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Keane Tahmaseb GC, Keane AM, Foppiani JA, Myckatyn TM. An Update on Implant-Associated Malignancies and Their Biocompatibility. Int J Mol Sci 2024; 25:4653. [PMID: 38731871 PMCID: PMC11083590 DOI: 10.3390/ijms25094653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Implanted medical devices are widely used across various medical specialties for numerous applications, ranging from cardiovascular supports to orthopedic prostheses and cosmetic enhancements. However, recent observations have raised concerns about the potential of these implants to induce malignancies in the tissues surrounding them. There have been several case reports documenting the occurrence of cancers adjacent to these devices, prompting a closer examination of their safety. This review delves into the epidemiology, clinical presentations, pathological findings, and hypothesized mechanisms of carcinogenesis related to implanted devices. It also explores how the surgical domain and the intrinsic properties and biocompatibility of the implants might influence the development of these rare but serious malignancies. Understanding these associations is crucial for assessing the risks associated with the use of medical implants, and for developing strategies to mitigate potential adverse outcomes.
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Affiliation(s)
- Grace C. Keane Tahmaseb
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Alexandra M. Keane
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Jose A. Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Terence M. Myckatyn
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
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2
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Duske K, Turan B, Prinz C, Lenz JH, Stahl F, Warkentin M. Functionality testing of an innovative biomechanically optimized and surface-modified orthodontic mini-screw-a comparative study. J Orofac Orthop 2024:10.1007/s00056-023-00508-9. [PMID: 38224419 DOI: 10.1007/s00056-023-00508-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/09/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE The failure rate of orthodontic mini-screws depends strongly on primary stability and, thus, on insertion torque. Further improvement regarding the failure rate might be achieved by modifying the surface coating. Therefore, the aim of the study was to investigate the stability of a newly designed and surface-modified orthodontic mini-screw in beagle dogs. METHODS Newly designed mini-screws coated either with DOTIZE® or DOTIZE®-copper (DOT GmbH, Rostock, Germany; each: n = 24) were inserted in the mandibles of eight beagle dogs for a duration of 8 months. Insertion and removal torque were measured. These data were compared to values generated by using the artificial bone material Sawbones® (Sawbones Europe AB, Malmö, Sweden). Experiments with and without torque limitation (each: n = 5) were run. The bone-to-implant contact rate and the amount of bone between the threads were examined. Statistical significance was set at P < 0.05. RESULTS The success rates of the in vivo study reached high levels with 95.3% for the DOTIZE-coated and 90.5% for the DOTIZE-copper-coated screws, whereas the insertion and removal torque did not differ between the coatings. During insertion, a torque limitation of 20 Ncm was necessary to ensure that the recommended limit was not exceeded. The insertion in Sawbones without torque limitation revealed a significantly higher torque compared to torque-limited insertion (18.2 ± 1.3 Ncm, 23.6 ± 1.3 Ncm). Bending occurred (n = 5) in the thread-free part of the mini-screw. CONCLUSIONS Surface coating might be able to improve the performance of orthodontic mini-screws. The study showed high success rates and stable mini-screws until the end of observation. Further investigations are necessary.
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Affiliation(s)
- Kathrin Duske
- Department of Orthodontics, University Dental School, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany.
| | - Billan Turan
- Department of Orthodontics, University Dental School, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany
| | | | - Jan Hendrik Lenz
- Department of Oral and Maxillofacial Surgery, Rostock University Medical Center, Rostock, Germany
| | - Franka Stahl
- Department of Orthodontics, University Dental School, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany
| | - Mareike Warkentin
- Working Group for Implant Materials, Faculty of Mechanical Engineering and Marine Technologies, University of Rostock, Rostock, Germany
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Zhao Y, Jia T, Wang Z. Comparative analysis of anchorage strength and histomorphometric changes after implantation of miniscrews in adults and adolescents: an experimental study in Beagles. BMC Oral Health 2023; 23:639. [PMID: 37670309 PMCID: PMC10478492 DOI: 10.1186/s12903-023-03318-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES This study aimed to explore the differences in anchorage strength and histomorphometric changes in orthodontic miniscrews between adult and adolescent beagles. MATERIAL AND METHOD Six adult beagles and six young beagles were used as experimental subjects, and eight miniscrews were symmetrically placed in the posterior mandible of each dog. Measurement of the displacement (mm) of two adjacent miniscrews after load application was performed to compare the anchorage strength between the adult and adolescent groups. Three intravital bone fluorochromes (oxytetracycline, calcein green, xylenol orange) were administered postoperatively to mark the active bone-forming surface. Subsequently, the mineral apposition rate and bone-implant contact ratio were measured for dynamic and static histomorphometry. Finally, the expression levels of the RANKL/OPG ratio were evaluated by immunohistochemistry. RESULTS The average displacement of miniscrews in the adult group was significantly less than that in the adolescent group after load application. For histomorphometry analysis, the mineral exposure rate in the adolescent group was higher than that in the adult group with or without force application. In addition, more fractures and new bone formation but deceased bone-implant contact ratios were observed in the adolescent group than in the adult group. The ratio of RANKL/OPG expression increased more in the adolescent group than in the adult group. CONCLUSION Miniscrews do not remain in the same position as skeletal anchors, and the amount of displacement was higher in adolescent group than that in adult group, reflecting the weaker anchorage strength of miniscrews in adolescents due to the higher bone turnover rate and active bone remodelling. Therefore, it is feasible to apply orthodontic loading to the miniscrews in adult patients earlier, even immediately, but it is recommended to wait a period for the adolescents.
