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Liu X, Feng Z, Ran Z, Zeng Y, Cao G, Li X, Ye H, Wang M, Liang W, He Y. External Stimuli-Responsive Strategies for Surface Modification of Orthopedic Implants: Killing Bacteria and Enhancing Osteogenesis. ACS APPLIED MATERIALS & INTERFACES 2024. [PMID: 38497341 DOI: 10.1021/acsami.3c19149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Bacterial infection and insufficient osteogenic activity are the main causes of orthopedic implant failure. Conventional surface modification methods are difficult to meet the requirements for long-term implant placement. In order to better regulate the function of implant surfaces, especially to improve both the antibacterial and osteogenic activity, external stimuli-responsive (ESR) strategies have been employed for the surface modification of orthopedic implants. External stimuli act as "smart switches" to regulate the surface interactions with bacteria and cells. The balance between antibacterial and osteogenic capabilities of implant surfaces can be achieved through these specific ESR manifestations, including temperature changes, reactive oxygen species production, controlled release of bioactive molecules, controlled release of functional ions, etc. This Review summarizes the recent progress on different ESR strategies (based on light, ultrasound, electric, and magnetic fields) that can effectively balance antibacterial performance and osteogenic capability of orthopedic implants. Furthermore, the current limitations and challenges of ESR strategies for surface modification of orthopedic implants as well as future development direction are also discussed.
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Affiliation(s)
- Xujie Liu
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Zhenzhen Feng
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Zhili Ran
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Yaoxun Zeng
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Guining Cao
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Xinyi Li
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Huiling Ye
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Meijing Wang
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Wanting Liang
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
| | - Yan He
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, China
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Wang A, Ma X, Bian J, Jiao Z, Zhu Q, Wang P, Zhao Y. Signalling pathways underlying pulsed electromagnetic fields in bone repair. Front Bioeng Biotechnol 2024; 12:1333566. [PMID: 38328443 PMCID: PMC10847561 DOI: 10.3389/fbioe.2024.1333566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024] Open
Abstract
Pulsed electromagnetic field (PEMF) stimulation is a prospective non-invasive and safe physical therapy strategy for accelerating bone repair. PEMFs can activate signalling pathways, modulate ion channels, and regulate the expression of bone-related genes to enhance osteoblast activity and promote the regeneration of neural and vascular tissues, thereby accelerating bone formation during bone repair. Although their mechanisms of action remain unclear, recent studies provide ample evidence of the effects of PEMF on bone repair. In this review, we present the progress of research exploring the effects of PEMF on bone repair and systematically elucidate the mechanisms involved in PEMF-induced bone repair. Additionally, the potential clinical significance of PEMF therapy in fracture healing is underscored. Thus, this review seeks to provide a sufficient theoretical basis for the application of PEMFs in bone repair.
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Affiliation(s)
- Aoao Wang
- Medical School of Chinese PLA, Beijing, China
| | - Xinbo Ma
- Department of Chemistry, Capital Normal University, Beijing, China
| | - Jiaqi Bian
- Senior Department of Orthopaedics, The Fourth Medical Center of PLA General Hospital, Beijing, China
| | | | - Qiuyi Zhu
- Medical School of Chinese PLA, Beijing, China
| | - Peng Wang
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yantao Zhao
- Senior Department of Orthopaedics, The Fourth Medical Center of PLA General Hospital, Beijing, China
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3
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Zhu T, Zhou H, Chen X, Zhu Y. Recent advances of responsive scaffolds in bone tissue engineering. Front Bioeng Biotechnol 2023; 11:1296881. [PMID: 38047283 PMCID: PMC10691504 DOI: 10.3389/fbioe.2023.1296881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
The investigation of bone defect repair has been a significant focus in clinical research. The gradual progress and utilization of different scaffolds for bone repair have been facilitated by advancements in material science and tissue engineering. In recent times, the attainment of precise regulation and targeted drug release has emerged as a crucial concern in bone tissue engineering. As a result, we present a comprehensive review of recent developments in responsive scaffolds pertaining to the field of bone defect repair. The objective of this review is to provide a comprehensive summary and forecast of prospects, thereby contributing novel insights to the field of bone defect repair.
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Affiliation(s)
| | | | | | - Yuanjing Zhu
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
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Javeed S, Zhang JK, Greenberg JK, Dibble CF, Zellmer E, Moran D, Leuthardt EC, Ray WZ, MacEwan MR. Electroactive Spinal Instrumentation for Targeted Osteogenesis and Spine Fusion: A Computational Study. Int J Spine Surg 2023; 17:95-102. [PMID: 36697205 PMCID: PMC10025838 DOI: 10.14444/8389] [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: 01/27/2023] Open
Abstract
BACKGROUND Direct current electrical stimulation may serve as a promising nonpharmacological adjunct promoting osteogenesis and fusion. The aim of this study was to evaluate the utility of electroactive spine instrumentation in the focal delivery of therapeutic electrical stimulation to enhance lumbar bone formation and interbody fusion. METHODS A finite element model of adult human lumbar spine (L4-L5) instrumented with single-level electroactive pedicle screws was simulated. Direct current electrical stimulation was routed through anodized electroactive pedicle screws to target regions of fusion. The electrical fields generated by electroactive pedicle screws were evaluated in various tissue compartments including isotropic tissue volumes, cortical, and trabecular bone. Electrical field distributions at various stimulation amplitudes (20-100 µA) and pedicle screw anodization patterns were analyzed in target regions of fusion (eg, intervertebral disc space, vertebral body, and pedicles). RESULTS Electrical stimulation with electroactive pedicle screws at various stimulation amplitudes and anodization patterns enabled modulation of spatial distribution and intensity of electric fields within the target regions of lumbar spine. Anodized screws (50%) vs unanodized screws (0%) induced high-amplitude electric fields within the intervertebral disc space and vertebral body but negligible electric fields in spinal canal. Direct current electrical stimulation via anodized screws induced electrical fields, at therapeutic threshold of >1 mV/cm, sufficient for osteoinduction within the target interbody region. CONCLUSIONS Selective anodization of electroactive pedicle screws may enable focal delivery of therapeutic electrical stimulation in the target regions in human lumbar spine. This study warrants preclinical and clinical testing of integrated electroactive system in inducing target lumbar fusion in vivo. CLINICAL RELEVANCE The findings of this study provide a foundation for clinically investigating electroactive intrumentation to enhance spine fusion. LEVEL OF EVIDENCE: 5
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Affiliation(s)
- Saad Javeed
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Justin K Zhang
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Jacob K Greenberg
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Christopher F Dibble
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Eric Zellmer
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Dan Moran
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Eric C Leuthardt
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Wilson Z Ray
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Matthew R MacEwan
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
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5
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Pulsed Electrical Stimulation Affects Osteoblast Adhesion and Calcium Ion Signaling. Cells 2022; 11:cells11172650. [PMID: 36078058 PMCID: PMC9454840 DOI: 10.3390/cells11172650] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
An extensive research field in regenerative medicine is electrical stimulation (ES) and its impact on tissue and cells. The mechanism of action of ES, particularly the role of electrical parameters like intensity, frequency, and duration of the electric field, is not yet fully understood. Human MG-63 osteoblasts were electrically stimulated for 10 min with a commercially available multi-channel system (IonOptix). We generated alternating current (AC) electrical fields with a voltage of 1 or 5 V and frequencies of 7.9 or 20 Hz, respectively. To exclude liquid-mediated effects, we characterized the AC-stimulated culture medium. AC stimulation did not change the medium’s pH, temperature, and oxygen content. The H2O2 level was comparable with the unstimulated samples except at 5 V_7.9 Hz, where a significant increase in H2O2 was found within the first 30 min. Pulsed electrical stimulation was beneficial for the process of attachment and initial adhesion of suspended osteoblasts. At the same time, the intracellular Ca2+ level was enhanced and highest for 20 Hz stimulated cells with 1 and 5 V, respectively. In addition, increased Ca2+ mobilization after an additional trigger (ATP) was detected at these parameters. New knowledge was provided on why electrical stimulation contributes to cell activation in bone tissue regeneration.
