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Zhai WJ, Liu L, Gao YH, Qin SL, Han PF, Xu YF. Application of 3D‑printed porous titanium interbody fusion cage vs. polyether ether ketone interbody fusion cage in anterior cervical discectomy and fusion: A systematic review and meta‑analysis update. Exp Ther Med 2024; 28:290. [PMID: 38827472 PMCID: PMC11140292 DOI: 10.3892/etm.2024.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/18/2024] [Indexed: 06/04/2024] Open
Abstract
The present study aimed to compare the differences between 3D-printed porous titanium and polyether ether ketone (PEEK) interbody fusion cages for anterior cervical discectomy and fusion (ACDF). Literature on the application of 3D-printed porous titanium and PEEK interbody fusion cages for ACDF was searched in the PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang and VIP databases. A total of 1,181 articles were retrieved and 12 were finally included. The Cochrane bias risk assessment criteria and Newcastle-Ottawa scale were used for quality evaluation and Review Manager 5.4 was used for data analysis. The 3D cage group was superior to the PEEK cage group in terms of operative time [mean difference (MD): -7.68; 95% confidence interval (CI): -11.08, -4.29; P<0.00001], intraoperative blood loss (MD: -6.17; 95%CI: -10.56, -1.78; P=0.006), hospitalization time (MD: -0.57; 95%CI: -0.86, -0.28: P=0.0001), postoperative complications [odds ratio (OR): 0.35; 95%CI: 0.15, 0.80; P=0.01], C2-7 Cobb angle (MD: 2.85; 95%CI: 1.45, 4.24; P<0.0001), intervertebral space height (MD: 1.20; 95%CI: 0.54, 1.87; P=0.0004), Japanese Orthopaedic Association Assessment of Treatment (MD: 0.69; 95%CI: 0.24, 1.15; P=0.003) and visual analogue scale score (MD: -0.43; 95%CI: -0.78, -0.07; P=0.02). The difference was statistically significant, while there was no significant difference between the two groups in terms of fusion rate (OR: 1.74; 95%CI: 0.71, 4.27; P=0.23). The use of 3D-printed porous titanium interbody fusion cage in ACDF has the advantages of short operation time, less bleeding loss, shorter hospitalization time and fewer postoperative complications. It can better maintain the cervical curvature and intervertebral height, relieve pain and accelerate postoperative functional recovery.
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Affiliation(s)
- Wan-Jing Zhai
- Graduate School, The First Clinical College of Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China
- Department of Orthopedics, Changzhi Yunfeng Hospital, Changzhi, Shanxi 046000, P.R. China
| | - Lun Liu
- Graduate School, The First Clinical College of Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China
| | - Yu-Hao Gao
- Graduate School, The First Clinical College of Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China
- Department of Orthopedics, Changzhi Yunfeng Hospital, Changzhi, Shanxi 046000, P.R. China
| | - Shi-Lei Qin
- Department of Orthopedics, Changzhi Yunfeng Hospital, Changzhi, Shanxi 046000, P.R. China
- Department of Orthopedics, Changzhi Institution of Spinal Disease, Changzhi, Shanxi 046000, P.R. China
| | - Peng-Fei Han
- Department of Orthopedics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China
| | - Yun-Feng Xu
- Department of Orthopedics, Changzhi Yunfeng Hospital, Changzhi, Shanxi 046000, P.R. China
- Department of Orthopedics, Changzhi Institution of Spinal Disease, Changzhi, Shanxi 046000, P.R. China
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De Stefano M, Singh K, Raina A, Mohan S, Ul Haq MI, Ruggiero A. Tribocorrosion of 3D printed dental implants: An overview. J Taibah Univ Med Sci 2024; 19:644-663. [PMID: 38807965 PMCID: PMC11131088 DOI: 10.1016/j.jtumed.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/30/2024] [Accepted: 05/03/2024] [Indexed: 05/30/2024] Open
Abstract
With the advancements in dental science and the growing need for improved dental health, it has become imperative to develop new implant materials which possess better geometrical, mechanical, and physical properties. The oral environment is a corrosive environment and the relative motion between the teeth also makes the environment more hostile. Therefore, the combined corrosion and tribology commonly known as tribocorrosion of implants needs to be studied. The complex shapes of the dental implants and the high-performance requirements of these implants make manufacturing difficult by conventional manufacturing processes. With the advent of additive manufacturing or 3D-printing, the development of implants has become easy. However, the various requirements such as surface roughness, mechanical strength, and corrosion resistance further make the manufacturing of implants difficult. The current paper reviews the various studies related to3D-printed implants. Also, the paper tries to highlight the role of 3D-Printing can play in the area of dental implants. Further studies both experimental and numerical are needed to devise optimized conditions for 3D-printing implants to develop implants with improved mechanical, corrosion, and biological properties.
