Osteoblast functions in functionally graded Ti-6Al-4 V mesh structures

Fibroblast Cell Responses to Vanadium and Niobium Titanium Alloys: A Biocompatibility Study

The interactions of a biomaterial with tissues must be determined for the material to be fully compatible with the body for a long time. The tissue and environment where the material is implanted are highly affected by its content. Titanium-6Aluminum-4Vanadium is widely used in orthopedics and dentistry. Recently, Titanium-6Aluminum-7Niobium alloys have been studied because of Titanium-6Aluminum-4Vanadium toxicity, which may be caused by vanadium. The aim of this study was to determine whether Titanium-6Aluminum-4Vanadium and Titanium-6Aluminum-7Niobium affect fibroblast cell proliferation, mineralization, and collagen production and whether they change the expression of type 1 collagen and fibronectin genes. It was determined that the niobium-containing alloy increased cell proliferation and calcium mineralization compared with the vanadium-containing alloy (p < 0.05). However, the alloys did not cause changes in the expression of collagen type 1 or fibronectin in cells. The collagen content of the cells on the niobium-containing alloy was lower than that on both the vanadium-containing alloy and tissue culture plate surface (p < 0.05). The niobium-containing alloy was found to be superior to the vanadium-containing alloy in terms of cell proliferation and calcium mineralization. Furthermore, neither vanadium-containing alloy nor niobium-containing alloy implant materials altered gene expression. Although both alloys are considered compatible with bone tissue, it should be considered whether they are also biocompatible with fibroblast cells.

Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry

Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.

Characterization of Titanium Surface Modification Strategies for Osseointegration Enhancement

As biocompatible metallic materials, titanium and its alloys have been widely used in the orthopedic field due to their superior strength, low density, and ease of processing. However, further improvement in biological response is still required for rapid osseointegration. Here, various Ti surface-treatment technologies were applied: hydroxyapatite blasting, sand blasting and acid etching, anodic oxidation, and micro-arc oxidation. The surface characteristics of specimens subjected to these techniques were analyzed in terms of structure, elemental composition, and wettability. The adhesion strength of the coating layer was also assessed for the coated specimens. Biocompatibility was compared via tests of in vitro attachment and proliferation of pre-osteoblast cells.

Functional Gradient Metallic Biomaterials: Techniques, Current Scenery, and Future Prospects in the Biomedical Field

Functional gradient materials (FGMs), as a modern group of materials, can provide multiple functions and are able to well mimic the hierarchical and gradient structure of natural systems. Because biomedical implants usually substitute the bone tissues and bone is an organic, natural FGM material, it seems quite reasonable to use the FGM concept in these applications. These FGMs have numerous advantages, including the ability to tailor the desired mechanical and biological response by producing various gradations, such as composition, porosity, and size; mitigating some limitations, such as stress-shielding effects; improving osseointegration; and enhancing electrochemical behavior and wear resistance. Although these are beneficial aspects, there is still a notable lack of comprehensive guidelines and standards. This paper aims to comprehensively review the current scenery of FGM metallic materials in the biomedical field, specifically its dental and orthopedic applications. It also introduces various processing methods, especially additive manufacturing methods that have a substantial impact on FGM production, mentioning its prospects and how FGMs can change the direction of both industry and biomedicine. Any improvement in FGM knowledge and technology can lead to big steps toward its industrialization and most notably for much better implant designs with more biocompatibility and similarity to natural tissues that enhance the quality of life for human beings.

Additively manufactured biodegradable porous metals

Partially due to the unavailability of ideal bone substitutes, the treatment of large bony defects remains one of the most important challenges of orthopedic surgery. Additively manufactured (AM) biodegradable porous metals that have emerged since 2018 provide unprecedented opportunities for fulfilling the requirements of an ideal bone implant. First, the multi-scale geometry of these implants can be customized to mimic the human bone in terms of both micro-architecture and mechanical properties. Second, a porous structure with interconnected pores possesses a large surface area, which is favorable for the adhesion and proliferation of cells and, thus, bony ingrowth. Finally, the freeform geometrical design of such biomaterials could be exploited to adjust their biodegradation behavior so as to maintain the structural integrity of the implant during the healing process while ensuring that the implant disappears afterwards, paving the way for full bone regeneration. While the AM biodegradable porous metals that have been studied so far have shown many unique properties as compared to their solid counterparts, the unprecedented degree of flexibility in their geometrical design has not yet been fully exploited to optimize their properties and performance. In order to develop the ideal bone implants, it is important to take advantage of the full potential of AM biodegradable porous metals through detailed and systematic study on their biodegradation behavior, mechanical properties, biocompatibility, and bone regeneration performance. This review paper presents the state of the art in AM biodegradable porous metals and is focused on the effects of material type, processing, geometrical design, and post-AM treatments on the mechanical properties, biodegradation behavior, in vitro biocompatibility, and in vivo bone regeneration performance of AM porous Mg, Fe, and Zn as well as their alloys. We also identify a number of knowledge gaps and the challenges encountered in adopting AM biodegradable porous metals for orthopedic applications and suggest some promising areas for future research.