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Response of Osteoblasts to Electric Field Line Patterns Emerging from Molecule Stripe Landscapes. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Molecular surface gradients can constitute electric field landscapes and serve to control local cell adhesion and migration. Cellular responses to electric field landscapes may allow the discovery of routes to improve osseointegration of implants. Flat molecule aggregate landscapes of amine- or carboxyl-teminated dendrimers, amine-containing protein and polyelectrolytes were prepared on glass to provide lateral electric field gradients through their differing zeta potentials compared to the glass substrate. The local as well as the mesoscopic morphological responses of adhered osteoblasts (MG-63) with respect to the stripes were studied by means of Scanning Ion Conductance Microscopy (SICM) and Fluorescence Microscopy, in situ. A distinct spindle shape oriented parallel to the surface pattern as well as a preferential adhesion of the cells on the glass site have been observed at a stripe and spacing width of 20 μm. Excessive ruffling is observed at the spindle poles, where the cells extend. To explain this effect of material preference and electro-deformation, we put forward a retraction mechanism, a localized form of double-sided cathodic taxis.
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Bone Mineralization in Electrospun-Based Bone Tissue Engineering. Polymers (Basel) 2022; 14:polym14102123. [PMID: 35632005 PMCID: PMC9146582 DOI: 10.3390/polym14102123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 02/06/2023] Open
Abstract
Increasing the demand for bone substitutes in the management of bone fractures, including osteoporotic fractures, makes bone tissue engineering (BTE) an ideal strategy for solving the constant shortage of bone grafts. Electrospun-based scaffolds have gained popularity in BTE because of their unique features, such as high porosity, a large surface-area-to-volume ratio, and their structural similarity to the native bone extracellular matrix (ECM). To imitate native bone mineralization through which bone minerals are deposited onto the bone matrix, a simple but robust post-treatment using a simulated body fluid (SBF) has been employed, thereby improving the osteogenic potential of these synthetic bone grafts. This study highlights recent electrospinning technologies that are helpful in creating more bone-like scaffolds, and addresses the progress of SBF development. Biomineralized electrospun bone scaffolds are also reviewed, based on the importance of bone mineralization in bone regeneration. This review summarizes the potential of SBF treatments for conferring the biphasic features of native bone ECM architectures onto electrospun-based bone scaffolds.
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Fong JSL, Booth MA, Rifai A, Fox K, Gelmi A. Diamond in the Rough: Toward Improved Materials for the Bone-Implant Interface. Adv Healthc Mater 2021; 10:e2100007. [PMID: 34170623 DOI: 10.1002/adhm.202100007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/17/2021] [Indexed: 01/16/2023]
Abstract
The ability of an orthopedic implant to integrate successfully with the surrounding bone tissue is imperative for optimal patient outcomes. Here, the recent advances and future prospects for diamond-based coatings of conventional osteo-implant materials (primarily titanium) are explored. The ability of these diamond coatings to enhance integration into existing bone, improved implant mechanical properties, facilitate surface chemical functionalization, and provide anti-microbial properties are discussed in context of orthopedic implants. These diamond-based materials may have the additional benefit of providing an osteo-inductive effect, enabling better integration into existing bone via stem cell recruitment and bone regeneration. Current and timely research is highlighted to support the discussion and suggestions in further improving implant integration via an osseoinductive effect from the diamond composite materials.
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Affiliation(s)
- Jessica S L Fong
- School of Science, RMIT University, Melbourne, VIC, 3000, Australia
| | - Marsilea A Booth
- School of Engineering, RMIT University, Melbourne, VIC, 3000, Australia
| | - Aaqil Rifai
- School of Engineering, RMIT University, Melbourne, VIC, 3000, Australia
- School of Medicine, Deakin University, Waurn Ponds, VIC, 3216, Australia
| | - Kate Fox
- School of Engineering, RMIT University, Melbourne, VIC, 3000, Australia
| | - Amy Gelmi
- School of Science, RMIT University, Melbourne, VIC, 3000, Australia
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Sarraf M, Nasiri-Tabrizi B, Yeong CH, Madaah Hosseini HR, Saber-Samandari S, Basirun WJ, Tsuzuki T. Mixed oxide nanotubes in nanomedicine: A dead-end or a bridge to the future? CERAMICS INTERNATIONAL 2021; 47:2917-2948. [PMID: 32994658 PMCID: PMC7513735 DOI: 10.1016/j.ceramint.2020.09.177] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 05/12/2023]
Abstract
Nanomedicine has seen a significant rise in the development of new research tools and clinically functional devices. In this regard, significant advances and new commercial applications are expected in the pharmaceutical and orthopedic industries. For advanced orthopedic implant technologies, appropriate nanoscale surface modifications are highly effective strategies and are widely studied in the literature for improving implant performance. It is well-established that implants with nanotubular surfaces show a drastic improvement in new bone creation and gene expression compared to implants without nanotopography. Nevertheless, the scientific and clinical understanding of mixed oxide nanotubes (MONs) and their potential applications, especially in biomedical applications are still in the early stages of development. This review aims to establish a credible platform for the current and future roles of MONs in nanomedicine, particularly in advanced orthopedic implants. We first introduce the concept of MONs and then discuss the preparation strategies. This is followed by a review of the recent advancement of MONs in biomedical applications, including mineralization abilities, biocompatibility, antibacterial activity, cell culture, and animal testing, as well as clinical possibilities. To conclude, we propose that the combination of nanotubular surface modification with incorporating sensor allows clinicians to precisely record patient data as a critical contributor to evidence-based medicine.
