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Sayed O, Abdalla MM, Elsayed A, El-Mahallawy Y, Al-Mahalawy H. Does strontium coated titanium implants enhance the osseointegration in animal models under osteoporotic condition? A systematic review and meta-analysis. BDJ Open 2024; 10:69. [PMID: 39181895 DOI: 10.1038/s41405-024-00220-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 08/27/2024] Open
Abstract
PURPOSE The aim of this study was to systematically review the literature to address the effect of strontium modified titanium implants on the osseointegration in the presence of osteoporotic conditions through animal models. MATERIALS AND METHODS The databases (PubMed, Scopus, Web of Science, and EBSCO) were searched electronically, and manual searches were performed till December 2022 to identify preclinical studies on the osseointegration of strontium coated titanium implants in animals with induced osteoporotic conditions. The primary outcomes were the bone-implant contact percentage (BIC%), bone area (BA) from the histomorphometric analysis, and the osseointegration parameters from biomechanical tests; the secondary outcomes were the osseointegration parameters from the micro computed tomography. RESULTS Nineteen articles were included for the quantitative analysis on basis of the inclusion criteria. The results revealed that Sr-modified implants showed a significant 19.05% increase in BIC, and 15.01% increase in BA. The results of biomechanical tests indicated a significant effect in favor of Sr-coated implants. Furthermore, Results of the secondary outcomes supported the significant advantages of Sr-coated implants over the un-coated implants. The overall, systematic analysis of implants osteointegration parameters proved a significant increase in favor of Sr-coated titanium implants (P < 0.01). CONCLUSION The present results provide evidence that strontium-coated titanium implants enhanced the osseointegration in animal models under osteoporotic condition as this surface modification techniques have improved the mechanical and biological properties of the titanium implants.
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Affiliation(s)
- Osama Sayed
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
| | - Mohamed Mahmoud Abdalla
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Dental Biomaterials, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt
| | - Ayman Elsayed
- Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Yehia El-Mahallawy
- Assistant Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Haytham Al-Mahalawy
- Professor and head of the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
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Isler SC, Bellon B, Foss M, Pippenger B, Stavropoulos A, Andersen OZ. Assessing the osseointegration potential of a strontium releasing nanostructured titanium oxide surface: A biomechanical study in the rabbit tibia plateau model. Clin Exp Dent Res 2024; 10:e812. [PMID: 38044566 PMCID: PMC10860460 DOI: 10.1002/cre2.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVES To investigate the impact of a Ti-Sr-O technology, applied to either a turned surface or an SLA surface, on the mechanical robustness of osseointegration, benchmarked against the SLActive surface. MATERIAL AND METHODS Ti discs (6.25-mm-diameter and 2-mm-thick) with three different surfaces were inserted on the proximal-anterior part of the tibial plateau of adult Swedish loop rabbits: (I) turned surface modified with Ti-Sr-O (turned + Ti-Sr-O), (II) SLA surface modified with Ti-Sr-O (SLA + Ti-Sr-O), and (III) SLActive surface (SLActive). Following a healing period of 2 weeks and 4 weeks, the pull-out (PO) force needed to detach the discs from the bone was assessed, as a surrogate of osseointegration. RESULTS The SLActive surface exhibited statistically significant higher median PO forces, compared with the SLA + Ti-Sr-O surfaces at both 2- and 4 weeks post-op (p > .05). In this study, no single turned + Ti-Sr-O surface disk was integrated. CONCLUSIONS The tested Ti-Sr-O technology failed to enhance osseointegration; however, this finding may be related to the inappropriateness of the rabbit tibia plateau model for assessing third-generation implant surface technologies, due to the limited diffusion and clearance at the disk-bone interface.
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Affiliation(s)
- Sila Cagri Isler
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Department of Periodontology, Faculty of DentistryGazi UniversityAnkaraTurkey
| | - Benjamin Bellon
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
- Department of Periodontology, Faculty of DentistryUniversity of ZurichZurichSwitzerland
| | - Morten Foss
- iNANO and Department of Physics and AstronomyScience and TechnologyAarhusDenmark
| | - Benjamin Pippenger
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
| | - Andreas Stavropoulos
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Department of Periodontology, Faculty of OdontologyMalmö UniversityMalmöSweden
- Division of Conservative Dentistry and Periodontology, University Clinic of DentistryMedical University of ViennaViennaAustria
| | - Ole Zoffmann Andersen
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
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Christensen TEK, Berglund Davidsen M, Van Malderen S, Garrevoet J, Offermanns V, Andersen OZ, Foss M, Birkedal H. Local Release of Strontium from Sputter-Deposited Coatings at Implants Increases the Strontium-to-Calcium Ratio in Peri-implant Bone. ACS Biomater Sci Eng 2022; 8:620-625. [PMID: 35099935 DOI: 10.1021/acsbiomaterials.1c01004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
It is well known that strontium (Sr) has a significant effect on peri-implant bone healing when administered systemically. Due to the risk of adverse effects of such treatments, new routes focusing on the local, sustained release of Sr from bone-implant contact surfaces have been explored, with success in in vivo experiments. However, the increase of Sr concentrations in the peri-implant bone has not been described in depth yet. Here, we show that a local, sustained Sr release from Ti-Sr-O physical vapor deposition (PVD) coatings by magnetron sputter coating increases the Sr/Ca ratio close to the implant in a rabbit model and that the Sr/Ca background level is reached approximately 500 μm from the implant.