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Affiliation(s)
- Yi Zhao
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China
| | - TingTing Jia
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China
| | - Zhiqiang Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
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Saran R, Ginjupalli K, George SD, Chidangil S, V K U. LASER as a tool for surface modification of dental biomaterials: A review. Heliyon 2023; 9:e17457. [PMID: 37408894 PMCID: PMC10319194 DOI: 10.1016/j.heliyon.2023.e17457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 06/09/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023] Open
Abstract
In recent years, the application of lasers for modifying the surface topography of dental biomaterials has received increased attention. This review paper aims to provide an overview of the current status on the utilization of lasers as a potential tool for surface modification of dental biomaterials such as implants, ceramics, and other materials used for restorative purposes. A literature search was done for articles related to the use of lasers for surface modification of dental biomaterials in English language published between October 2000 and March 2023 in Scopus, Pubmed and web of science, and relevant articles were reviewed. Lasers have been mainly used for surface modification of implant materials (71%), especially titanium and its alloys, to promote osseointegration. In recent years, laser texturing has also emerged as a promising technique to reduce bacterial adhesion on titanium implant surfaces. Currently, lasers are being widely used for surface modifications to improve osseointegration and reduce peri-implant inflammation of ceramic implants and to enhance the retention of ceramic restorations to the tooth. The studies considered in this review seem to suggest laser texturing to be more proficient than the conventional methods of surface modification. Lasers can alter the surface characteristics of dental biomaterials by creating innovative surface patterns without significantly affecting their bulk properties. With advances in laser technology and availability of newer wavelengths and modes, laser as a tool for surface modification of dental biomaterials is a promising field, with excellent potential for future research.
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Affiliation(s)
- Runki Saran
- Department of Dental Materials, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Kishore Ginjupalli
- Department of Dental Materials, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Sajan D. George
- Department of Atomic and Molecular Physics, Manipal Academy of Higher Education, Manipal, 576104, India
- Centre for Applied Nanosciences, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Santhosh Chidangil
- Department of Atomic and Molecular Physics, Manipal Academy of Higher Education, Manipal, 576104, India
- Centre of Excellence for Biophotonics, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Unnikrishnan V K
- Department of Atomic and Molecular Physics, Manipal Academy of Higher Education, Manipal, 576104, India
- Centre of Excellence for Biophotonics, Department of Atomic and Molecular Physics, Manipal Academy of Higher Education, Manipal, 576104, India
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Li M, Wang M, Wei L, Werner A, Liu Y. Biomimetic calcium phosphate coating on medical grade stainless steel improves surface properties and serves as a drug carrier for orthodontic applications. Dent Mater 2023; 39:152-161. [PMID: 36610898 DOI: 10.1016/j.dental.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/05/2022] [Accepted: 12/24/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Recently, stainless steel (SSL) miniscrew implants have been used in orthodontic clinics as temporary anchorage devices. Although they have excellent physical properties, their biocompatibility is relatively poor. Previously, our group developed a two-phase biomimetic calcium phosphate (BioCaP) coating that can significantly improve the biocompatibility of medical devices. This study aimed to improve the biocompatibility of SSL by coating SSL surface with the BioCaP coating. METHODS Titanium (Ti) discs and SSL discs (diameter: 5 mm, thickness: 1 mm) were used in this study. To form an amorphous layer, the Ti discs were immersed in a biomimetic modified Tyrode solution (BMT) for 24 h. The SSL discs were immersed in the same solution for 0 h, 12 h, 24 h, 36 h and 48 h. To form a crystalline layer, the discs were then immersed in a supersaturated calcium phosphate solution (CPS) for 48 h. The surface properties of the BioCaP coatings were analysed. In addition, bovine serum albumin (BSA) was incorporated into the crystalline layer during biomimetic mineralisation as a model protein. RESULTS The morphology, chemical composition and drug loading capacity of the BioCaP coating on smooth SSL were confirmed. This coating improved roughness and wettability of SSL surface. In vitro, with the extension of BMT coating period, the cell seeding efficiency, cell spreading area and cell proliferation on the BioCaP coating were increased. SIGNIFICANCE These in vitro results show that the BioCaP coating can improve surface properties of smooth medical grade SSL and serve as a carrier system for bioactive agents.
