Magnesium-Based Temporary Implants: Potential, Current Status, Applications, and Challenges

Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview

Magnesium-based biomaterials hold remarkable promise for various clinical applications, offering advantages such as reduced stress-shielding and enhanced bone strengthening and vascular remodeling compared to traditional materials. However, ensuring the quality of preclinical research is crucial for the development of these implants. To achieve implant success, an understanding of the cellular responses post-implantation, proper model selection, and good study design are crucial. There are several challenges to reaching a safe and effective translation of laboratory findings into clinical practice. The utilization of Mg-based biomedical devices eliminates the need for biomaterial removal surgery post-healing and mitigates adverse effects associated with permanent biomaterial implantation. However, the high corrosion rate of Mg-based implants poses challenges such as unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. The biocompatibility and degradability of materials based on magnesium have been studied by many researchers in vitro; however, evaluations addressing the impact of the material in vivo still need to be improved. Several animal models, including rats, rabbits, dogs, and pigs, have been explored to assess the potential of magnesium-based materials. Moreover, strategies such as alloying and coating have been identified to enhance the degradation rate of magnesium-based materials in vivo to transform these challenges into opportunities. This review aims to explore the utilization of Mg implants across various biomedical applications within cellular (in vitro) and animal (in vivo) models.

The Characterization of a Biodegradable Mg Alloy after Powder Bed Fusion with Laser Beam/Metal Processing for Custom Shaped Implants

A new Mg-Zn-Zr-Ca alloy in a powder state, intended to be used for custom shaped implants, was obtained via a mechanical alloying method from pure elemental powder. Further, the obtained powder alloy was processed by a PBF-LB/M (powder bed fusion with laser beam/of metal) procedure to obtain additive manufactured samples for small biodegradable implants. A series of microstructural, mechanical and corrosion analyses were performed. The SEM (scanning electron microscopy) analysis of the powder alloy revealed a good dimensional homogeneity, with a uniform colour, no agglutination and almost rounded particles, suitable for the powder bed fusion procedure. Further, the PBF-LB/M samples revealed a robust and unbreakable morphology, with a suitable porosity (that can reproduce that of cortical bone) and without an undesirable balling effect. The tested Young's modulus of the PBF-LB/M samples, which was 42 GPa, is close to that of cortical bone, 30 GPa. The corrosion tests that were performed in PBS (Phosphate-buffered saline) solution, with three different pH values, show that the corrosion parameters have a satisfactory evolution comparative to the commercial ZK 60 alloy.

Three-dimensional measurements of symmetry for the mandibular ramus

BACKGROUND

The study examines a sample of patients presenting for viscerocranial computer tomography that does not display any apparent signs of asymmetry, assesses the three-dimensional congruency of the mandibular ramus, and focuses on differences in age and gender.

METHODS

This cross-sectional cohort study screened viscerocranial CT data of patients without deformation or developmental anomalies. Segmentations were obtained from the left and right sides and superimposed according to the best-fit alignment. Comparisons were made to evaluate three-dimensional congruency and compared between subgroups according to age and gender.

RESULTS

Two hundred and sixty-eight patients were screened, and one hundred patients met the inclusion criteria. There were no statistical differences between the left and right sides of the mandibular ramus. Also, there were no differences between the subgroups. The overall root mean square was 0.75 ± 0.15 mm, and the mean absolute distance from the mean was 0.54 ± 0.10 mm.

CONCLUSION

The mean difference was less than one millimetre, far below the two-millimetre distance described in the literature that defines relative symmetry. Our study population displays a high degree of three-dimensional congruency. Our findings help to understand that there is sufficient three-dimensional congruency of the mandibular ramus, thus contributing to facilitating CAD-CAM-based procedures based on symmetry for this specific anatomic structure.

[Research progress of magnesium and magnesium alloy implants in sports medicine]

Objective

To review the research progress of magnesium and magnesium alloy implants in the repair and reconstruction of sports injury.

Methods

Relevant literature of magnesium and magnesium alloys for sports injury repair and reconstruction was extensively reviewed. The characteristics of magnesium and its alloys and their applications in the repair and reconstruction of sports injuries across various anatomical sites were thoroughly discussed and summarized.

Results

Magnesium and magnesium alloys have advantages in mechanical properties, biosafety, and promoting tendon-bone interface healing. Many preclinical studies on magnesium and magnesium alloy implants for repairing and reconstructing sports injuries have yielded promising results. However, successful clinical translation still requires addressing issues related to mechanical strength and degradation behavior, where alloying and surface treatments offer feasible solutions.