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Affiliation(s)
- Thorbjørn Erik Køppen Christensen
- Department of Chemistry and iNANO, Faculty of Natural Sciences, Aarhus University, 14 Gustav Wieds Vej, 8000 Aarhus, Denmark.,Sino-Danish College (SDC), University of Chinese Academy of Sciences
| | - Maiken Berglund Davidsen
- Department of Chemistry and iNANO, Faculty of Natural Sciences, Aarhus University, 14 Gustav Wieds Vej, 8000 Aarhus, Denmark
| | - Stijn Van Malderen
- Deutsches Elektronen Synchrotron DESY, Notkestr. 85, D-22607 Hamburg, Germany
| | - Jan Garrevoet
- Deutsches Elektronen Synchrotron DESY, Notkestr. 85, D-22607 Hamburg, Germany
| | | | | | - Morten Foss
- Sino-Danish College (SDC), University of Chinese Academy of Sciences.,iNANO and Department of Physics and Astronomy, Faculty of Natural Sciences, Aarhus University, 14 Gustav Wieds Vej, 8000 Aarhus, Denmark
| | - Henrik Birkedal
- Department of Chemistry and iNANO, Faculty of Natural Sciences, Aarhus University, 14 Gustav Wieds Vej, 8000 Aarhus, Denmark
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Geng Z, Sang S, Wang S, Meng F, Li Z, Zhu S, Cui Z, Jing Y, Wang C, Su J. Optimizing the strontium content to achieve an ideal osseointegration through balancing apatite-forming ability and osteogenic activity. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2022; 133:112647. [DOI: 10.1016/j.msec.2022.112647] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022]
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Stich T, Alagboso F, Křenek T, Kovářík T, Alt V, Docheva D. Implant-bone-interface: Reviewing the impact of titanium surface modifications on osteogenic processes in vitro and in vivo. Bioeng Transl Med 2022; 7:e10239. [PMID: 35079626 PMCID: PMC8780039 DOI: 10.1002/btm2.10239] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/08/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022] Open
Abstract
Titanium is commonly and successfully used in dental and orthopedic implants. However, patients still have to face the risk of implant failure due to various reasons, such as implant loosening or infection. The risk of implant loosening can be countered by optimizing the osteointegration capacity of implant materials. Implant surface modifications for structuring, roughening and biological activation in favor for osteogenic differentiation have been vastly studied. A key factor for a successful stable long-term integration is the initial cellular response to the implant material. Hence, cell-material interactions, which are dependent on the surface parameters, need to be considered in the implant design. Therefore, this review starts with an introduction to the basics of cell-material interactions as well as common surface modification techniques. Afterwards, recent research on the impact of osteogenic processes in vitro and vivo provoked by various surface modifications is reviewed and discussed, in order to give an update on currently applied and developing implant modification techniques for enhancing osteointegration.
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Affiliation(s)
- Theresia Stich
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
| | - Francisca Alagboso
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
| | - Tomáš Křenek
- New Technologies Research CentreUniversity of West BohemiaPilsenCzech Republic
| | - Tomáš Kovářík
- New Technologies Research CentreUniversity of West BohemiaPilsenCzech Republic
| | - Volker Alt
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
- Clinic and Polyclinic for Trauma Surgery, University Regensburg Medical CentreRegensburgGermany
| | - Denitsa Docheva
- Experimental Trauma Surgery, Department of Trauma SurgeryUniversity Regensburg Medical CentreRegensburgGermany
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Salamanna F, Gambardella A, Contartese D, Visani A, Fini M. Nano-Based Biomaterials as Drug Delivery Systems Against Osteoporosis: A Systematic Review of Preclinical and Clinical Evidence. NANOMATERIALS 2021; 11:nano11020530. [PMID: 33669621 PMCID: PMC7922277 DOI: 10.3390/nano11020530] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 12/16/2022]
Abstract
Osteoporosis (OP) is one of the most significant causes of morbidity, particularly in post-menopausal women and older men. Despite its remarkable occurrence, the search for an effective treatment is still an open challenge. Here, we systematically reviewed the preclinical and clinical progress in the development of nano-based materials as drug delivery systems against OP, considering the effects on bone healing and regeneration, the more promising composition and manufacturing methods, and the more hopeful drugs and delivery methods. The results showed that almost all the innovative nano-based delivery systems developed in the last ten years have been assessed by preclinical investigations and are still in the preliminary/early research stages. Our search strategy retrieved only one non-randomized controlled trial (RCT) on oligosaccharide nanomedicine of alginate sodium used for degenerative lumbar diseases in OP patients. Further investigations are mandatory for assessing the clinical translation and commercial purposes of these materials. To date, the main limits for the clinical translation of nano-based materials as drug delivery systems against OP are probably due to the low reproducibility of the manufacturing processes, whose specificity and complexity relies on an adequate chemical, structural, and biomechanical characterization, as the necessary prerequisite before assessing the efficacy of a given treatment or process. Finally, an unsatisfactory drug-loading capacity, an uncontrollable release kinetic, and a low delivery efficiency also limit the clinical application.