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Key Words
- ALP, Alkaline Phosphatase
- APH, Anodization-Cyclic Precalcification-Heat Treatment
- Ag2O NPs, Silver Oxide Nanoparticles
- AgNPs, Silver Nanoparticles
- Anodization
- BIC, Bone-Implant Contact
- Bioassays
- CAGR, Compound Annual Growth Rate
- CT, Computed Tomography
- DMF, Dimethylformamide
- DMSO, Dimethyl Sulfoxide
- DRI, Drug-Releasing Implants
- E. Coli, Escherichia Coli
- ECs, Endothelial Cells
- EG, Ethylene Glycol
- Electrochemistry
- FA, Formamide
- Fe2+, Ferrous Ion
- Fe3+, Ferric Ion
- Fe3O4, Magnetite
- GEP, Gene Expression Programming
- GO, Graphene Oxide
- HA, Hydroxyapatite
- HObs, Human Osteoblasts
- HfO2 NTs, Hafnium Oxide Nanotubes
- IMCs, Intermetallic Compounds
- LEDs, Light emitting diodes
- MEMS, Microelectromechanical Systems
- MONs, Mixed Oxide Nanotubes
- MOPSO, Multi-Objective Particle Swarm Optimization
- MSCs, Mesenchymal Stem Cells
- Mixed oxide nanotubes
- NMF, N-methylformamide
- Nanomedicine
- OPC1, Osteo-Precursor Cell Line
- PSIs, Patient-Specific Implants
- PVD, Physical Vapor Deposition
- RF, Radio-Frequency
- ROS, Radical Oxygen Species
- S. aureus, Staphylococcus Aureus
- S. epidermidis, Staphylococcus Epidermidis
- SBF, Simulated Body Fluid
- TiO2 NTs, Titanium Dioxide Nanotubes
- V2O5, Vanadium Pentoxide
- VSMCs, Vascular Smooth Muscle Cells
- XPS, X-ray Photoelectron Spectroscopy
- ZrO2 NTs, Zirconium Dioxide Nanotubes
- hASCs, Human Adipose-Derived Stem Cells
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Affiliation(s)
- Masoud Sarraf
- Centre of Advanced Materials, Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Materials Science and Engineering Department, Sharif University of Technology, P.O. Box 11155-9466, Azadi Avenue, Tehran, Iran
| | - Bahman Nasiri-Tabrizi
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
- New Technologies Research Center, Amirkabir University of Technology, Tehran, Iran
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Hamid Reza Madaah Hosseini
- Materials Science and Engineering Department, Sharif University of Technology, P.O. Box 11155-9466, Azadi Avenue, Tehran, Iran
| | | | - Wan Jefrey Basirun
- Department of Chemistry, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Takuya Tsuzuki
- Research School of Electrical Energy and Materials Engineering, College of Engineering and Computer Science, Australian National University, Canberra, 2601, Australia
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Leppik L, Oliveira KMC, Bhavsar MB, Barker JH. Electrical stimulation in bone tissue engineering treatments. Eur J Trauma Emerg Surg 2020; 46:231-244. [PMID: 32078704 PMCID: PMC7113220 DOI: 10.1007/s00068-020-01324-1] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/04/2020] [Indexed: 12/20/2022]
Abstract
Electrical stimulation (EStim) has been shown to promote bone healing and regeneration both in animal experiments and clinical treatments. Therefore, incorporating EStim into promising new bone tissue engineering (BTE) therapies is a logical next step. The goal of current BTE research is to develop combinations of cells, scaffolds, and chemical and physical stimuli that optimize treatment outcomes. Recent studies demonstrating EStim's positive osteogenic effects at the cellular and molecular level provide intriguing clues to the underlying mechanisms by which it promotes bone healing. In this review, we discuss results of recent in vitro and in vivo research focused on using EStim to promote bone healing and regeneration and consider possible strategies for its application to improve outcomes in BTE treatments. Technical aspects of exposing cells and tissues to EStim in in vitro and in vivo model systems are also discussed.
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Affiliation(s)
- Liudmila Leppik
- Frankfurt Initiative for Regenerative Medicine, Experimental Orthopedics and Trauma Surgery, J.W. Goethe University, Frankfurt/Main, Germany.
| | - Karla Mychellyne Costa Oliveira
- Frankfurt Initiative for Regenerative Medicine, Experimental Orthopedics and Trauma Surgery, J.W. Goethe University, Frankfurt/Main, Germany
| | - Mit Balvantray Bhavsar
- Frankfurt Initiative for Regenerative Medicine, Experimental Orthopedics and Trauma Surgery, J.W. Goethe University, Frankfurt/Main, Germany
| | - John Howard Barker
- Frankfurt Initiative for Regenerative Medicine, Experimental Orthopedics and Trauma Surgery, J.W. Goethe University, Frankfurt/Main, Germany
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Ehrensberger MT, Clark CM, Canty MK, McDermott EP. Electrochemical methods to enhance osseointegrated prostheses. Biomed Eng Lett 2020; 10:17-41. [PMID: 32175128 PMCID: PMC7046908 DOI: 10.1007/s13534-019-00134-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/11/2019] [Accepted: 10/20/2019] [Indexed: 12/19/2022] Open
Abstract
Osseointegrated (OI) prosthetic limbs have been shown to provide an advantageous treatment option for amputees. In order for the OI prosthesis to be successful, the titanium implant must rapidly achieve and maintain proper integration with the bone tissue and remain free of infection. Electrochemical methods can be utilized to control and/or monitor the interfacial microenvironment where the titanium implant interacts with the biological system (host bone tissue or bacteria). This review will summarize the current understanding of how electrochemical modalities can influence bone tissue and bacteria with specific emphasis on applications where the metallic prosthesis itself can be utilized directly as a stimulating electrode for enhanced osseointegration and infection control. In addition, a summary of electrochemical impedance sensing techniques that could be used to potentially assess osseointegration and infection status of the metallic prosthesis is presented.