Conclusion

The clinical translation of magnesium and magnesium alloy implants for repairing and reconstructing sports injuries holds promise. Subsequent efforts should focus on optimizing the mechanical strength and degradation behavior of magnesium and magnesium alloy implants. Conducting larger-scale biocompatibility testing and developing novel magnesium-containing implants represent new directions for future research.

Powder Bed Fusion 3D Printing in Precision Manufacturing for Biomedical Applications: A Comprehensive Review

Precision manufacturing requirements are the key to ensuring the quality and reliability of biomedical implants. The powder bed fusion (PBF) technique offers a promising solution, enabling the creation of complex, patient-specific implants with a high degree of precision. This technology is revolutionizing the biomedical industry, paving the way for a new era of personalized medicine. This review explores and details powder bed fusion 3D printing and its application in the biomedical field. It begins with an introduction to the powder bed fusion 3D-printing technology and its various classifications. Later, it analyzes the numerous fields in which powder bed fusion 3D printing has been successfully deployed where precision components are required, including the fabrication of personalized implants and scaffolds for tissue engineering. This review also discusses the potential advantages and limitations for using the powder bed fusion 3D-printing technology in terms of precision, customization, and cost effectiveness. In addition, it highlights the current challenges and prospects of the powder bed fusion 3D-printing technology. This work offers valuable insights for researchers engaged in the field, aiming to contribute to the advancement of the powder bed fusion 3D-printing technology in the context of precision manufacturing for biomedical applications.

Effect of coating time on the formation of coating layer and degradation behavior of hydroxyapatite coated ZK60 alloy

OBJECTIVES

This study aims to investigate the effect of coating time on the formation of hydroxyapatite (HA) coating layer on ZK60 substrate and understand the biodegradation behavior of the coated alloy for biodegradable implant applications.

METHODS

Biodegradable ZK60 alloy was coated by HA layer for different times of 0.5, 1, 2, and 4 h by chemical conversion method. After coating, all the coated specimens were used for immersion test in Hanks' solution to understand the effect of coating time on the degradation behavior of the alloy. The degradation rate of the coated alloy was evaluated by Mg2+ ion quantification and pH change during immersion test. The microstructure of the coating layer was examined by scanning electron microscope (SEM) equipped with an energy-dispersive X-ray spectroscopy (EDS) before and after immersion to understand the degradation behavior of the coated alloy.

RESULTS

HA coating layers were formed successfully on surface of ZK60 specimens after 0.5, 1, 2, and 4 h with different microstructure. Optimal coating quality was observed at 1 or 2 h, characterized by well-formed and uniform HA layers. However, extending the coating duration to 4 h led to the formation of cracks within the HA layer, accompanied by Mg(OH)2. Specimens coated for 1 and 2 h exhibited the lowest degradation rates, while specimens coated for 0.5 and 4 h showed the highest degradation rates. Furthermore, analysis of degradation products revealed the predominance of calcium phosphates formed on the surface of specimens coated for 1 and 2 h. Conversely, specimens coated for 0.5 and 4 h exhibited Mg(OH)2 as the primary degradation product, suggesting a less effective corrosion barrier under these conditions.

CONCLUSION

The HA layer formed after 2 h demonstrated as the most effective coating layer for enhancing the corrosion resistance of the ZK60 alloy for biomedical applications.

Bone Regeneration Induced by Patient-Adapted Mg Alloy-Based Scaffolds for Bone Defects: Present and Future Perspectives

Treatment of bone defects resulting after tumor surgeries, accidents, or non-unions is an actual problem linked to morbidity and the necessity of a second surgery and often requires a critical healthcare cost. Although the surgical technique has changed in a modern way, the treatment outcome is still influenced by patient age, localization of the bone defect, associated comorbidities, the surgeon approach, and systemic disorders. Three-dimensional magnesium-based scaffolds are considered an important step because they can have precise bone defect geometry, high porosity grade, anatomical pore shape, and mechanical properties close to the human bone. In addition, magnesium has been proven in in vitro and in vivo studies to influence bone regeneration and new blood vessel formation positively. In this review paper, we describe the magnesium alloy's effect on bone regenerative processes, starting with a short description of magnesium's role in the bone healing process, host immune response modulation, and finishing with the primary biological mechanism of magnesium ions in angiogenesis and osteogenesis by presenting a detailed analysis based on a literature review. A strategy that must be followed when a patient-adapted scaffold dedicated to bone tissue engineering is proposed and the main fabrication technologies are combined, in some cases with artificial intelligence for Mg alloy scaffolds, are presented with examples. We emphasized the microstructure, mechanical properties, corrosion behavior, and biocompatibility of each study and made a basis for the researchers who want to start to apply the regenerative potential of magnesium-based scaffolds in clinical practice. Challenges, future directions, and special potential clinical applications such as osteosarcoma and persistent infection treatment are present at the end of our review paper.

