1
|
Cui C, Zhao Y, Bai Z, Yan J, Qin D, Peng H, Liu Y, Tong J, Sun L, Wu X, Li B. The Effect of Antibacterial-Osteogenic Surface Modification on the Osseointegration of Titanium Implants: A Static and Dynamic Strategy. ACS Biomater Sci Eng 2024; 10:4093-4113. [PMID: 38829538 DOI: 10.1021/acsbiomaterials.3c01756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Titanium (Ti) and its alloys are widely used biomaterials in bone repair. Although these biomaterials possess stable properties and good biocompatibility, the high elastic modulus and low surface activity of Ti implants have often been associated with infection, inflammation, and poor osteogenesis. Therefore, there is an urgent need to modify the surface of Ti implants, where changes in surface morphology or coatings loading can confer specific functions to help them adapt to the osseointegration formation phase and resist bacterial infection. This can further ensure a healthy microenvironment for bone regeneration as well as the promotion of immunomodulation, angiogenesis, and osteogenesis. Therefore, in this review, we evaluated various functional Ti implants after surface modification, both in terms of static modifications and dynamic response strategies, mainly focusing on the synergistic effects of antimicrobial activities and functionalized osteogenic. Finally, the current challenges and future perspectives are summarized to provide innovative and effective solutions for osseointegration and bone defect repair.
Collapse
Affiliation(s)
- Chenying Cui
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Yifan Zhao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Ziyang Bai
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Jingyu Yan
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Danlei Qin
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Hongyi Peng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Yingyu Liu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Jiahui Tong
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Lingxiang Sun
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Xiuping Wu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| | - Bing Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, Shanxi, China
| |
Collapse
|
2
|
Zhang X, Zhou W, Xi W. Advancements in incorporating metal ions onto the surface of biomedical titanium and its alloys via micro-arc oxidation: a research review. Front Chem 2024; 12:1353950. [PMID: 38456182 PMCID: PMC10917964 DOI: 10.3389/fchem.2024.1353950] [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: 12/11/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
The incorporation of biologically active metallic elements into nano/micron-scale coatings through micro-arc oxidation (MAO) shows significant potential in enhancing the biological characteristics and functionality of titanium-based materials. By introducing diverse metal ions onto titanium implant surfaces, not only can their antibacterial, anti-inflammatory and corrosion resistance properties be heightened, but it also promotes vascular growth and facilitates the formation of new bone tissue. This review provides a thorough examination of recent advancements in this field, covering the characteristics of commonly used metal ions and their associated preparation parameters. It also highlights the diverse applications of specific metal ions in enhancing osteogenesis, angiogenesis, antibacterial efficacy, anti-inflammatory and corrosion resistance properties of titanium implants. Furthermore, the review discusses challenges faced and future prospects in this promising area of research. In conclusion, the synergistic approach of micro-arc oxidation and metal ion doping demonstrates substantial promise in advancing the effectiveness of biomedical titanium and its alloys, promising improved outcomes in medical implant applications.
Collapse
Affiliation(s)
- Xue’e Zhang
- Jiangxi Province Key Laboratory of Oral Biomedicine, School of Stomatology, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
| | - Wuchao Zhou
- Jiangxi Province Key Laboratory of Oral Biomedicine, The Affiliated Stomatological Hospital, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
| | - Weihong Xi
- Jiangxi Province Key Laboratory of Oral Biomedicine, The Affiliated Stomatological Hospital, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
| |
Collapse
|
3
|
Bai L, Song P, Su J. Bioactive elements manipulate bone regeneration. BIOMATERIALS TRANSLATIONAL 2023; 4:248-269. [PMID: 38282709 PMCID: PMC10817798 DOI: 10.12336/biomatertransl.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 01/30/2024]
Abstract
While bone tissue is known for its inherent regenerative abilities, various pathological conditions and trauma can disrupt its meticulously regulated processes of bone formation and resorption. Bone tissue engineering aims to replicate the extracellular matrix of bone tissue as well as the sophisticated biochemical mechanisms crucial for effective regeneration. Traditionally, the field has relied on external agents like growth factors and pharmaceuticals to modulate these processes. Although efficacious in certain scenarios, this strategy is compromised by limitations such as safety issues and the transient nature of the compound release and half-life. Conversely, bioactive elements such as zinc (Zn), magnesium (Mg) and silicon (Si), have garnered increasing interest for their therapeutic benefits, superior stability, and reduced biotic risks. Moreover, these elements are often incorporated into biomaterials that function as multifaceted bioactive components, facilitating bone regeneration via release on-demand. By elucidating the mechanistic roles and therapeutic efficacy of the bioactive elements, this review aims to establish bioactive elements as a robust and clinically viable strategy for advanced bone regeneration.