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Affiliation(s)
- Mark T. Ehrensberger
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
- Department of Orthopaedics, University at Buffalo, Buffalo, NY USA
| | - Caelen M. Clark
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
| | - Mary K. Canty
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
- Department of Microbiology and Immunology, University at Buffalo, Buffalo, NY USA
| | - Eric P. McDermott
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
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12
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Electrical stimulation-based bone fracture treatment, if it works so well why do not more surgeons use it? Eur J Trauma Emerg Surg 2019; 46:245-264. [PMID: 30955053 DOI: 10.1007/s00068-019-01127-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Electrical stimulation (EStim) has been proven to promote bone healing in experimental settings and has been used clinically for many years and yet it has not become a mainstream clinical treatment. METHODS To better understand this discrepancy we reviewed 72 animal and 69 clinical studies published between 1978 and 2017, and separately asked 161 orthopedic surgeons worldwide about their awareness, experience, and acceptance of EStim for treating fracture patients. RESULTS Of the 72 animal studies, 77% reported positive outcomes, and the most common model, bone, fracture type, and method of administering EStim were dog, tibia, large bone defects, and DC, respectively. Of the 69 clinical studies, 73% reported positive outcomes, and the most common bone treated, fracture type, and method of administration were tibia, delayed/non-unions, and PEMF, respectively. Of the 161 survey respondents, most (73%) were aware of the positive outcomes reported in the literature, yet only 32% used EStim in their patients. The most common fracture they treated was delayed/non-unions, and the greatest problems with EStim were high costs and inconsistent results. CONCLUSION Despite their awareness of EStim's pro-fracture healing effects few orthopedic surgeons use it in their patients. Our review of the literature and survey indicate that this is due to confusion in the literature due to the great variation in methods reported, and the inconsistent results associated with this treatment approach. In spite of this surgeons seem to be open to using this treatment if advancements in the technology were able to provide an easy to use, cost-effective method to deliver EStim in their fracture patients.
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13
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Liu Z, Dong L, Wang L, Wang X, Cheng K, Luo Z, Weng W. Mediation of cellular osteogenic differentiation through daily stimulation time based on polypyrrole planar electrodes. Sci Rep 2017; 7:17926. [PMID: 29263335 PMCID: PMC5738366 DOI: 10.1038/s41598-017-17120-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/22/2017] [Indexed: 12/12/2022] Open
Abstract
In electrical stimulation (ES), daily stimulation time means the interacting duration with cells per day, and is a vital factor for mediating cellular function. In the present study, the effect of stimulation time on osteogenic differentiation of MC3T3-E1 cells was investigated under ES on polypyrrole (Ppy) planar interdigitated electrodes (IDE). The results demonstrated that only a suitable daily stimulation time supported to obviously upregulate the expression of ALP protein and osteogenesis-related genes (ALP, Col-I, Runx2 and OCN), while a short or long daily stimulation time showed no significant outcomes. These might be attributed to the mechanism that an ES induced transient change in intracellular calcium ion concentration, which was responsible for activating calcium ion signaling pathway to enhance cellular osteogenic differentiation. A shorter daily time could lead to insufficient duration for the transient change in intracellular calcium ion concentration, and a longer daily time could give rise to cellular fatigue with no transient change. This work therefore provides new insights into the fundamental understanding of cell responses to ES and will have an impact on further designing materials to mediate cell behaviors.
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Affiliation(s)
- Zongguang Liu
- School of Materials Science and Engineering, State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou, 310027, China
| | - Lingqing Dong
- School of Materials Science and Engineering, State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou, 310027, China
| | - Liming Wang
- School of Materials Science and Engineering, State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou, 310027, China
| | - Xiaozhao Wang
- School of Materials Science and Engineering, State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou, 310027, China
| | - Kui Cheng
- School of Materials Science and Engineering, State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou, 310027, China
| | - Zhongkuan Luo
- Zhejiang-California International NanoSystems Institute, Hangzhou, 310058, China
| | - Wenjian Weng
- School of Materials Science and Engineering, State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou, 310027, China.
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Staruch R, Griffin MF, Butler P. Nanoscale Surface Modifications of Orthopaedic Implants: State of the Art and Perspectives. Open Orthop J 2016; 10:920-938. [PMID: 28217214 PMCID: PMC5299555 DOI: 10.2174/1874325001610010920] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 11/10/2015] [Accepted: 05/31/2016] [Indexed: 01/18/2023] Open
Abstract
Background: Orthopaedic implants such as the total hip or total knee replacement are examples of surgical interventions with postoperative success rates of over 90% at 10 years. Implant failure is associated with wear particles and pain that requires surgical revision. Improving the implant - bone surface interface is a key area for biomaterial research for future clinical applications. Current implants utilise mechanical, chemical or physical methods for surface modification. Methods: A review of all literature concerning the nanoscale surface modification of orthopaedic implant technology was conducted. Results: The techniques and fabrication methods of nanoscale surface modifications are discussed in detail, including benefits and potential pitfalls. Future directions for nanoscale surface technology are explored. Conclusion: Future understanding of the role of mechanical cues and protein adsorption will enable greater flexibility in surface control. The aim of this review is to investigate and summarise the current concepts and future directions for controlling the implant nanosurface to improve interactions.