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Affiliation(s)
- Menghong Li
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - Mingjie Wang
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - Lingfei Wei
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands; Department of Oral Implantology, Yantai Stomatological Hospital, Yantai, China; Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, China
| | - Arie Werner
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - Yuelian Liu
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands.
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Exposto CR, Oz U, Westgate PM, Huja SS. Influence of mini-screw diameter and loading conditions on static and dynamic assessments of bone-implant contact: An animal study. Orthod Craniofac Res 2019; 22 Suppl 1:96-100. [PMID: 31074154 DOI: 10.1111/ocr.12293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The goal was to compare static versus dynamic bone-implant interface histology of mini-screws and to evaluate its relation to diameter and load. SETTING AND SAMPLE POPULATION Canine animal model. MATERIAL AND METHODS Custom-machined, titanium alloy (Ti6AI4V) mini-screws (n = 70) of 1.60, 2.00, 3.00 and 3.75 mm diameter were placed into edentulous sites in five skeletally mature beagle dogs. Using a split-mouth design, no load (NL) was applied to one side while a 2N load (L) was applied by calibrated coil springs on the other side. Intravenous bone labels were administered 21 and 7 days prior to sacrifice. Dogs were euthanized 90 days after screw placement. Bone sections were analysed under bright-field and epifluorescent light. The region of interest was defined as the bone within the threads of the screws. The following parameters were quantified: (a) Static-bone volume/tissue volume (BV/TV %) and bone-implant contact (BIC, %); (b) Dynamic-labelled bone/bone volume (LB/BV, %), and dynamic BIC (DBIC, %). RESULTS BV/TV ranged from 71.2% to 85.0% of the screw surface. BIC ranged from 45.7% to 55.4% of the screw surface and was not affected by diameter (P = 0.66). In contrast, the percentage of DBIC did not vary with the applied load (P = 0.41); however, it correlated significantly with the diameter of the screw (P = 0.001). CONCLUSION The percentage of DBIC that is actively remodelling increases with increasing diameter of the screw. Dynamic histomorphometry is more sensitive to detecting changes in bone-implant contact when compared to static measurements.
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Affiliation(s)
- Cristina R Exposto
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Ulas Oz
- Department of Orthodontics, School of Dentistry, Near East University, Lefkoşa, Northern Cyprus
| | - Philip M Westgate
- Department of Biostatistics, University of Kentucky, Lexington, Kentucky
| | - Sarandeep S Huja
- Department of Orthodontics, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
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Maiborodin IV, Shevela AA, Toder MS, Shevela AI. [Current trends of the choice and processing of materials for dental implantation]. STOMATOLOGII︠A︡ 2018; 97:68-76. [PMID: 30199073 DOI: 10.17116/stomat20189704168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For assessment of the modern situation about the choice of materials for manufacture of dental implants and the processing of their surface the scientific literature for the last 2 years was study. On the basis of a large number of contradictory results of the researches devoted to each of dental implantation problems it is possible to draw a conclusion that any of primal problems of implantology is finally not solved. There is no unique opinion at the choice of optimum material for manufacture of dental implants, at the way of processing and modification of their surface. The problem of improvement of quality of dental implantation and fight against complications of this procedure cannot be solved simple drawing other substances on the implanted material surface, this task more easily and more successfully is solved via changes of product structure and various modification of implant surface. Up to the present the researches of an opportunity to influence on characteristics of the implanted materials, changing their structure and character of a surface, continue. And the publications reporting about the considerable positive effect of artificially created roughnesses on product surfaces, and the articles claiming that there are no big differences between the rough and polished implants are confirmed by objective measurements with statistical processing of the obtained data. It should be noted that among articles there are very many works of the doubtful plan or with insufficiently valid conclusions. This review leads to the conclusion that further clinical and experimental studies and about the choice of materials for manufacture of implants and at the ways of processing of their surface are necessary.