Collapse
Affiliation(s)
- Long Bai
- Organoid Research Center, Institute of Translational Medicine, Shanghai University, Shanghai, China
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai, China
| | - Peiran Song
- Organoid Research Center, Institute of Translational Medicine, Shanghai University, Shanghai, China
- National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai, China
| | - Jiacan Su
- Organoid Research Center, Institute of Translational Medicine, Shanghai University, Shanghai, China
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai, China
| |
Collapse
|
4
|
Ray S, Thormann U, Kramer I, Sommer U, Budak M, Schumacher M, Bernhardt A, Lode A, Kern C, Rohnke M, Heiss C, Lips KS, Gelinsky M, Alt V. Mesoporous Bioactive Glass-Incorporated Injectable Strontium-Containing Calcium Phosphate Cement Enhanced Osteoconductivity in a Critical-Sized Metaphyseal Defect in Osteoporotic Rats. Bioengineering (Basel) 2023; 10:1203. [PMID: 37892933 PMCID: PMC10604136 DOI: 10.3390/bioengineering10101203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/28/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
In this study, the in vitro and in vivo bone formation behavior of mesoporous bioactive glass (MBG) particles incorporated in a pasty strontium-containing calcium phosphate bone cement (pS100G10) was studied in a metaphyseal fracture-defect model in ovariectomized rats and compared to a plain pasty strontium-containing calcium phosphate bone cement (pS100) and control (empty defect) group, respectively. In vitro testing showed good cytocompatibility on human preosteoblasts and ongoing dissolution of the MBG component. Neither the released strontium nor the BMG particles from the pS100G10 had a negative influence on cell viability. Forty-five female Sprague-Dawley rats were randomly assigned to three different treatment groups: (1) pS100 (n = 15), (2) pS100G10 (n = 15), and (3) empty defect (n = 15). Twelve weeks after bilateral ovariectomy and multi-deficient diet, a 4 mm wedge-shaped fracture-defect was created at the metaphyseal area of the left femur in all animals. The originated fracture-defect was substituted with pS100 or pS100G10 or left empty. After six weeks, histomorphometrical analysis revealed a statistically significant higher bone volume/tissue volume ratio in the pS100G10 group compared to the pS100 (p = 0.03) and empty defect groups (p = 0.0001), indicating enhanced osteoconductivity with the incorporation of MBG. Immunohistochemistry revealed a significant decrease in the RANKL/OPG ratio for pS100 (p = 0.004) and pS100G10 (p = 0.003) compared to the empty defect group. pS100G10 showed a statistically higher expression of BMP-2. In addition, a statistically significant higher gene expression of alkaline phosphatase, osteoprotegerin, collagen1a1, collagen10a1 with a simultaneous decrease in RANKL, and carbonic anhydrase was seen in the pS100 and pS100G10 groups compared to the empty defect group. Mass spectrometric imaging by time-of-flight secondary ion mass spectrometry (ToF-SIMS) showed the release of Sr2+ ions from both pS100 and pS100G10, with a gradient into the interface region. ToF-SIMS imaging also revealed that resorption of the MBG particles allowed for new bone formation in cement pores. In summary, the current work shows better bone formation of the injectable pasty strontium-containing calcium phosphate bone cement with incorporated mesoporous bioactive glass compared to the bioactive-free bone cement and empty defects and can be considered for clinical application for osteopenic fracture defects in the future.
Collapse
Affiliation(s)
- Seemun Ray
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Ulrich Thormann
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
| | - Inga Kramer
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Ursula Sommer
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Matthäus Budak
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
| | - Matthias Schumacher
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Anne Bernhardt
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Anja Lode
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Christine Kern
- Institute of Physical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany; (C.K.); (M.R.)
| | - Marcus Rohnke
- Institute of Physical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany; (C.K.); (M.R.)
| | - Christian Heiss
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
| | - Katrin S. Lips
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
| | - Michael Gelinsky
- Centre for Translational Bone, Joint, and Soft Tissue Research, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (M.S.); (A.B.); (A.L.); (M.G.)
| | - Volker Alt
- Laboratory of Experimental Trauma Surgery, Justus Liebig University, 35390 Giessen, Germany; (S.R.); (U.T.); (I.K.); (U.S.); (M.B.); (C.H.); (K.S.L.)
