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Nowotnick AG, Xi Z, Jin Z, Khalatbarizamanpoor S, Brauer DS, Löffler B, Jandt KD. Antimicrobial Biomaterials Based on Physical and Physicochemical Action. Adv Healthc Mater 2024:e2402001. [PMID: 39301968 DOI: 10.1002/adhm.202402001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 08/09/2024] [Indexed: 09/22/2024]
Abstract
Developing effective antimicrobial biomaterials is a relevant and fast-growing field in advanced healthcare materials. Several well-known (e.g., traditional antibiotics, silver, copper etc.) and newer (e.g., nanostructured, chemical, biomimetic etc.) approaches have been researched and developed in recent years and valuable knowledge has been gained. However, biomaterials associated infections (BAIs) remain a largely unsolved problem and breakthroughs in this area are sparse. Hence, novel high risk and potential high gain approaches are needed to address the important challenge of BAIs. Antibiotic free antimicrobial biomaterials that are largely based on physical action are promising, since they reduce the risk of antibiotic resistance and tolerance. Here, selected examples are reviewed such antimicrobial biomaterials, namely switchable, protein-based, carbon-based and bioactive glass, considering microbiological aspects of BAIs. The review shows that antimicrobial biomaterials mainly based on physical action are powerful tools to control microbial growth at biomaterials interfaces. These biomaterials have major clinical and application potential for future antimicrobial healthcare materials without promoting microbial tolerance. It also shows that the antimicrobial action of these materials is based on different complex processes and mechanisms, often on the nanoscale. The review concludes with an outlook and highlights current important research questions in antimicrobial biomaterials.
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Affiliation(s)
- Adrian G Nowotnick
- Chair of Materials Science (CMS), Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743, Jena, Germany
- Jena School for Microbial Communication (JSMC), 07743, Neugasse 23, Jena, Germany
| | - Zhongqian Xi
- Chair of Materials Science (CMS), Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743, Jena, Germany
- Jena School for Microbial Communication (JSMC), 07743, Neugasse 23, Jena, Germany
| | - Zhaorui Jin
- Bioactive Glasses Group, Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Lessingstraße 12, 07743, Jena, Germany
| | - Sadaf Khalatbarizamanpoor
- Jena School for Microbial Communication (JSMC), 07743, Neugasse 23, Jena, Germany
- Institute of Medical Microbiology, Jena University Hospital, 07747, Am Klinikum 1, Jena, Germany
| | - Delia S Brauer
- Bioactive Glasses Group, Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Lessingstraße 12, 07743, Jena, Germany
| | - Bettina Löffler
- Jena School for Microbial Communication (JSMC), 07743, Neugasse 23, Jena, Germany
- Institute of Medical Microbiology, Jena University Hospital, 07747, Am Klinikum 1, Jena, Germany
| | - Klaus D Jandt
- Chair of Materials Science (CMS), Otto Schott Institute of Materials Research (OSIM), Friedrich Schiller University Jena, Löbdergraben 32, 07743, Jena, Germany
- Jena School for Microbial Communication (JSMC), 07743, Neugasse 23, Jena, Germany
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Zhao X, Zhang Y, Wang P, Guan J, Zhang D. Construction of multileveled and oriented micro/nano channels in Mg doped hydroxyapitite bioceramics and their effect on mimicking mechanical property of cortical bone and biological performance of cancellous bone. BIOMATERIALS ADVANCES 2024; 161:213871. [PMID: 38692181 DOI: 10.1016/j.bioadv.2024.213871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/13/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024]
Abstract
Drawing on the structure and components of natural bone, this study developed Mg-doped hydroxyapatite (Mg-HA) bioceramics, characterized by multileveled and oriented micro/nano channels. These channels play a critical role in ensuring both mechanical and biological properties, making bioceramics suitable for various bone defects, particularly those bearing loads. Bioceramics feature uniformly distributed nanogrooves along the microchannels. The compressive strength or fracture toughness of the Mg-HA bioceramics with micro/nano channels formed by single carbon nanotube/carbon fiber (CNT/CF) (Mg-HA(05-CNT/CF)) are comparable to those of cortical bone, attributed to a combination of strengthened compact walls and microchannels, along with a toughening mechanism involving crack pinning and deflection at nanogroove intersections. The introduction of uniform nanogrooves also enhanced the porosity by 35.4 %, while maintaining high permeability owing to the capillary action in the oriented channels. This leads to superior degradation properties, protein adsorption, and in vivo osteogenesis compared with bioceramics with only microchannels. Mg-HA(05-CNT/CF) exhibited not only high strength and toughness comparable to cortical bone, but also permeability similar to cancellous bone, enhanced cell activity, and excellent osteogenic properties. This study presents a novel approach to address the global challenge of applying HA-based bioceramics to load-bearing bone defects, potentially revolutionizing their application in tissue engineering.