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Affiliation(s)
- Marco De Stefano
- Department of Industrial Engineering, University of Salerno, Fisciano, Italy
| | - Khushneet Singh
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, Katra, Jammu and Kashmir, India
| | - Ankush Raina
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, Katra, Jammu and Kashmir, India
| | - Sanjay Mohan
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, Katra, Jammu and Kashmir, India
| | - Mir Irfan Ul Haq
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, Katra, Jammu and Kashmir, India
| | - Alessandro Ruggiero
- Department of Industrial Engineering, University of Salerno, Fisciano, Italy
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Safaei M, Mohammadi H, Beddu S, Mozaffari HR, Rezaei R, Sharifi R, Moradpoor H, Fallahnia N, Ebadi M, Md Jamil MS, Md Zain AR, Yusop MR. Surface Topography Steer Soft Tissue Response and Antibacterial Function at the Transmucosal Region of Titanium Implant. Int J Nanomedicine 2024; 19:4835-4856. [PMID: 38828200 PMCID: PMC11141758 DOI: 10.2147/ijn.s461549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/10/2024] [Indexed: 06/05/2024] Open
Abstract
Metallic dental implants have been extensively used in clinical practice due to their superior mechanical properties, biocompatibility, and aesthetic outcomes. However, their integration with the surrounding soft tissue at the mucosal region remains challenging and can cause implant failure due to the peri-implant immune microenvironment. The soft tissue integration of dental implants can be ameliorated through different surface modifications. This review discussed and summarized the current knowledge of topography-mediated immune response and topography-mediated antibacterial activity in Ti dental implants which enhance soft tissue integration and their clinical performance. For example, nanopillar-like topographies such as spinules, and spikes showed effective antibacterial activity in human salivary biofilm which was due to the lethal stretching of bacterial membrane between the nanopillars. The key findings of this review were (I) cross-talk between surface nanotopography and soft tissue integration in which the surface nanotopography can guide the perpendicular orientation of collagen fibers into connective tissue which leads to the stability of soft tissue, (II) nanotubular array could shift the macrophage phenotype from pro-inflammatory (M1) to anti-inflammatory (M2) and manipulate the balance of osteogenesis/osteoclasia, and (III) surface nanotopography can provide specific sites for the loading of antibacterial agents and metallic nanoparticles of clinical interest functionalizing the implant surface. Silver-containing nanotubular topography significantly decreased the formation of fibrous encapsulation in per-implant soft tissue and showed synergistic antifungal and antibacterial properties. Although the Ti implants with surface nanotopography have shown promising in targeting soft tissue healing in vitro and in vivo through their immunomodulatory and antibacterial properties, however, long-term in vivo studies need to be conducted particularly in osteoporotic, and diabetic patients to ensure their desired performance with immunomodulatory and antibacterial properties. The optimization of product development is another challenging issue for its clinical translation, as the dental implant with surface nanotopography must endure implantation and operation inside the dental microenvironment. Finally, the sustainable release of metallic nanoparticles could be challenging to reduce cytotoxicity while augmenting the therapeutic effects.
