Antibacterial Electrodeposited Copper-Doped Calcium Phosphate Coatings for Dental Implants

Dental implants provide a good solution for the replacement of tooth roots. However, the full restoration of tooth functions relies on the bone-healing period before positioning the abutment and the crown on the implant, with the associated risk of post-operative infection. This study aimed at developing a homogeneous and adherent thin calcium phosphate antibacterial coating on titanium dental implants by electrodeposition to favor both implant osseointegration and to limit peri-implantitis. By combining global (XRD, FTIR-ATR, elemental titration) and local (SEM, Raman spectroscopy on the coating surface and thickness) characterization techniques, we determined the effect of electrodeposition time on the characteristics and phases content of the coating and the associated mechanism of its formation. The 1-min-electrodeposited CaP coating (thickness: 2 ± 1 μm) was mainly composed of nano-needles of octacalcium phosphate. We demonstrated its mechanical stability after screwing and unscrewing the dental implant in an artificial jawbone. Then, we showed that we can reach a high copper incorporation rate (up to a 27% Cu/(Cu+Ca) molar ratio) in this CaP coating by using an ionic exchange post-treatment with copper nitrate solution at different concentrations. The biological properties (antibiofilm activity and cytotoxicity) were tested in vitro using a model of mixed bacteria biofilm mimicking peri-implantitis and the EN 10993-5 standard (direct contact), respectively. An efficient copper-doping dose was determined, providing an antibiofilm property to the coating without cytotoxic side effects. By combining the electrodeposition and copper ionic exchange processes, we can develop an antibiofilm calcium phosphate coating on dental implants with a tunable thickness and phases content.

Corrosion of Metallic Biomaterials: A Review

Metallic biomaterials are used in medical devices in humans more than any other family of materials. The corrosion resistance of an implant material affects its functionality and durability and is a prime factor governing biocompatibility. The fundamental paradigm of metallic biomaterials, except biodegradable metals, has been "the more corrosion resistant, the more biocompatible." The body environment is harsh and raises several challenges with respect to corrosion control. In this invited review paper, the body environment is analysed in detail and the possible effects of the corrosion of different biomaterials on biocompatibility are discussed. Then, the kinetics of corrosion, passivity, its breakdown and regeneration in vivo are conferred. Next, the mostly used metallic biomaterials and their corrosion performance are reviewed. These biomaterials include stainless steels, cobalt-chromium alloys, titanium and its alloys, Nitinol shape memory alloy, dental amalgams, gold, metallic glasses and biodegradable metals. Then, the principles of implant failure, retrieval and failure analysis are highlighted, followed by description of the most common corrosion processes in vivo. Finally, approaches to control the corrosion of metallic biomaterials are highlighted.

Atomically resolved calcium phosphate coating on a gold substrate

Some articles have revealed that the electrodeposition of calcium phosphate (CaP) coatings entails a precursor phase, similarly to biomineralization in vivo. The chemical composition of the initial layer and its thickness are, however, still arguable, to the best of our knowledge. Moreover, while CaP and electrodeposition of metal coatings have been studied utilizing atom-probe tomography (APT), the electrodeposition of CaP ceramics has not been heretofore studied. Herein, we present an investigation of the CaP deposition on a gold substrate. Using APT and transmission electron microscopy (TEM) it is found that a mixture of phases, which could serve as transient precursor phases to hydroxyapatite (HAp), can be detected. The thickness of these phases is tens of nanometers, and they consist of amorphous CaP (ACP), dibasic calcium phosphate dihydrate (DCPD), and octacalcium phosphate (OCP). This demonstrates the value of using atomic-resolved characterization techniques for identifying the precursor phases. It also indicates that the kinetics of their transformation into the more stable HAp is not too fast to enable their observation. The coating gradually displays higher Ca/P atomic ratios, a porous nature, and concomitantly a change in its density.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

Porous low modulus Ti40Nb compacts with electrodeposited hydroxyapatite coating for biomedical applications

Porous ß-type non-toxic Ti40Nb alloy was prepared by compaction of mechanically alloyed powder mixed with NaCl or Mg particles as space-holder material. The compacts with porosity of 36-80% demonstrated a very low Young's modulus of ~1.5-3 GPa and compression strength of ~10-35 MPa, which is suitable for potential implant material application. Porous samples were electrochemically covered with hydroxyapatite. The influence of the deposition time and of the electrolyte concentrations on the morphology of the hydroxyapatite coating was studied. It is demonstrated that a homogenous coating of hydroxyapatite crystals with different shape and size can be obtained on the surface of the porous samples.