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Affiliation(s)
- Rmt Staruch
- Department of Surgery & Interventional Science, University College London, London, England
| | - M F Griffin
- Department of Surgery & Interventional Science, University College London, London, England
| | - Pem Butler
- Department of Surgery & Interventional Science, University College London, London, England; University College London & The Royal Free Hospital, Pond Street, London, England
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Karazisis D, Ballo AM, Petronis S, Agheli H, Emanuelsson L, Thomsen P, Omar O. The role of well-defined nanotopography of titanium implants on osseointegration: cellular and molecular events in vivo. Int J Nanomedicine 2016; 11:1367-82. [PMID: 27099496 PMCID: PMC4824366 DOI: 10.2147/ijn.s101294] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose Mechanisms governing the cellular interactions with well-defined nanotopography are not well described in vivo. This is partly due to the difficulty in isolating a particular effect of nanotopography from other surface properties. This study employed colloidal lithography for nanofabrication on titanium implants in combination with an in vivo sampling procedure and different analytical techniques. The aim was to elucidate the effect of well-defined nanotopography on the molecular, cellular, and structural events of osseointegration. Materials and methods Titanium implants were nanopatterned (Nano) with semispherical protrusions using colloidal lithography. Implants, with and without nanotopography, were implanted in rat tibia and retrieved after 3, 6, and 28 days. Retrieved implants were evaluated using quantitative polymerase chain reaction, histology, immunohistochemistry, and energy dispersive X-ray spectroscopy (EDS). Results Surface characterization showed that the nanotopography was well defined in terms of shape (semispherical), size (79±6 nm), and distribution (31±2 particles/µm2). EDS showed similar levels of titanium, oxygen, and carbon for test and control implants, confirming similar chemistry. The molecular analysis of the retrieved implants revealed that the expression levels of the inflammatory cytokine, TNF-α, and the osteoclastic marker, CatK, were reduced in cells adherent to the Nano implants. This was consistent with the observation of less CD163-positive macrophages in the tissue surrounding the Nano implant. Furthermore, periostin immunostaining was frequently detected around the Nano implant, indicating higher osteogenic activity. This was supported by the EDS analysis of the retrieved implants showing higher content of calcium and phosphate on the Nano implants. Conclusion The results show that Nano implants elicit less periimplant macrophage infiltration and downregulate the early expression of inflammatory (TNF-α) and osteoclastic (CatK) genes. Immunostaining and elemental analyses show higher osteogenic activity at the Nano implant. It is concluded that an implant with the present range of well-defined nanocues attenuates the inflammatory response while enhancing mineralization during osseointegration.
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Affiliation(s)
- Dimitrios Karazisis
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden; Department of Oral and Maxillofacial Surgery, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ahmed M Ballo
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden; Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Sarunas Petronis
- BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden; Department of Chemistry, Materials and Surfaces, SP Technical Research Institute of Sweden, Borås, Sweden
| | - Hossein Agheli
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden
| | - Lena Emanuelsson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden
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Jurczyk K, Miklaszewski A, Jurczyk MU, Jurczyk M. Development of β Type Ti23Mo-45S5 Bioglass Nanocomposites for Dental Applications. MATERIALS (BASEL, SWITZERLAND) 2015; 8:8032-8046. [PMID: 28793695 PMCID: PMC5458847 DOI: 10.3390/ma8125441] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 01/28/2023]
Abstract
Titanium β-type alloys attract attention as biomaterials for dental applications. The aim of this work was the synthesis of nanostructured β type Ti23Mo-x wt % 45S5 Bioglass (x = 0, 3 and 10) composites by mechanical alloying and powder metallurgy methods and their characterization. The crystallization of the amorphous material upon annealing led to the formation of a nanostructured β type Ti23Mo alloy with a grain size of approximately 40 nm. With the increase of the 45S5 Bioglass contents in Ti23Mo, nanocomposite increase of the α-phase is noticeable. The electrochemical treatment in phosphoric acid electrolyte resulted in a porous surface, followed by bioactive ceramic Ca-P deposition. Corrosion resistance potentiodynamic testing in Ringer solution at 37 °C showed a positive effect of porosity and Ca-P deposition on nanostructured Ti23Mo 3 wt % 45S5 Bioglass nanocomposite. The contact angles of glycerol on the nanostructured Ti23Mo alloy were determined and show visible decrease for bulk Ti23Mo 3 wt % 45S5 Bioglass and etched Ti23Mo 3 wt % 45S5 Bioglass nanocomposites. In vitro tests culture of normal human osteoblast cells showed very good cell proliferation, colonization, and multilayering. The present study demonstrated that porous Ti23Mo 3 wt % 45S5 Bioglass nanocomposite is a promising biomaterial for bone tissue engineering.
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Affiliation(s)
- Karolina Jurczyk
- Department of Conservative Dentistry and Periodontology, Poznan University of Medical Sciences, Bukowska 70, Poznan 60-812, Poland.
| | - Andrzej Miklaszewski
- Institute of Materials Science and Engineering, Poznan University of Technology, Jana Pawla II 24, Poznan 61-138, Poland.
| | - Mieczyslawa U Jurczyk
- Division of Mother's and Child's Health, Poznan University of Medical Sciences, Polna 33, Poznan 60-535, Poland.
| | - Mieczyslaw Jurczyk
- Institute of Materials Science and Engineering, Poznan University of Technology, Jana Pawla II 24, Poznan 61-138, Poland.
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Mao L, Liu J, Zhao J, Chang J, Xia L, Jiang L, Wang X, Lin K, Fang B. Effect of micro-nano-hybrid structured hydroxyapatite bioceramics on osteogenic and cementogenic differentiation of human periodontal ligament stem cell via Wnt signaling pathway. Int J Nanomedicine 2015; 10:7031-44. [PMID: 26648716 PMCID: PMC4648603 DOI: 10.2147/ijn.s90343] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The surface structure of bioceramic scaffolds is crucial for its bioactivity and osteoinductive ability, and in recent years, human periodontal ligament stem cells have been certified to possess high osteogenic and cementogenic differential ability. In the present study, hydroxyapatite (HA) bioceramics with micro-nano-hybrid surface (mnHA [the hybrid of nanorods and microrods]) were fabricated via hydrothermal reaction of the α-tricalcium phosphate granules as precursors in aqueous solution, and the effects of mnHA on the attachment, proliferation, osteogenic and cementogenic differentiations of human periodontal ligament stem cells as well as the related mechanisms were systematically investigated. The results showed that mnHA bioceramics could promote cell adhesion, proliferation, alkaline phosphatase (ALP) activity, and expression of osteogenic/cementogenic-related markers including runt-related transcription factor 2 (Runx2), ALP, osteocalcin (OCN), cementum attachment protein (CAP), and cementum protein (CEMP) as compared to the HA bioceramics with flat and dense surface. Moreover, mnHA bioceramics stimulated gene expression of low-density lipoprotein receptor-related protein 5 (LRP5) and β-catenin, which are the key genes of canonical Wnt signaling. Moreover, the stimulatory effect on ALP activity and osteogenic and cementogenic gene expression, including that of ALP, OCN, CAP, CEMP, and Runx2 of mnHA bioceramics could be repressed by canonical Wnt signaling inhibitor dickkopf1 (Dkk1). The results suggested that the HA bioceramics with mnHA could act as promising grafts for periodontal tissue regeneration.