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Affiliation(s)
- Mohsen Safaei
- Division of Dental Biomaterials, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Advanced Dental Sciences and Technology Research Center, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Mohammadi
- Biomaterials Research Group, School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, Nibong Tebal, Penang, 14300, Malaysia
- Institute of Energy Infrastructure (IEI), Universiti Tenaga Nasional, Jalan IKRAM UNITEN, Kajang, Selangor, 43000, Malaysia
| | - Salmia Beddu
- Institute of Energy Infrastructure (IEI), Universiti Tenaga Nasional, Jalan IKRAM UNITEN, Kajang, Selangor, 43000, Malaysia
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Razieh Rezaei
- Advanced Dental Sciences and Technology Research Center, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roohollah Sharifi
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hedaiat Moradpoor
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nima Fallahnia
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mona Ebadi
- Department of Chemical Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, 43600, Malaysia
| | - Mohd Suzeren Md Jamil
- Department of Chemical Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, 43600, Malaysia
| | - Ahmad Rifqi Md Zain
- Institute of Microengineering and Nanoelectronics (IMEN), Universiti Kebangsaan Malaysia (UKM), Bangi, Selangor, 43600, Malaysia
| | - Muhammad Rahimi Yusop
- Department of Chemical Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, 43600, Malaysia
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Cai FF, Blanquer A, Costa MB, Schweiger L, Sarac B, Greer AL, Schroers J, Teichert C, Nogués C, Spieckermann F, Eckert J. Hierarchical Surface Pattern on Ni-Free Ti-Based Bulk Metallic Glass to Control Cell Interactions. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2310364. [PMID: 38109153 DOI: 10.1002/smll.202310364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Indexed: 12/19/2023]
Abstract
Ni-free Ti-based bulk metallic glasses (BMGs) are exciting materials for biomedical applications because of their outstanding biocompatibility and advantageous mechanical properties. The glassy nature of BMGs allows them to be shaped and patterned via thermoplastic forming (TPF). This work demonstrates the versatility of the TPF technique to create micro- and nano-patterns and hierarchical structures on Ti40Zr10Cu34Pd14Sn2 BMG. Particularly, a hierarchical structure fabricated by a two-step TPF process integrates 400 nm hexagonal close-packed protrusions on 2.5 µm square protuberances while preserving the advantageous mechanical properties from the as-cast material state. The correlations between thermal history, structure, and mechanical properties are explored. Regarding biocompatibility, Ti40Zr10Cu34Pd14Sn2 BMGs with four surface topographies (flat, micro-patterned, nano-patterned, and hierarchical-structured surfaces) are investigated using Saos-2 cell lines. Alamar Blue assay and live/dead analysis show that all tested surfaces have good cell proliferation and viability. Patterned surfaces are observed to promote the formation of longer filopodia on the edge of the cytoskeleton, leading to star-shaped and dendritic cell morphologies compared with the flat surface. In addition to potential implant applications, TPF-patterned Ti-BMGs enable a high level of order and design flexibility on the surface topography, expanding the available toolbox for studying cell behavior on rigid and ordered surfaces.