- Department of Trauma Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, 35390 Giessen, Germany
- Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| |
Collapse
|
5
|
Li R, Li S, Zhang Y, Jin D, Lin Z, Tao X, Chen T, Zheng L, Zhang Z, Wu Q. Titanium surfaces with biomimetic topography and copper incorporation to modulate behaviors of stem cells and oral bacteria. Front Bioeng Biotechnol 2023; 11:1223339. [PMID: 37492800 PMCID: PMC10363716 DOI: 10.3389/fbioe.2023.1223339] [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: 05/16/2023] [Accepted: 06/30/2023] [Indexed: 07/27/2023] Open
Abstract
Purpose: Insufficient osseointegration and implant-associated infection are major factors in the failure of Ti-based implants, thus spurring scientists to develop multifunctional coatings that are better suited for clinical requirements. Here, a new biomimetic micro/nanoscale topography coating combined with antibacterial copper was simultaneously designed for Ti-based implant surfaces by adopting a hybrid approach combining plasma electrolytic oxidation and hydrothermal treatment. Results: The biological interactions between this biofunctionalized material interface and stem cells promoted cellular adhesion and spreading during initial attachment and supported cellular proliferation for favorable biocompatibility. Bone marrow mesenchymal stem cells (BMMSCs) on the coating displayed enhanced cellular mineral deposition ability, higher alkaline phosphatase activity, and upregulated expression of osteogenic-related markers without the addition of osteoinductive chemical factors, which improved osseointegration. More interestingly, this new coating reduced the viability of oral pathogens (Fusobacterium nucleatum and Porphyromonas gingivalis)-the primary causes of implant-associated infections as indicated by damage of cellular structures and decreased population. This is the first study investigating the antibacterial property of dental implants modified by a hybrid approach against oral pathogens to better mimic the oral environment. Conclusion: These findings suggest that biofunctionalization of the implant coating by surface modification methods and the incorporation of antibacterial copper (Cu) offer superior osteogenesis capability and effective antibacterial activity, respectively. These strategies have great value in orthopedic and dental implant applications.
Collapse
Affiliation(s)
- Ruiying Li
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Shuigen Li
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Yi Zhang
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Di Jin
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Zhiming Lin
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Xian Tao
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Tianlai Chen
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Liyuan Zheng
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Zhisheng Zhang
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Qianju Wu
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Xiamen, China
| |
Collapse
|
6
|
Li D, Dai D, Xiong G, Lan S, Zhang C. Composite Nanocoatings of Biomedical Magnesium Alloy Implants: Advantages, Mechanisms, and Design Strategies. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2300658. [PMID: 37097626 PMCID: PMC10288271 DOI: 10.1002/advs.202300658] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/25/2023] [Indexed: 06/19/2023]
Abstract
The rapid degradation of magnesium (Mg) alloy implants erodes mechanical performance and interfacial bioactivity, thereby limiting their clinical utility. Surface modification is among the solutions to improve corrosion resistance and bioefficacy of Mg alloys. Novel composite coatings that incorporate nanostructures create new opportunities for their expanded use. Particle size dominance and impermeability may increase corrosion resistance and thereby prolong implant service time. Nanoparticles with specific biological effects may be released into the peri-implant microenvironment during the degradation of coatings to promote healing. Composite nanocoatings provide nanoscale surfaces to promote cell adhesion and proliferation. Nanoparticles may activate cellular signaling pathways, while those with porous or core-shell structures may carry antibacterial or immunomodulatory drugs. Composite nanocoatings may promote vascular reendothelialization and osteogenesis, attenuate inflammation, and inhibit bacterial growth, thus increasing their applicability in complex clinical microenvironments such as those of atherosclerosis and open fractures. This review combines the physicochemical properties and biological efficiency of Mg-based alloy biomedical implants to summarize the advantages of composite nanocoatings, analyzes their mechanisms of action, and proposes design and construction strategies, with the purpose of providing a reference for promoting the clinical application of Mg alloy implants and to further the design of nanocoatings.
