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Grzeskowiak R, Schumacher J, Omidi O, Bowers K, Cassone LMC, Abedi R, Hespel AM, Mulon PY, Anderson DE. Enhancing prosthesis stability at the cricoid cartilage in equine laryngoplasty using 3-D-printed laryngeal clamps: An ex vivo model study. Vet Surg 2024. [PMID: 38840447 DOI: 10.1111/vsu.14115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/20/2024] [Accepted: 05/05/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To assess a three-dimensional (3-D)-printed laryngeal clamp (LC) designed to enhance the anchoring of laryngeal prostheses at the cricoid cartilage. STUDY DESIGN Ex vivo biomechanical study. SAMPLE POPULATION A total of 22 equine larynges. METHODS Two experimental groups included larynges with standard prosthetic laryngoplasty (PL; n = 10) and larynges with prosthetic laryngoplasty modified with laryngeal clamps (PLLC; n = 10). All constructs underwent 3000 cycles of tension loading and a single tension to failure. Recorded biomechanical parameters included maximum load, actuator displacement, and construct failure. Finite element analysis (FEA) was performed on one PL and one PLLC construct. RESULTS The maximum load at single tension to failure was 183.7 ± 46.8 N for the PL construct and 292.7 ± 82.3 N for the PLLC construct (p = .003). Actuator displacement at 30 N was 1.7 ± 0.5 mm and 2.7 ± 0.7 mm for the PL and PLLC constructs, respectively (p = .011). The cause of PL constructs failure was mostly tearing through the cartilage whereas the PLLC constructs failed through fracture of the cricoid cartilage (p = .000). FEA revealed an 11-fold reduction in the maximum equivalent plastic strain, a four-fold reduction in maximum compressive stress, and a two-fold increase in the volume of engaged cartilage in PLLC constructs. CONCLUSION The PLLC constructs demonstrated superior performance in biomechanical testing and FEA compared to standard PL constructs. CLINICAL SIGNIFICANCE The use of 3-D-printed laryngeal clamps may enhance the outcomes of laryngoplasty in horses. In vivo studies are necessary to determine the feasibility of performing laryngoplasty using the laryngeal clamp in horses.
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Affiliation(s)
- Remigiusz Grzeskowiak
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Jim Schumacher
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Omid Omidi
- Tickle College of Engineering, Mechanical, Aerospace and Biomedical Engineering, The University of Tennessee, Knoxville, Tennessee, USA
| | - Kristin Bowers
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Lynne M C Cassone
- College of Agriculture, Food and Environment, Veterinary Diagnostic Laboratory, The University of Kentucky, Lexington, Kentucky, USA
| | - Reza Abedi
- Tickle College of Engineering, Mechanical, Aerospace and Biomedical Engineering, The University of Tennessee, Knoxville, Tennessee, USA
| | - Adrien-Maxence Hespel
- College of Veterinary Medicine, Small Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Pierre-Yves Mulon
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - David E Anderson
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
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Xin H, Ferguson BM, Wan B, Al Maruf DSA, Lewin WT, Cheng K, Kruse HV, Leinkram D, Parthasarathi K, Wise IK, Froggatt C, Crook JM, McKenzie DR, Li Q, Clark JR. A Preclinical Trial Protocol Using an Ovine Model to Assess Scaffold Implant Biomaterials for Repair of Critical-Sized Mandibular Defects. ACS Biomater Sci Eng 2024; 10:2863-2879. [PMID: 38696332 DOI: 10.1021/acsbiomaterials.4c00262] [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: 05/04/2024]
Abstract
The present work describes a preclinical trial (in silico, in vivo and in vitro) protocol to assess the biomechanical performance and osteogenic capability of 3D-printed polymeric scaffolds implants used to repair partial defects in a sheep mandible. The protocol spans multiple steps of the medical device development pipeline, including initial concept design of the scaffold implant, digital twin in silico finite element modeling, manufacturing of the device prototype, in vivo device implantation, and in vitro laboratory mechanical testing. First, a patient-specific one-body scaffold implant used for reconstructing a critical-sized defect along the lower border of the sheep mandible ramus was designed using on computed-tomographic (CT) imagery and computer-aided design software. Next, the biomechanical performance of the implant was predicted numerically by simulating physiological load conditions in a digital twin in silico finite element model of the sheep mandible. This allowed for possible redesigning of the implant prior to commencing in vivo experimentation. Then, two types of polymeric biomaterials were used to manufacture the mandibular scaffold implants: poly ether ether ketone (PEEK) and poly ether ketone (PEK) printed with fused deposition modeling (FDM) and selective laser sintering (SLS), respectively. Then, after being implanted for 13 weeks in vivo, the implant and surrounding bone tissue was harvested and microCT scanned to visualize and quantify neo-tissue formation in the porous space of the scaffold. Finally, the implant and local bone tissue was assessed by in vitro laboratory mechanical testing to quantify the osteointegration. The protocol consists of six component procedures: (i) scaffold design and finite element analysis to predict its biomechanical response, (ii) scaffold fabrication with FDM and SLS 3D printing, (iii) surface treatment of the scaffold with plasma immersion ion implantation (PIII) techniques, (iv) ovine mandibular implantation, (v) postoperative sheep recovery, euthanasia, and harvesting of the scaffold and surrounding host bone, microCT scanning, and (vi) in vitro laboratory mechanical tests of the harvested scaffolds. The results of microCT imagery and 3-point mechanical bend testing demonstrate that PIII-SLS-PEK is a promising biomaterial for the manufacturing of scaffold implants to enhance the bone-scaffold contact and bone ingrowth in porous scaffold implants. MicroCT images of the harvested implant and surrounding bone tissue showed encouraging new bone growth at the scaffold-bone interface and inside the porous network of the lattice structure of the SLS-PEK scaffolds.
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Affiliation(s)
- Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Ben M Ferguson
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Darlington, NSW 2006, Australia
| | - Boyang Wan
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Darlington, NSW 2006, Australia
| | - D S Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - William T Lewin
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Kai Cheng
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Hedi V Kruse
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Physics, Faculty of Science, The University of Sydney, Syndey, NSW 2006, Australia
| | - David Leinkram
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Krishnan Parthasarathi
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Innes K Wise
- Laboratory Animal Services, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Catriona Froggatt
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Jeremy M Crook
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong, NSW 2519, Australia
| | - David R McKenzie
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Physics, Faculty of Science, The University of Sydney, Syndey, NSW 2006, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Darlington, NSW 2006, Australia
- Centre for Advanced Materials Technology, The University of Sydney, Darlington, NSW 2006, Australia
| | - Jonathan R Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia
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Bhatia A, Hanna J, Stuart T, Kasper KA, Clausen DM, Gutruf P. Wireless Battery-free and Fully Implantable Organ Interfaces. Chem Rev 2024; 124:2205-2280. [PMID: 38382030 DOI: 10.1021/acs.chemrev.3c00425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.