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Affiliation(s)
- Lixia Mao
- Center of Craniofacial Orthodontics, Department of Oral and Craniomaxillofacial Science, Top Priority Clinical Medical Center of Shanghai Municipal Commission of Health and Family Planning, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Jiaqiang Liu
- Center of Craniofacial Orthodontics, Department of Oral and Craniomaxillofacial Science, Top Priority Clinical Medical Center of Shanghai Municipal Commission of Health and Family Planning, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Jinglei Zhao
- Center of Craniofacial Orthodontics, Department of Oral and Craniomaxillofacial Science, Top Priority Clinical Medical Center of Shanghai Municipal Commission of Health and Family Planning, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Jiang Chang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Tongji University, Shanghai, People’s Republic of China
| | - Lunguo Xia
- Center of Craniofacial Orthodontics, Department of Oral and Craniomaxillofacial Science, Top Priority Clinical Medical Center of Shanghai Municipal Commission of Health and Family Planning, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Lingyong Jiang
- Center of Craniofacial Orthodontics, Department of Oral and Craniomaxillofacial Science, Top Priority Clinical Medical Center of Shanghai Municipal Commission of Health and Family Planning, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Xiuhui Wang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Tongji University, Shanghai, People’s Republic of China
| | - Kaili Lin
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Tongji University, Shanghai, People’s Republic of China
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, School of Stomatology, Tongji University, Shanghai, People’s Republic of China
| | - Bing Fang
- Center of Craniofacial Orthodontics, Department of Oral and Craniomaxillofacial Science, Top Priority Clinical Medical Center of Shanghai Municipal Commission of Health and Family Planning, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
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Gittens RA, Olivares-Navarrete R, Rettew R, Butera RJ, Alamgir FM, Boyan BD, Schwartz Z. Electrical polarization of titanium surfaces for the enhancement of osteoblast differentiation. Bioelectromagnetics 2013; 34:599-612. [PMID: 23996899 DOI: 10.1002/bem.21810] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 07/24/2013] [Indexed: 02/03/2023]
Abstract
Electrical stimulation has been used clinically to promote bone regeneration in cases of fractures with delayed union or nonunion, with several in vitro and in vivo reports suggesting its beneficial effects on bone formation. However, the use of electrical stimulation of titanium (Ti) implants to enhance osseointegration is less understood, in part because of the few in vitro models that attempt to represent the in vivo environment. In this article, the design of a new in vitro system that allows direct electrical stimulation of osteoblasts through their Ti substrates without the flow of exogenous currents through the media is presented, and the effect of applied electrical polarization on osteoblast differentiation and local factor production was evaluated. A custom-made polycarbonate tissue culture plate was designed to allow electrical connections directly underneath Ti disks placed inside the wells, which were supplied with electrical polarization ranging from 100 to 500 mV to stimulate MG63 osteoblasts. Our results show that electrical polarization applied directly through Ti substrates on which the cells are growing in the absence of applied electrical currents may increase osteoblast differentiation and local factor production in a voltage-dependent manner.
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Affiliation(s)
- Rolando A Gittens
- Center for Drug Discovery and Biodiversity, Institute for Advanced Scientific Research and High Technology Services (INDICASAT), Panama City, Republic of Panama
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19
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Dubey AK, Agrawal P, Misra RDK, Basu B. Pulsed electric field mediated in vitro cellular response of fibroblast and osteoblast-like cells on conducting austenitic stainless steel substrate. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:1789-1798. [PMID: 23529292 DOI: 10.1007/s10856-013-4921-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 03/18/2013] [Indexed: 06/02/2023]
Abstract
This article reports the intermittent pulse electric field stimulus mediated in vitro cellular response of L929 mouse fibroblast/SaOS2 osteoblast-like cells on austenitic steel substrates in reference to the field strength dependent behavior. The cellular density and morphometric analyses revealed that the optimal electric (E) fields for the maximum cell density of adhered L929 (~270 % to that of untreated sample) and SaOS2 (~280 % to that of untreated sample) cells are 1 V (0.33 V/cm) and 2 V (0.67 V/cm), respectively. The trend in aspect ratio of elongated SaOS2 cells did not indicate any significant difference among the untreated and treated (up to 3.33 V/cm) cells. The average cell and nucleus areas (for SaOS2 cells) were increased with an increase in the applied voltage up to 8 V (2.67 V/cm) and reduced thereafter. However, the ratio of nucleus to total cell area was increased significantly on the application of higher voltages (2-10 V), indicating the possible influence of E-field on cell growth. Further, the cell density results were compared with earlier results obtained with sintered Hydroxyapatite (HA) and HA-BaTiO3 composites and such comparison revealed that the enhanced cell density on steel sample occurs upon application of much lower field strength and stimulation time. This indicates the possible role of substrate conductivity towards cell growth in pulsed E-field mediated culture conditions.
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Affiliation(s)
- Ashutosh Kumar Dubey
- Laboratory for Biomaterials, Materials Research Center, Indian Institute of Science, Bangalore, 560012, India
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20
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Ross AP, Webster TJ. Anodizing color coded anodized Ti6Al4V medical devices for increasing bone cell functions. Int J Nanomedicine 2013; 8:109-17. [PMID: 23319862 PMCID: PMC3540959 DOI: 10.2147/ijn.s36203] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Current titanium-based implants are often anodized in sulfuric acid (H2SO4) for color coding purposes. However, a crucial parameter in selecting the material for an orthopedic implant is the degree to which it will integrate into the surrounding bone. Loosening at the bone–implant interface can cause catastrophic failure when motion occurs between the implant and the surrounding bone. Recently, a different anodization process using hydrofluoric acid has been shown to increase bone growth on commercially pure titanium and titanium alloys through the creation of nanotubes. The objective of this study was to compare, for the first time, the influence of anodizing a titanium alloy medical device in sulfuric acid for color coding purposes, as is done in the orthopedic implant industry, followed by anodizing the device in hydrofluoric acid to implement nanotubes. Specifically, Ti6Al4V model implant samples were anodized first with sulfuric acid to create color-coding features, and then with hydrofluoric acid to implement surface features to enhance osteoblast functions. The material surfaces were characterized by visual inspection, scanning electron microscopy, contact angle measurements, and energy dispersive spectroscopy. Human osteoblasts were seeded onto the samples for a series of time points and were measured for adhesion and proliferation. After 1 and 2 weeks, the levels of alkaline phosphatase activity and calcium deposition were measured to assess the long-term differentiation of osteoblasts into the calcium depositing cells. The results showed that anodizing in hydrofluoric acid after anodizing in sulfuric acid partially retains color coding and creates unique surface features to increase osteoblast adhesion, proliferation, alkaline phosphatase activity, and calcium deposition. In this manner, this study provides a viable method to anodize an already color coded, anodized titanium alloy to potentially increase bone growth for numerous implant applications.