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Affiliation(s)
- Xueni Zhao
- College of Mechanical and Electrical Engineering, Shaanxi University of Science and Technology, Xi'an, Shaanxi 710021, PR China.
| | - Yu Zhang
- College of Mechanical and Electrical Engineering, Shaanxi University of Science and Technology, Xi'an, Shaanxi 710021, PR China
| | - Pengfei Wang
- College of Mechanical and Electrical Engineering, Shaanxi University of Science and Technology, Xi'an, Shaanxi 710021, PR China
| | - Jinxin Guan
- College of Mechanical and Electrical Engineering, Shaanxi University of Science and Technology, Xi'an, Shaanxi 710021, PR China
| | - Dexin Zhang
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, PR China.
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Zhang X, Zhou W, Xi W. Advancements in incorporating metal ions onto the surface of biomedical titanium and its alloys via micro-arc oxidation: a research review. Front Chem 2024; 12:1353950. [PMID: 38456182 PMCID: PMC10917964 DOI: 10.3389/fchem.2024.1353950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
The incorporation of biologically active metallic elements into nano/micron-scale coatings through micro-arc oxidation (MAO) shows significant potential in enhancing the biological characteristics and functionality of titanium-based materials. By introducing diverse metal ions onto titanium implant surfaces, not only can their antibacterial, anti-inflammatory and corrosion resistance properties be heightened, but it also promotes vascular growth and facilitates the formation of new bone tissue. This review provides a thorough examination of recent advancements in this field, covering the characteristics of commonly used metal ions and their associated preparation parameters. It also highlights the diverse applications of specific metal ions in enhancing osteogenesis, angiogenesis, antibacterial efficacy, anti-inflammatory and corrosion resistance properties of titanium implants. Furthermore, the review discusses challenges faced and future prospects in this promising area of research. In conclusion, the synergistic approach of micro-arc oxidation and metal ion doping demonstrates substantial promise in advancing the effectiveness of biomedical titanium and its alloys, promising improved outcomes in medical implant applications.
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Affiliation(s)
- Xue’e Zhang
- Jiangxi Province Key Laboratory of Oral Biomedicine, School of Stomatology, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
| | - Wuchao Zhou
- Jiangxi Province Key Laboratory of Oral Biomedicine, The Affiliated Stomatological Hospital, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
| | - Weihong Xi
- Jiangxi Province Key Laboratory of Oral Biomedicine, The Affiliated Stomatological Hospital, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
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Wang W, Zhou X, Yin Z, Yu X. Fabrication and Evaluation of Porous dECM/PCL Scaffolds for Bone Tissue Engineering. J Funct Biomater 2023; 14:343. [PMID: 37504838 PMCID: PMC10381742 DOI: 10.3390/jfb14070343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
Porous scaffolds play a crucial role in bone tissue regeneration and have been extensively investigated in this field. By incorporating a decellularized extracellular matrix (dECM) onto tissue-engineered scaffolds, bone regeneration can be enhanced by replicating the molecular complexity of native bone tissue. However, the exploration of porous scaffolds with anisotropic channels and the effects of dECM on these scaffolds for bone cells and mineral deposition remains limited. To address this gap, we developed a porous polycaprolactone (PCL) scaffold with anisotropic channels and functionalized it with dECM to capture the critical physicochemical properties of native bone tissue, promoting osteoblast cells' proliferation, differentiation, biomineralization, and osteogenesis. Our results demonstrated the successful fabrication of porous dECM/PCL scaffolds with multiple channel sizes for bone regeneration. The incorporation of 100 μm grid-based channels facilitated improved nutrient and oxygen infiltration, while the porous structure created using 30 mg/mL of sodium chloride significantly enhanced the cells' attachment and proliferation. Notably, the mechanical properties of the scaffolds closely resembled those of human bone tissue. Furthermore, compared with pure PCL scaffolds, the presence of dECM on the scaffolds substantially enhanced the proliferation and differentiation of bone marrow stem cells. Moreover, dECM significantly increased mineral deposition on the scaffold. Overall, the dECM/PCL scaffold holds significant potential as an alternative bone graft substitute for repairing bone injuries.