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Efficacy of strontium supplementation on implant osseointegration under osteoporotic conditions: A systematic review. J Prosthet Dent 2021; 128:341-349. [PMID: 33589234 DOI: 10.1016/j.prosdent.2020.12.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 01/24/2023]
Abstract
STATEMENT OF PROBLEM Strontium has been validated for potent bone-seeking and antiosteoporotic properties and elicits a potentially beneficial impact on implant osseointegration in patients with osteoporosis. However, the efficacy of strontium supplementation on improving new bone formation and implant osseointegration in the presence of osteoporotic bone is still unclear. PURPOSE The purpose of this systematic review was to comprehensively assess the efficacy of strontium supplementation, encompassing oral intake and local delivery of strontium, on implant osseointegration in patients with osteoporosis. MATERIAL AND METHODS Searches on electronic databases (MEDLINE or PubMed, Web of Science, EBSCO, Embase, and Clinicaltrials.gov) and manual searches were conducted to identify relevant preclinical animal trials up to June 2020. The primary outcomes were the percentage of bone-implant contact and bone area; the secondary outcomes were quantitative parameters of biomechanical tests and microcomputed tomography (μCT). RESULTS Fourteen preclinical trials (1 rabbit, 1 sheep, and 12 rat), with a total of 404 ovariectomized animals and 798 implants, were eligible for analysis. The results revealed a significant 17.1% increase in bone-implant contact and 13.5% increase in bone area, favoring strontium supplementation despite considerable heterogeneity. Subgroup analyses of both bone-implant contact and bone area exhibited similar outcomes with low to moderate heterogeneity. Results of biomechanical and μCT tests showed that strontium-enriched implantation tended to optimize the mechanical strength and microarchitecture of newly formed bone despite moderate to generally high heterogeneity. CONCLUSIONS Based on the available preclinical evidence, strontium supplementation, including local and systemic delivery, showed promising results for enhancing implant osseointegration in the presence of osteoporosis during 4 to 12 weeks of healing. Future well-designed standardized studies are necessary to validate the efficacy and safety of strontium supplementation and to establish a standard methodology for incorporating Sr into implant surfaces in a clinical setting.
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Xu N, Fu J, Zhao L, Chu PK, Huo K. Biofunctional Elements Incorporated Nano/Microstructured Coatings on Titanium Implants with Enhanced Osteogenic and Antibacterial Performance. Adv Healthc Mater 2020; 9:e2000681. [PMID: 32875743 DOI: 10.1002/adhm.202000681] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/02/2020] [Indexed: 12/20/2022]
Abstract
Bone fracture is prevalent among athletes and senior citizens and may require surgical insertion of bone implants. Titanium (Ti) and its alloys are widely used in orthopedics due to its high corrosion resistance, good biocompatibility, and modulus compatible with natural bone tissues. However, bone repair and regrowth are impeded by the insufficient intrinsic osteogenetic capability of Ti and Ti alloys and potential bacterial infection. The physicochemical properties of the materials and nano/microstructures on the implant surface are crucial for clinical success and loading with biofunctional elements such as Sr, Zn, Cu, Si, and Ag into nano/microstructured TiO2 coating has been demonstrated to enhance bone repair/regeneration and bacterial resistance of Ti implants. In this review, recent advances in biofunctional element-incorporated nano/microstructured coatings on Ti and Ti alloy implants are described and the prospects and limitations are discussed.
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Affiliation(s)
- Na Xu
- The State Key Laboratory of Refractories and Metallurgy, Institute of Advanced Materials and Nanotechnology, College of Life Sciences and Health, Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Jijiang Fu
- The State Key Laboratory of Refractories and Metallurgy, Institute of Advanced Materials and Nanotechnology, College of Life Sciences and Health, Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Lingzhou Zhao
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Paul K Chu
- Department of Physics, Department of Materials Science and Engineering and Department of Biomedical Engineering, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China
| | - Kaifu Huo
- The State Key Laboratory of Refractories and Metallurgy, Institute of Advanced Materials and Nanotechnology, College of Life Sciences and Health, Wuhan University of Science and Technology, Wuhan, 430081, China
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
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Adipose-Derived Stem Cells in Bone Tissue Engineering: Useful Tools with New Applications. Stem Cells Int 2019; 2019:3673857. [PMID: 31781238 PMCID: PMC6875209 DOI: 10.1155/2019/3673857] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Adipose stem cells (ASCs) are a crucial element in bone tissue engineering (BTE). They are easy to harvest and isolate, and they are available in significative quantities, thus offering a feasible and valid alternative to other sources of mesenchymal stem cells (MSCs), like bone marrow. Together with an advantageous proliferative and differentiative profile, they also offer a high paracrine activity through the secretion of several bioactive molecules (such as growth factors and miRNAs) via a sustained exosomal release which can exert efficient conditioning on the surrounding microenvironment. BTE relies on three key elements: (1) scaffold, (2) osteoprogenitor cells, and (3) bioactive factors. These elements have been thoroughly investigated over the years. The use of ASCs has offered significative new advancements in the efficacy of each of these elements. Notably, the phenotypic study of ASCs allowed discovering cell subpopulations, which have enhanced osteogenic and vasculogenic capacity. ASCs favored a better vascularization and integration of the scaffolds, while improvements in scaffolds' materials and design tried to exploit the osteogenic features of ASCs, thus reducing the need for external bioactive factors. At the same time, ASCs proved to be an incredible source of bioactive, proosteogenic factors that are released through their abundant exosome secretion. ASC exosomes can exert significant paracrine effects in the surroundings, even in the absence of the primary cells. These paracrine signals recruit progenitor cells from the host tissues and enhance regeneration. In this review, we will focus on the recent discoveries which have involved the use of ASCs in BTE. In particular, we are going to analyze the different ASCs' subpopulations, the interaction between ASCs and scaffolds, and the bioactive factors which are secreted by ASCs or can induce their osteogenic commitment. All these advancements are ultimately intended for a faster translational and clinical application of BTE.