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Affiliation(s)
- Aman Bhatia
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Jessica Hanna
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Tucker Stuart
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Kevin Albert Kasper
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - David Marshall Clausen
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Philipp Gutruf
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Department of Electrical and Computer Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Bio5 Institute, The University of Arizona, Tucson, Arizona 85721, United States
- Neuroscience Graduate Interdisciplinary Program (GIDP), The University of Arizona, Tucson, Arizona 85721, United States
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Siverino C, Tirkkonen-Rajasalo L, Freitag L, Günther C, Thompson K, Styger U, Zeiter S, Eglin D, Stadelmann VA. Restoring implant fixation strength in osteoporotic bone with a hydrogel locally delivering zoledronic acid and bone morphogenetic protein 2. A longitudinal in vivo microCT study in rats. Bone 2024; 180:117011. [PMID: 38176642 DOI: 10.1016/j.bone.2023.117011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024]
Abstract
Osteoporosis poses a major public health challenge, and it is characterized by low bone mass, deterioration of the microarchitecture of bone tissue, causing a consequent increase in bone fragility and susceptibility to fractures and complicating bone fixation, particularly screw implantation. In the present study, our aim was to improve implant stability in osteoporotic bone using a thermoresponsive hyaluronan hydrogel (HA-pNIPAM) to locally deliver the bisphosphonate zoledronic acid (ZOL) to prevent bone resorption and bone morphogenetic protein 2 (BMP2) to induce bone formation. Adult female Wistar rats (n = 36) were divided into 2 treatment groups: one group of SHAM-operated animals and another group that received an ovariectomy (OVX) to induce an osteoporotic state. All animals received a polyetheretherketone (PEEK) screw in the proximal tibia. In addition, subgroups of SHAM or OVX animals received either the HA-pNIPAM hydrogel without or with ZOL/BMP2, placed into the defect site prior to screw implantation. Periprosthetic bone and implant fixation were monitored using longitudinal in vivo microCT scanning post-operatively and at 3, 6, 9, 14, 20 and 28 days. Histological assessment was performed post-mortem. Our data showed that pure hydrogel has no impact of implant fixation The ZOL/BMP2-hydrogel significantly increased bone-implant contact and peri-implant bone fraction, primarily through reduced resorption. STATEMENT OF CLINICAL SIGNIFICANCE: Local delivery of ZOL and BMP2 using a biocompatible hydrogel improved implant stability in osteoporotic bone. This approach could constitute a potent alternative to systemic drug administration and may be useful in avoiding implant loosening in clinical settings.
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Affiliation(s)
| | | | | | | | | | | | | | - David Eglin
- AO Research Institute Davos, Davos, Switzerland; Mines Saint-Étienne, Univ Jean Monnet, INSERM, U1059 Sainbiose, Saint-Étienne, France.
| | - Vincent A Stadelmann
- AO Research Institute Davos, Davos, Switzerland; Schulthess Klinik, Department of Research and Development, Zürich, Switzerland.
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Yang X, Wu L, Li C, Li S, Hou W, Hao Y, Lu Y, Li L. Synergistic Amelioration of Osseointegration and Osteoimmunomodulation with a Microarc Oxidation-Treated Three-Dimensionally Printed Ti-24Nb-4Zr-8Sn Scaffold via Surface Activity and Low Elastic Modulus. ACS APPLIED MATERIALS & INTERFACES 2024; 16:3171-3186. [PMID: 38205810 DOI: 10.1021/acsami.3c16459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Biomaterial scaffolds, including bone substitutes, have evolved from being primarily a biologically passive structural element to one in which material properties such as surface topography and chemistry actively direct bone regeneration by influencing stem cells and the immune microenvironment. Ti-6Al-4V(Ti6Al4V) implants, with a significantly higher elastic modulus than human bone, may lead to stress shielding, necessitating improved stability at the bone-titanium alloy implant interface. Ti-24Nb-4Zr-8Sn (Ti2448), a low elastic modulus β-type titanium alloy devoid of potentially toxic elements, was utilized in this study. We employed 3D printing technology to fabricate a porous scaffold structure to further decrease the structural stiffness of the implant to approximate that of cancellous bone. Microarc oxidation (MAO) surface modification technology is then employed to create a microporous structure and a hydrophilic oxide ceramic layer on the surface and interior of the scaffold. In vitro studies demonstrated that MAO treatment enhances the proliferation, adhesion, and osteogenesis capabilities on the scaffold surface. The chemical composition of the MAO-Ti2448 oxide layer is found to enhance the transcription and expression of osteogenic genes in bone mesenchymal stem cells (BMSCs), potentially related to the enrichment of Nb2O5 and SnO2 in the oxide layer. The MAO-Ti2448 scaffold, with its synergistic surface activity and low stiffness, significantly activates the anti-inflammatory macrophage phenotype, creating an immune microenvironment that promotes the osteogenic differentiation of BMSCs. In vivo experiments in a rabbit model demonstrated a significant improvement in the quantity and quality of the newly formed bone trabeculae within the scaffold under the contact osteogenesis pattern with a matched elastic modulus. These trabeculae exhibit robust connections to the external structure of the scaffold, accelerating the formation of an interlocking structure between the bone and implant and providing higher implantation stability. These findings suggest that the MAO-Ti2448 scaffold has significant potential as a bone defect repair material by regulating osteoimmunomodulation and osteogenesis to enhance osseointegration. This study demonstrates an optional strategy that combines the mechanism of reducing the elastic modulus with surface modification treatment, thereby extending the application scope of β-type titanium alloy.