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Affiliation(s)
- I V Maiborodin
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
| | - A A Shevela
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - M S Toder
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - A I Shevela
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
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Maver U, Xhanari K, Žižek M, Korte D, Gradišnik L, Franko M, Finšgar M. A combination of interdisciplinary analytical tools for evaluation of multi-layered coatings on medical grade stainless steel for biomedical applications. Eur J Pharm Biopharm 2018; 128:230-246. [PMID: 29730258 DOI: 10.1016/j.ejpb.2018.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/25/2018] [Accepted: 05/02/2018] [Indexed: 12/31/2022]
Abstract
In this comprehensive study several analytical techniques were used in order to evaluate multi-layered biomedical surface coatings composed of a drug (diclofenac) and a polymer (chitosan). Such a thorough examination is of paramount importance in order to assure safety and prove efficiency of potential biomedical materials already at the in vitro level, hence leading to their potentially faster introduction to clinical trials. For the first time a novel technique based on thermal diffusivity and conductivity measurements (photothermal beam deflection spectroscopy - BDS) was employed in order to analyse in a non-destructive way the thickness of respective layers, together with their thermal diffusivity and conductivity. In addition to attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR), BDS confirmed successive surface layers of the prepared coatings. Scanning electron microscopy and atomic force microscopy were used to examine structural information on the macro- and micro/nano-scale, respectively. Surface hydrophobicity was measured with the contact angle analysis, which clearly showed differences in hydrophobicity between coated and non-coated samples. Considering the targeted application of the prepared coatings (as implant in orthopaedic treatments), the in vitro drug release was analysed spectrophotometrically to examine the coatings potential for a controlled drug release. Furthermore, the material was also tested by electrochemical impedance spectroscopy and cyclic polarisation techniques, which were able to detect even minor differences between the performance of the coated and non-coated materials. As the final test, the biocompatibility of the coatings with human osteoblasts was determined.
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Affiliation(s)
- Uroš Maver
- University of Maribor, Faculty of Medicine, Institute of Biomedical Sciences, Taborska ulica 8, SI-2000 Maribor, Slovenia; University of Maribor, Faculty of Medicine, Department of Pharmacology, Taborska ulica 8, SI-2000 Maribor, Slovenia.
| | - Klodian Xhanari
- University of Maribor, Faculty of Chemistry and Chemical Engineering, Laboratory for Analytical Chemistry and Industrial Analysis, Smetanova ulica 17, SI-2000 Maribor, Slovenia; University of Tirana, Faculty of Natural Sciences, Boulevard "Zogu I", AL-1001 Tirana, Albania
| | - Marko Žižek
- University of Maribor, Faculty of Chemistry and Chemical Engineering, Laboratory for Analytical Chemistry and Industrial Analysis, Smetanova ulica 17, SI-2000 Maribor, Slovenia
| | - Dorota Korte
- University of Nova Gorica, The Laboratory for Environmental and Life Sciences, Vipavska 13, SI-5001 Nova Gorica, Slovenia
| | - Lidija Gradišnik
- University of Maribor, Faculty of Medicine, Institute of Biomedical Sciences, Taborska ulica 8, SI-2000 Maribor, Slovenia
| | - Mladen Franko
- University of Nova Gorica, The Laboratory for Environmental and Life Sciences, Vipavska 13, SI-5001 Nova Gorica, Slovenia
| | - Matjaž Finšgar
- University of Maribor, Faculty of Chemistry and Chemical Engineering, Laboratory for Analytical Chemistry and Industrial Analysis, Smetanova ulica 17, SI-2000 Maribor, Slovenia.
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Agarwal R, González-García C, Torstrick B, Guldberg RE, Salmerón-Sánchez M, García AJ. Simple coating with fibronectin fragment enhances stainless steel screw osseointegration in healthy and osteoporotic rats. Biomaterials 2015; 63:137-45. [PMID: 26100343 DOI: 10.1016/j.biomaterials.2015.06.025] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/09/2015] [Accepted: 06/12/2015] [Indexed: 01/27/2023]
Abstract
Metal implants are widely used to provide structural support and stability in current surgical treatments for bone fractures, spinal fusions, and joint arthroplasties as well as craniofacial and dental applications. Early implant-bone mechanical fixation is an important requirement for the successful performance of such implants. However, adequate osseointegration has been difficult to achieve especially in challenging disease states like osteoporosis due to reduced bone mass and strength. Here, we present a simple coating strategy based on passive adsorption of FN7-10, a recombinant fragment of human fibronectin encompassing the major cell adhesive, integrin-binding site, onto 316-grade stainless steel (SS). FN7-10 coating on SS surfaces promoted α5β1 integrin-dependent adhesion and osteogenic differentiation of human mesenchymal stem cells. FN7-10-coated SS screws increased bone-implant mechanical fixation compared to uncoated screws by 30% and 45% at 1 and 3 months, respectively, in healthy rats. Importantly, FN7-10 coating significantly enhanced bone-screw fixation by 57% and 32% at 1 and 3 months, respectively, and bone-implant ingrowth by 30% at 3 months compared to uncoated screws in osteoporotic rats. These coatings are easy to apply intra-operatively, even to implants with complex geometries and structures, facilitating the potential for rapid translation to clinical settings.
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Affiliation(s)
- Rachit Agarwal
- Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Cristina González-García
- Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA; Biomedical Engineering Research Division, University of Glasgow, Glasgow, UK
| | - Brennan Torstrick
- Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Robert E Guldberg
- Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Andrés J García
- Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.
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