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Affiliation(s)
- Alexandra P Ross
- School of Engineering and Department of Orthopedics, Brown University, Providence, RI 02912, USA
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21
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HARADA Y, KADONO K, TERAO T, SUZUKI M, IKADA Y, TOMITA N. Helical Conformation Endows Poly- l-Lactic Acid Fibers with a Piezoelectric Charge under Tensile Stress. J Vet Med Sci 2013; 75:1187-92. [DOI: 10.1292/jvms.12-0323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Yasuji HARADA
- Division of Veterinary Surgery, Nippon Veterinary and Life Science University, 1–7–1 Kyonan-cho, Musashino-shi, Tokyo 180–8602, Japan
| | - Kunihiko KADONO
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijoh-cho, Kashihara-shi, Nara 634–8522, Japan
| | - Tomohiro TERAO
- Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606–8501, Japan
| | - Masakazu SUZUKI
- Research and Development Department, GUNZE LIMITED, 46 Natsumegaichi, Aono, Ayabe, Kyoto 623–8513, Japan
| | - Yoshito IKADA
- Department of Bioenvironmental Medicine, Nara Medical University, 840 Shijoh-cho, Kashihara-shi, Nara 634–8521, Japan
| | - Naohide TOMITA
- Department of Mechanical Engineering, Graduate School of Engineering, Kyoto University, Yoshida-Honmachi, Sakyo-ku, Kyoto 606–8501, Japan
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Bodhak S, Bose S, Kinsel WC, Bandyopadhyay A. Investigation of In Vitro Bone Cell Adhesion and Proliferation on Ti Using Direct Current Stimulation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2012; 32:2163-2168. [PMID: 23144532 PMCID: PMC3491996 DOI: 10.1016/j.msec.2012.05.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our objective was to establish an in vitro cell culture protocol to improve bone cell attachment and proliferation on Ti substrate using direct current stimulation. For this purpose, a custom made electrical stimulator was developed and a varying range of direct currents, from 5 to 25 µA, were used to study the current stimulation effect on bone cells cultured on conducting Ti samples in vitro. Cell-materials interaction was studied for a maximum of 5 days by culturing with human fetal osteoblast cells (hFOB). The direct current was applied in every 8 h time interval and the duration of electrical stimulation was kept constant at 15 min for all cases. In vitro results showed that direct current stimulation significantly favored bone cell attachment and proliferation in comparison to nonstimulated Ti surface. Immunochemistry and confocal microscopy results confirmed that the cell adhesion was most pronounced on 25 µA direct current stimulated Ti surfaces as hFOB cells expressed higher vinculin protein with increasing amount of direct current. Furthermore, MTT assay results established that cells grew 30% higher in number under 25 µA electrical stimulation as compared to nonstimulated Ti surface after 5 days of culture period. In this work we have successfully established a simple and cost effective in vitro protocol offering easy and rapid analysis of bone cell-materials interaction which can be used in promotion of bone cell attachment and growth on Ti substrate using direct current electrical stimulation in an in vitro model.
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Affiliation(s)
- Subhadip Bodhak
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164-2920, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164-2920, USA
| | - William C. Kinsel
- Mechanical Engineering, Washington State University, Tri-Cities, WA, USA
| | - Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164-2920, USA
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Moradi I, Behjati M, Kazemi M. Application of anodized titanium for enhanced recruitment of endothelial progenitor cells. NANOSCALE RESEARCH LETTERS 2012; 7:298. [PMID: 22676440 PMCID: PMC3413549 DOI: 10.1186/1556-276x-7-298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 06/07/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To study the efficacy of an effective anodized titanium surface with enhanced attachment of endothelial progenitor cell (EPC). BACKGROUND In-stent restenosis is a major obstacle for vascular patency after catheter-based intravascular interventions. Recently, stents that capture EPCs have been paid attention in order to make a functional endothelialized layer at the site of stent-induced endothelial denudation. Anodized titanium has been shown to enhance stem cell attachment. Anodization is a quick and inexpensive method, which can provide suitable stent surface. METHODS Surface topography was examined by high-resolution scanning electron microscopy (SEM). Substrates were co-cultured with EPCs at second passage in 24-well culture plates. Evaluation of cell growth, proliferation, viability, surface cytotoxicity and cell adhesion was performed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test and 4,6-diamidino-2-phenylindole dihydrochloride staining. For platelet attachment, platelets added to substrates were evaluated under SEM. RESULTS The average MTT values for tissue culture polystyrene plate, unanodized and anodized titanium with nanostructure were equal to 0.49, 0.16 and 0.72, respectively (P < 0.05). The surface had no cytotoxic effects on cells. The average cell attachment results showed that 9,955 ± 461.18, 3,300 ± 197.98 and 11,359 ± 458.10 EPCs were attached per well of tissue culture polystyrene plate, unanodized and anodized titanium surfaces, respectively (P < 0.05). CONCLUSIONS Anodized titanium surfaces can be potentially applied for devices that need enhanced recruitment of EPCs. This unique property makes these anodized surfaces good and cheap candidates for designing cardiovascular medical devices as endovascular stents.