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Affiliation(s)
- Weiwei Wang
- Department of Biomedical Engineering, Charles V. Schaefer School of Engineering and Sciences, Stevens Institute of Technology, Hoboken, NJ 07030, USA
| | - Xiaqing Zhou
- Department of Biomedical Engineering, Charles V. Schaefer School of Engineering and Sciences, Stevens Institute of Technology, Hoboken, NJ 07030, USA
| | - Zhuozhuo Yin
- Department of Biomedical Engineering, Charles V. Schaefer School of Engineering and Sciences, Stevens Institute of Technology, Hoboken, NJ 07030, USA
| | - Xiaojun Yu
- Department of Biomedical Engineering, Charles V. Schaefer School of Engineering and Sciences, Stevens Institute of Technology, Hoboken, NJ 07030, USA
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In Vitro and In Vivo Studies of Hydrogenated Titanium Dioxide Nanotubes with Superhydrophilic Surfaces during Early Osseointegration. Cells 2022; 11:cells11213417. [DOI: 10.3390/cells11213417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Titanium-based implants are often utilized in oral implantology and craniofacial reconstructions. However, the biological inertness of machined titanium commonly results in unsatisfactory osseointegration. To improve the osseointegration properties, we modified the titanium implants with nanotubular/superhydrophilic surfaces through anodic oxidation and thermal hydrogenation and evaluated the effects of the machined surfaces (M), nanotubular surfaces (Nano), and hydrogenated nanotubes (H-Nano) on osteogenesis and osseointegration in vitro and in vivo. After incubation of mouse bone marrow mesenchymal stem cells on the samples, we observed improved cell adhesion, alkaline phosphatase activity, osteogenesis-related gene expression, and extracellular matrix mineralization in the H-Nano group compared to the other groups. Subsequent in vivo studies indicated that H-Nano implants promoted rapid new bone regeneration and osseointegration at 4 weeks, which may be attributed to the active osteoblasts adhering to the nanotubular/superhydrophilic surfaces. Additionally, the Nano group displayed enhanced osteogenesis in vitro and in vivo at later stages, especially at 8 weeks. Therefore, we report that hydrogenated superhydrophilic nanotubes can significantly accelerate osteogenesis and osseointegration at an early stage, revealing the considerable potential of this implant modification for clinical applications.
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Mao M, Zhu S, Zhang L, Liu F, Kong L, Xue Y, Rotello VM, Han Y. An Extracellular Matrix-like Surface for Zn Alloy to Enhance Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2022; 14:43955-43964. [PMID: 36098563 DOI: 10.1021/acsami.2c12513] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Zn-based alloys are promising biodegradable implants for bone defect repair due to their good mechanical performance and degradability. However, local Zn2+ released from Zn-based implants can seriously affect adhering cell behaviors as well as new bone formation on implant surfaces. To address this issue, we have fabricated a bone-mimetic extracellular matrix (ECM)-like surface on Zn-1Ca implants using a hybrid process of anodization, hydrothermal treatment (HT), and fluorous-curing. The ECM-like surface consisted of Zn2SiO4 nanorods layered with collagen I (Col-I). The Zn2SiO4 nanorods were hemicrystallized and transformed by the reaction of Zn(OH)2 and SiO44- during the HT. The Zn2SiO4 nanorods effectively protected the substrate from corrosion; the Col-I layer decreased the degradation of Zn2SiO4 nanorods and further reduced Zn2+ release into the medium. This ECM-like surface generated a microenvironment with appropriate Zn2+ levels, nanorod-like topography, and Col-I. It significantly improved adhesion, proliferation, and differentiation of osteoblasts on implant surfaces and vascularization of endothelial cells in the extract medium. The in vivo results are in good agreement with in vitro tests, with the ECM-like surface significantly enhancing new bone formation and bone-implant contact compared to the bare implant surface. Overall, this bone-mimetic ECM-like material of Col-I layered Zn2SiO4 nanorods is a promising scaffold that promotes the bone regeneration of Zn-based implants.
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Affiliation(s)
- Mengting Mao
- State-Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shengbo Zhu
- State-Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an 710049, China
| | - Lan Zhang
- State-Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an 710049, China
- Department of Chemistry, University of Massachusetts Amherst, Amherst, Massachusetts 01003, United States
| | - Fuwei Liu
- Fourth Military Medical University, Xi'an, 710038, China
| | - Liang Kong
- Fourth Military Medical University, Xi'an, 710038, China
| | - Yang Xue
- State-Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an 710049, China
| | - Vincent M Rotello
- Department of Chemistry, University of Massachusetts Amherst, Amherst, Massachusetts 01003, United States
| | - Yong Han
- State-Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an 710049, China
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Characterization of Hydroxyapatite Film Obtained by Er:YAG Pulsed Laser Deposition on Sandblasted Titanium: An In Vitro Study. MATERIALS 2022; 15:ma15062306. [PMID: 35329758 PMCID: PMC8955651 DOI: 10.3390/ma15062306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 12/21/2022]
Abstract
The surface of titanium (Ti) dental implants must be modified to improve their applicability, owing to the biological inertness of Ti. This study aims to use sandblasting as a pretreatment method and prepare a hydroxyapatite (HA) coating on Ti to improve its biocompatibility and induce bone bonding and osteogenesis. In this paper, sandblasted Ti discs were coated with α-tricalcium phosphate (α-TCP) via Er:YAG pulsed laser deposition (Er:YAG-PLD). An HA coating was then obtained via the hydrothermal treatment of the discs at 90 °C for 10 h. The surface characteristics of the samples were evaluated by SEM, SPM, XPS, XRD, FTIR, and tensile tests. Rat bone marrow mesenchymal stem cells were seeded on the HA-coated discs to determine cellular responses in vitro. The surface characterization results indicated the successful transformation of the HA coating with a nanorod-like morphology, and its surface roughness increased. In vitro experiments revealed increased cell attachment on the HA-coated discs, as did the cell morphology of fluorescence staining and SEM analysis; in contrast, there was no increase in cell proliferation. This study confirms that Er:YAG-PLD could be used as an implant surface-modification technique to prepare HA coatings with a nanorod-like morphology on Ti discs.
