutical sciences due to their versatility and inherent soft-tissue like properties. With the ability to simulate native tissue function, hydrogels are potentially well suited for cellular therapy applications. In this study, we have fabricated nanofibrillar cellulose-alginate (NFCA) suture coatings as biomedical devices to help overcome some of the limitations related to cellular therapy, such as low cell survivability and distribution out of target tissue. The addition of sodium alginate 8% (w/v) increased the NFCA hydrogel viscosity, storage and loss moduli by slightly under one order of magnitude, thus contributing significantly to coating strength. Confocal microscopy showed nearly 100% cell viability throughout the 2-week incubation period within and on the surface of the coating. Additionally, typical morphologies in the dual cell culture of spheroid forming HepG2 and monolayer type SK-HEP-1 were observed. Twelve out of 14 NFCA coated surgical sutures remained intact during the suturing operation with various mice and rat tissue; however, partial peeling off was observed in 2 of the coated sutures. We conclude that NFCA suture coatings could perform as cell-carrier systems for cellular based therapy and post-surgical treatment.

A review of biocompatible metal injection moulding process parameters for biomedical applications

Biocompatible metals have been revolutionizing the biomedical field, predominantly in human implant applications, where these metals widely used as a substitute to or as function restoration of degenerated tissues or organs. Powder metallurgy techniques, in specific the metal injection moulding (MIM) process, have been employed for the fabrication of controlled porous structures used for dental and orthopaedic surgical implants. The porous metal implant allows bony tissue ingrowth on the implant surface, thereby enhancing fixation and recovery. This paper elaborates a systematic classification of various biocompatible metals from the aspect of MIM process as used in medical industries. In this study, three biocompatible metals are reviewed-stainless steels, cobalt alloys, and titanium alloys. The applications of MIM technology in biomedicine focusing primarily on the MIM process setting parameters discussed thoroughly. This paper should be of value to investigators who are interested in state of the art of metal powder metallurgy, particularly the MIM technology for biocompatible metal implant design and development.

In vitro study of electrodeposited fluoridated hydroxyapatite coating on G-II titanium with a nanostructured TiO2 interlayer

Titanium and its alloys have been widely used as orthopedic and dental implants for several decades due to their superior mechanical properties, corrosion resistance and biocompatibility. Recently, many researches revealed that the hydroxyapatite coatings on biomedical materials can further improve their biocompatibility and bioactivity. However, hydroxyapatite coatings are easily decomposed, weakening the bonding between implants and bone tissues and resulting in a high dissolution rate in the biological environment. Prolonging the lifetime of hydroxyapatite in implants is valuable for improving postoperative quality. Hydroxyapatite is the primary inorganic component of bones and teeth. A suitable amount of fluoride ions would be beneficial for the formation of fluoridated hydroxyapatite, which can enhance bone-cell response and the acid resistance of enamel. In this study, G-II titanium substrate was anodized to form a TiO₂ interlayer with a nanotube structure. An electrolyte composed of fluoride, calcium and phosphorus ions was prepared for electroplating fluoridated hydroxyapatite (FHA) coatings onto anodized G-II titanium substrates at a constant voltage. The obtained coatings were examined for their microstructure, mechanical properties; moreover, the changes of apatite structure, surface morphology and corrosion resistance were further investigated after immersion in simulated body fluid (SBF) for a number of weeks. The results show that FHA coatings have a higher surface roughness and hardness than plain hydroxyapatite. After immersion in SBF, the FHA coatings induced the nucleation and growth of apatite on the surface and increased their crystallinity. In a potentiodynamic polarization test, FHA coatings exhibited a better anti-corrosion ability than bare G-II titanium substrate in SBF. Additionally, the anodized TiO₂ nanotube improved the adhesion and corrosion resistance of FHA as well.

Monocyte subsets in blood correlate with obesity related response of macrophages to biomaterials in vitro

Macrophages play a key role in the foreign body response. In this study it was investigated whether obesity affects the acute response of macrophages to biomaterials in vitro and whether this response is associated with biomarkers in blood. CD14 ⁺ monocytes were isolated from blood from obese and age and gender matched lean persons. Monocyte subsets were determined based on CD14 and CD16 on their surface. C-reactive protein (CRP) was measured in peripheral blood. The response of monocyte-derived macrophages to polypropylene (PP), polylactic acid (PLA), polyethylene terephthalate (PET) monofilament, and PET-multifilament (mPET) in culture was based on cytokine production. More IL-6 (for PET), less CCL18 (all materials) and IL-1ra (for PLA) was produced by macrophages from obese patients than lean subjects. Body mass index, serum CRP and to a lesser extend percentages of monocyte subtypes correlated with IL-6, TNFα, CCL18, and IL-1ra production. Taken together, monocyte-derived macrophages of obese patients respond more pro-inflammatory and less anti-inflammatory to biomaterials than macrophages from lean subjects, depending on the material. These results are a step towards personalized medicine for the development of a model or even a blood test to decide which biomaterial might be suitable for each patient.