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Affiliation(s)
- Xinyue Yang
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
| | - Lijun Wu
- Engineering Research Center of High Entropy Alloy Materials (Liaoning Province), School of Materials Science and Engineering, Dalian University of Technology, Dalian 116024, P.R. China
| | - Cheng Li
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
| | - Shujun Li
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Wentao Hou
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Yulin Hao
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Yiping Lu
- Engineering Research Center of High Entropy Alloy Materials (Liaoning Province), School of Materials Science and Engineering, Dalian University of Technology, Dalian 116024, P.R. China
| | - Lei Li
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
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Hijazi KM, Dixon SJ, Armstrong JE, Rizkalla AS. Titanium Alloy Implants with Lattice Structures for Mandibular Reconstruction. MATERIALS (BASEL, SWITZERLAND) 2023; 17:140. [PMID: 38203994 PMCID: PMC10779528 DOI: 10.3390/ma17010140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
In recent years, the field of mandibular reconstruction has made great strides in terms of hardware innovations and their clinical applications. There has been considerable interest in using computer-aided design, finite element modelling, and additive manufacturing techniques to build patient-specific surgical implants. Moreover, lattice implants can mimic mandibular bone's mechanical and structural properties. This article reviews current approaches for mandibular reconstruction, their applications, and their drawbacks. Then, we discuss the potential of mandibular devices with lattice structures, their development and applications, and the challenges for their use in clinical settings.
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Affiliation(s)
- Khaled M. Hijazi
- School of Biomedical Engineering, Faculty of Engineering, The University of Western Ontario, London, ON N6A 3K7, Canada
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4, Canada
| | - S. Jeffrey Dixon
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4, Canada
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Jerrold E. Armstrong
- Division of Oral and Maxillofacial Surgery, Department of Otolaryngology Head and Neck Surgery, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Amin S. Rizkalla
- School of Biomedical Engineering, Faculty of Engineering, The University of Western Ontario, London, ON N6A 3K7, Canada
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4, Canada
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1, Canada
- Chemical and Biochemical Engineering, Faculty of Engineering, The University of Western Ontario, London, ON N6A 5B9, Canada
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Cassuto J, Folestad A, Göthlin J, Malchau H, Kärrholm J. The importance of BMPs and TGF-βs for endochondral bone repair - A longitudinal study in hip arthroplasty patients. Bone Rep 2023; 19:101723. [PMID: 38047271 PMCID: PMC10690547 DOI: 10.1016/j.bonr.2023.101723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/14/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Osseointegration of hip implants, although a decade-long process, shows striking similarities with the four major phases of endochondral bone repair. In the current study we investigated the spatiotemporal involvement of bone morphogenic proteins (BMPs) and transforming growth factor betas (TGF-βs) throughout the process of bone repair leading to successfully osseointegrated hip implants. Materials and methods Twenty-four patients that had undergone primary total hip arthroplasty (THA) due to one-sided osteoarthritis (OA) were investigated during a period of 18 years (Y) with repeated measurements of plasma biomarkers as well as clinical and radiological variables. All implants were clinically and radiographically well anchored throughout the follow-up. Eighty-one healthy donors divided in three gender- and age-matched groups and twenty OA patients awaiting THA, served as controls. Plasma was analyzed for BMP-1, -2, -3, -4, -6, -7 -9 and TGF-β1, -β2, -β3 by use of a high-sensitivity and wide dynamic range electrochemiluminescence technique allowing for detection of minor changes. Results Spatiotemporal changes during the follow-up are presented in the context of the four phases of endochondral bone repair shown in earlier studies and transposed to the current study based on similarities in biomarker responses. Phase 1: Primary proinflammatory phase lasting from surgery until day 7, Phase 2: Chondrogenic phase from day 7 until 18 months postsurgery, Phase 3: Secondary proinflammatory and cartilage remodeling phase lasting from 18 months until 7Y, Phase 4: coupled bone remodeling from 7Y until 18Y postsurgery. BMP-1 increased sharply shortly after surgery and remained significantly above healthy during the chondrocyte recruitment, proliferation, and hypertrophy phases with a subsequent return to control level at 5Y postsurgery. BMP-2 was above healthy controls before surgery and 1 day after surgery before decreasing to control level and remaining there throughout the follow-up. BMP-3 was at control level from presurgery until 6M after surgery when it increased to a peak at 2Y during the cartilage hypertrophy phase followed by a gradual decrease to control level at 10Y during the phase of bone formation. In the following, BMP-3 decreased below controls to a nadir 15Y postsurgery during coupled bone remodeling. BMP-4 was at control level from presurgery until 10Y postsurgery when it increased to a sharp peak at 15Y after surgery followed by a return to the level of healthy at 18Y. BMP-6 did not differ from healthy during the follow-up. BMP-7 was at control level from presurgery until 1Y postsurgery before gradually increasing to a peak at 10Y during the early phase of osteogenesis with a gradual return to control level at 18Y during the phase of coupled bone remodeling. BMP-9 was above OA before surgery followed by a decrease to basal level on day 1 after surgery and a renewed increase to a plateau above controls lasting from 6 W until returning to the level of healthy at 18Y postsurgery, i.e., throughout the phases of cartilage formation, cartilage hypertrophy and remodeling, bone formation and coupled bone remodeling. TGF-β1 was above controls presurgery before decreasing to baseline shortly after surgery followed by a renewed increase at 6 M to a peak at 2Y during cartilage hypertrophy/remodeling followed by a gradual return to baseline at 10Y during early osteoblastogenesis. TGF-β2 was at control level from presurgery until the phase of cartilage remodeling at 5Y when it increased sharply to a peak at 7Y with a gradual return to baseline at 18Y postsurgery. TGF-β3 remained at control level throughout the study. Conclusion This study shows that the involvement of BMPs and TGF-βs in endochondral bone repair is a process of stepwise recruitment of individual biomarkers characterized by distinct, yet overlaping, spatiotemporal patterns that extend from the early phase of pre-chondrocyte recruitment until the late phase of coupled bone remodeling.