Examining trabecular morphology and chemical composition of peri-scaffold osseointegrated bone

Background

Porous titanium alloy scaffold fabricated by 3D printing technology could induce osseointegration well to repair bone defect during early postoperative period. However, trabecular histomorphological features and chemical compositions of ingrowth bone in the long term after surgery still lacked in-depth research.

Methods

Fourteen New Zealand rabbits were divided into two groups (7 rabbits in surgery group and 7 rabbits in control group). A 3D-printed porous titanium alloy scaffold was implanted into right femoral condyle of each rabbit in the surgery group. Preload was produced at the surface between bone tissue and scaffold through interference assembly during implantation process. Rabbits in the control group were feed free. All rabbits were sacrificed to extract femoral condyles at week 12 after surgery. All right femoral condyles were performed micro-CT scanning to test bone mineral density (BMD) and trabecular histomorphological parameters, including bone volume fraction (BV/TV), bone surface/volume ratio (BS/BV), bone surface density (BS/TV), structure model index (SMI), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp), porosity (PO), connectivity density (Conn.Dn), and degree of anisotropy (DA). Scanning electron microscope was used to observe osteogenesis peri-scaffold. Fourier transform infrared spectroscopy (FTIR) scanning was performed to analyze chemical compositions of peri-scaffold trabeculae. All trabecular morphological parameters and BMDs were statistically analyzed between surgery group and control group.

Results

The pores of scaffold were filled with ingrowth bone tissues after 12 weeks osseointegration. However, the mean BMD peri-scaffold in surgery group was 800 ± 20 mg/cm³, which was 18.37% lower than that in the control group. There was a significant decrease in BV/TV, Tb.N, and BS/TV, and there was a significant increase in Tb.Sp and PO between the surgery group and control group (p < 0.05). There were no significant differences in Tb.Th, SMI, Conn.Dn, BS/BV, and DA. Although ingrowth of bone tissue was very effective, some fragmented connective tissues were still found instead of bone tissues on the partial beams of scaffolds through SEM images. It was found from FTIR that there was no significant hydroxyapatite peak signal in surgery group. Collagen in the control group mainly existed as cross-link structure, while non-cross-link structure in the surgery group.

Conclusions

Preload could promote the same good osseointegration ability as chemical surface modification method in the early term after surgery, and better osseointegration effect than chemical surface modification method in the mid-long term after surgery. However, histomorphological features of peri-scaffold trabeculae were still in deterioration and low collagen maturity caused by stress shielding. It was suggested from this study that extra physical training should be taken to stimulate the bone remodeling process for recovering to a healthy level.

Obtaining a Wire of Biocompatible Superelastic Alloy Ti-28Nb-5Zr

Using the methods of electric arc melting, intermediate heat treatments, and consecutive intensive plastic deformation, a Ti-Nb-Zr alloy wire with a diameter of 1200 μm was obtained with a homogeneous chemical and phase (β-Ti body-centered crystal lattice) composition corresponding to the presence of superelasticity and shape memory effect, corrosion resistance and biocompatibility. Perhaps the wire structure is represented by grains with a nanoscale diameter. For the wire obtained after stabilizing annealing, the proof strength Rp0.2 is 635 MPa, tensile strength is 840 MPa and Young's modulus is 22 GPa, relative elongation is 6.76%. No toxicity was detected. The resulting wire is considered to be promising for medical use.