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Affiliation(s)
- Fei-Fan Cai
- Department of Materials Science, Chair of Materials Physics, Montanuniversität Leoben, Jahnstraße 12, Leoben, A-8700, Austria
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, Jahnstraße 12, Leoben, A-8700, Austria
| | - Andreu Blanquer
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, 08193, Spain
| | - Miguel B Costa
- Department of Materials Science & Metallurgy, University of Cambridge, Cambridge, CB3 0FS, UK
| | - Lukas Schweiger
- Department of Materials Science, Chair of Materials Physics, Montanuniversität Leoben, Jahnstraße 12, Leoben, A-8700, Austria
| | - Baran Sarac
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, Jahnstraße 12, Leoben, A-8700, Austria
| | - A Lindsay Greer
- Department of Materials Science & Metallurgy, University of Cambridge, Cambridge, CB3 0FS, UK
| | - Jan Schroers
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06511, USA
| | - Christian Teichert
- Department Physics, Mechanics and Electrical Engineering, Chair of Physics, Montanuniversität Leoben, Franz-Josef-Strasse 18, Leoben, A-8700, Austria
| | - Carme Nogués
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, 08193, Spain
| | - Florian Spieckermann
- Department of Materials Science, Chair of Materials Physics, Montanuniversität Leoben, Jahnstraße 12, Leoben, A-8700, Austria
| | - Jürgen Eckert
- Department of Materials Science, Chair of Materials Physics, Montanuniversität Leoben, Jahnstraße 12, Leoben, A-8700, Austria
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, Jahnstraße 12, Leoben, A-8700, Austria
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Deng J, Joshua Cohen D, Matias EB, Olson LO, McClure MJ, Boyan BD, Schwartz Z. Reduced osseointegration in disuse and denervation rat models results from impaired cellular responses to multiscale microstructured titanium surfaces. J Orthop Res 2024. [PMID: 38644051 DOI: 10.1002/jor.25843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/15/2023] [Accepted: 03/11/2024] [Indexed: 04/23/2024]
Abstract
Immobilization-induced skeletal unloading results in muscle atrophy and rapid bone loss, thereby increasing the risk of falling and the need for implant therapy in patients with extended bed rest or neuromuscular injuries. Skeletal unloading causes bone loss by altering bone growth and resorption, suggesting that implant performance might be affected. To test this, we focused on early events in implant osseointegration. We used the rat sciatic neurectomy-induced disuse model under two different settings. In Study 1, 16 Sprague Dawley rats (SD) were separated into control, sham operated+cast immobilization, and sciatic neurectomy+casting groups; titanium implants with multiscale microtextured topography and hydrophilic chemistry (modSLA) were inserted in the distal femoral metaphysis. Neurectomy surgeries and casting were performed at the same surgical setting as implant placement; rats were euthanized 4 weeks post-implantation. In Study 2, we established the unloaded condition before implantation. A total of 12 SD rats were divided into control and sciatic+femoral neurectomy groups. A total of 24 days after sciatic and femoral neurectomy surgery, rats received implants. Study 2 rats were euthanized at 4 weeks post-implantation. MicroCT and histomorphometry showed that trabecular bone and osseointegration were reduced when disuse was established before implantation. Osteoblasts isolated from Study 1 sciatic neurectomy tibial bones exhibited impaired differentiation on modSLA culture disks, revealing a possible mechanism responsible for the decreased osseointegration observed in the Study 2 rats. This study addressed the importance of considering the mechanical unloading and muscle function history before implant insertion and suggests that implant performance was reduced due to poor cellular ability to regenerate.
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Affiliation(s)
- Jingyao Deng
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - David Joshua Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Enrique B Matias
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Lucas O Olson
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michael J McClure
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Barbara D Boyan
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Sun G, Shu T, Ma S, Li M, Qu Z, Li A. A submicron forest-like silicon surface promotes bone regeneration by regulating macrophage polarization. Front Bioeng Biotechnol 2024; 12:1356158. [PMID: 38707505 PMCID: PMC11066256 DOI: 10.3389/fbioe.2024.1356158] [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: 12/15/2023] [Accepted: 03/14/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction: Silicon is a major trace element in humans and a prospective supporting biomaterial to bone regeneration. Submicron silicon pillars, as a representative surface topography of silicon-based biomaterials, can regulate macrophage and osteoblastic cell responses. However, the design of submicron silicon pillars for promoting bone regeneration still needs to be optimized. In this study, we proposed a submicron forest-like (Fore) silicon surface (Fore) based on photoetching. The smooth (Smo) silicon surface and photoetched regular (Regu) silicon pillar surface were used for comparison in the bone regeneration evaluation. Methods: Surface parameters were investigated using a field emission scanning electron microscope, atomic force microscope, and contact angle instrument. The regulatory effect of macrophage polarization and succedent osteogenesis was studied using Raw264.7, MC3T3-E1, and rBMSCs. Finally, a mouse calvarial defect model was used for evaluating the promoting effect of bone regeneration on the three surfaces. Results: The results showed that the Fore surface can increase the expression of M2-polarized markers (CD163 and CD206) and decrease the expression of inflammatory cytokines, including interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α). Fore surface can promote the osteogenesis in MC3T3-E1 cells and osteoblastic differentiation of rBMSCs. Furthermore, the volume fraction of new bone and the thickness of trabeculae on the Fore surface were significantly increased, and the expression of RANKL was downregulated. In summary, the upregulation of macrophage M2 polarization on the Fore surface contributed to enhanced osteogenesis in vitro and accelerated bone regeneration in vivo. Discussion: This study strengthens our understanding of the topographic design for developing future silicon-based biomaterials.