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Affiliation(s)
- Jean Cassuto
- Orthopedic Research Unit & Department of Orthopedic Surgery, Sahlgrenska University Hospital, Mölndal, Sweden
- Institution of Clinical Sciences, Göteborg University, Göteborg, Sweden
| | - Agnetha Folestad
- Department of Orthopedics, CapioLundby Hospital, Göteborg, Sweden
| | - Jan Göthlin
- Department of Radiology, Sahlgrenska University Hospital, Mölndal, Sweden
- Institution of Clinical Sciences, Göteborg University, Göteborg, Sweden
| | - Henrik Malchau
- Orthopedic Research Unit & Department of Orthopedic Surgery, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Orthopedic Surgery, Harvard Medical School, Boston, USA
| | - Johan Kärrholm
- Orthopedic Research Unit & Department of Orthopedic Surgery, Sahlgrenska University Hospital, Mölndal, Sweden
- Institution of Clinical Sciences, Göteborg University, Göteborg, Sweden
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Rojas-Rojas L, Tozzi G, Guillén-Girón T. A Comprehensive Mechanical Characterization of Subject-Specific 3D Printed Scaffolds Mimicking Trabecular Bone Architecture Biomechanics. Life (Basel) 2023; 13:2141. [PMID: 38004281 PMCID: PMC10672154 DOI: 10.3390/life13112141] [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: 09/27/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023] Open
Abstract
This study presents a polymeric scaffold designed and manufactured to mimic the structure and mechanical compressive characteristics of trabecular bone. The morphological parameters and mechanical behavior of the scaffold were studied and compared with trabecular bone from bovine iliac crest. Its mechanical properties, such as modulus of elasticity and yield strength, were studied under a three-step monotonic compressive test. Results showed that the elastic modulus of the scaffold was 329 MPa, and the one for trabecular bone reached 336 MPa. A stepwise dynamic compressive test was used to assess the behavior of samples under various loading regimes. With microcomputed tomography (µCT), a three-dimensional reconstruction of the samples was obtained, and their porosity was estimated as 80% for the polymeric scaffold and 88% for trabecular bone. The full-field strain distribution of the samples was measured using in situ µCT mechanics and digital volume correlation (DVC). This provided information on the local microdeformation mechanism of the scaffolds when compared to that of the tissue. The comprehensive results illustrate the potential of the fabricated scaffolds as biomechanical templates for in vitro studies. Furthermore, there is potential for extending this structure and fabrication methodology to incorporate suitable biocompatible materials for both in vitro and in vivo clinical applications.
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Affiliation(s)
- Laura Rojas-Rojas
- Materials Science and Engineering School, Tecnológico de Costa Rica, Cartago 30109, Costa Rica;
| | - Gianluca Tozzi
- School of Engineering, University of Greenwich, Chatham ME4 4TB, UK;
- School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth PO1 3DJ, UK
| | - Teodolito Guillén-Girón
- Materials Science and Engineering School, Tecnológico de Costa Rica, Cartago 30109, Costa Rica;
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Wang L, Huang H, Yuan H, Yao Y, Park JH, Liu J, Geng X, Zhang K, Hollister SJ, Fan Y. In vitro fatigue behavior and in vivo osseointegration of the auxetic porous bone screw. Acta Biomater 2023; 170:185-201. [PMID: 37634835 DOI: 10.1016/j.actbio.2023.08.040] [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: 03/27/2023] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
The incidence of screw loosening, migration, and pullout caused by the insufficient screw-bone fixation stability is relatively high in clinical practice. To solve this issue, the auxetic unit-based porous bone screw (AS) has been put forward in our previous work. Its favorable auxetic effect can improve the primary screw-bone fixation stability after implantation. However, porous structure affected the fatigue behavior and in vivo longevity of bone screw. In this study, in vitro fatigue behaviors and in vivo osseointegration performance of the re-entrant unit-based titanium auxetic bone screw were studied. The tensile-tensile fatigue behaviors of AS and nonauxetic bone screw (NS) with the same porosity (51%) were compared via fatigue experiments, fracture analysis, and numerical simulation. The in vivo osseointegration of AS and NS were compared via animal experiment and biomechanical analysis. Additionally, the effects of in vivo dynamic tensile loading on the osseointegration of AS and NS were investigated and analyzed. The fatigue strength of AS was approximately 43% lower while its osseointegration performance was better than NS. Under in vivo dynamic tensile loading, the osseointegration of AS and NS both improved significantly, with the maximum increase of approximately 15%. Preferrable osseointegration of AS might compensate for the shortage of fatigue resistance, ensuring its long-term stability in vivo. Adequate auxetic effect and long-term stability of the AS was supposed to provide enough screw-bone fixation stability to overcome the shortages of the solid bone screw, developing the success of surgery and showing significant clinical application prospects in orthopedic surgery. STATEMENT OF SIGNIFICANCE: This research investigated the high-cycle fatigue behavior of re-entrant unit-based auxetic bone screw under tensile-tensile cyclic loading and its osseointegration performance, which has not been focused on in existing studies. The fatigue strength of auxetic bone screw was lower while the osseointegration was better than non-auxetic bone screw, especially under in vivo tensile loading. Favorable osseointegration of auxetic bone screw might compensate for the shortage of fatigue resistance, ensuring its long-term stability and longevity in vivo. This suggested that with adequate auxetic effect and long-term stability, the auxetic bone screw had significant application prospects in orthopedic surgery. Findings of this study will provide a theoretical guidance for design optimization and clinical application of the auxetic bone screw.
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Affiliation(s)
- Lizhen Wang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Huiwen Huang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Hao Yuan
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Yan Yao
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Jeong Hun Park
- Wallace H. Coulter Department of Biomedical Engineering and Center for 3D Medical Fabrication, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Jinglong Liu
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Xuezheng Geng
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Kuo Zhang
- Laboratory Animal Science Center, Peking University Health Science Center, Beijing 100083, China
| | - Scott J Hollister
- Wallace H. Coulter Department of Biomedical Engineering and Center for 3D Medical Fabrication, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China.