Mechanical aspects of dental implants and osseointegration: A narrative review

With the need of rapid healing and long-term stability of dental implants, the existing Ti-based implant materials do not meet completely the current expectation of patients. Low elastic modulus Ti-alloys have shown superior biocompatibility and can achieve comparable or even faster bone formation in vivo at the interface of bone and the implant. Porous structured Ti alloys have shown to allow rapid bone ingrowth through their open structure and to achieve anchorage with bone tissue by increasing the bone-implant interface area. In addition to the mechanical properties of implant materials, the design of the implant body can be used to optimize load transfer and affect the ultimate results of osseointegration. The aim of this narrative review is to define the mechanical properties of dental implants, summarize the relationship between implant stability and osseointegration, discuss the effect of metallic implant mechanical properties (e.g. stiffness and porosity) on the bone response based on existing in vitro and in vivo information, and analyze load transfer through mechanical properties of the implant body. This narrative review concluded that although several studies have presented the advantages of low elastic modulus or high porosity alloys and their effect on osseointegration, further in vivo studies, especially long-term observational studies are needed to justify these novel materials as a replacement for current Ti-based implant materials.

Additively manufactured functionally graded biodegradable porous iron

Additively manufactured (AM) functionally graded porous metallic biomaterials offer unique opportunities to satisfy the contradictory design requirements of an ideal bone substitute. However, no functionally graded porous structures have ever been 3D-printed from biodegradable metals, even though biodegradability is crucial both for full tissue regeneration and for the prevention of implant-associated infections in the long term. Here, we present the first ever report on AM functionally graded biodegradable porous metallic biomaterials. We made use of a diamond unit cell for the topological design of four different types of porous structures including two functionally graded structures and two reference uniform structures. Specimens were then fabricated from pure iron powder using selective laser melting (SLM), followed by experimental and computational analyses of their permeability, dynamic biodegradation behavior, mechanical properties, and cytocompatibility. It was found that the topological design with functional gradients controlled the fluid flow, mass transport properties and biodegradation behavior of the AM porous iron specimens, as up to 4-fold variations in permeability and up to 3-fold variations in biodegradation rate were observed for the different experimental groups. After 4 weeks of in vitro biodegradation, the AM porous scaffolds lost 5-16% of their weight. This falls into the desired range of biodegradation rates for bone substitution and confirms our hypothesis that topological design could indeed accelerate the biodegradation of otherwise slowly degrading metals, like iron. Even after 4 weeks of biodegradation, the mechanical properties of the specimens (i.e., E = 0.5-2.1 GPa, σ_y = 8-48 MPa) remained within the range of the values reported for trabecular bone. Design-dependent cell viability did not differ from gold standard controls for up to 48 h. This study clearly shows the great potential of AM functionally graded porous iron as a bone substituting material. Moreover, we demonstrate that complex topological design permits the control of mechanical properties, degradation behavior of AM porous metallic biomaterials. STATEMENT OF SIGNIFICANCE: No functionally graded porous structures have ever been 3D-printed from biodegradable metals, even though biodegradability is crucial both for full tissue regeneration and for the prevention of implant-associated infections in the long term. Here, we present the first report on 3D-printed functionally graded biodegradable porous metallic biomaterials. Our results suggest that topological design in general, and functional gradients in particular can be used as an important tool for adjusting the biodegradation behavior of AM porous metallic biomaterials. The biodegradation rate and mass transport properties of AM porous iron can be increased while maintaining the bone-mimicking mechanical properties of these biomaterials. The observations reported here underline the importance of proper topological design in the development of AM porous biodegradable metals.

Cell Behavior on 3D Ti-6Al-4 V Scaffolds with Different Porosities

Porous titanium (Ti) and its alloys fabricated by additive manufacturing (AM) techniques have attractive potential for dental and bone defect repair fields. Understanding the relationship between cells and the surface of the as-built three-dimensional (3D) scaffold interactions is not only necessary for tissue engineering but also promising for improving the fabrication process in the manufacture of artificial implants by AM technology. In this study, we have aimed to investigate the cell behavior including adhesion and proliferation of fibroblasts (L929) on Ti-6Al-4 V scaffolds fabricated by the electron beam melting method. The porosities of Ti-6Al-4 V scaffolds are 0% (compact), 60%, and 70%, respectively. Different cell behaviors have been observed from all of the specimens after 4 and 8 days of cell incubation. The present result indicates that, besides the surface roughness, the surface topography of specimens should also be taken into consideration to investigate the interaction between implants and cells. Therefore, this study would provide several possibilities for improving the osteointegration functions of the manufactured porous metallic implants in orthopedic and dental applications.