Collapse
Affiliation(s)
- Dan Li
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Danni Dai
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Gege Xiong
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Shuquan Lan
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Chao Zhang
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| |
Collapse
|
7
|
Sheng X, Li C, Wang Z, Xu Y, Sun Y, Zhang W, Liu H, Wang J. Advanced applications of strontium-containing biomaterials in bone tissue engineering. Mater Today Bio 2023; 20:100636. [PMID: 37441138 PMCID: PMC10333686 DOI: 10.1016/j.mtbio.2023.100636] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 07/15/2023] Open
Abstract
Strontium (Sr) and strontium ranelate (SR) are commonly used therapeutic drugs for patients suffering from osteoporosis. Researches have showed that Sr can significantly improve the biological activity and physicochemical properties of materials in vitro and in vivo. Therefore, a large number of strontium containing biomaterials have been developed for repairing bone defects and promoting osseointegration. In this review, we provide a comprehensive overview of Sr-containing biomaterials along with the current state of their clinical use. For this purpose, the different types of biomaterials including calcium phosphate, bioactive glass, and polymers are discussed and provided future outlook on the fabrication of the next-generation multifunctional and smart biomaterials.
Collapse
|
8
|
Malheiros SS, Nagay BE, Bertolini MM, de Avila ED, Shibli JA, Souza JGS, Barão VAR. Biomaterial engineering surface to control polymicrobial dental implant-related infections: focusing on disease modulating factors and coatings development. Expert Rev Med Devices 2023:1-17. [PMID: 37228179 DOI: 10.1080/17434440.2023.2218547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/29/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Peri-implantitis is the leading cause of dental implant loss and is initiated by a polymicrobial dysbiotic biofilm formation on the implant surface. The destruction of peri-implant tissue by the host immune response and the low effectiveness of surgical or non-surgical treatments highlight the need for new strategies to prevent, modulate and/or eliminate biofilm formation on the implant surface. Currently, several surface modifications have been proposed using biomolecules, ions, antimicrobial agents, and topography alterations. AREAS COVERED Initially, this review provides an overview of the etiopathogenesis and host- and material-dependent modulating factors of peri-implant disease. In addition, a critical discussion about the antimicrobial surface modification mechanisms and techniques employed to modify the titanium implant material is provided. Finally, we also considered the future perspectives on the development of antimicrobial surfaces to narrow the bridge between idea and product and favor the clinical application possibility. EXPERT OPINION Antimicrobial surface modifications have demonstrated effective results; however, there is no consensus about the best modification strategy and in-depth information on the safety and longevity of the antimicrobial effect. Modified surfaces display recurring challenges such as short-term effectiveness, the burst release of drugs, cytotoxicity, and lack of reusability. Stimulus-responsive surfaces seem to be a promising strategy for a controlled and precise antimicrobial effect, and future research should focus on this technology and study it from models that better mimic clinical conditions.
Collapse
Affiliation(s)
- Samuel S Malheiros
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Bruna E Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Martinna M Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15106, USA
| | - Erica D de Avila
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araçatuba, São Paulo State University (UNESP), Araçatuba, Sao Paulo 16015-050, Brazil
| | - Jamil A Shibli
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo 07023-070, Brazil
| | - João Gabriel S Souza
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo 07023-070, Brazil
- Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais39401-303, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| |
Collapse
|
9
|
Wang YR, Yang NY, Sun H, Dong W, Deng JP, Zheng TX, Qi MC. The effect of strontium content on physicochemical and osteogenic property of Sr/Ag-containing TiO 2 microporous coatings. J Biomed Mater Res B Appl Biomater 2023; 111:846-857. [PMID: 36455234 DOI: 10.1002/jbm.b.35195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/17/2022] [Accepted: 11/06/2022] [Indexed: 12/05/2022]
Abstract
Strontium (Sr) is the most common element introduced into TiO2 coatings to strengthen the osteogenic property of titanium implants. However, the optimal Sr content and its effect on osteogenic and physicochemical properties of the coatings need to be clarified. In the current study, TiO2 microporous coatings with different contents of Sr (9.64-21.25 wt %) and silver (Ag) (0.38-0.75 wt %) were prepared via micro-arc oxidation technique. Sr contents did not change physicochemical properties of the coatings, including surface microstructure, micropore size and distribution, phase composition, roughness and hydrophilicity. Meanwhile, higher Sr contents (18.23-21.25 wt %) improved cytocompatibility, proliferation and alkaline phosphatase (ALP) activity of preosteoblasts, even the coatings underwent 30 days' PBS immersion. Furthermore, higher Sr contents facilitated preosteoblast growth and spreading, which are essential for their proliferation and osteogenic differentiation. Therefore, it is promising to incorporate higher Sr content (18.23-21.25 wt %) within TiO2 microporous coatings to improve their osteogenic capability.