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10
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Martinez DC, Dobkowska A, Marek R, Ćwieka H, Jaroszewicz J, Płociński T, Donik Č, Helmholz H, Luthringer-Feyerabend B, Zeller-Plumhoff B, Willumeit-Römer R, Święszkowski W. In vitro and in vivo degradation behavior of Mg-0.45Zn-0.45Ca (ZX00) screws for orthopedic applications. Bioact Mater 2023; 28:132-154. [PMID: 37250863 PMCID: PMC10209338 DOI: 10.1016/j.bioactmat.2023.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
Magnesium (Mg) alloys have become a potential material for orthopedic implants due to their unnecessary implant removal, biocompatibility, and mechanical integrity until fracture healing. This study examined the in vitro and in vivo degradation of an Mg fixation screw composed of Mg-0.45Zn-0.45Ca (ZX00, in wt.%). With ZX00 human-sized implants, in vitro immersion tests up to 28 days under physiological conditions, along with electrochemical measurements were performed for the first time. In addition, ZX00 screws were implanted in the diaphysis of sheep for 6, 12, and 24 weeks to assess the degradation and biocompatibility of the screws in vivo. Using scanning electron microscopy (SEM) coupled with energy dispersive X-ray spectroscopy (EDX), micro-computed tomography (μCT), X-ray photoelectron spectroscopy (XPS), and histology, the surface and cross-sectional morphologies of the corrosion layers formed, as well as the bone-corrosion-layer-implant interfaces, were analyzed. Our findings from in vivo testing demonstrated that ZX00 alloy promotes bone healing and the formation of new bone in direct contact with the corrosion products. In addition, the same elemental composition of corrosion products was observed for in vitro and in vivo experiments; however, their elemental distribution and thicknesses differ depending on the implant location. Our findings suggest that the corrosion resistance was microstructure-dependent. The head zone was the least corrosion-resistant, indicating that the production procedure could impact the corrosion performance of the implant. In spite of this, the formation of new bone and no adverse effects on the surrounding tissues demonstrated that the ZX00 is a suitable Mg-based alloy for temporary bone implants.
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Affiliation(s)
- Diana C. Martinez
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Anna Dobkowska
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Romy Marek
- Department of Orthopedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Hanna Ćwieka
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | - Jakub Jaroszewicz
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Tomasz Płociński
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Črtomir Donik
- Department of Physics and Chemistry of Materials, Institute of Metals and Technology, University of Ljubljana, Lepi Pot 11, SI-1000, Ljubljana, Slovenia
| | - Heike Helmholz
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | | | - Berit Zeller-Plumhoff
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | - Regine Willumeit-Römer
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | - Wojciech Święszkowski
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
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11
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Lubis RT, Azhari A, Pramanik F. Analysis of Bone Density and Bone Morphometry by Periapical Radiographs in Dental Implant Osseointegration Process. Int J Dent 2023; 2023:4763961. [PMID: 37051187 PMCID: PMC10085658 DOI: 10.1155/2023/4763961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
Objective. This research aimed to analyze the differences in bone density and bone morphometry by periapical implant radiography in the dental implant osseointegration stages. Methods. This experimental research uses 12 periapical radiographs of tibial bones from a New Zealand white rabbit (Oryctolagus cuniculus). The analysis was performed on day 3, 14, and 28 of the osseointegration stages with density, trabecular thickness (Tb.Th.), trabecular separation (Tb.Sp.), and trabecular number (Tb.N.) as parameters. The implant used is a titanium alloy and coated by SA (sunblasted with alumina acid) of 4 mm in diameter and 7 mm in length. The radiographic assessment of the osseointegration process is obtained with the region of interest (ROI) segmentation results. Additionally, each ROI was analyzed for bone density and morphometry using the open-source ImageJ software with the BoneJ plugin. The significant difference was evaluated by analysis of variance (F-test) with
and nonparametric Kruskal–Wallis test with
. Results. Analysis of the osseointegration images of dental implants at day 3, 14, and 28 with the periapical X-ray modality shows significant differences (
) in the parameters measuring density and trabecular thickness (Tb.Th.). In the variables of trabecular separation (Tb.Sp.) and number (Tb.N.) (
), there is no significant difference. Conclusion. Based on the results, density and trabecular thickness (Tb.Th.) showed a significant difference between healing times. However, trabecular separation (Tb.Sp.) and trabecular number (Tb.N.) showed no difference in healing time.
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Affiliation(s)
- Ratih Trikusumadewi Lubis
- Dentomaxillofacial Radiology Specialist Program, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
| | - Azhari Azhari
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
| | - Farina Pramanik
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
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12
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Fröschen FS, Wirtz DC, Schildberg FA. [Physiological reactions in the interface between cementless implants and bone]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:178-185. [PMID: 36749380 DOI: 10.1007/s00132-023-04347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Surgical treatment of patients with osteoarthritis of the hip and persisting symptoms under conservative therapy has become increasingly important against the background of an aging population. OBJECTIVES What are the physiological reactions in the interface between cementless implants and bone? METHODS The literature is reviewed, expert opinions and animal models are analyzed and discussed. RESULTS Surface coating of implants with hydroxyapatite or titanium can have positive effects on osteointegration. Additional local application of mediators might be beneficial for osteointegration in the future. CONCLUSION Early peri-implant bone healing directly after implantation and late remodeling of the bone-implant interface are essential for secondary implant stability.
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Affiliation(s)
- Frank Sebastian Fröschen
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Dieter Christian Wirtz
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Frank Alexander Schildberg
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
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13
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Castellarin G, Bori E, Rapallo L, Pianigiani S, Innocenti B. Biomechanical analysis of different levels of constraint in TKA during daily activities. ARTHROPLASTY (LONDON, ENGLAND) 2023; 5:3. [PMID: 36597168 PMCID: PMC9811790 DOI: 10.1186/s42836-022-00157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Numerous total knee prosthetic implants are currently available on the orthopedic market, and this variety covers a set of different levels of constraint: among the various models available, a significant role is covered by mobile bearing cruciate-retaining design with an ultra-congruent insert, mobile bearing cruciate-retaining design, fixed-bearing posterior stabilized prosthesis and fixed-bearing constrained condylar knee. A biomechanical comparative study among them could therefore be helpful for the clinical decision-making process. This study aimed to compare the effect of these different levels of constraint in the knee biomechanics of a patient, in three different configurations representing the typical boundary conditions experienced by the knee joint during daily activities. METHOD The investigation was performed via finite element analysis with a knee model based on an already published and validated one. Four different types of prosthesis designs were analyzed: two mobile-bearing models and two fixed-bearing models, each one having a different level of constraint. The different designs were incorporated in to the 3D finite element model of the lower leg and analyzed in three different configurations reproducing the landing and the taking-off phases occurring during the gait cycle and chair-rising. Implant kinetics (in terms of polyethylene contact areas and contact pressure), polyethylene and tibial bone stresses were calculated under three different loading conditions for each design. RESULTS The tibial stress distribution in the different regions of interest of the tibia remains relatively homogeneous regardless of the type of design used. The main relevant difference was observed between the mobile and fixed-bearing models, as the contact areas were significantly different between these models in the different loading conditions. As a consequence, significant changes in the stress distribution were observed at the interface between the prosthetic components, but no significant changes were noted on the tibial bone. Moreover, the different models exhibited a symmetrical medial and lateral distribution of the contact areas, which was not always common among all the currently available prostheses (i.e. medial pivot designs). CONCLUSION The changes of the prosthetic implant did not induce a big variation of the stress distribution in the different regions of the tibial bone, while they significantly changed the distribution of stress at the interface between the prosthetic components.