Sulfuretin promotes osteoblastic differentiation in primary cultured osteoblasts and in vivo bone healing

Although sulfuretin, the major flavonoid of Rhus verniciflua Stokes, has a variety of biological actions, its in vitro and in vivo effects on osteogenic potential remain poorly understood. The objective of the present study was to investigate the effects of sulfuretin on in vitro osteoblastic differentiation and the underlying signal pathway mechanisms in primary cultured osteoblasts and on in vivo bone formation using critical-sized calvarial defects in mice. Sulfuretin promoted osteogenic differentiation of primary osteoblasts, with increased ALP activity and mineralization, and upregulated differentiation markers, including ALP, osteocalcin, and osteopontin, in a concentration-dependent manner. The expression levels of Runx2, BMP-2, and phospho-Smad1/5/8 were upregulated by sulfuretin. Moreover, sulfuretin increased phosphorylation of Akt, mTOR, ERK, and JNK. Furthermore, sulfuretin treatment increased mRNA expression of Wnt ligands, phosphorylation of GSK3, and nuclear β-catenin protein expression. In vivo studies with calvarial bone defects revealed that sulfuretin significantly enhanced new bone formation by micro-computed tomography and histologic analysis. Collectively, these data suggest that sulfuretin acts through the activation of BMP, mTOR, Wnt/β-catenin, and Runx2 signaling to promote in vitro osteoblast differentiation and facilitate in vivo bone regeneration, and might be have therapeutic benefits in bone disease and regeneration.

Surface nanotopography-induced favorable modulation of bioactivity and osteoconductive potential of anodized 3D printed Ti-6Al-4V alloy mesh structure

The objective of the study described here is to fundamentally elucidate the biological response of 3D printed Ti-6Al-4V alloy mesh structures that were surface modified to introduce titania nanotubes with an average pore size of ∼80 nm via an electrochemical anodization process from the perspective of enhancing bioactivity. The bioactivity of the mesh structures were analyzed through immersion test in simulated body fluid, which confirmed the nucleation and growth of fine globular nanoscale apatite on the nanoporous titania-modified (anodized) mesh structure surface, and agglomerated apatite with fine flakes of apatite crystals on as-fabricated mesh structure surface, that were rich in calcium and phosphorous. The cellular activity of bioactive anodized mesh structure was explored in terms of cell–material interactions involving adhesion, proliferation, synthesis of extracellular and intracellular proteins, differentiation, and mineralization. Cells adhered with a sheet-like morphology on as-fabricated mesh structure, whereas, on anodized mesh structure, numerous filopodia-like cellular extensions interacting with nanotube pores were observed. The formation of a bioactive nanoscale apatite, cell–nanotube interactions as imaged via electron microscopy, higher expression of proteins (actin, vinculin, fibronectin, and alkaline phosphatase (ALP)), and calcium content points toward the determining role of anodized mesh structure in modulating osteoblasts functions. The unique combination of nanoporous bioactive titania and interconnected porous architecture of anodized titanium alloy mesh structure provided a multimodal roughness surface ranging from nano to micro to macroscale, which helps in attaining strong primary and secondary fixation of the implant device along with the pathway for supply of nutrients and oxygen to cells and tissue.

The functional response of bioactive titania-modified three-dimensional Ti-6Al-4V mesh structure toward providing a favorable pathway for intercellular communication and osteoincorporation

The objective of the study is to fundamentally elucidate the biological response of 3D printed mesh structures subjected to plasma electrolytic oxidation process through the study of osteoblast functions. The cellular activity of plasma electrolytic-oxidized mesh structure was explored in terms of cell-to-cell communication involving proliferation, synthesis of extracellular and intracellular proteins, and mineralization. Upon plasma electrolytic oxidation of the mesh structure, a thin layer of bioactive titania with pore size 1-3 µm was nucleated on the surface. The combination of microporous bioactive titania and interconnected porous architecture provided the desired pathway for supply of nutrients and oxygen to cells and tissue and a favorable osteogenic microenvironment for tissue on-growth and in-growth, in relation to the unmodified mesh structure. The formation of a confluent layer as envisaged via electron microscopy and quantitative assessment of the expression level of proteins (actin, vinculin, and fibronectin) point toward the determining role of surface-modified mesh structure in modulating osteoblasts functions. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2488-2501, 2016.