Titanium implant with nanostructured zirconia surface promotes maturation of peri-implant bone in osseointegration

Bio-clickable mussel-inspired peptides improve titanium-based material osseointegration synergistically with immunopolarization-regulation

Upon the osteoporotic condition, sluggish osteogenesis, excessive bone resorption, and chronic inflammation make the osseointegration of bioinert titanium (Ti) implants with surrounding bone tissues difficult, often lead to prosthesis loosening, bone collapse, and implant failure. In this study, we firstly designed clickable mussel-inspired peptides (DOPA-N3) and grafted them onto the surfaces of Ti materials through robust catechol-TiO₂ coordinative interactions. Then, two dibenzylcyclooctyne (DBCO)-capped bioactive peptides RGD and BMP-2 bioactive domain (BMP-2) were clicked onto the DOPA-N3-coated Ti material surfaces via bio-orthogonal reaction. We characterized the surface morphology and biocompatibility of the Ti substrates and optimized the osteogenic capacity of Ti surfaces through adjusting the ideal ratios of BMP-2/RGD at 3:1. In vitro, the dual-functionalized Ti substrates exhibited excellent promotion on adhesion and osteogenesis of mesenchymal stem cells (MSCs), and conspicuous immunopolarization-regulation to shift macrophages to alternative (M2) phenotypes and inhibit inflammation, as well as enhancement of osseointegration and mechanical stability in osteoporotic rats. In summary, our biomimetic surface modification strategy by bio-orthogonal reaction provided a convenient and feasible method to resolve the bioinertia and clinical complications of Ti-based implants, which was conducive to the long-term success of Ti implants, especially in the osteoporotic or inflammatory conditions.

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A clickable mussel-inspired peptide and two DBCO-capped bioactive peptides for facile decoration of Ti prostheses via robust catechol/TiO2 coordinative interactions and click chemical reaction.

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Dual functionalized Ti-based surface can improve cell anchoring and osteogenicitity by rationally adjusting the grafting ratio of BMP-2 and RGD peptides.

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Dual functionalized Ti-based surface synergistically achieve M2 shifting and efficient inflammation inhibition for osseointegration.

[Nanomaterials in the modern dentistry (review)]

Was to study the promising areas for using nanotechnologies in dentistry, existing methods of diagnostics, treatment and prevention of the dental diseases based on the properties of nanoparticles, to review the scientific literature devoted to this problem. In this literature review we use 86 sources: 1 Russian and 85 foreign articles. Analyzed articles were published within the last 5 years. The literature review summarizes and presents up-to-date methods of diagnosing, treating, and preventing dental disease that use nanotechnologies. Development and implementation of nanotechnological treatment are a promising direction for modern dentistry.

Additive manufacturing of porous titanium metaphyseal components: Early osseointegration and implant stability in revision knee arthroplasty

AIMS

Metaphyseal cones and sleeves are components used in revision knee arthroplasty to ensure load transfer, encourage bone on-growth and prevent stress shielding. Additive manufacturing of titanium alloy implants is a novel technique with limited clinical outcome reports in the literature. The aim of this study was to determine radiographic evidence of osseointegration and early results of a single manufacturer porous titanium metaphyseal components in the proximal tibia.

METHODS

We retrospectively reviewed the prospectively collected database of two institutions. Patients who underwent revision knee arthroplasty using porous titanium components by a single manufacturer were identified. Immediate post-operative and latest follow-up radiographs were independently analysed by 2 reviewers to determine metaphyseal bone contact and level of osseointegration in relevant Knee Society Radiographic Evaluation and Scoring System zones.

RESULTS

22 patients (15 males; 7 females) with a mean age of 71 (49-92) years were included. The mean follow-up period was 14 months (2-44 months). Cones were used in 16 patients and sleeves in 6. Interobserver reliability assessment showed substantial agreement (weighted Kappa 0.71, (95% CI: 0.60, 0.81). There was significant correlation between the bone contact in the immediate postop radiograph and osseointegration at final follow-up (kendall's tau-b: 0.698, p < 0.001). Infection free prosthetic joint survival was 20/22 at final follow-up.

CONCLUSION

Porous titanium metaphyseal components produced with additive manufacturing provided excellent osseointegration and no early clinical failures. Partial or complete contact of the cone with native bone in the immediate postoperative radiograph resulted in osseointegration in all cases.

Local Cellular Responses to Metallic and Ceramic Nanoparticles from Orthopedic Joint Arthroplasty Implants

Over the last decades, joint arthroplasty has become a successful treatment for joint disease. Nowadays, with a growing demand and increasingly younger and active patients accepting these approaches, orthopedic surgeons are seeking implants with improved mechanical behavior and longer life span. However, aseptic loosening as a result of wear debris from implants is considered to be the main cause of long-term implant failure. Previous studies have neatly illustrated the role of micrometric wear particles in the pathological mechanisms underlying aseptic loosening. Recent osteoimmunologic insights into aseptic loosening highlight the important and heretofore underrepresented contribution of nanometric orthopedic wear particles. The present review updates the characteristics of metallic and ceramic nanoparticles generated after prosthesis implantation and summarizes the current understanding of their hazardous effects on peri-prosthetic cells.

