In Vivo Assessment of Synthetic and Biological-Derived Calcium Phosphate-Based Coatings Fabricated by Pulsed Laser Deposition: A Review

There Are over 60 Ways to Produce Biocompatible Calcium Orthophosphate (CaPO4) Deposits on Various Substrates

A The present overview describes various production techniques for biocompatible calcium orthophosphate (abbreviated as CaPO4) deposits (coatings, films and layers) on the surfaces of various types of substrates to impart the biocompatible properties for artificial bone grafts. Since, after being implanted, the grafts always interact with the surrounding biological tissues at the interfaces, their surface properties are considered critical to clinical success. Due to the limited number of materials that can be tolerated in vivo, a new specialty of surface engineering has been developed to desirably modify any unacceptable material surface characteristics while maintaining the useful bulk performance. In 1975, the development of this approach led to the emergence of a special class of artificial bone grafts, in which various mechanically stable (and thus suitable for load-bearing applications) implantable biomaterials and artificial devices were coated with CaPO4. Since then, more than 7500 papers have been published on this subject and more than 500 new publications are added annually. In this review, a comprehensive analysis of the available literature has been performed with the main goal of finding as many deposition techniques as possible and more than 60 methods (double that if all known modifications are counted) for producing CaPO4 deposits on various substrates have been systematically described. Thus, besides the introduction, general knowledge and terminology, this review consists of two unequal parts. The first (bigger) part is a comprehensive summary of the known CaPO4 deposition techniques both currently used and discontinued/underdeveloped ones with brief descriptions of their major physical and chemical principles coupled with the key process parameters (when possible) to inform readers of their existence and remind them of the unused ones. The second (smaller) part includes fleeting essays on the most important properties and current biomedical applications of the CaPO4 deposits with an indication of possible future developments.

Microstructure and Properties of Hydroxyapatite Coatings Made by Aerosol Cold Spraying–Sintering Technology

Hydroxyapatite is a widely used material used for the bioactivation of an implant’s surface. A promising hydroxyapatite coating approach is the kinetic deposition of powder particles. The possibility of solid-state deposition improvement through the merging of Aerosol Deposition and Low Pressure Cold Spraying techniques is a promising prospect for improving the deposition efficiency and the quality of coatings. The objective of the paper is to study the possibilities of hydroxyapatite coating structure modification through changes in the coating process and post-heat treatment. The novel Aerosol Cold Spraying system joining Low Pressure Cold Spraying and Aerosol Deposition was used for the deposition of coatings. The coating’s post-processing was conducted using two techniques: Spark Plasma Sintering and Pressureless Sintering. The coating’s structure was examined using scanning, transmission, and light microscopy, and X-ray diffraction. Substrate–coating bond strength was assessed using a tensile test. Homogenous buildup using Aerosol Cold Spraying of hydroxyapatite was achieved. Various pores and microcracks were visible in the sprayed coatings. The deposition process and the thermal post-processing did not lead to significant degradation of the hydroxyapatite phase. As a result of the Spark Plasma Sintering and Pressureless Sintering at 800 °C, an increase in tensile adhesion bond strength and crystal size was obtained.

Probing the Structure, Cytocompatibility, and Antimicrobial Efficacy of Silver-, Strontium-, and Zinc-Doped Monetite

Calcium phosphate phases are among the most widely accepted compounds for biomaterial applications, of which the resorbable phases have gained particular attention in recent years. Brushite and its anhydrous form monetite are among the most interesting resorbable calcium phosphate phases that can be applied as cements and for in situ fabrication of three-dimensional (3D) implants. Of these two dicalcium phosphate compounds, monetite is more stable and undergoes slower degradation than brushite. The purpose of the current study is to synthesize and dope monetite with the antimicrobial elements silver and zinc and the osteoinductive element strontium and investigate the possible structural variations as well as their biocompatibility and antimicrobial effectiveness. For this, powder X-ray diffraction (PXRD), energy-dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), and cryo-transmission electron microscopy (cryo-TEM) were used to thoroughly study the synthesized structures. Moreover, the ASTM E-2149-01 protocol and a cell proliferation assay were used to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) and the cytocompatibility of the different phases with the Soas-2 cell line, respectively. The results confirm the successful synthesis and doping procedures, such that zinc was the most incorporated element into the monetite phase and strontium was the least incorporated element. The microbiological studies revealed that silver is a very effective antimicrobial agent at low concentrations but unsuitable at high concentrations because its cytotoxicity would prevail. On the other hand, doping the compounds with zinc led to a reasonable antimicrobial activity without compromising the biocompatibility to obviously high concentrations. The study also highlights that strontium, widely known for its osteoinductivity, bears an antimicrobial effect at high concentrations. The generated doped compounds could be beneficial for prospective studies as bone cements or for scaffold biomaterial applications.