The effect of surface treatments on the adhesion of electrochemically deposited hydroxyapatite coating to titanium and on its interaction with cells and bacteria

The effect of different mechanical and chemical pre-treatments on the adhesion strength of hydroxyapatite (HAp) coating on a commercially pure titanium (CP-Ti) substrate was studied by means of a standard tensile test followed by microscopic and chemical analysis to determine the locus of fracture. In addition, the effects of either these pre-treatments or post-treatment by low-energy electron irradiation, which allowed tuning the wettability of the surface, on both osteoblast progenitor attachment and S. aureus bacteria attachment were investigated. A dedicated program was developed for unambiguous identification and count of stained cells. A single-phase HAp coating was formed by electrodeposition. A series of surface pre-treatments consisted of grinding down to P1000, etching in HNO₃/HF solution, grit blast, soaking in NaOH and subsequent heat treatment provided the highest adhesion strength to the HAp coating. Osteoblast progenitors derived from rats may be attached preferentially to a hydrophilic surface (post-treatment to θ = 30°), while the bacteria seemed to be less attached to hydrophobic surfaces (post-treatment to θ = 105°). However, the results were not statistically different. The bacteria seemed to be less attached to the smoother, uncoated surfaces.

The effect of hyaluronan injections into human knees on the number of bone and cartilage wear particles captured by bio-ferrography

Osteoarthritis is characterized by degradation of cartilage and subchondral bone, releasing wear particles into the synovial fluid. Intra-articular injections of exogenous hyaluronan are often given to patients suffering from osteoarthritis in order to compensate for the reduction in the level of endogenous hyaluronan and to restore the rheological properties of the synovial fluid. The exact effect of these injections is still ambiguous. In this work bio-ferrography was used to capture magnetically labeled cartilage and bone debris from the synovial fluid in human knees before each of four injections (Euflexxa). The wear particles were counted and characterized microscopically and chemically. WOMAC, VAS, SF-36 and KS questionnaires indicated significant pain relief during the treatment, but suffered from inconsistency. Bio-ferrography showed a reduction in the concentration of both cartilage and bone particles, with a minimum after the third hyaluronan injection. The advantages of bio-ferrography as a primary assessment tool are discussed. The results indicate that while hyaluronan treatment may temporarily slow the wear rate to an extent beyond a placebo effect, it does not prevent joint degradation altogether.

Electrodeposition on nanofibrous polymer scaffolds: Rapid mineralization, tunable calcium phosphate composition and topography

We developed a straightforward, fast, and versatile technique to fabricate mineralized nanofibrous polymer scaffolds for bone regeneration in this work. Nanofibrous poly(l-lactic acid) scaffolds were fabricated using both electrospinning and phase separation techniques. An electrodeposition process was designed to deposit calcium phosphate on the nanofibrous scaffolds. Such scaffolds contain a high quality mineral coating on the fiber surface with tunable surface topography and chemical composition by varying the processing parameters, which can mimic the composition and structure of natural bone extracellular matrix and provide a more biocompatible interface for bone regeneration.

Enhanced osseointegration of grit-blasted, NaOH-treated and electrochemically hydroxyapatite-coated Ti-6Al-4V implants in rabbits

Osseointegration, in terms of the bone apposition ratio (BAR) and the new bone area (NBA), was measured by backscattered electron imaging. The results were compared for four implant types: grit-blasted and NaOH-treated Ti-6Al-4V (Uncoated-NaOH), electrodeposited with hydroxyapatite without alkali treatment (ED-HAp), electrodeposited with hydroxyapatite after alkali treatment (NaOH-ED-HAp), and plasma sprayed with hydroxyapatite (PS-HAp). No heat treatment was done after soaking in NaOH. The implants were press fitted into the intramedullary canal of mature New Zealand white rabbits and analyzed, both at the diaphyseal and at the metaphyseal zones, either 1week or 12weeks after surgery. NaOH-ED-HAp already exhibited a higher BAR value than the ED-HAp at 1week, and was as good as the commercial PS-HAp at 12weeks. The NBA value for NaOH-ED-HAp at 12weeks was the highest. The higher content of octacalcium phosphate in NaOH-ED-HAp, as evident from the X-ray photoelectron spectroscopy analysis of the oxygen shake-up peaks, and the associated increase in the solubility of this coating in vivo are considered responsible for the enhanced osseointegration. Taking into account also the reduced occurrence of delamination and the inherent advantages of the electrodeposition process, electrodeposition of HAp following soaking in NaOH may become an attractive alternative for the traditional plasma-sprayed process for coating of orthopedic and dental implants.