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Affiliation(s)
- Iman Moradi
- Nanotechnology Consultancy & Development Center (NCDC), Via Svizzera 16, Padova, 35127, Italy
| | - Mohaddeseh Behjati
- Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
| | - Mohammad Kazemi
- Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
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Durmus NG, Taylor EN, Inci F, Kummer KM, Tarquinio KM, Webster TJ. Fructose-enhanced reduction of bacterial growth on nanorough surfaces. Int J Nanomedicine 2012; 7:537-45. [PMID: 22334783 PMCID: PMC3273985 DOI: 10.2147/ijn.s27957] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Patients on mechanical ventilators for extended periods of time often face the risk of developing ventilator-associated pneumonia. During the ventilation process, patients incapable of breathing are intubated with polyvinyl chloride (PVC) endotracheal tubes (ETTs). PVC ETTs provide surfaces where bacteria can attach and proliferate from the contaminated oropharyngeal space to the sterile bronchoalveolar area. To overcome this problem, ETTs can be coated with antimicrobial agents. However, such coatings may easily delaminate during use. Recently, it has been shown that changes in material topography at the nanometer level can provide antibacterial properties. In addition, some metabolites, such as fructose, have been found to increase the efficiency of antibiotics used to treat Staphylococcus aureus (S. aureus) infections. In this study, we combined the antibacterial effect of nanorough ETT topographies with sugar metabolites to decrease bacterial growth and biofilm formation on ETTs. We present for the first time that the presence of fructose on the nanorough surfaces decreases the number of planktonic S. aureus bacteria in the solution and biofilm formation on the surface after 24 hours. We thus envision that this method has the potential to impact the future of surface engineering of biomaterials leading to more successful clinical outcomes in terms of longer ETT lifetimes, minimized infections, and decreased antibiotic usage; all of which can decrease the presence of antibiotic resistant bacteria in the clinical setting.
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Gittens R, Olivares-Navarrete R, Tannenbaum R, Boyan B, Schwartz Z. Electrical implications of corrosion for osseointegration of titanium implants. J Dent Res 2011; 90:1389-97. [PMID: 21555775 PMCID: PMC3215755 DOI: 10.1177/0022034511408428] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 03/07/2011] [Accepted: 03/09/2011] [Indexed: 12/13/2022] Open
Abstract
The success rate of titanium implants for dental and orthopedic applications depends on the ability of surrounding bone tissue to integrate with the surface of the device, and it remains far from ideal in patients with bone compromised by physiological factors. The electrical properties and electrical stimulation of bone have been shown to control its growth and healing and can enhance osseointegration. Bone cells are also sensitive to the chemical products generated during corrosion events, but less is known about how the electrical signals associated with corrosion might affect osseointegration. The metallic nature of the materials used for implant applications and the corrosive environments found in the human body, in combination with the continuous and cyclic loads to which these implants are exposed, may lead to corrosion and its corresponding electrochemical products. The abnormal electrical currents produced during corrosion can convert any metallic implant into an electrode, and the negative impact on the surrounding tissue due to these extreme signals could be an additional cause of poor performance and rejection of implants. Here, we review basic aspects of the electrical properties and electrical stimulation of bone, as well as fundamental concepts of aqueous corrosion and its electrical and clinical implications.
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Affiliation(s)
- R.A. Gittens
- Institute for Bioengineering and Bioscience, Georgia Institute of Technology, 315 Ferst Dr., Atlanta, GA 30332-0363, USA
- School of Materials Science and Engineering, Georgia Institute of Technology, 711 Ferst Dr., Atlanta, GA, USA
| | - R. Olivares-Navarrete
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA, USA
| | - R. Tannenbaum
- Institute for Bioengineering and Bioscience, Georgia Institute of Technology, 315 Ferst Dr., Atlanta, GA 30332-0363, USA
- School of Materials Science and Engineering, Georgia Institute of Technology, 711 Ferst Dr., Atlanta, GA, USA
| | - B.D. Boyan
- Institute for Bioengineering and Bioscience, Georgia Institute of Technology, 315 Ferst Dr., Atlanta, GA 30332-0363, USA
- School of Materials Science and Engineering, Georgia Institute of Technology, 711 Ferst Dr., Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA, USA
| | - Z. Schwartz
- Institute for Bioengineering and Bioscience, Georgia Institute of Technology, 315 Ferst Dr., Atlanta, GA 30332-0363, USA
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA, USA
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Variola F, Brunski J, Orsini G, de Oliveira PT, Wazen R, Nanci A. Nanoscale surface modifications of medically relevant metals: state-of-the art and perspectives. NANOSCALE 2011; 3:335-53. [PMID: 20976359 PMCID: PMC3105323 DOI: 10.1039/c0nr00485e] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Evidence that nanoscale surface properties stimulate and guide various molecular and biological processes at the implant/tissue interface is fostering a new trend in designing implantable metals. Cutting-edge expertise and techniques drawn from widely separated fields, such as nanotechnology, materials engineering and biology, have been advantageously exploited to nanoengineer surfaces in ways that control and direct these processes in predictable manners. In this review, we present and discuss the state-of-the-art of nanotechnology-based approaches currently adopted to modify the surface of metals used for orthopedic and dental applications, and also briefly consider their use in the cardiovascular field. The effects of nanoengineered surfaces on various in vitro molecular and cellular events are firstly discussed. This review also provides an overview of in vivo and clinical studies with nanostructured metallic implants, and addresses the potential influence of nanotopography on biomechanical events at interfaces. Ultimately, the objective of this work is to give the readership a comprehensive picture of the current advances, future developments and challenges in the application of the infinitesimally small to biomedical surface science. We believe that an integrated understanding of the in vitro and particularly of the in vivo behavior is mandatory for the proper exploitation of nanostructured implantable metals and, indeed, of all biomaterials.
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Affiliation(s)
- Fabio Variola
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, ON, K1N 6N5 (Canada)
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculté de Médecine Dentaire, Université de Montréal, Montréal, QC, H3C 3J7 (Canada)
| | - John Brunski
- Division of Plastic & Reconstructive Surgery, Department of Surgery PSRL, School of Medicine, Stanford University, 257 Campus Drive Stanford, CA 94305 (USA)
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology, University of Marche, Via Tronto 10, 66026 Ancona (Italy)
| | - Paulo Tambasco de Oliveira
- Department of Morphology, Stomatology and Physiology, University of São Paulo, Ribeirão Preto, SP, 14040-904 (Brazil)
| | - Rima Wazen
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculté de Médecine Dentaire, Université de Montréal, Montréal, QC, H3C 3J7 (Canada)
| | - Antonio Nanci
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculté de Médecine Dentaire, Université de Montréal, Montréal, QC, H3C 3J7 (Canada)
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