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Affiliation(s)
- Guo Sun
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Tianyu Shu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Shaoyang Ma
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Meng Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Zhiguo Qu
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
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Srivastava S, Sarangi SK. A relationship of tightening torque and initial load of dental implant of nano bio-silica and bamboo fiber-reinforced bio-composite material. Comput Methods Biomech Biomed Engin 2024:1-15. [PMID: 38419505 DOI: 10.1080/10255842.2024.2320750] [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: 10/16/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
Due to entry of body fluid like saliva, blood, etc. in the dental implant assembly lowers the preload value, thus dental implant abutment tightening torque loses. In this article a novel chitosan-reinforced bamboo and nano bio-silica-reinforced five composite materials (CP, CF, C1, C2, and C3) are fabricated using the hand layup method, and their mechanical, biocompatible, and moisture absorption properties are observed and discussed. The present study examines the impact of friction and Young's modulus on the correlation between torque and starting load in dental implant abutment screws, utilizing the attributes of a bio-composite material. C2 bio-composite composite material exhibits the highest tensile strength (139.442 MPa), flexural strength (183.571 MPa), compressive strength (62.78 MPa), and a minimum value of 1.35% absorption of water. C3 is tested with no cytotoxicity, while C3 and CF exhibit weak biofilm resistance against S. aureus gram-positive bacteria. The C2 bio-composite material demonstrated a maximum initial load of 20 N with a tightening torque of 20 N-cm, under both 0.12 and 0.16 coefficients of friction. The simulated results were compared with several theoretical relations of torque and initial load and found that the Motos equation holds the nearest result to the obtained preload value from finite element analysis. Overall, the experimental findings suggest that the C2 bio-composite material holds significant potential as a prominent material for dental implants or fixtures.
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Affiliation(s)
- Sambhrant Srivastava
- Mechanical Engineering Department, Rajkiya Engineering College, Azamgarh, Uttar Pradesh, India
- Mechanical Engineering Department, National Institute of Technology Patna, Patna, Bihar, India
| | - Saroj Kumar Sarangi
- Mechanical Engineering Department, National Institute of Technology Patna, Patna, Bihar, India
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Shu T, Wang X, Li M, Ma S, Cao J, Sun G, Lai T, Liu S, Li A, Qu Z, Pei D. Nanoscaled Titanium Oxide Layer Provokes Quick Osseointegration on 3D-Printed Dental Implants: A Domino Effect Induced by Hydrophilic Surface. ACS NANO 2024; 18:783-797. [PMID: 38117950 DOI: 10.1021/acsnano.3c09285] [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: 12/22/2023]
Abstract
Three-dimensional printing is a revolutionary strategy to fabricate dental implants. Especially, 3D-printed dental implants modified with nanoscaled titanium oxide layer (H-SLM) have impressively shown quick osseointegration, but the accurate mechanism remains elusive. Herein, we unmask a domino effect that the hydrophilic surface of the H-SLM facilitates blood wetting, enhances the blood shear rate, promotes blood clotting, and changes clot features for quick osseointegration. Combining computational fluid dynamic simulation and biological verification, we find a blood shear rate during blood wetting of the hydrophilic H-SLM 1.2-fold higher than that of the raw 3D-printed implant, which activates blood clot formation. Blood clots formed on the hydrophilic H-SLM demonstrate anti-inflammatory and pro-osteogenesis effects, leading to a 1.5-fold higher bone-to-implant contact and a 1.8-fold higher mechanical anchorage at the early stage of osseointegration. This mechanism deepens current knowledge between osseointegration speed and implant surface characteristics, which is instructive in surface nanoscaled modification of multiple 3D-printed intrabony implants.