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Chen L, Ren J, Hu N, Du Q, Wei D. Rapid structural regulation, apatite-inducing mechanism and in vivo investigation of microwave-assisted hydrothermally treated titania coating. RSC Adv 2021; 11:7305-7317. [PMID: 35423257 PMCID: PMC8695042 DOI: 10.1039/d0ra08511a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/25/2021] [Indexed: 11/21/2022] Open
Abstract
Owing to the poor bioactivity of microarc oxidation (MAO) coating and the rapid activation ability of the microwave hydrothermal (MH) technique, MH treatment was applied to optimize the in vivo interface status between MAO-treated titanium and bone. In this study, consequently, new outermost layers were prepared using hydroxyapatite (HA) nanorods, HA submicron pillars or sodium titanate nanosheets. The results revealed that the NaOH concentration significantly influenced the surface structure and phase constitution of the MAO samples. Moreover, on enhancing the NaOH concentration, the number of HA phases was decreased. Further, the influence of the NaOH concentration on the interfacial bonding strength was insignificant for concentrations ≤0.5 mol L−1. Transmission electron microscopy (TEM) analysis showed that the induction of apatite was accompanied by the dissolution of the HA crystals and there was excellent crystallographic matching with the HA crystals. The in vitro and in vivo analyses revealed that the MH-treated MAO sample with the HA nanorods possessed superior apatite-formation ability and osseointegration, including a small amount of soft tissue and optimal bone–implant interfacial bonding force, thus signifying strong potential for the optimization of the bone–implant interfacial status. In this work, the micro/nano scale structures of HA nanorods integrated on a titanium were prepared using MAO and MH treatment. The in vivo results indicate that HA crystals play a crucial role in the improvement of the osseointegration.![]()
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Affiliation(s)
- Lin Chen
- Orthopedics, Second Affiliated Hospital of Harbin Medical University Harbin 150086 China
| | - Junyu Ren
- Oral Implant Center, Second Affiliated Hospital of Harbin Medical University No. 246 Xuefu Road, Nangang District Harbin 150086 China
| | - Narisu Hu
- Oral Implant Center, Second Affiliated Hospital of Harbin Medical University No. 246 Xuefu Road, Nangang District Harbin 150086 China
| | - Qing Du
- Center of Analysis and Measurement, Harbin Institute of Technology Science Park, No. 2 Yikuang Street Harbin 150001 China .,Institute for Advanced Ceramics, Department of Materials Science and Engineering, Harbin Institute of Technology Harbin 150001 China.,Key Laboratory of Advanced Structural-Functional Integration Materials & Green Manufacturing Technology, Harbin Institute of Technology Harbin 150001 China
| | - Daqing Wei
- Center of Analysis and Measurement, Harbin Institute of Technology Science Park, No. 2 Yikuang Street Harbin 150001 China .,Institute for Advanced Ceramics, Department of Materials Science and Engineering, Harbin Institute of Technology Harbin 150001 China.,Key Laboratory of Advanced Structural-Functional Integration Materials & Green Manufacturing Technology, Harbin Institute of Technology Harbin 150001 China
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Li K, Xue Y, Yan T, Zhang L, Han Y. Si substituted hydroxyapatite nanorods on Ti for percutaneous implants. Bioact Mater 2020; 5:116-123. [PMID: 32021946 PMCID: PMC6994265 DOI: 10.1016/j.bioactmat.2020.01.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 12/15/2022] Open
Abstract
An ideal intraosseous transcutaneous implant should form a tight seal with soft tissue, besides a requirement of osseointegration at the bone-fixed position. Si substituted hydroxyapatite (Si-HA) nanorods releasing Si ion and simulating nanotopography of natural tissue were designed on Ti to enhance fibroblast response in vitro and biosealing with soft tissue in vivo. Si-HA nanorods were fabricated by alkali-heat treatment followed with hydrothermal treatment. The hydrothermal formation mechanism of Si-HA nanorods was explored. The surface characteristic of Si-HA nanorods was compared with pure HA nanorods. Fibroblast behaviors in vitro and skin response in vivo on different surfaces were also evaluated. The obtained results show that the substitution of Si did not significantly alter the phase component, morphology, roughness and wettability of HA, but additional Si and more Ca were released from Si-HA into medium. Comparing to pure HA nanrods and Ti substrate, Si-HA nanrods enhanced cell behaviors including proliferation, fibrotic phenotype and collagen secretion in vitro, and reduced epithelial down growth in vivo. The enhanced cell response and biosealing should be due to the releasing of Ca, Si and nanotopography of Si-HA nanorods. Si-HA nanorods can be a potential coating to accelerate skin integration for percutaneous implants in clinic.