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Affiliation(s)
| | - Edoardo Bori
- grid.4989.c0000 0001 2348 0746BEAMS Department, Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Laurence Rapallo
- grid.4989.c0000 0001 2348 0746BEAMS Department, Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Silvia Pianigiani
- grid.4989.c0000 0001 2348 0746BEAMS Department, Université Libre de Bruxelles, 1050 Bruxelles, Belgium ,Adler Ortho, Cormano, 20032 Milan, Italy
| | - Bernardo Innocenti
- grid.4989.c0000 0001 2348 0746BEAMS Department, Université Libre de Bruxelles, 1050 Bruxelles, Belgium
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14
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Li X, Liu Z, Xu S, Ma X, Zhao Z, Hu H, Deng J, Peng C, Wang Y, Ma S. A drug delivery system constructed by a fusion peptide capturing exosomes targets to titanium implants accurately resulting the enhancement of osseointegration peri-implant. Biomater Res 2022; 26:89. [PMID: 36575503 PMCID: PMC9795642 DOI: 10.1186/s40824-022-00331-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Exosomes derived from bone marrow mesenchymal stem cells (BMSC-exos) have been shown triggering osteogenic differentiation and mineralization of MSCs, but exosomes administered via bolus injections are rapidly sequestered and cleared. Therefore, we considered the implant as a new organ of patient's body and expected to find a method to treat implant with BMSC-exos in vivo directly. METHODS A fusion peptide (PEP), as a drug delivery system (DDS) which contained a titanium-binding peptide (TBP) possessing the ability to selectively bind to the titanium surface and another peptide CP05 being able to capture exosomes expertly, is constructed to modify the titanium surface. RESULTS Both in vitro and in vivo experiments prove PEP retains the ability to bind titanium and exosome simultaneously, and the DDS gain the ability to target exosomes to titanium implants surface following enhancing osseointegration post-implantation. Moreover, the DDS constructed by exosomes of diverse origins shows the similar combination rate and efficiency of therapy. CONCLUSION This drug delivery system demonstrates the concept that EXO-PEP system can offer an accurate and efficient therapy for treating implants with long-term effect.
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Affiliation(s)
- Xuewen Li
- grid.265021.20000 0000 9792 1228Department of Stomatology, Tianjin Medical University Second Hospital, 23 Pingjiang Road, Tianjin, 300211 China ,grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Zihao Liu
- grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Shendan Xu
- grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Xinying Ma
- grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Zhezhe Zhao
- grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Han Hu
- grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Jiayin Deng
- grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Cheng Peng
- grid.265021.20000 0000 9792 1228Department of Stomatology, Tianjin Medical University Second Hospital, 23 Pingjiang Road, Tianjin, 300211 China
| | - Yonglan Wang
- grid.265021.20000 0000 9792 1228School and Hospital of Stomotology, Tianjin Medical University, 12 Observatory Road, Heping District, Tianjin, 030070 China
| | - Shiqing Ma
- grid.265021.20000 0000 9792 1228Department of Stomatology, Tianjin Medical University Second Hospital, 23 Pingjiang Road, Tianjin, 300211 China
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15
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Wang R, Ni S, Ma L, Li M. Porous construction and surface modification of titanium-based materials for osteogenesis: A review. Front Bioeng Biotechnol 2022; 10:973297. [PMID: 36091459 PMCID: PMC9452912 DOI: 10.3389/fbioe.2022.973297] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Titanium and titanium alloy implants are essential for bone tissue regeneration engineering. The current trend is toward the manufacture of implants from materials that mimic the structure, composition and elasticity of bones. Titanium and titanium alloy implants, the most common materials for implants, can be used as a bone conduction material but cannot promote osteogenesis. In clinical practice, there is a high demand for implant surfaces that stimulate bone formation and accelerate bone binding, thus shortening the implantation-to-loading time and enhancing implantation success. To avoid stress shielding, the elastic modulus of porous titanium and titanium alloy implants must match that of bone. Micro-arc oxidation technology has been utilized to increase the surface activity and build a somewhat hard coating on porous titanium and titanium alloy implants. More recently, a growing number of researchers have combined micro-arc oxidation with hydrothermal, ultrasonic, and laser treatments, coatings that inhibit bacterial growth, and acid etching with sand blasting methods to improve bonding to bone. This paper summarizes the reaction at the interface between bone and implant material, the porous design principle of scaffold material, MAO technology and the combination of MAO with other technologies in the field of porous titanium and titanium alloys to encourage their application in the development of medical implants.
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Affiliation(s)
- Rui Wang
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, China
| | - Shilei Ni
- Department of Plastic and Aesthetic Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Li Ma
- Department of Fever Clinic, The Second Hospital of Jilin University, Changchun, China
| | - Meihua Li
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, China
- *Correspondence: Meihua Li,
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16
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Effects of Magnetic Stimulation on Dental Implant Osseointegration: A Scoping Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This PRISMA-ScR driven scoping review aims to evaluate the influence of magnetic field stimulation on dental implant osseointegration. Seven databases were screened adopting ad-hoc strings. All clinical and preclinical studies analyzing the effects of magnetic fields on dental implant osseointegration were included. From 3124 initial items, on the basis of the eligibility criteria, 33 articles, regarding both Pulsed ElectroMagnetic Fields (PEMF) and Static magnetic Fields from permanent Magnets (SFM) were finally included and critically analyzed. In vitro studies showed a positive effect of PEMF, but contrasting effects of SFM on bone cell proliferation, whereas cell adhesion and osteogenic differentiation were induced by both types of stimulation. In vivo studies showed an increased bone-to-implant contact rate in different animal models and clinical studies revealed positive effects on implant stability, under magnetic stimulation. In conclusion, although positive effects of magnetic exposure on osteogenesis activity and osseointegration emerged, this scoping review highlighted the need for further preclinical and clinical studies. More standardized designs, accurate choice of stimulation parameters, adequate methods of evaluation of the outcomes, greater sample size and longer follow-ups are needed to clearly assess the effect of magnetic fields on dental implant osseointegration.