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Affiliation(s)
- Tianyu Shu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Xueliang Wang
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Meng Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shaoyang Ma
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Jiao Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Guo Sun
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Tao Lai
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shaobao Liu
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Zhiguo Qu
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
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Abd Halim ZA, Mat Yajid MA, Hassan AG, Saud SN, Abu Bakar TA. The effect of CNTs/ PEEK coating thickness on the friction and wear behavior of porous Ti‐30Ta alloys for biomaterial implants. J Appl Polym Sci 2023. [DOI: 10.1002/app.54531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/12/2023] [Indexed: 09/02/2023]
Abstract
AbstractElectrophoretic deposition was used to deposit carbon nanotube/polyether ether ketone (CNTs/PEEK) composite coatings onto porous titanium‐tantalum (Ti‐30Ta) substrates at different PEEK concentrations (4.5, 6.0, and 7.5 mg/mL). Coatings were analyzed for thickness, porosity, surface roughness, microhardness and bonding strength, with higher PEEK concentrations producing thicker and more uniform coatings. However, optimal coating thickness showed highest bonding strength; lower and higher thickness led to decreased bonding strength. The tribological properties of the CNTs/PEEK coated Ti‐30Ta samples of different thicknesses (50, 70, and 100 μm) were evaluated using ball‐on‐flat linear reciprocating sliding tests under dry and wet conditions using simulated body fluid (SBF) as a lubricant. The CNTs/PEEK coatings provided excellent tribological protection under dry friction, with thicker coatings having lower friction and negligible wear. However, under wet sliding, the coating's wear rate increased significantly due to softening of the rubbing surface caused by SBF lubrication that increase transfer film onto the counter body surface. Coating with optimal thickness of 74 μm demonstrated the lowest friction and wear under SBF lubrication due to its highest hardness and bonding strength. This study highlights the importance of controlling coating thickness in determining the performance of the CNTs/PEEK coatings for orthopedic implants.
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Affiliation(s)
| | - M. A. Mat Yajid
- Faculty of Mechanical Engineering Universiti Teknologi Malaysia Skudai Johor Malaysia
| | - Ahmed. G. Hassan
- Faculty of Mechanical Engineering Universiti Teknologi Malaysia Skudai Johor Malaysia
- Faculty of Engineering University of Thi‐Qar Thi‐Qar Iraq
| | - S. N. Saud
- Faculty of Information Sciences and Engineering Management and Science University Shah Alam Malaysia
| | - T. A. Abu Bakar
- Faculty of Mechanical Engineering Universiti Teknologi Malaysia Skudai Johor Malaysia
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Chen H, Jiang N, Zhang J, Tan P, Wang M, Zhu S, Cao P. Micron/Submicron Scaled Hierarchical Ti Phosphate/Ti Oxide Hybrid Coating on 3D Printed Scaffolds for Improved Osteointegration. ACS Biomater Sci Eng 2023; 9:1274-1284. [PMID: 36802473 DOI: 10.1021/acsbiomaterials.2c01354] [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: 02/22/2023]
Abstract
Three-dimensional (3D) printed implants have attracted substantial attention in the field of personalized medicine, but negative impacts on mechanical properties or initial osteointegration have limited their application. To address these problems, we prepared hierarchical Ti phosphate/Ti oxide (TiP-Ti) hybrid coatings on 3D printed Ti scaffolds. The surface morphology, chemical composition, and bonding strength of the scaffolds were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), contact angle measurement, X-ray diffraction (XRD), and scratch test. In vitro performance was analyzed by colonization and proliferation of rat bone marrow mesenchymal stem cells (BMSCs). In vivo osteointegration of the scaffolds in rat femurs was assessed by micro-CT and histological analyses. The results demonstrated improved cell colonization and proliferation as well as excellent osteointegration obtained by incorporation of our scaffolds with the novel TiP-Ti coating. In conclusion, micron/submicron scaled Ti phosphate/Ti oxide hybrid coatings on 3D printed scaffolds have promising potential in future biomedical applications.