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Affiliation(s)
| | | | | | - Lan Zhang
- State-key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Yong Han
- State-key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China
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Li K, Dai F, Yan T, Xue Y, Zhang L, Han Y. Magnetic Silicium Hydroxyapatite Nanorods for Enhancing Osteoblast Response in Vitro and Biointegration in Vivo. ACS Biomater Sci Eng 2019; 5:2208-2221. [PMID: 33405773 DOI: 10.1021/acsbiomaterials.9b00073] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Osteoblast behavior playing an important role in the biointegration of the Ti implant with host bone in vivo can be regulated by surface properties and magnetic field. In order to endow the Ti surface with good osteogenesis activity, Si monosubstituted and Fe and Si cosubstituted hydroxyapatite (HAp) nanorods were fabricated on microporous TiO2 by microarc oxidation (MAO) followed with hydrothermal treatment (HT). The surface properties including microstructure, microroughness, hydrophilicity, ion release, magnetic property, cytocompatibility, and biointegration of substituted HAp nanorods were observed and evaluated, together with pure HAp nanorods and microarc oxidated (MAOed) TiO2 as controls. After being doped with Fe, MAOed TiO2 has no changes in phase composition and microroughness, whereas it displays weakly ferromagnetic behavior and can enhance osteoblast differentiation in vitro and formation of new bone in vivo, compared with the undoped one. The substituted HAp nanorods adhere firmly to TiO2 and have almost the same wettability and microroughness but additional Si, Fe, and/or Ca released into the medium, compared with pure HAp nanorods. Moreover, the cosubstituted HAp has a small ferromagnetic signal, while its saturation magnetization value is less than that of the MAOed doped with Fe. Compared to pure HA nanorods, the substituted HAp nanorods not only improve cell proliferation and differentiation in vitro, but also enhance the ability of bone integration in vivo, especially for the cosubstituted one, which should be ascribed to the combined effect of microstructure, magnetic property, and released ions.
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Affiliation(s)
- Kai Li
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710049, P. R. China
| | - Fang Dai
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710049, P. R. China
| | - Ting Yan
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710049, P. R. China
| | - Yang Xue
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710049, P. R. China
| | - Lan Zhang
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710049, P. R. China
| | - Yong Han
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710049, P. R. China
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Nanorod diameter modulated osteogenic activity of hierarchical micropore/nanorod-patterned coatings via a Wnt/β-catenin pathway. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2018; 14:1719-1731. [DOI: 10.1016/j.nano.2018.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 01/16/2023]
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12
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Surface characterization, in vitro and in vivo biocompatibility of Mg-0.3Sr-0.3Ca for temporary cardiovascular implant. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 67:72-84. [DOI: 10.1016/j.msec.2016.04.108] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/10/2016] [Accepted: 04/27/2016] [Indexed: 11/18/2022]
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The osteogenic capacity of biomimetic hierarchical micropore/nanorod-patterned Sr-HA coatings with different interrod spacings. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2016; 12:1161-73. [DOI: 10.1016/j.nano.2016.01.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 12/28/2015] [Accepted: 01/21/2016] [Indexed: 01/16/2023]
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Zhou J, Zhao L. Multifunction Sr, Co and F co-doped microporous coating on titanium of antibacterial, angiogenic and osteogenic activities. Sci Rep 2016; 6:29069. [PMID: 27353337 PMCID: PMC4926257 DOI: 10.1038/srep29069] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/14/2016] [Indexed: 12/25/2022] Open
Abstract
Advanced multifunction titanium (Ti) based bone implant with antibacterial, angiogenic and osteogenic activities is stringently needed in clinic, which may be accomplished via incorporation of proper inorganic bioactive elements. In this work, microporous TiO2/calcium-phosphate coating on Ti doped with strontium, cobalt and fluorine (SCF-TiCP) was developed, which had a hierarchical micro/nano-structure with a microporous structure evenly covered with nano-grains. SCF-TiCP greatly inhibited the colonization and growth of both gram-positive and gram-negative bacteria. No cytotoxicity appeared for SCF-TiCP. Furthermore, SCF-TiCP stimulated the expression of key angiogenic factors in rat bone marrow stem cells (MSCs) and dramatically enhanced MSC osteogenic differentiation. The in vivo animal test displayed that SCF-TiCP induced more new bone and tighter implant/bone bonding. In conclusion, multifunction SCF-TiCP of antibacterial, angiogenic and osteogenic activities is a promising orthopedic and dental Ti implant coating for improved clinical performance.