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Alenezi A, Galli S, Atefyekta S, Andersson M, Wennerberg A. Osseointegration effects of local release of strontium ranelate from implant surfaces in rats. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:116. [PMID: 31606798 PMCID: PMC6790188 DOI: 10.1007/s10856-019-6314-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Numerous studies have reported the beneficial effects of strontium on bone growth, particularly by stimulating osteoblast proliferation and differentiation. Thus, strontium release around implants has been suggested as one possible strategy to enhance implant osseointegration. AIM This study aimed to evaluate whether the local release of strontium ranelate (Sr-ranelate) from implants coated with mesoporous titania could improve bone formation around implants in an animal model. MATERIALS AND METHODS Mesoporous titania (MT) thin coatings were formed utilizing the evaporation induced self-assembly (EISA) method using Pluronic (P123) with or without the addition of poly propylene glycol (PPG) to create materials with two different pore sizes. The MT was deposited on disks and mini-screws, both made of cp Ti grade IV. Scanning electron microscopy (SEM) was performed to characterize the MT using a Leo Ultra55 FEG instrument (Zeiss, Oberkochen, Germany). The MT was loaded with Sr-ranelate using soaking and the drug uptake and release kinetics to and from the surfaces were evaluated using quartz crystal microbalance with dissipation monitoring (QCM-D) utilizing a Q-sense E4 instrument. For the in vivo experiment, 24 adult rats were analyzed at two time points of implant healing (2 and 6 weeks). Titanium implants shaped as mini screws were coated with MT films and divided into two groups; supplied with Sr-ranelate (test group) and without Sr-ranelate (control group). Four implants (both test and control) were inserted in the tibia of each rat. The in vivo study was evaluated using histomorphometric analyses of the implant/bone interphase using optical microscopy. RESULTS SEM images showed the successful formation of evenly distributed MT films covering the entire surface with pore sizes of 6 and 7.2 nm, respectively. The QCM-D analysis revealed an absorption of 3300 ng/cm2 of Sr-ranelate on the 7.2 nm MT, which was about 3 times more than the observed amount on the 6 nm MT (1200 ng/cm2). Both groups showed sustained release of Sr-ranelate from MT coated disks. The histomorphometric analysis revealed no significant differences in bone implant contact (BIC) and bone area (BA) between the implants with Sr-ranelate and implants in the control groups after 2 and 6 weeks of healing (BIC with a p-value of 0.43 after 2 weeks and 0.172 after 6 weeks; BA with a p-value of 0.503 after 2 weeks, and 0.088 after 6 weeks). The mean BIC and BA values within the same group showed significant increase among all groups between 2 and 6 weeks. CONCLUSION This study could not confirm any positive effects of Sr-ranelate on implant osseointegration.
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Affiliation(s)
- Ali Alenezi
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
- Department of Prosthodontics, College of Dentistry, Qassim University, Buraidah, Saudi Arabia.
| | - Silvia Galli
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Saba Atefyekta
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Martin Andersson
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Ann Wennerberg
- Department of Prosthodontics/Dental Materials Science, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Wang Y, Xie J, Ai Z, Su J. Nobiletin-loaded micelles reduce ovariectomy-induced bone loss by suppressing osteoclastogenesis. Int J Nanomedicine 2019; 14:7839-7849. [PMID: 31576127 PMCID: PMC6769031 DOI: 10.2147/ijn.s213724] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 08/30/2019] [Indexed: 01/01/2023] Open
Abstract
Background Nobiletin (NOB), a polymethoxy flavonoid, possesses anti-cancer and anti-inflammatory activities, has been reported that it played role in anti-osteoporosis treatment. However, previous research did not focus on practical use due to lack of hydrophilicity and cytotoxicity at high concentrations. The aim of this study was to develop a therapeutic formulation for osteoporosis based on the utilization of NOB. Methods In this study, NOB-loaded poly(ethylene glycol)-block-poly(e-caprolactone) (NOB-PEG-PCL) was prepared by dialysis method. The effects on osteoclasts and anti-osteoporosis functions were investigated in a RANKL-induced cell model and ovariectomized (OVX) mice. Results Dynamic light scattering and transmission electron microscopy examination results revealed that the NOB-PEG-PCL had a round shape, with a mean diameter around 124 nm. The encapsulation efficiency and drug loading were 76.34±3.25% and 7.60±0.48%, respectively. The in vitro release of NOB from NOB-PEG-PCL showed a remarkably sustained releasing characteristic and could be retained at least 48 hrs in pH 7.4 PBS. Anti-osteoclasts effects demonstrated that the NOB-PEG-PCL significantly inhibited the formation of tartrate-resistant acid phosphatase (TRAP)-positive multinuclear cells stimulated by RANKL. Furthermore, the NOB-PEG-PCL did not produce cytotoxicity on bone marrow-derived macrophages (BMMs). The mRNA expressions of genetic markers of osteoclasts including TRAP and cathepsin K were significantly decreased in the presence of NOB-PEG-PCL. In addition, the NOB-PEG-PCL inhibited OC differentiation of BMMs through RANKL-induced MAPK signal pathway. After administration of the NOB-PEG-PCL, NOB-PEG-PCL prevented bone loss and improved bone density in OVX mice. These findings suggest that NOB-PEG-PCL might have great potential in the treatment of osteoporosis. Conclusion The results suggested that NOB-PEG-PCL micelles could effectively prevent NOB fast release from micelles and extend circulation time. The NOB-PEG-PCL delivery system may be a promising way to prevent and treat osteoporosis.