Collapse
Affiliation(s)
- Yi-Rui Wang
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, People's Republic of China
| | - Nuo-Ya Yang
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, People's Republic of China
| | - Hong Sun
- Department of Pathology, college of basic medicine, North China University of Science and Technology, Tangshan, China
| | - Wei Dong
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, People's Republic of China
| | - Jiu-Peng Deng
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, People's Republic of China
| | - Tian-Xia Zheng
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, People's Republic of China
| | - Meng-Chun Qi
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, People's Republic of China
| |
Collapse
|
10
|
Wang H, Zheng TX, Yang NY, Li Y, Sun H, Dong W, Feng LF, Deng JP, Qi MC. Osteogenic and long-term antibacterial properties of Sr/Ag-containing TiO 2 microporous coating in vitro and in vivo. J Mater Chem B 2023; 11:2972-2988. [PMID: 36919628 DOI: 10.1039/d2tb01658c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Bacterial infection and poor osseointegration are two critical issues that need to be solved for long-term use of titanium implants. As such, Sr/Ag-containing TiO2 microporous coatings were prepared on a Ti alloy surface in the current study via a single-step microarc oxidation technique. The coatings showed both good cytocompatibility in vitro and biosafety in vivo. Sr/Ag incorporation brought no significant change in the surface micromorphology and physicochemical properties, but endowed the coating with strong osteogenic activity and long-term antibacterial capability in vitro. Furthermore, the osteogenic and antibacterial capability of the coating was also confirmed in vivo. In a rat osseointegration model, new bone formation, implant-bone contact, removal torque and bone mineralization were all significantly increased in the M-Sr/Ag group when compared with those in group M, although they were slightly lower than those in group M-Sr. In a periimplantitis model, no rats suffered infection in the M-Sr/Ag group after 3 months of osseointegration and 5 weeks of bacterial inoculation period, when compared to 100% and 75% infection rates in M and M-Sr groups, respectively. In addition, active bone remodeling and many mesenchymal cells were observed in the M-Sr group, suggesting good bone regeneration potential in Sr-containing coatings in the case of controlled periimplantitis. Overall, the Sr/Ag-containing TiO2 microporous coating is valuable for preventing periimplantitis and improving implant reosseointegration, and is therefore promising for long-term and high quality use of titanium implants.
Collapse
Affiliation(s)
- Huan Wang
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Tian-Xia Zheng
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Nuo-Ya Yang
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Ying Li
- Department of Stomatology, First Hospital of Qinhuangdao, Qinhuangdao City, Hebei Province, China
| | - Hong Sun
- Department of Pathology, College of Basic Medicine, North China University of Science and Technology, Tangshan, Hebei Province, China
| | - Wei Dong
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Li-Fang Feng
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Jiu-Peng Deng
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Meng-Chun Qi
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| |
Collapse
|
11
|
Strontium ion attenuates osteoarthritis through inhibiting senescence and enhancing autophagy in fibroblast-like synoviocytes. Mol Biol Rep 2023; 50:1437-1446. [PMID: 36472726 DOI: 10.1007/s11033-022-08112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) mainly occurs in the elderly population and seriously affects their quality of life (QOL). Strontium (Sr) ions have shown positive effects on bone tissue and are promising for OA treatment. However, the adequate treatment dosage and underlying mechanisms are unclear. This study investigated the effects and underlying mechanisms of different concentrations of Sr ions in a mouse model of OA induced by destabilization of the medial meniscus (DMM) surgery. DMM-induced OA mice received intra-articular injections of different concentrations of Sr ions, and a suitable concentration of Sr ions was found to improve OA. Furthermore, we investigated the mechanism by which Sr ions mediate senescence and autophagy in fibroblast-like synoviocytes (FLSs) in the synovial tissues of DMM-induced OA mice. OA mice treated with 10 µl of 5 mmol/L SrCl2 showed the greatest improvement in pain-related behavior and cartilage damage. In addition, in vivo and in vitro experiments revealed that Sr ions inhibit senescence and improve the autophagic function of FLSs. We also found that enhancement of the autophagic function of FLSs could effectively slow down senescence. Therefore, we show that Sr ions through the AMPK/mTOR/LC3B-II signal axis improve FLSs autophagy function and delay FLSs senescence, and furthermore, improve OA. These results suggest that senescence and autophagy function of FLSs may serve as promising targets for OA treatment, and that Sr ions may inhibit OA progression through these two targets.