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Affiliation(s)
- Jianhong Zhou
- Institute of Physics &Optoelectronics Technology, Baoji University of Arts and Sciences, Baoji, 721016, China
| | - Lingzhou Zhao
- State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
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15
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Han J, Wan P, Ge Y, Fan X, Tan L, Li J, Yang K. Tailoring the degradation and biological response of a magnesium–strontium alloy for potential bone substitute application. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 58:799-811. [DOI: 10.1016/j.msec.2015.09.057] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 08/26/2015] [Accepted: 09/13/2015] [Indexed: 10/23/2022]
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Zhang L, Huang X, Han Y. Formation mechanism and cytocompatibility of nano-shaped calcium silicate hydrate/calcium titanium silicate/TiO2 composite coatings on titanium. J Mater Chem B 2016; 4:6734-6745. [DOI: 10.1039/c6tb01699e] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Compared with as-MAOed TiO2, the triple-layered coating (HT2h) comprised of an outer layer of nanoleaf Ca3Si6O15(H2O)7, a middle layer of nanograined Ca(Si1.9Ti0.1)O5 and an inner layer of microporous TiO2 can significantly improve the behaviors of osteoblasts.
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Affiliation(s)
- Lan Zhang
- State-key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
| | - Xiaoyan Huang
- State-key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
| | - Yong Han
- State-key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
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17
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Zhang L, Han Y, Tan G. Hydroxyaptite nanorods patterned ZrO2 bilayer coating on zirconium for the application of percutaneous implants. Colloids Surf B Biointerfaces 2015; 127:8-14. [DOI: 10.1016/j.colsurfb.2015.01.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 12/09/2014] [Accepted: 01/11/2015] [Indexed: 11/26/2022]
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18
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Li B, Han Y. Fast formation of a novel bilayer coating with enhanced corrosion resistance and cytocompatibility on magnesium. RSC Adv 2015. [DOI: 10.1039/c5ra04454e] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A bilayer coating on magnesium provides effective protection to the substrate from corrosion and facilitates osteoblast adhesion and proliferation.
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Affiliation(s)
- Bo Li
- State Key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
| | - Yong Han
- State Key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
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19
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Wang C, Fan Z, Han Y. Formation and osteoblast behavior of HA nano-rod/fiber patterned coatings on tantalum in porous and compact forms. J Mater Chem B 2015; 3:5442-5454. [DOI: 10.1039/c5tb00839e] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Osteoblast survival and proliferation are enhanced on quasi-upright HA nanorods but inhibited on paralleled HA nanofibers compared to Ta.
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Affiliation(s)
- Cuicui Wang
- State-key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
| | - Zhibin Fan
- State-key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
| | - Yong Han
- State-key Laboratory for Mechanical Behavior of Materials
- Xi'an Jiaotong University
- Xi'an 710049
- China
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20
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Wen J, Li J, Pan H, Zhang W, Zeng D, Xu L, Wu Q, Zhang X, Liu X, Jiang X. Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats. J Mater Chem B 2015; 3:4790-4804. [PMID: 32262668 DOI: 10.1039/c5tb00128e] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Strontium-substituted hierarchical Ti surface can enhance the osseointegration by both increasing new bone formation and reducing bone resorption under osteoporotic conditions.
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21
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Li B, Han Y, Qi K. Formation mechanism, degradation behavior, and cytocompatibility of a nanorod-shaped HA and pore-sealed MgO bilayer coating on magnesium. ACS APPLIED MATERIALS & INTERFACES 2014; 6:18258-74. [PMID: 25265530 DOI: 10.1021/am505437e] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A novel bilayer coating (HT24h) was fabricated on magnesium using microarc oxidation (MAO) and hydrothermal treatment (HT). The coating comprises an outer layer of narrow interrod spaced hydroxyapatite (HA) nanorods and an inner layer of MgO containing Mg(OH)2/HA-sealing-pores. The hydrothermal formation mechanism of HA nanorods on MAO-formed MgO was explored. Also, evolution of structure and bonding integrity of HT24h coating with immersion in physiological saline (PS) for 0-90 days, corrosion resistance and cytocompatibility of the coating were investigated, together with MgO containing Mg(OH)2-sealing-pores (HT2h) and porous MgO (MAO) coatings. Corrosion resistance was identified by three-point bending and electrochemical tests in PS, while cytocompatibility was determined by MTT, live/dead staining, and vinculin-actin-nucleus tricolor staining assays of hFOB1.19 cells. Immersion tests indicate that cracking rather than delamination is a common feature in most areas of the coatings up to day 90 and degradation is the reason for thinning in thickness of the coatings. MAO and HT2h coatings exhibit a significant thinning due to fast degradation of MgO. However, HT24h coating shows a quite small thinning, owing to the fact that the HA nanorods underwent quite slow degradation while the underlying MgO only underwent conversion to Mg(OH)2 without dissolution of the Mg(OH)2. Scratch tests reveal that HT24h coating still retains relatively high bonding integrity, although the failure position changes from the MgO interior to a point between the HA and MgO layers after 90 days of immersion. HT24h coating appears far more effective than MAO and HT2h coatings in reducing degradation and maintaining the mechanical integrity of Mg, as well as enhancing the mitochondrial activity, adhesion, and proliferation of osteoblasts.