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Affiliation(s)
- Yabing Wang
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, People's Republic of China
| | - Jian Xie
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, People's Republic of China
| | - Zexin Ai
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, People's Republic of China
| | - Jiansheng Su
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, People's Republic of China
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Lin G, Zhou C, Lin M, Xu A, He F. Strontium‐incorporated titanium implant surface treated by hydrothermal reactions promotes early bone osseointegration in osteoporotic rabbits. Clin Oral Implants Res 2019; 30:777-790. [PMID: 31104360 DOI: 10.1111/clr.13460] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 04/27/2019] [Accepted: 05/07/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Guofen Lin
- Department of General Dentistry, The Affiliated Stomatology Hospital, School of Medicine Zhejiang University Hangzhou China
| | - Chuan Zhou
- Department of Prosthodontics, The Affiliated Stomatology Hospital, School of Medicine Zhejiang University Hangzhou China
| | - Mengna Lin
- Department of Prosthodontics, The Affiliated Stomatology Hospital, School of Medicine Zhejiang University Hangzhou China
| | - Antian Xu
- Department of Prosthodontics, The Affiliated Stomatology Hospital, School of Medicine Zhejiang University Hangzhou China
| | - Fuming He
- Department of Prosthodontics, The Affiliated Stomatology Hospital, School of Medicine Zhejiang University Hangzhou China
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Li D, Li Y, Shrestha A, Wang S, Wu Q, Li L, Guan C, Wang C, Fu T, Liu W, Huang Y, Ji P, Chen T. Effects of Programmed Local Delivery from a Micro/Nano-Hierarchical Surface on Titanium Implant on Infection Clearance and Osteogenic Induction in an Infected Bone Defect. Adv Healthc Mater 2019; 8:e1900002. [PMID: 30985090 DOI: 10.1002/adhm.201900002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 03/24/2019] [Indexed: 02/05/2023]
Abstract
The two major causes for implant failure are postoperative infection and poor osteogenesis. Initial period of osteointegration is regulated by immunocytes and osteogenic-related cells resulting in inflammatory response and tissue healing. The healing phase can be influenced by various environmental factors and biological cascade effect. To synthetically orchestrate bone-promoting factors on biomaterial surface, built is a dual delivery system coated on a titanium surface (abbreviated as AH-Sr-AgNPs). The results show that this programmed delivery system can release Ag+ and Sr2+ in a temporal-spatial manner to clear pathogens and activate preosteoblast differentiation partially through manipulating the polarization of macrophages. Both in vitro and in vivo assays show that AH-Sr-AgNPs-modified surface renders a microenvironment adverse for bacterial survival and favorable for macrophage polarization (M2), which further promotes the differentiation of preosteoblasts. Infected New Zealand rabbit femoral metaphysis defect model is used to confirm the osteogenic property of AH-Sr-AgNPs implants through micro-CT, histological, and histomorphometric analyses. These findings demonstrate that the programmed surface with dual delivery of Sr2+ and Ag+ has the potential of achieving an enhanced osteogenic outcome through favorable immunoregulation.
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Affiliation(s)
- Dize Li
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Yihan Li
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Annie Shrestha
- Faculty of DentistryUniversity of Toronto Toronto ON M5G 1G6 Canada
| | - Si Wang
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Qingqing Wu
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Lingjie Li
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Chao Guan
- Jiaxing Hospital of Traditional Chinese Medicine Jiaxing 314001 P. R. China
| | - Chao Wang
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Tiwei Fu
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Wenzhao Liu
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Yuanding Huang
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Ping Ji
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
| | - Tao Chen
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing 401147 P. R. China
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Zhou C, Chen Y, Zhu Y, Lin G, Zhang L, Liu X, He F. Antiadipogenesis and Osseointegration of Strontium-Doped Implant Surfaces. J Dent Res 2019; 98:795-802. [PMID: 31136719 DOI: 10.1177/0022034519850574] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The decreased bone density and increased marrow adiposity that occur with aging may influence the outcome of dental implants. Strontium (Sr), an anabolic agent for the treatment of osteoporosis, has an inhibitory effect on adipogenesis but favors osteogenesis of bone marrow–derived mesenchymal stem cells (BMSCs). However, little is known about the effects and mechanisms of local Sr release on adipogenesis during bone formation in aged bone. In this study, a potential dental implant material, Sr-doped titanium, was developed via a sandblasted, large-grit, and acid-etched (SLA) method combined with a hydrothermal process. The effects of Sr-SLA on initial adhesion, proliferation, intracellular redox state, and adipogenic differentiation of senescent BMSCs were investigated. The in vitro results showed that Sr-SLA promoted spreading of senescent BMSCs via upregulation of the gene and protein expression of integrin β1. In addition, it was revealed that Sr-SLA could reduce intracellular oxidative stress by decreasing the levels of reactive oxygen species and oxygen radicals and increasing the content of glutathione peroxidase. More important, Sr-SLA suppressed lipid droplet production and adipokines expression via downregulation of transcription peroxisome proliferator-activated receptor γ (PPARγ) and signal transducer and activator of transcription 1, thus inhibiting adipogenesis. Finally, the Sr-SLA implants were implanted in tibiae of aged (18-mo-old) Sprague-Dawley rats for 2 and 8 wk. Histomorphometric analysis demonstrated that Sr-SLA implants significantly enhanced osseointegration, and the inhibition effect on marrow adipose tissue formation was moderate. All these results suggest that due to the multiple functions produced by Sr, antiadipogenesis capability and rapid osseointegration were enhanced by the Sr-SLA coatings, which have potential application in dental implantation in the aged population.