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Abstract
The excellent combination of properties has seen a steep increase in the demand for titanium (Ti)-based material as biomedical implant devices. However, some features that promote biocompatibility are found to be lacking in Ti implants. The use of polymer nanofiber (NF) coating on the surfaces of the implants has been proven to remedy these setbacks. In particular, electrospun NFs are versatile as natural extracellular matrix mimics and as facilitators in the biocompatibility function of Ti-based implants. Therefore, various properties of Ti implants coated with polymer NFs and the correlations among these properties are explored in this review. Synthetic polymers are favorable in tissue engineering applications because they are biocompatible and have low toxicity and degradation rates. Several approved synthetic polymers and polymer hybrids have been electrospun onto Ti implant surfaces to successfully improve the biomedical applicability of the implants with regard to their physical (including diameter and porosity), chemical (including corrosion resistance), mechanical (including elastic modulus, strength and ductility) and biological properties (including tissue integration, antimicrobial and cytotoxicity).
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18
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Zhang Z, Ye Z, Hu F, Wang W, Zhang S, Gao L, Lu H. Double‐network polyvinyl alcohol composite hydrogel with self‐healing and low friction. J Appl Polym Sci 2022. [DOI: 10.1002/app.51563] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Zhouqiang Zhang
- Group of Mechanical and Biomedical Engineering, Xi'an Key Laboratory of Modern Intelligent Textile Equipment College of Mechanical & Electronic Engineering, Xi'an Polytechnic University Xi'an Shaanxi China
| | - Zishuo Ye
- Group of Mechanical and Biomedical Engineering, Xi'an Key Laboratory of Modern Intelligent Textile Equipment College of Mechanical & Electronic Engineering, Xi'an Polytechnic University Xi'an Shaanxi China
| | - Feng Hu
- Group of Mechanical and Biomedical Engineering, Xi'an Key Laboratory of Modern Intelligent Textile Equipment College of Mechanical & Electronic Engineering, Xi'an Polytechnic University Xi'an Shaanxi China
| | - Wenbo Wang
- College of Chemistry and Chemical Engineering Inner Mongolia University Hohhot China
| | - Shoujing Zhang
- Group of Mechanical and Biomedical Engineering, Xi'an Key Laboratory of Modern Intelligent Textile Equipment College of Mechanical & Electronic Engineering, Xi'an Polytechnic University Xi'an Shaanxi China
| | - Li Gao
- Department of Gynaecology and Obstetrics The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University Xi'an Shaanxi China
| | - Hailin Lu
- Group of Mechanical and Biomedical Engineering, Xi'an Key Laboratory of Modern Intelligent Textile Equipment College of Mechanical & Electronic Engineering, Xi'an Polytechnic University Xi'an Shaanxi China
- Department of Gynaecology and Obstetrics The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University Xi'an Shaanxi China
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19
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Ferguson BM, Entezari A, Fang J, Li Q. Optimal placement of fixation system for scaffold-based mandibular reconstruction. J Mech Behav Biomed Mater 2021; 126:104855. [PMID: 34872868 DOI: 10.1016/j.jmbbm.2021.104855] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 12/23/2022]
Abstract
A current challenge in bone tissue engineering is to create favourable biomechanical conditions conducive to tissue regeneration for a scaffold implanted in a segmental defect. This is particularly the case immediately following surgical implantation when a firm mechanical union between the scaffold and host bone is yet to be established via osseointegration. For mandibular reconstruction of a large segmental defect, the position of the fixation system is shown here to have a profound effect on the mechanical stimulus (for tissue regeneration within the scaffold), structural strength, and structural stiffness of the tissue scaffold-host bone construct under physiological load. This research combines computer tomography (CT)-based finite element (FE) modelling with multiobjective optimisation to determine the optimal height and angle to place a titanium fixation plate on a reconstructed mandible so as to enhance tissue ingrowth, structural strength and structural stiffness of the scaffold-host bone construct. To this end, the respective design criteria for fixation plate placement are to: (i) maximise the volume of the tissue scaffold experiencing levels of mechanical stimulus sufficient to initiate bone apposition, (ii) minimise peak stress in the scaffold so that it remains intact with a diminished risk of failure and, (iii) minimise scaffold ridge displacement so that the reconstructed jawbone resists deformation under physiological load. First, a CT-based FE model of a reconstructed human mandible implanted with a bioceramic tissue scaffold is developed to visualise and quantify changes in the biomechanical responses as the fixation plate's height and/or angle are varied. The volume of the scaffold experiencing appositional mechanical stimulus is observed to increase with the height of the fixation plate. Also, as the principal load-transfer mechanism to the scaffold is via the fixation system, there is a significant ingress of appositional stimulus from the buccal side towards the centre of the scaffold, notably in the region bounded by the screws. Next, surrogate modelling is implemented to generate bivariate cubic polynomial functions of the three biomechanical responses with respect to the two design variables (height and angle). Finally, as the three design objectives are found to be competing, bi- and tri-objective particle swarm optimisation algorithms are invoked to determine the most optimal Pareto solution, which represents the best possible trade-off between the competing design objectives. It is recommended that consideration be given to placing the fixation system along the upper boundary of the mandible with a small clockwise rotation about its posterior end. The methodology developed here forms a useful decision aid for optimal surgical planning.
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Affiliation(s)
- Ben M Ferguson
- School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering and Australian Research Council Centre for Innovative BioEngineering, The University of Sydney, NSW, 2006, Australia.