Biomaterials and host versus graft response: a short review

Biomaterials and biotechnology are increasing becoming an important area in modern medicine. The main aim in this area is the development of materials, which are biocompatible to normal tissue. Tissue-implant interactions with molecular, biological and cellular characteristics at the implant-tissue interface are important for the use and development of implants. Implantation may cause an inflammatory and immune response in tissue, foreign body reaction, systemic toxicity and imminent infection. Tissue-implant interactions determine the implant life-period. The aims of the study are to consider the biological response to implants. Biomaterials and host reactions to implants and their mechanisms are also briefly discussed.

Latham J, G. Dunlop D, Oreffo RO. Bone and metal: an orthopaedic perspective on osseointegration of metals

The area of implant osseointegration is of major importance, given the predicted significant rise in the number of orthopaedic procedures and an increasingly ageing population. Osseointegration is a complex process involving a number of distinct mechanisms affected by the implant bulk properties and surface characteristics. Our understanding and ability to modify these mechanisms through alterations in implant design is continuously expanding. The following review considers the main aspects of material and surface alterations in metal implants, and the extent of their subsequent influence on osseointegration. Clinically, osseointegration results in asymptomatic stable durable fixation of orthopaedic implants. The complexity of achieving this outcome through incorporation and balance of contributory factors is highlighted through a clinical case report.

Reprogramming and carcinogenesis--parallels and distinctions

Rapid progress made in various areas of regenerative medicine in recent years occurred both at the cellular level, with the Nobel prize-winning discovery of reprogramming (generation of induced pluripotent stem (iPS) cells) and also at the biomaterial level. The use of four transcription factors, Oct3/4, Sox2, c-Myc, and Klf4 (called commonly "Yamanaka factors") for the conversion of differentiated cells, back to the pluripotent/embryonic stage, has opened virtually endless and ethically acceptable source of stem cells for medical use. Various types of stem cells are becoming increasingly popular as starting components for the development of replacement tissues, or artificial organs. Interestingly, many of the transcription factors, key to the maintenance of stemness phenotype in various cells, are also overexpressed in cancer (stem) cells, and some of them may find the use as prognostic factors. In this review, we describe various methods of iPS creation, followed by overview of factors known to interfere with the efficiency of reprogramming. Next, we discuss similarities between cancer stem cells and various stem cell types. Final paragraphs are dedicated to interaction of biomaterials with tissues, various adverse reactions generated as a result of such interactions, and measures available, that allow for mitigation of such negative effects.

Potential of microneedle-assisted micro-particle delivery by gene guns: a review

CONTEXT

Gene guns have been used to deliver deoxyribonucleic acid (DNA) loaded micro-particle and breach the muscle tissue to target cells of interest to achieve gene transfection.

OBJECTIVE

This article aims to discuss the potential of microneedle (MN) assisted micro-particle delivery from gene guns, with a view to reducing tissue damage.

METHODS

Using a range of sources, the main gene guns for micro-particle delivery are reviewed along with the primary features of their technology, e.g. their design configurations, the material selection of the micro-particle, the driving gas type and pressure. Depending on the gene gun system, the achieved penetration depths in the skin are discussed as a function of the gas pressure, the type of the gene gun system and particle size, velocity and density. The concept of MN-assisted micro-particles delivery which consists of three stages (namely, acceleration, separation and decoration stage) is discussed. In this method, solid MNs are inserted into the skin to penetrate the epidermis/dermis layer and create holes for particle injection. Several designs of MN array are discussed and the insertion mechanism is explored, as it determines the feasibility of the MN-based system for particle transfer.

RESULTS

This review suggests that one of the problems of gene guns is that they need high operating pressures, which may result in direct or indirect tissue/cells damage. MNs seem to be a promising method which if combined with the gene guns may reduce the operating pressures for these devices and reduce tissue/cell damages.

CONCLUSIONS

There is sufficient potential for MN-assisted particle delivery systems.