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Affiliation(s)
- C. Zhou
- Department of Prothodontics, The Affiliated Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Y.Q. Chen
- Department of Prothodontics, The Affiliated Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Y.H. Zhu
- Department of Prothodontics, The Affiliated Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - G.F. Lin
- Department of General Dentistry, The Affiliated Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - L.F. Zhang
- Department of Prothodontics, The Affiliated Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - X.C. Liu
- Department of Prothodontics, The Affiliated Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - F.M. He
- Department of Oral Implantology and Prosthodontics, The Affiliated Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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15
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Liu F, Li Y, Liang J, Sui W, Bellare A, Kong L. Effects of micro/nano strontium‐loaded surface implants on osseointegration in ovariectomized sheep. Clin Implant Dent Relat Res 2019; 21:377-385. [DOI: 10.1111/cid.12719] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/04/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Fuwei Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial SurgerySchool of Stomatology, The Fourth Military Medical University Xi'an People's Republic of China
| | - Yongfeng Li
- Department of StomatologyPLA 301 Hospital Beijing People's Republic of China
| | - Jianfei Liang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial SurgerySchool of Stomatology, The Fourth Military Medical University Xi'an People's Republic of China
| | - Wen Sui
- Department of StomatologyShenzhen Hospital of Southern Medical University Shenzhen People's Republic of China
| | - Anuj Bellare
- Department of Orthopedic SurgeryBrigham and Women's Hospital Boston Massachusetts
| | - Liang Kong
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial SurgerySchool of Stomatology, The Fourth Military Medical University Xi'an People's Republic of China
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16
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Zhao H, Huang Y, Zhang W, Guo Q, Cui W, Sun Z, Eglin D, Liu L, Pan G, Shi Q. Mussel-Inspired Peptide Coatings on Titanium Implant to Improve Osseointegration in Osteoporotic Condition. ACS Biomater Sci Eng 2018; 4:2505-2515. [PMID: 33435114 DOI: 10.1021/acsbiomaterials.8b00261] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Huan Zhao
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Yingkang Huang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Wen Zhang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Qianping Guo
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Wenguo Cui
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Zhiyong Sun
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
| | - David Eglin
- AO Research Institute Davos, Clavadelerstrasse 8, Davos, 7270, Switzerland
| | - Lei Liu
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Guoqing Pan
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Qin Shi
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
- Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, 199 Renai Road, Suzhou, 215123, China
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17
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Offermanns V, Andersen OZ, Sillassen M, Almtoft KP, Andersen IH, Kloss F, Foss M. A comparative in vivo study of strontium-functionalized and SLActive™ implant surfaces in early bone healing. Int J Nanomedicine 2018; 13:2189-2197. [PMID: 29692613 PMCID: PMC5903483 DOI: 10.2147/ijn.s161061] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose Studies have shown that strontium-doped medical applications benefit bone metabolism leading to improved bone healing and osseointegration. Based on this knowledge, the aim of the study was to evaluate the performance of an implant surface, functionalized by a physical vapor deposition (PVD) coating (Ti-Sr-O), designed to yield predictable release of strontium. The Ti-Sr-O functionalized surface is compared to a routinely used, commercially available surface (SLActive™) with respect to bone-to-implant contact (BIC%) and new bone formation (BF%) in two defined regions of interest (ROI-I and ROI-II, respectively). Materials and methods: Ti-Sr-O functionalized, SLActive, and Grade 4 titanium implants were inserted in the femoral condyle of adult male New Zealand White rabbits. The PVD magnetron-sputtered Ti-Sr-O surface coating was characterized using scanning electron microscopy (SEM) for morphology and coating thickness. Strontium release and mechanical stability of the coating, under simulated insertion conditions, were evaluated. Furthermore, histomorphometrical BIC and BF were carried out 2 weeks after insertion. Results Histomorphometry revealed increased bone formation of Ti-Sr-O with significant differences compared to SLActive and Grade 4 titanium in both regions of interest, ROI-I and ROI-II, at 0–250 µm and 250–500 µm distance from the implant surfaces. Analogous results of bone-to-implant contact were observed for the two modified surfaces. Conclusion The results show that a nanopatterned Ti-Sr-O functionalized titanium surface, with sustained release of strontium, increases peri-implant bone volume and could potentially contribute to enhancement of bone anchorage of osseointegrated implants.