| | - Ali Entezari
- School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering and Australian Research Council Centre for Innovative BioEngineering, The University of Sydney, NSW, 2006, Australia
| | - Jianguang Fang
- School of Civil and Environmental Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering and Australian Research Council Centre for Innovative BioEngineering, The University of Sydney, NSW, 2006, Australia
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20
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Abend A, Steele C, Jahnke HG, Zink M. Adhesion of Neurons and Glial Cells with Nanocolumnar TiN Films for Brain-Machine Interfaces. Int J Mol Sci 2021; 22:8588. [PMID: 34445294 PMCID: PMC8395253 DOI: 10.3390/ijms22168588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/29/2021] [Accepted: 08/07/2021] [Indexed: 12/12/2022] Open
Abstract
Coupling of cells to biomaterials is a prerequisite for most biomedical applications; e.g., neuroelectrodes can only stimulate brain tissue in vivo if the electric signal is transferred to neurons attached to the electrodes' surface. Besides, cell survival in vitro also depends on the interaction of cells with the underlying substrate materials; in vitro assays such as multielectrode arrays determine cellular behavior by electrical coupling to the adherent cells. In our study, we investigated the interaction of neurons and glial cells with different electrode materials such as TiN and nanocolumnar TiN surfaces in contrast to gold and ITO substrates. Employing single-cell force spectroscopy, we quantified short-term interaction forces between neuron-like cells (SH-SY5Y cells) and glial cells (U-87 MG cells) for the different materials and contact times. Additionally, results were compared to the spreading dynamics of cells for different culture times as a function of the underlying substrate. The adhesion behavior of glial cells was almost independent of the biomaterial and the maximum growth areas were already seen after one day; however, adhesion dynamics of neurons relied on culture material and time. Neurons spread much better on TiN and nanocolumnar TiN and also formed more neurites after three days in culture. Our designed nanocolumnar TiN offers the possibility for building miniaturized microelectrode arrays for impedance spectroscopy without losing detection sensitivity due to a lowered self-impedance of the electrode. Hence, our results show that this biomaterial promotes adhesion and spreading of neurons and glial cells, which are important for many biomedical applications in vitro and in vivo.
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Affiliation(s)
- Alice Abend
- Research Group Biotechnology and Biomedicine, Faculty of Physics and Earth Sciences, Peter Debye Institute for Soft Matter Physics, Leipzig University, Linnéstraße 5, 04103 Leipzig, Germany;
| | - Chelsie Steele
- Research Group Biotechnology and Biomedicine, Faculty of Physics and Earth Sciences, Peter Debye Institute for Soft Matter Physics, Leipzig University, Linnéstraße 5, 04103 Leipzig, Germany;
| | - Heinz-Georg Jahnke
- Centre for Biotechnology and Biomedicine, Molecular Biological-Biochemical Processing Technology, Leipzig University, Deutscher Platz 5, 04103 Leipzig, Germany;
| | - Mareike Zink
- Research Group Biotechnology and Biomedicine, Faculty of Physics and Earth Sciences, Peter Debye Institute for Soft Matter Physics, Leipzig University, Linnéstraße 5, 04103 Leipzig, Germany;
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21
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Grzeskowiak RM, Rifkin RE, Croy EG, Steiner RC, Seddighi R, Mulon PY, Adair HS, Anderson DE. Temporal Changes in Reverse Torque of Locking-Head Screws Used in the Locking Plate in Segmental Tibial Defect in Goat Model. Front Surg 2021; 8:637268. [PMID: 33987199 PMCID: PMC8111000 DOI: 10.3389/fsurg.2021.637268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
The objective of this study was to evaluate changes in peak reverse torque (PRT) of the locking head screws that occur over time. A locking plate construct, consisting of an 8-hole locking plate and 8 locking screws, was used to stabilize a tibia segmental bone defect in a goat model. PRT was measured after periods of 3, 6, 9, and 12 months of ambulation. PRT for each screw was determined during plate removal. Statistical analysis revealed that after 6 months of loading, locking screws placed in position no. 4 had significantly less PRT as compared with screws placed in position no. 5 (p < 0.05). There were no statistically significant differences in PRT between groups as a factor of time (p > 0.05). Intracortical fractures occurred during the placement of 151 out of 664 screws (22.7%) and were significantly more common in the screw positions closest to the osteotomy (positions 4 and 5, p < 0.05). Periosteal and endosteal bone reactions and locking screw backout occurred significantly more often in the proximal bone segments (p < 0.05). Screw backout significantly, negatively influenced the PRT of the screws placed in positions no. 3, 4, and 5 (p < 0.05). The locking plate-screw constructs provided stable fixation of 2.5-cm segmental tibia defects in a goat animal model for up to 12 months.
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Affiliation(s)
- Remigiusz M Grzeskowiak
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Rebecca E Rifkin
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Elizabeth G Croy
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Richard C Steiner
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Reza Seddighi
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Pierre-Yves Mulon
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Henry S Adair
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - David E Anderson
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States
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22
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De Santis S, Sotgiu G, Porcelli F, Marsotto M, Iucci G, Orsini M. A Simple Cerium Coating Strategy for Titanium Oxide Nano-tubes' Bioactivity Enhancement. NANOMATERIALS 2021; 11:nano11020445. [PMID: 33578788 PMCID: PMC7916473 DOI: 10.3390/nano11020445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 12/20/2022]
Abstract
Despite the well-known favorable chemical and mechanical properties of titanium-based materials for orthopedic and dental applications, poor osseointegration of the implants, bacteria adhesion, and excessive inflammatory response from the host remain major problems to be solved. Here, the antioxidant and anti-inflammatory enzyme-like abilities of ceria (CeOx) were coupled to the advantageous features of titanium nanotubes (TiNTs). Cost-effective and fast methods, such as electrochemical anodization and drop casting, were used to build active surfaces with enhanced bioactivity. Surface composition, electrochemical response, and in vitro ability to induce hydroxyapatite (HA) precipitation were evaluated. The amount of cerium in the coating did not significantly affect wettability, yet a growing ability to induce early HA precipitation from simulated body fluid (SBF) was observed as the oxide content at the surface increased. The presence of 4%wt CeOx was also able to stimulate rapid HA maturation in a (poorly) crystalline form, indicating an interesting potential to induce rapid in vivo osseointegration process.
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Affiliation(s)
- Serena De Santis
- Department of Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy; (G.S.); (F.P.); (M.O.)
- Correspondence:
| | - Giovanni Sotgiu
- Department of Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy; (G.S.); (F.P.); (M.O.)
| | - Francesco Porcelli
- Department of Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy; (G.S.); (F.P.); (M.O.)
| | - Martina Marsotto
- Department of Science, Roma Tre University, Via della Vasca Navale 79, 00146 Rome, Italy; (M.M.); (G.I.)
| | - Giovanna Iucci
- Department of Science, Roma Tre University, Via della Vasca Navale 79, 00146 Rome, Italy; (M.M.); (G.I.)
| | - Monica Orsini
- Department of Engineering, Roma Tre University, Via Vito Volterra 62, 00146 Rome, Italy; (G.S.); (F.P.); (M.O.)
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