Surface modification by argon plasma treatment improves antioxidant defense ability of CHO-k1 cells on titanium surfaces

Titanium is one of the most used materials in implants and changes in its surface can modify the cellular functional response to better implant fixation. An argon plasma treatment generates a surface with improved mechanical proprieties without modifying its chemical composition. Oxidative stress induced by biomaterials is considered one of the major causes of implant failure and studies in this field are fundamental to evaluate the biocompatibility of a new material. Therefore, in this work, induction of oxidative stress by titanium surfaces subjected to plasma treatment (PTTS) was evaluated. The viability of CHO-k1 cells was higher on PTTS discs. Cells grown on titanium surfaces are subjected to intracellular oxidative stress. Titanium discs subjected to the plasma treatment induced less oxidative stress than the untreated ones, which resulted in improved cellular survival. These were associated with improved cellular antioxidant response in Plasma Treated Titanium Surface (PTTS). Furthermore, a decrease in protein and DNA oxidative damage was observed on cells grown on the roughed surface when compared to the smooth one. In conclusion, our data suggest that the treatment of titanium with argon plasma may improve its biocompatible, thus improving its performance as implants or as a scaffold in tissue engineering.

Influence of laser light on bioimplants used in otorhinolaryngology

In otorhinolaryngology, dermatology and reconstructive surgery biomaterials as implants and a variety of lasers are used. Laser light applied near to an implant could have the risk to damage these materials. Therefore, their resistance exposed to laser light is of interest. A diode laser emitting at 940 nm and a CO2 laser were used to investigate its effects to the biomaterials Bioverit®, Medpor® and Palacos®, and in addition, an excised implant containing Medpor® and nasal turbinate tissue, excised and fixed in formalin. The macro- and microscopic changes of the material, temperature development during laser energy application in dependency to distance of fibre and material, time of exposure and applied power were investigated. Interaction of diode laser light with Bioverit® (0 mm distance, 360 s, 10 W, 3,600 J) resulted in minimal microscopic effects in direct contact of with the fibre. Using Medpor® (1 mm, 10s, 10 W, 100 J) resulted in melting and perforation. In the case of Palacos® (0.6 mm, 10s, 10 W, 100 J), melting occurred creating a flat excavation. The effect to Medpor® in nasal turbinate (1-2 mm, 10s, 10 W, 100 J) showed tissue denaturation and carbonisation and creation of a hole. The interaction of the CO2 laser with Bioverit® (3 cm, 0.5, 1 and 5 s, 2, 10 or 20 W) induced melting and discolouring resulting finally in a perforating hole. Depending on the material, first damage starts 10 s after an impact of 100 J (threshold value). So interaction between laser energy and biomaterials occurs. This should be carefully considered during clinical laser treatments especially nearby implants.

Silk-silica composites from genetically engineered chimeric proteins: materials properties correlate with silica condensation rate and colloidal stability of the proteins in aqueous solution

The aim of the study was to determine the extent and mechanism of influence on silica condensation that is presented by a range of known silicifying recombinant chimeras (R5: SSKKSGSYSGSKGSKRRIL; A1: SGSKGSKRRIL; and Si4-1: MSPHPHPRHHHT and repeats thereof) attached at the N-terminus end of a 15-mer repeat of the 32 amino acid consensus sequence of the major ampullate dragline Spindroin 1 (Masp1) Nephila clavipes spider silk sequence ([SGRGGLGGQG AGAAAAAGGA GQGGYGGLGSQG](15)X). The influence of the silk/chimera ratio was explored through the adjustment of the type and number of silicifying domains (denoted X above), and the results were compared with their non-chimeric counterparts and the silk from Bombyx mori. The effect of pH (3-9) on reactivity was also explored. Optimum conditions for rate and control of silica deposition were determined, and the solution properties of the silks were explored to determine their mode(s) of action. For the silica-silk-chimera materials formed there is a relationship between the solution properties of the chimeric proteins (ability to carry charge), the pH of reaction, and the solid state materials that are generated. The region of colloidal instability correlates with the pH range observed for morphological control and coincides with the pH range for the highest silica condensation rates. With this information it should be possible to predict how chimeric or chemically modified proteins will affect structure and morphology of materials produced under controlled conditions and extend the range of composite materials for a wide spectrum of uses in the biomedical and technology fields.