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Affiliation(s)
- Vincent Offermanns
- Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Ole Z Andersen
- Interdisciplinary Nanoscience Center (iNANO), Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
| | - Michael Sillassen
- Interdisciplinary Nanoscience Center (iNANO), Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
| | - Klaus P Almtoft
- Tribology Center, Danish Technological Institute, Aarhus, Denmark
| | - Inge H Andersen
- Tribology Center, Danish Technological Institute, Aarhus, Denmark
| | | | - Morten Foss
- Interdisciplinary Nanoscience Center (iNANO), Faculty of Science and Technology, Aarhus University, Aarhus, Denmark.,Department of Physics and Astronomy, Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
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18
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Offermanns V, Andersen OZ, Riede G, Sillassen M, Jeppesen CS, Almtoft KP, Talasz H, Öhman-Mägi C, Lethaus B, Tolba R, Kloss F, Foss M. Effect of strontium surface-functionalized implants on early and late osseointegration: A histological, spectrometric and tomographic evaluation. Acta Biomater 2018; 69:385-394. [PMID: 29425718 DOI: 10.1016/j.actbio.2018.01.049] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/18/2018] [Accepted: 01/30/2018] [Indexed: 12/15/2022]
Abstract
Numerous in vivo, in vitro and clinical studies report on beneficial effects of strontium with respect to increased bone growth. Based on this knowledge the aim of this study was to evaluate early and late osseointegration stages of functionalized titanium implants showing sustained release of strontium (Sr) and further investigate its potential systemic effect. Strontium functionalized (Ti-Sr-O) and Grade 4 (Control) titanium implants were inserted in the femoral condyle of New Zealand White rabbits. The Ti-Sr-O coating was characterized using Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectrometry (EDX) for structure, coating thickness and chemical composition. Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES) was used to evaluate released strontium in vitro while Atomic Absorption Spectrometry (AAS) was utilized to monitor serum levels of strontium and calcium. Additionally, histological and tomographic analysis of bone-to-implant contact (BIC%) and bone formation (BF%) was performed, following implantation periods of two or twelve weeks, respectively. Median values for BIC% for Ti-Sr-O revealed significant differences within the two- and twelve-week observation periods, while exceeding BF% was discovered especially after twelve weeks when performing the histological evaluation. The results from the micro-computed tomography (µ-CT) showed no significant differences, when comparing the experimental groups. AAS measurements did not indicate a systemic effect by the local strontium release. Within the limitations of the study, it was shown that a Ti-Sr-O coating with sustained release characteristics of strontium, accelerates bone apposition and represents a potential potent surface modification for endosseous medical implant devices. STATEMENT OF SIGNIFICANCE This study presents first data with respect to early and late in vivo response on a strontium functionalized titanium surface comprising a nanotopography manufactured by a magnetron sputtering process. We investigated different osseointegration stages of screw-shaped implants with dental implant geometries in a rabbit femur model observing beneficial effects of the functionalized surface on bone-to-implant contact and bone formation caused by tailored release of the bone anabolic strontium. Histomorphometrical data revealed that a functionalized titanium surface with controlled liberation of strontium accelerates osseointegration while spectrometry measurements did not indicate a potential systemic effect of this osteoinductive agent and could thus have impact on modifications of medical implant devices.
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19
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Strontium Hydroxyapatite scaffolds engineered with stem cells aid osteointegration and osteogenesis in osteoporotic sheep model. Colloids Surf B Biointerfaces 2017; 163:346-354. [PMID: 29331906 DOI: 10.1016/j.colsurfb.2017.12.048] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 12/13/2017] [Accepted: 12/27/2017] [Indexed: 01/16/2023]
Abstract
Osteoporotic fracture healing is an orthopaedic challenge due to excessive bone resorption and impaired osteogenesis. Majority of current treatment strategies focus on regulating bone resorption and the potential application of Mesenchymal Stem Cells (MSCs) in promoting osteogenesis has not been explored much. Furthermore, the present study has put forth a novel approach, wherein the synergistic action of Strontium (Sr) and MSCs in a single implant may facilitate osteoporotic bone healing. Strontium Hydroxyapatite (SrHA) synthesized by wet precipitation was fabricated into tissue engineered Strontium incorporated Hydroxyapatite (cSrHA) using sheep adipose tissue derived MSCs (ADMSCs). Porosity, radiopacity and cytocompatibility of SrHA scaffolds were found appropriate for orthopaedic applications. cSrHA scaffolds exhibited an in vitro Alkaline Phosphatase activity of 20 μmol pnp/30 min comparable to that of Hydroxyapatite (HA) - control scaffold, proving its osteogenic efficacy. Implantation studies in sheep osteoporotic model depicted enhanced osteogenic ability with mature lamellar bone formation in cSrHA implanted group, compared to bare HA, SrHA and tissue engineered HA implanted groups. Histomorphometry data substantiated improved osteogenesis on par with material resorption, as cSrHA implanted group exhibited highest regeneration ratio of 0.38 ± 0.05. Density histograms from micro CT further signified the enhanced osteointegrative ability of cSrHA implants. Results of the study depicted the therapeutic potential of cSrHA in osteoporotic bone healing and proposes the use of allogenic ADMSCs for fabricating "Off the Shelf Tissue Engineered Products".