Surface nano-modification by ion beam–assisted deposition alters the expression of osteogenic genes in osteoblasts

Biomaterials with enhanced biocompatibility are favored in implant studies to improve the outcomes of total joint replacement surgeries. This study tested the hypothesis that nano-structured surfaces for orthopedic applications, produced by the ion beam–assisted deposition method, would enhance osteointegration by altering the expression of bone-associated genes in osteoblasts. The ion beam–assisted deposition technique was employed to deposit nano-films on glass or titanium substrates. The effects of the ion beam–assisted deposition produced surfaces on the human osteosarcoma cell line SAOS-2 at the molecular level were investigated by assays of adhesion, proliferation, differentiation, and apoptosis on coated surfaces versus uncoated cobalt–chrome, as the control. Ion beam–assisted deposition nano-coatings enhanced bone-associated gene expression at initial cell adhesion, proliferation, and differentiation compared to cobalt–chrome surfaces as assessed by polymerase chain reaction techniques. Increased cell proliferation was observed using a nuclear cell proliferation–associated antigen. Moreover, enhanced cell differentiation was determined by alkaline phosphatase activity, an indicator of bone formation. In addition, programmed cell death assessed by annexin V staining and flow cytometry was lower on nano-surfaces compared to cobalt–chrome surfaces. Overall, the results indicate that nano-coated surfaces produced by the ion beam–assisted deposition technique for use on implants were superior to orthopedic grade cobalt–chrome in supporting bone cell adhesion, proliferation, and differentiation and reducing apoptosis. Thus, surface properties altered by the ion beam–assisted deposition technique should enhance bone formation and increase the biocompatibility of bone cell–associated surfaces.

A Precautionary Approach to Guide the Use of Transition Metal-Based Nanotechnology to Prevent Orthopedic Infections

The increase of multidrug-resistant bacteria remains a global concern. Among the proposed strategies, the use of nanoparticles (NPs) alone or associated with orthopedic implants represents a promising solution. NPs are well-known for their antimicrobial effects, induced by their size, shape, charge, concentration and reactive oxygen species (ROS) generation. However, this non-specific cytotoxic potential is a powerful weapon effective against almost all microorganisms, but also against eukaryotic cells, raising concerns related to their safe use. Among the analyzed transition metals, silver is the most investigated element due to its antimicrobial properties per se or as NPs; however, its toxicity raises questions about its biosafety. Even though it has milder antimicrobial and cytotoxic activity, TiO₂ needs to be exposed to UV light to be activated, thus limiting its use conjugated to orthopedic devices. By contrast, gold has a good balance between antimicrobial activity as an NP and cytocompatibility because of its inability to generate ROS. Nevertheless, although the toxicity and persistence of NPs within filter organs are not well verified, nowadays, several basic research on NP development and potential uses as antimicrobial weapons is reported, overemphasizing NPs potentialities, but without any existing potential of translation in clinics. This analysis cautions readers with respect to regulation in advancing the development and use of NPs. Hopefully, future works in vivo and clinical trials will support and regulate the use of nano-coatings to guarantee safer use of this promising approach against antibiotic-resistant microorganisms.

Construction of a bioactive surface with micro/nano-topography on titanium alloy by micro-milling and alkali-hydrothermal treatment

The surface topography and wettability are important factors that determine the biocompatibility of biomaterials. In this article, the hierarchical micro/nano-topography of titanium alloy surface was fabricated by micro-milling and alkali-hydrothermal reaction. The surface topography and chemical composition of treated surfaces were characterized using laser scanning microscope and scanning electron microscope. The contact angles of surfaces with different micro/nano-topographies were measured by contact angle tester. MC3T3s morphology and osteocalcin productions were characterized to investigate the influence of surface modification on implants’ biocompatibility. The results show that hydrophilicity of micro-structured surface decreased compared to the untextured surface and contact angle values decreased with the increase in micro-groove spacing in small increments. In addition, the surfaces treated with alkali-hydrothermal reaction displayed strong hydrophilicity and the surface energy increased by 40 nJ/cm2 approximately. In vitro tests indicated that micro/nano-structured surface improved the adhesion, spreading, and differentiation of MC3T3s.

Enhanced cell growth by nanoengineering zirconia to stimulate electrostatic fibronectin activation

We address the enhanced bone growth on designed nanocrystalline zirconia implants as reported by in vivo experiments. In vitro experiments demonstrate that the activation of adhesive proteins on nanoengineered zirconia stimulates cell adhesion and growth as shown by confocal microscopy. Fibrillar fibronectin (FN) forms a matrix assembly on the nanostructured surface in the cell adhesion process. We discuss the importance of FN dimer activation due to its immobilization on the designed nanocrystalline ZrO2 implant fabricated by ion beam assisted deposition. The Monte-Carlo analysis indicates that FN activation on the surface can be promoted by selective electrostatic interactions between negatively charged ZrO2 surface patches and oppositely charged FN domains.