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Affiliation(s)
- Bo Li
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University , Xi'an 710049, China
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22
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Formation and bioactivity of HA nanorods on micro-arc oxidized zirconium. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 43:86-91. [DOI: 10.1016/j.msec.2014.06.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 05/23/2014] [Accepted: 06/30/2014] [Indexed: 11/23/2022]
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23
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Liu P, Wang N, Hao Y, Zhao Q, Qiao Y, Li H, Li J. Entangled titanium fibre balls combined with nano strontium hydroxyapatite in repairing bone defects. Med Princ Pract 2014; 23:264-70. [PMID: 24686383 PMCID: PMC5586876 DOI: 10.1159/000359951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 01/23/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate the effect of entangled titanium fibre balls (ETFBs) combined with nano strontium hydroxyapatite (nano-Sr-HAP) on the repair of bone defects in vivo. MATERIALS AND METHODS Twenty-four 6-month-old, specific pathogen-free, male Sprague-Dawley rats were used. Drill defects were created in bilateral femoral condyles. ETFBs combined with nano-Sr-HAP were selected randomly from 72 samples and implanted into the femoral bone defects of left legs, which served as the experimental group, while ETFBs without nano-Sr-HAP were implanted into right legs for comparison. The bone defects on both sides were X-rayed. The anteroposterior positions and histological procedures and evaluations of each sample were performed at 1, 2, 4 and 8 weeks post-surgery. RESULTS Histological results showed that the ETBs allowed new bone to grow within their structure. Additionally, an increase in new bone was seen on the nano-Sr-HAP side compared to the control side. The results of histomorphometric analysis confirmed that the new bone formation on the left side gradually increased with time. There was a statistical increase in new bone at 2, 4 and 8 weeks, and the differences between the two sides were statistically significant at weeks 4 and 8 (p < 0.05 for all comparisons). CONCLUSION The results showed that ETFBs possess a unique 3-dimensional interconnective porous structure and have excellent biocompatibility, cell affinity and osteoconductivity, which makes them useful as scaffold materials for repairing bone defects. On the other hand, nano-Sr-HAP improved the bone defect-repairing capacity of the ETFBs, which showed osteoinductive properties.
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Affiliation(s)
- Ping Liu
- Department of Research and Development, Shanghai Shanshan Tech. Co., Ltd, Hangzhou, China
- School of Chemistry, Zhejinag University, Hangzhou, China
| | - Nan Wang
- Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Hangzhou, China
| | - Yongqiang Hao
- Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Hangzhou, China
| | - Qinghua Zhao
- Department of Orthopaedic Surgery, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yongmin Qiao
- Department of Research and Development, Shanghai Shanshan Tech. Co., Ltd, Hangzhou, China
| | - Hui Li
- Department of Research and Development, Shanghai Shanshan Tech. Co., Ltd, Hangzhou, China
| | - Jipeng Li
- Department of Orthopaedic Surgery, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Zhou J, Han Y, Lu S. Direct role of interrod spacing in mediating cell adhesion on Sr-HA nanorod-patterned coatings. Int J Nanomedicine 2014; 9:1243-60. [PMID: 24634585 PMCID: PMC3952902 DOI: 10.2147/ijn.s58236] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The process in which nanostructured surfaces mediate cell adhesion is not well understood, and may be indirect (via protein adsorption) or direct. We prepared Sr-doped hydroxyapatite (Sr1-HA) 3D nanorods (with interrod spacing of 67.3 ± 3.8, 95.7 ± 4.2, and 136.8 ± 8.7 nm) and 2D nanogranulate patterned coatings on titanium. Employing the coatings under the same surface chemistry and roughness, we investigated the indirect/direct role of Sr1-HA nanotopographies in the regulation of osteoblast adhesion in both serum-free and serum-containing Dulbecco's Modified Eagle/Ham's Medium. The results reveal that the number of adherent cells, cell-secreted anchoring proteins (fibronectin, vitronectin, and collagen), vinculin and focal adhesion kinase (FAK) denoted focal adhesion (FA) contact, and gene expression of vinculin, FAK, and integrin subunits (α2, α5, αv, β1, and β3), undergo significant changes in the inter-nanorod spacing and dimensionality of Sr1-HA nanotopographies in the absence of serum; they are significantly enhanced on the <96 nm spaced nanorods and more pronounced with decreasing interrod spacing. However, they are inhibited on the >96 nm spaced nanorods compared to nanogranulated 2D topography. Although the adsorption of fibronectin and vitronectin from serum are higher on 136.8 ± 8.7 nm spaced nanorod patterned topography than nanogranulated topography, cell adhesion is inhibited on the former compared to the latter in the presence of serum, further suggesting that reduced cell adhesion is independent of protein adsorption. It is clearly indicated that 3D nanotopography can directly modulate cell adhesion by regulating integrins, which subsequently mediate anchoring proteins' secretion and FA formation rather than via protein adsorption.