Collapse
|
12
|
Biodegradable Mg-Sc-Sr Alloy Improves Osteogenesis and Angiogenesis to Accelerate Bone Defect Restoration. J Funct Biomater 2022; 13:jfb13040261. [PMID: 36547521 PMCID: PMC9787880 DOI: 10.3390/jfb13040261] [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: 10/23/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022] Open
Abstract
Magnesium (Mg) and its alloys are considered to be biodegradable metallic biomaterials for potential orthopedic implants. While the osteogenic properties of Mg alloys have been widely studied, few reports focused on developing a bifunctional Mg implant with osteogenic and angiogenic properties. Herein, a Mg-Sc-Sr alloy was developed, and this alloy's angiogenesis and osteogenesis effects were evaluated in vitro for the first time. X-ray Fluorescence (XRF), X-ray diffraction (XRD), and metallography images were used to evaluate the microstructure of the developed Mg-Sc-Sr alloy. Human umbilical vein/vascular endothelial cells (HUVECs) were used to evaluate the angiogenic character of the prepared Mg-Sc-Sr alloy. A mix of human bone-marrow-derived mesenchymal stromal cells (hBM-MSCs) and HUVEC cell cultures were used to assess the osteogenesis-stimulating effect of Mg-Sc-Sr alloy through alkaline phosphatase (ALP) and Von Kossa staining. Higher ALP activity and the number of calcified nodules (27% increase) were obtained for the Mg-Sc-Sr-treated groups compared to Mg-treated groups. In addition, higher VEGF expression (45.5% increase), tube length (80.8% increase), and number of meshes (37.9% increase) were observed. The Mg-Sc-Sr alloy showed significantly higher angiogenesis and osteogenic differentiation than pure Mg and the control group, suggesting such a composition as a promising candidate in bone implants.
Collapse
|
13
|
Pabst A, Asran A, Lüers S, Laub M, Holfeld C, Palarie V, Thiem DGE, Becker P, Hartmann A, Heimes D, Al-Nawas B, Kämmerer PW. Osseointegration of a New, Ultrahydrophilic and Nanostructured Dental Implant Surface: A Comparative In Vivo Study. Biomedicines 2022; 10:943. [PMID: 35625680 PMCID: PMC9138320 DOI: 10.3390/biomedicines10050943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 02/01/2023] Open
Abstract
This study compared the osseointegration of acid-etched, ultrahydrophilic, micro- and nanostructured implant surfaces (ANU) with non-ultra-hydrophilic, microstructured (SA) and non-ultrahydrophilic, micro- and nanostructured implant surfaces (AN) in vivo. Fifty-four implants (n = 18 per group) were bilaterally inserted into the proximal tibia of New Zealand rabbits (n = 27). After 1, 2, and 4 weeks, bone-implant contact (BIC, %) in the cortical (cBIC) and spongious bone (sBIC), bone chamber ingrowth (BChI, %), and the supra-crestal, subperiosteal amount of newly formed bone, called percentage of linear bone fill (PLF, %), were analyzed. After one week, cBIC was significantly higher for AN and ANU when compared to SA (p = 0.01 and p = 0.005). PLF was significantly increased for ANU when compared to AN and SA (p = 0.022 and p = 0.025). After 2 weeks, cBIC was significantly higher in SA when compared to AN (p = 0.039) and after 4 weeks, no significant differences in any of the measured parameters were found anymore. Ultrahydrophilic implants initially improved osseointegration when compared to their non-ultrahydrophilic counterparts. In accordance, ultrahydrophilic implants might be appropriate in cases with a necessity for an accelerated and improved osseointegration, such as in critical size alveolar defects or an affected bone turnover.
Collapse
Affiliation(s)
- Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072 Koblenz, Germany; (A.P.); (P.B.)
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Ashraf Asran
- Morphoplant GmbH, Universitätsstr. 136, 44799 Bochum, Germany; (A.A.); (S.L.); (M.L.)
| | - Steffen Lüers
- Morphoplant GmbH, Universitätsstr. 136, 44799 Bochum, Germany; (A.A.); (S.L.); (M.L.)
| | - Markus Laub
- Morphoplant GmbH, Universitätsstr. 136, 44799 Bochum, Germany; (A.A.); (S.L.); (M.L.)
| | - Christopher Holfeld
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Victor Palarie
- Laboratory of Tissue Engineering and Cellular Culture, State University of Medicine and Pharmaceutics “Nicolae Testemitanu”, Stefan cel Mare si Sfant Boulevard 165, 2004 Chisinau, Moldova;
| | - Daniel G. E. Thiem
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Philipp Becker
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072 Koblenz, Germany; (A.P.); (P.B.)
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Amely Hartmann
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Diana Heimes
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| |
Collapse
|