Bioactive Coatings Loaded with Osteogenic Protein for Metallic Implants

Osteoconductive and osteoinductive coatings represent attractive and tunable strategies towards the enhanced biomechanics and osseointegration of metallic implants, providing accurate local modulation of bone-to-implant interface. Composite materials based on polylactide (PLA) and hydroxyapatite (HAp) are proved beneficial substrates for the modulation of bone cells' development, being suitable mechanical supports for the repair and regeneration of bone tissue. Moreover, the addition of osteogenic proteins represents the next step towards the fabrication of advanced biomaterials for hard tissue engineering applications, as their regulatory mechanisms beneficially contribute to the new bone formation. In this respect, laser-processed composites, based on PLA, Hap, and bone morphogenetic protein 4(BMP4), are herein proposed as bioactive coatings for metallic implants. The nanostructured coatings proved superior ability to promote the adhesion, viability, and proliferation of osteoprogenitor cells, without affecting their normal development and further sustaining the osteogenic differentiation of the cells. Our results are complementary to previous studies regarding the successful use of chemically BMP-modified biomaterials in orthopedic and orthodontic applications.

Substituted Hydroxyapatite, Glass, and Glass-Ceramic Thin Films Deposited by Nanosecond Pulsed Laser Deposition (PLD) for Biomedical Applications: A Systematic Review

The deposition of thin films of bioactive materials is the most common approach to improve the bone bonding ability of an implant surface. With this purpose, several wet and plasma assisted deposition methods were proposed in the scientific literature. In this review, we considered films obtained by nanosecond Pulsed Laser Deposition (PLD). Since hydroxyapatite (HA) has composition and structure similar to that of the mineral component of the bone, the initial studies focused on the selection of experimental conditions that would allow the deposition of films that retain HA stoichiometry and crystallinity. However, biological apatite was found to be a poorly crystalline and multi-substituted mineral; consequently, the attention of researchers was oriented towards the deposition of substituted HA, glass (BG), and glass-ceramic (BGC) bioactive materials to exploit the biological relevance of foreign ions and crystallinity. In this work, after a description of the nanosecond ablation and film growth of ceramic materials, we reported studies on the mechanism of HA ablation and deposition, evidencing the peculiarities of PLD. The literature concerning the PLD of ion substituted HA, BG, and BGC was then reviewed and the performances of the coatings were discussed. We concluded by describing the advantages, limitations, and perspectives of PLD for biomedical applications.

Innovative Surface Modification Procedures to Achieve Micro/Nano-Graded Ti-Based Biomedical Alloys and Implants

Due to the growing aging population of the world, and as a result of the increasing need for dental implants and prostheses, the use of titanium and its alloys as implant materials has spread rapidly. Although titanium and its alloys are considered the best metallic materials for biomedical applications, the need for innovative technologies is necessary due to the sensitivity of medical applications and to eliminate any potentially harmful reactions, enhancing the implant-to-bone integration and preventing infection. In this regard, the implant’s surface as the substrate for any reaction is of crucial importance, and it is accurately addressed in this review paper. For constructing this review paper, an internet search was performed on the web of science with these keywords: surface modification techniques, titanium implant, biomedical applications, surface functionalization, etc. Numerous recent papers about titanium and its alloys were selected and reviewed, except for the section on forthcoming modern implants, in which extended research was performed. This review paper aimed to briefly introduce the necessary surface characteristics for biomedical applications and the numerous surface treatment techniques. Specific emphasis was given to micro/nano-structured topographies, biocompatibility, osteogenesis, and bactericidal effects. Additionally, gradient, multi-scale, and hierarchical surfaces with multifunctional properties were discussed. Finally, special attention was paid to modern implants and forthcoming surface modification strategies such as four-dimensional printing, metamaterials, and metasurfaces. This review paper, including traditional and novel surface modification strategies, will pave the way toward designing the next generation of more efficient implants.