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Affiliation(s)
- Jianhong Zhou
- State Key Laboratory for Mechanical Behavior of Materials, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yong Han
- State Key Laboratory for Mechanical Behavior of Materials, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Shemin Lu
- Department of Genetics and Molecular Biology, College of Medicine, Xi’an Jiaotong University, Xi’an, People’s Republic of China
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Zhou J, Li B, Lu S, Zhang L, Han Y. Regulation of osteoblast proliferation and differentiation by interrod spacing of Sr-HA nanorods on microporous titania coatings. ACS APPLIED MATERIALS & INTERFACES 2013; 5:5358-65. [PMID: 23668394 DOI: 10.1021/am401339n] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Strontium-doped hydroxyapatite (Ca9Sr1(PO4)6(OH)2, Sr1-HA) nanorods with different lateral spacing (e.g., interrod spacing) values (67.3 ± 3.8, 95.7 ± 4.2, and 136.8 ± 8.7 nm) and nanogranulates were grown on microarc-oxidized microporous TiO2, respectively, to form multilayer coatings. The coatings reveal two kinds of micro/nanoscaled hierarchical surfaces with a similar microscale roughness, e.g., nanogranulated 2D pattern and nanorod-shaped 3D pattern in nanotopography. When hFOB1.19 cells are employed, the proliferation and differentiation of osteoblasts on the coatings were evaluated by examining MTT assay, expressions of osteogenesis-related genes [alkaline phosphatase (ALP), runt-related transcription factor 2, osterix, osteopontin (OPN), osteocalcin (OCN), and collagen I (Col-I)], ALP activity, contents of intracellular Ca(2+), Col-I, OPN, and OCN, extracellular collagen secretion, and extracellular matrix mineralization. The results reveal that the proliferation and differentiation of osteoblasts can be directly regulated by the interrod spacing of the Sr1-HA nanorods, which are significantly enhanced on the nanorod-shaped 3D patterns with interrod spacing smaller than 96 nm and more pronounced with decreasing the interrod spacing but inhibited on the nanorods with spacing larger than 96 nm compared to the nanogranulated 2D pattern. The difference in the cellular activity is found to be related with the intracellular Ca(2+) concentrations, which are regulated by variation of the surface topology of Sr1-HA crystals. Our work provides insight to the surface structural design of a biomedical implant favoring osteointegration.
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Affiliation(s)
- Jianhong Zhou
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an 710049, China
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26
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Bornapour M, Muja N, Shum-Tim D, Cerruti M, Pekguleryuz M. Biocompatibility and biodegradability of Mg-Sr alloys: the formation of Sr-substituted hydroxyapatite. Acta Biomater 2013; 9:5319-30. [PMID: 22871640 DOI: 10.1016/j.actbio.2012.07.045] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 07/26/2012] [Accepted: 07/27/2012] [Indexed: 10/28/2022]
Abstract
Magnesium is an attractive material for use in biodegradable implants due to its low density, non-toxicity and mechanical properties similar to those of human tissue such as bone. Its biocompatibility makes it amenable for use in a wide range of applications from bone to cardiovascular implants. Here we investigated the corrosion rate in simulated body fluid (SBF) of a series of Mg-Sr alloys, with Sr in the range of 0.3-2.5%, and found that the Mg-0.5 Sr alloy showed the slowest corrosion rate. The degradation rate from this alloy indicated that the daily Sr intake from a typical stent would be 0.01-0.02 mg day⁻¹, which is well below the maximum daily Sr intake levels of 4 mg day⁻¹. Indirect cytotoxicity assays using human umbilical vascular endothelial cells indicated that Mg-0.5 Sr extraction medium did not cause any toxicity or detrimental effect on the viability of the cells. Finally, a tubular Mg-0.5 Sr stent sample, along with a WE43 control stent, was implanted into the right and left dog femoral artery. No thrombosis effect was observed in the Mg-0.5 Sr stent after 3 weeks of implantation while the WE43 stent thrombosed. X-ray diffraction demonstrated the formation of hydroxyapatite and Mg(OH)₂ as a result of the degradation of Mg-0.5 Sr alloy after 3 days in SBF. X-ray photoelectron spectroscopy further showed the possibility of the formation of a hydroxyapatite Sr-substituted layer that presents as a thin layer at the interface between the Mg-0.5 Sr alloy and the corrosion products. We believe that this interfacial layer stabilizes the surface of the Mg-0.5 Sr alloy, and slows down its degradation rate over time.
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27
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Han Y, Zhou J, Lu S, Zhang L. Enhanced osteoblast functions of narrow interligand spaced Sr-HA nano-fibers/rods grown on microporous titania coatings. RSC Adv 2013. [DOI: 10.1039/c3ra23425h] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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