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Affiliation(s)
- Haozhe Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jie Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Peijie Tan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Min Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Pinyin Cao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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11
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Ravidà A, Samal A, Qazi M, Webber LP, Wang HL, Galindo-Moreno P, Borgnakke WS, Saleh MHA. Interproximal implant thread exposure after initial bone remodeling as a risk indicator for peri-implantitis. J Periodontol 2022. [PMID: 36576085 DOI: 10.1002/jper.22-0499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Due to the clinical challenges involved in successfully treating peri-implantitis, it is imperative to identify patient- and implant-level risk factors for its prevention. The main goal of this retrospective longitudinal radiographic and clinical study was to investigate whether interproximal radiographic implant thread exposure after physiological bone remodeling may be a risk factor for peri-implantitis. The secondary goal was to evaluate several other potential risk indicators. METHODS Of 4325 active dental school patients having implants placed, 165 partially edentulous adults (77 men, 88 women) aged 30-91 with ≥2 years of follow-up upon implant restoration were included. Implants with ≥1 interproximal thread exposed (no bone-to-implant contact) (n = 98, 35%) constituted the test group and those without exposed threads (n = 182, 65%) the control group. Descriptive, binary, and multivariate regression analyses were evaluated for goodness of fit. Wald tests were used to evaluate for significance set at 0.05. RESULTS Of the 280 implants (98 test, 182 control), 8 (2.9%) failed over a mean follow-up period of 7.67 (±2.63) years, and 27 implants (19 test, 8 control) developed peri-implantitis, with the exposed group having eight-fold (7.82 times) adjusted greater odds than the non-exposed. The risk increased four-fold (3.77 times) with each thread exposed. No other patient- or implant-related potentially confounding risk factors were identified. CONCLUSIONS Exposed interproximal implant threads after physiologic bone remodeling may be an independent risk indicator for incident peri-implantitis. Hence, clinicians should closely monitor patients with implant threads that have no bone-to-implant contact for incident peri-implantitis.
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Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Ankita Samal
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Musa Qazi
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Liana Preto Webber
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Hom-Lay Wang
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implantology, University of Granada, Granada, Spain
| | - Wenche S Borgnakke
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
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12
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Analysis of disordered abrasive scratches on titanium surfaces and their impact on nuclear translocation of yes-associated protein. Sci Rep 2022; 12:21705. [PMID: 36522392 PMCID: PMC9755118 DOI: 10.1038/s41598-022-26203-0] [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: 10/18/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
The morphology of the metallic surface of an implant is important for its contact with bone tissue as it directly affects osteoblast functions, such as cell adhesion, proliferation, and differentiation. Firm contact between the implant and cells creates a barrier that prevents inflammation and bacterial infections. Therefore, optimizing surface morphology, such as surface roughness adjustments, is essential to improving the adhesion between the implant and cells for successful tissue regeneration. However, the manner in which the cells sense the surface roughness and morphology remains unclear. Previously, we analyzed cell adhesion behavior and observed that inhibited cell spreading can delay osteoblast functions. Therefore, assuming that the surface morphology can be sensed through cell spreading, we investigated the cell spreading area and yes-associated protein (YAP) localization in mouse osteoblasts (MC3T3-E1) on a titanium surface with disordered abrasive scratches. Surface roughness of 100-150 nm was obtained by polishing, which inhibited the cell spreading, indicating that YAP localization in the nucleus was lower than that on other surfaces. The obtained results indicate that the cells sense the surface environment based on their spreading area, which regulates cellular functions via the Hippo pathway.
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13
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Shirazi S, Ravindran S, Cooper LF. Topography-mediated immunomodulation in osseointegration; Ally or Enemy. Biomaterials 2022; 291:121903. [PMID: 36410109 PMCID: PMC10148651 DOI: 10.1016/j.biomaterials.2022.121903] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.
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Affiliation(s)
- Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | - Sriram Ravindran
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.