Effects of mobility/immobility of surface modification by 2-methacryloyloxyethyl phosphorylcholine polymer on the durability of polyethylene for artificial joints

Surface modification is important for the improvement in medical device materials. 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymers have attracted considerable attention as surface modifiable polymers for several medical devices. In this study, we hypothesize that the structure of the surface modification layers might affect the long-term stability, hydration kinetics, wear resistance, and so forth, of medical devices such as artificial joints, and the poly(MPC) (PMPC) grafted surface might assure the long-term performance of such devices. Therefore, we investigate the surface properties of various surface modifications by using dip coatings of MPC-co-n-butyl methacrylate (PMB30) and MPC-co-3-methacryloxypropyl trimethoxysilane (PMSi90) polymers, or photoinduced radical grafting of PMPC and also the effects of the surface properties on the durability of cross-linked polyethylene (CLPE) for artificial joints. The PMPC-grafted CLPE has an extremely low and stable coefficient of dynamic friction and volumetric wear as compared to the untreated CLPE, PMB30-coated CLPE, and PMSi90-coated CLPE. It is concluded that the photoinduced radical graft polymerization of MPC is the best method to retain the benefits of the MPC polymer used in artificial joints under variable and multidirectional loads for long periods with strong bonding between the MPC polymer and the CLPE surface, and also to retain the high mobility of the MPC polymer.

Bone regeneration using an injectable calcium phosphate/autologous iliac crest bone composites for segmental ulnar defects in rabbits

BACKGROUND

Treatment of segmental bone loss remains a challenge in skeletal repair. A major therapeutic goal is the development of implantable materials that will promote bone regeneration.

OBJECTIVE

We evaluate bone regeneration in grafts containing different concentrations autologous iliac crest bone (ACB) particles, carried in a new injectable calcium phosphate cement (CPC), in ulnar bone defects in rabbits.

METHODS

Large upper-mid-diaphyseal defects (10 mm) were created in the left ulnae of 60 skeletally mature New Zealand white rabbits. ACB concentrations of 0, 25, 50, 75, and 100% (by volume) in CPC were used to fill operated sites. Defect bridging was monitored by serial radiography at 4, 8, and 12 weeks post-operation. Samples were then examined histologically and by manual palpation to determine the extent of new bone formation.

RESULTS

At 4 weeks, we observed more elaborate structures and extensive absorption in ulnae treated with mixtures containing low concentrations of ACB (such as 0% and 25% volume of ACB/CPC), compared with those treated with mixtures containing high concentrations of ACB (such as 75% and 100% volume of ACB/CPC). At 8 weeks, histomorphometry revealed increased trabecular area and volume in the group treated with high ACB concentrations compared with those treated with low ACB concentrations. At 12 weeks, complete cortical bridging and regeneration of marrow space were detected in groups treated with high concentrations of ACB, and the amount of new bone regeneration was greater in these groups than in those treated with low ACB concentrations.

CONCLUSIONS

Treatment of rabbit ulnar defects with injectable CPC carrying an optimized concentration of ACB particles can lead to cortical bridging and bone marrow regeneration within 12 weeks.

Inorganic materials for bone repair or replacement applications

In recent years, excipient systems have been used increasingly in biomedicine in reconstructive and replacement surgery, as bone cements, drug-delivery vehicles and contrast agents. Particularly, interest has been growing in the development and application of controlled pore inorganic ceramic materials for use in bone-replacement and bone-repair roles and, in this context, attention has been focused on calcium-phosphate, bioactive glasses and SiO2- and TiO2-based materials. It has been shown that inorganic materials that most closely mimic bone structure and surface chemistry most closely function best in bone replacement/repair and, in particular, if a substance possesses a macroporous structure (pores and interconnections >100µm diameter), then cell infiltration, bone growth and vascularization can all be promoted. The surface roughness and micro/mesoporosity of a material have also been observed to significantly influence its ability to promote apatite nucleation and cell attachment significantly. Pores (where present) can also be packed with pharmaceuticals and biomolecules (e.g., bone morphogenetic proteins [BMPs], which can stimulate bone formation). Finally, the most bio-efficient – in terms of collagen formation and apatite nucleation – materials are those that are able to provide soluble mineralizing species (Si, Ca, PO4) at their implant sites and/or are doped or have been surface-activated with specific functional groups. This article presents the context and latest advances in the field of bone-repair materials, especially with respect to the development of bioactive glasses and micro/mesoporous and macroporous inorganic scaffolds. It deals with the possible methods of preparing porous pure/doped or functionalized silicas or their composites, the studies that have been undertaken to evaluate their abilities to act as bone repair scaffolds and also presents future directions for work in that context.