An Overview of Scaffolds and Biomaterials for Skin Expansion and Soft Tissue Regeneration: Insights on Zinc and Magnesium as New Potential Key Elements

The utilization of materials in medical implants, serving as substitutes for non-functional biological structures, supporting damaged tissues, or reinforcing active organs, holds significant importance in modern healthcare, positively impacting the quality of life for millions of individuals worldwide. However, certain implants may only be required temporarily to aid in the healing process of diseased or injured tissues and tissue expansion. Biodegradable metals, including zinc (Zn), magnesium (Mg), iron, and others, present a new paradigm in the realm of implant materials. Ongoing research focuses on developing optimized materials that meet medical standards, encompassing controllable corrosion rates, sustained mechanical stability, and favorable biocompatibility. Achieving these objectives involves refining alloy compositions and tailoring processing techniques to carefully control microstructures and mechanical properties. Among the materials under investigation, Mg- and Zn-based biodegradable materials and their alloys demonstrate the ability to provide necessary support during tissue regeneration while gradually degrading over time. Furthermore, as essential elements in the human body, Mg and Zn offer additional benefits, including promoting wound healing, facilitating cell growth, and participating in gene generation while interacting with various vital biological functions. This review provides an overview of the physiological function and significance for human health of Mg and Zn and their usage as implants in tissue regeneration using tissue scaffolds. The scaffold qualities, such as biodegradation, mechanical characteristics, and biocompatibility, are also discussed.

Optimization of Machining Parameters to Minimize Cutting Forces and Surface Roughness in Micro-Milling of Mg13Sn Alloy

This comprehensive study investigates the micro-milling of a Mg13Sn alloy, a material of considerable interest in various high-precision applications, such as biomedical implants. The main objective of the study was to explore the optimizations of variable feed per tooth (fz), cutting speed (Vc), and depth of cut (ap) parameters on the key outcomes of the micro-milling process. A unique experimental setup was employed, employing a spindle capable of achieving up to 60,000 revolutions per minute. Additionally, the study leveraged linear slides backed by micro-step motors to facilitate precise axis movements, thereby maintaining a resolution accuracy of 0.1 μm. Cutting forces were accurately captured by a mini dynamometer and subsequently evaluated based on the peak to valley values for Fx (tangential force) and Fy (feed force). The study results revealed a clear and complex interplay between the varied cutting parameters and their subsequent impacts on the cutting forces and surface roughness. An increase in feed rate and depth of cut significantly increased the cutting forces. However, the cutting forces were found to decrease noticeably with the elevation of cutting speed. Intriguingly, the tangential force (Fx) was consistently higher than the feed force (Fy). Simultaneously, the study determined that the surface roughness, denoted by Sa values, increased in direct proportion to the feed rate. It was also found that the Sa surface roughness values decreased with the increase in cutting speed. This study recommends a parameter combination of fz = 5 µm/tooth feed rate, Vc = 62.8 m/min cutting speed, and ap = 400 µm depth of cut to maintain a Sa surface roughness value of less than 1 µm while ensuring an optimal material removal rate and machining time. The results derived from this study offer vital insights into the micro-milling of Mg13Sn alloys and contribute to the current body of knowledge on the topic.

Biodegradable Magnesium Alloys for Personalised Temporary Implants

The objective of this experimental work was to examine and characterise the route for obtaining demonstrative temporary biodegradable personalised implants from the Mg alloy Mg-10Zn-0.5Zr-0.8Ca (wt.%). This studied Mg alloy was obtained in its powder state using the mechanical alloying method, with shape and size characteristics suitable for ensuing 3D additive manufacturing using the SLM (selective laser melting) procedure. The SLM procedure was applied to various processing parameters. All obtained samples were characterised microstructurally (using XRD-X-ray diffraction, and SEM-scanning electron microscopy); mechanically, by applying a compression test; and, finally, from a corrosion resistance viewpoint. Using the optimal test processing parameters, a few demonstrative temporary implants of small dimensions were made via the SLM method. Our conclusion is that mechanical alloying combined with SLM processing has good potential to manage 3D additive manufacturing for personalised temporary biodegradable implants of magnesium alloys. The compression tests show results closer to those of human bones compared to other potential metallic alloys. The applied corrosion test shows result comparable with that of the commercial magnesium alloy ZK60.