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14
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In Vitro and In Vivo Studies of Hydrogenated Titanium Dioxide Nanotubes with Superhydrophilic Surfaces during Early Osseointegration. Cells 2022; 11:cells11213417. [DOI: 10.3390/cells11213417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Titanium-based implants are often utilized in oral implantology and craniofacial reconstructions. However, the biological inertness of machined titanium commonly results in unsatisfactory osseointegration. To improve the osseointegration properties, we modified the titanium implants with nanotubular/superhydrophilic surfaces through anodic oxidation and thermal hydrogenation and evaluated the effects of the machined surfaces (M), nanotubular surfaces (Nano), and hydrogenated nanotubes (H-Nano) on osteogenesis and osseointegration in vitro and in vivo. After incubation of mouse bone marrow mesenchymal stem cells on the samples, we observed improved cell adhesion, alkaline phosphatase activity, osteogenesis-related gene expression, and extracellular matrix mineralization in the H-Nano group compared to the other groups. Subsequent in vivo studies indicated that H-Nano implants promoted rapid new bone regeneration and osseointegration at 4 weeks, which may be attributed to the active osteoblasts adhering to the nanotubular/superhydrophilic surfaces. Additionally, the Nano group displayed enhanced osteogenesis in vitro and in vivo at later stages, especially at 8 weeks. Therefore, we report that hydrogenated superhydrophilic nanotubes can significantly accelerate osteogenesis and osseointegration at an early stage, revealing the considerable potential of this implant modification for clinical applications.
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15
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Fernández-Lizárraga M, García-López J, Rodil SE, Ribas-Aparicio RM, Silva-Bermudez P. Evaluation of the Biocompatibility and Osteogenic Properties of Metal Oxide Coatings Applied by Magnetron Sputtering as Potential Biofunctional Surface Modifications for Orthopedic Implants. MATERIALS 2022; 15:ma15155240. [PMID: 35955174 PMCID: PMC9369574 DOI: 10.3390/ma15155240] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 01/11/2023]
Abstract
Biomaterials with adequate properties to direct a biological response are essential for orthopedic and dental implants. The surface properties are responsible for the biological response; thus, coatings with biologically relevant properties such as osteoinduction are exciting options to tailor the surface of different bulk materials. Metal oxide coatings such as TiO2, ZrO2, Nb2O5 and Ta2O5 have been suggested as promising for orthopedic and dental implants. However, a comparative study among them is still missing to select the most promising for bone-growth-related applications. In this work, using magnetron sputtering, TiO2, ZrO2, Ta2O5, and Nb2O5 thin films were deposited on Si (100) substrates. The coatings were characterized by Optical Profilometry, Scanning Electron Microscopy, Energy-Dispersive X-ray Spectroscopy, X-ray Photoelectron Spectroscopy, X-ray Diffraction, Water Contact Angle measurements, and Surface Free Energy calculations. The cell adhesion, viability, proliferation, and differentiation toward the osteoblastic phenotype of mesenchymal stem cells plated on the coatings were measured to define the biological response. Results confirmed that all coatings were biocompatible. However, a more significant number of cells and proliferative cells were observed on Nb2O5 and Ta2O5 compared to TiO2 and ZrO2. Nevertheless, Nb2O5 and Ta2O5 seemed to induce cell differentiation toward the osteoblastic phenotype in a longer cell culture time than TiO2 and ZrO2.
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Affiliation(s)
- Mariana Fernández-Lizárraga
- Posgrado de Doctorado en Ciencias en Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico;
- Laboratorio de Producción y Control de Biológicos, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Julieta García-López
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico;
| | - Sandra E. Rodil
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | - Rosa María Ribas-Aparicio
- Posgrado de Doctorado en Ciencias en Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
- Laboratorio de Producción y Control de Biológicos, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico
- Correspondence: (R.M.R.-A.); (P.S.-B.)
| | - Phaedra Silva-Bermudez
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico;
- Correspondence: (R.M.R.-A.); (P.S.-B.)
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