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Effect of titanium implants with strontium incorporation on bone apposition in animal models: A systematic review and meta-analysis. Sci Rep 2017; 7:15563. [PMID: 29138499 PMCID: PMC5686172 DOI: 10.1038/s41598-017-15488-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/27/2017] [Indexed: 01/07/2023] Open
Abstract
This systematic review aims to assess the efficacy of titanium (Ti) implant surfaces with or without strontium (Sr) incorporation on osseointegration in animal experimental studies. An electronic search was conducted using databases of PubMed and EMBASE up to November 2016 to identify studies focusing on osseointegration of strontium-modified titanium implants following PRISMA criteria. The primary outcome was the percentage of bone-to-implant contact (BIC) around the implants with or without strontium-modified surface. Of the 1320 studies, 17 studies fulfilling the inclusion criteria were finally included. A random effect meta-analysis was conducted based on BIC in 17 studies, and the results demonstrated considerable heterogeneity (I² = 79%). A sensitivity analysis found that three studies using the same surface modification method were the major source of the heterogeneity. Therefore, exploratory subgroup analysis was performed. Subgroup one including 14 studies showed a standard mean differences (SMD) of 1.42 (95% CI, 1.13-1.71) with no heterogeneity (I² = 0.0%), while subgroup two including the other three studies showed a SMD of 9.49.95% CI, 7.51-11.47) with low heterogeneity (I² = 0.1%). Sr-modified implants in both subgroups showed significantly higher BIC than unmodified implants (P < 0.01). The results showed a statistically significant effect of Sr-modified titanium implant surfaces on osseointegration and bone apposition in animal models.
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Göttlicher M, Rohnke M, Moryson Y, Thomas J, Sann J, Lode A, Schumacher M, Schmidt R, Pilz S, Gebert A, Gemming T, Janek J. Functionalization of Ti-40Nb implant material with strontium by reactive sputtering. Biomater Res 2017; 21:18. [PMID: 29046823 PMCID: PMC5634847 DOI: 10.1186/s40824-017-0104-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/28/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Surface functionalization of orthopedic implants with pharmaceutically active agents is a modern approach to enhance osseointegration in systemically altered bone. A local release of strontium, a verified bone building therapeutic agent, at the fracture site would diminish side effects, which could occur otherwise by oral administration. Strontium surface functionalization of specially designed titanium-niobium (Ti-40Nb) implant alloy would provide an advanced implant system that is mechanically adapted to altered bone with the ability to stimulate bone formation. METHODS Strontium-containing coatings were prepared by reactive sputtering of strontium chloride (SrCl2) in a self-constructed capacitively coupled radio frequency (RF) plasma reactor. Film morphology, structure and composition were investigated by scanning electron microscopy (SEM), time of flight secondary ion mass spectrometry (ToF-SIMS) and X-ray photoelectron spectroscopy (XPS). High-resolution transmission electron microscopy (HR-TEM) was used for the investigation of thickness and growth direction of the product layer. TEM lamellae were prepared using the focused ion beam (FIB) technique. Bioactivity of the surface coatings was tested by cultivation of primary human osteoblasts and subsequent analysis of cell morphology, viability, proliferation and differentiation. The results are correlated with the amount of strontium that is released from the coating in biomedical buffer solution, quantified by inductively coupled plasma mass spectrometry (ICP-MS). RESULTS Dense coatings, consisting of SrOxCly, of more than 100 nm thickness and columnar structure, were prepared. TEM images of cross sections clearly show an incoherent but well-structured interface between coating and substrate without any cracks. Sr2+ is released from the SrOxCly coating into physiological solution as proven by ICP-MS analysis. Cell culture studies showed excellent biocompatibility of the functionalized alloy. CONCLUSIONS Ti-40Nb alloy, a potential orthopedic implant material for osteoporosis patients, could be successfully plasma coated with a dense SrOxCly film. The material performed well in in vitro tests. Nevertheless, the Sr2+ release must be optimized in future work to meet the requirements of an effective drug delivery system.
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Affiliation(s)
- Markus Göttlicher
- Institute of Physical Chemistry and Center of Materials Research, Justus-Liebig-University of Giessen, Heinrich-Buff-Ring 17, 35392, Giessen, Germany
| | - Marcus Rohnke
- Institute of Physical Chemistry and Center of Materials Research, Justus-Liebig-University of Giessen, Heinrich-Buff-Ring 17, 35392, Giessen, Germany
| | - Yannik Moryson
- Institute of Physical Chemistry and Center of Materials Research, Justus-Liebig-University of Giessen, Heinrich-Buff-Ring 17, 35392, Giessen, Germany
| | - Jürgen Thomas
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Joachim Sann
- Institute of Physical Chemistry and Center of Materials Research, Justus-Liebig-University of Giessen, Heinrich-Buff-Ring 17, 35392, Giessen, Germany
| | - Anja Lode
- Centre for Translational Bone, Joint and Soft Tissue Research, Faculty of Medicine and University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Matthias Schumacher
- Centre for Translational Bone, Joint and Soft Tissue Research, Faculty of Medicine and University Hospital, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Romy Schmidt
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Stefan Pilz
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Annett Gebert
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Thomas Gemming
- IFW Dresden, Institute for Complex Materials, Helmholtzstrasse 20, 01069 Dresden, Germany
| | - Jürgen Janek
- Institute of Physical Chemistry and Center of Materials Research, Justus-Liebig-University of Giessen, Heinrich-Buff-Ring 17, 35392, Giessen, Germany
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