Proliferation of Osteoblasts on Laser-Modified Nanostructured Titanium Surfaces

In Vitro and In Vivo Biocompatibility of Bacterial Cellulose

Bacterial cellulose is a unique biomaterial produced by various species of bacteria that offers a range of potential applications in the biomedical field. To provide a cost-effective alternative to soft-tissue implants used in cavity infills, remodeling, and subdermal wound healing, in vitro cytotoxicity and in vivo biocompatibility of native bacterial cellulose were investigated. Cytotoxicity was assessed using a metabolic assay on Swiss 3T3 fibroblasts and INS-1832/13 rat insulinoma. Results showed no cytotoxicity, whether the cells were seeded over or under the bacterial cellulose scaffolds. Biocompatibility was performed on Sprague-Dawley rats (males and females, 8 weeks old) by implanting bacterial cellulose membranes subcutaneously for 1 or 12 weeks. The explanted scaffolds were then sliced and stained with hematoxylin and eosin for histological characterization. The first series of results revealed acute and chronic inflammation persisting over 12 weeks. Examination of the explants indicated a high number of granulocytes within the periphery of the bacterial cellulose, suggesting the presence of endotoxins within the membrane, confirmed by a Limulus amebocyte lysate test. This discovery motivated the development of non-pyrogenic bacterial cellulose scaffolds. Following this, a second series of animal experiments was done, in which materials were implanted for 1 or 2 weeks. The results revealed mild inflammation 1 week after implantation, which then diminished to minimal inflammation after 2 weeks. Altogether, this study highlights that unmodified, purified native bacterial cellulose membranes may be used as a cost-effective biomedical device provided that proper endotoxin clearance is achieved.

Cytocompatibility, antibacterial, and corrosion properties of chitosan/polymethacrylates and chitosan/poly(4-vinylpyridine) smart coatings, electrophoretically deposited on nanosilver-decorated titania nanotubes

The development of novel implants subjected to surface modification to achieve high osteointegration properties at simultaneous antimicrobial activity is a highly current problem. This study involved different surface treatments of titanium surface, mainly by electrochemical oxidation to produce a nanotubular oxide layer (TNTs), a subsequent electrochemical reduction of silver nitrate and decoration of a nanotubular surface with silver nanoparticles (AgNPs), and finally electrophoretic deposition (EPD) of a composite of chitosan (CS) and either polymethacrylate-based copolymer Eudragit E 100 (EE100) or poly(4-vinylpyridine) (P4VP) coating. The effects of each stage of this multi-step modification were examined in terms of morphology, roughness, wettability, corrosion resistance, coating-substrate adhesion, antibacterial properties, and osteoblast cell adhesion and proliferation. The results showed that the titanium surface formed nanotubes (inner diameter of 97 ± 12 nm, length of 342 ± 36 nm) subsequently covered with silver nanoparticles (with a diameter of 88 ± 8 nm). Further, the silver-decorated nanotubes were tightly coated with biopolymer films. Most of the applied modifications increased both the roughness and the surface contact angle of the samples. The deposition of biopolymer coatings resulted in reduced burst release of silver. The coated samples revealed potent antimicrobial activity against both Gram-positive and Gram-negative bacteria. Total elimination (99.9%) of E. coli was recorded for a sample with CS/P4VP coating. Cytotoxicity results using hFOB 1.19, a human osteoblast cell line, showed that after 3 days the tested modifications did not affect the cellular growth according to the titanium control. The proposed innovative multilayer antibacterial coatings can be successful for titanium implants as effective postoperative anti-inflammation protection.

Influence of Topography and Composition of Commercial Titanium Dental Implants on Cell Adhesion of Human Gingiva-Derived Mesenchymal Stem Cells: An In Vitro Study

The topography and composition of dental implant surfaces directly impact mesenchymal cell adhesion, proliferation, and differentiation, crucial aspects of achieving osseointegration. However, cell adhesion to biomaterials is considered a key step that drives cell proliferation and differentiation. The aim of this study was to characterize characterize the topography and composition of commercial titanium dental implants manufactured with different surface treatments (two sandblasted/acid-etched (SLA) (INNO Implants, Busan, Republic of Korea; BioHorizonsTM, Oceanside, CA, USA) and two calcium phosphate (CaP) treated (Biounite®, Berazategui, Argentina; Zimmer Biomet, Inc., Warsaw, IN, USA)) and to investigate their influence on the process of cell adhesion in vitro. A smooth surface implant (Zimmer Biomet, Inc.) was used as a control. For that, high-resolution methodologies such as scanning electron microscopy (SEM), X-ray dispersive spectroscopy (EDX), laser scanning confocal microscopy (LSCM), and atomic force microscopy (AFM) were employed. Protein adsorption and retromolar gingival mesenchymal stem cells (GMSCs) adhesion to the implant surfaces were evaluated after 48 h. The adherent cells were examined by SEM and LSCM for morphologic and quantitative analyses. ANOVA and Tukey tests (α = 0.05) were employed to determine statistical significance. SEM revealed that INNO, BioHorizonsTM, and Zimmer implants have an irregular surface, whereas Biounite® has a regular topography consisting of an ordered pattern. EDX confirmed a calcium and phosphate layer on the Biounite® and Zimmer surfaces, and AFM exhibited different roughness parameters. Protein adsorption and cell adhesion were detected on all the implant surfaces studied. However, the Biounite® implant with CaP and regular topography showed the highest protein adsorption capacity and density of adherent GMSCs. Although the Zimmer implant also had a CaP treatment, protein and cell adhesion levels were lower than those observed with Biounite®. Our findings indicated that the surface regularity of the implants is a more determinant factor in the cell adhesion process than the CaP treatment. A regular, nanostructured, hydrophilic, and moderately rough topography generates a higher protein adsorption capacity and thus promotes more efficient cell adhesion.

Human cells with osteogenic potential in bone tissue research

Bone regeneration after injury or after surgical bone removal due to disease is a serious medical challenge. A variety of materials are being tested to replace a missing bone or tooth. Regeneration requires cells capable of proliferation and differentiation in bone tissue. Although there are many possible human cell types available for use as a model for each phase of this process, no cell type is ideal for each phase. Osteosarcoma cells are preferred for initial adhesion assays due to their easy cultivation and fast proliferation, but they are not suitable for subsequent differentiation testing due to their cancer origin and genetic differences from normal bone tissue. Mesenchymal stem cells are more suitable for biocompatibility testing, because they mimic natural conditions in healthy bone, but they proliferate more slowly, soon undergo senescence, and some subpopulations may exhibit weak osteodifferentiation. Primary human osteoblasts provide relevant results in evaluating the effect of biomaterials on cellular activity; however, their resources are limited for the same reasons, like for mesenchymal stem cells. This review article provides an overview of cell models for biocompatibility testing of materials used in bone tissue research.

Nanomaterials in Bone Regeneration

Nanomaterials are promising in the development of innovative therapeutic options that include tissue and organ replacement, as well as bone repair and regeneration. The expansion of new nanoscaled biomaterials is based on progress in the field of nanotechnologies, material sciences, and biomedicine. In recent decades, nanomaterial systems have bridged the line between the synthetic and natural worlds, leading to the emergence of a new science called nanomaterial design for biological applications. Nanomaterials replicating bone properties and providing unique functions help in bone tissue engineering. This review article is focused on nanomaterials utilized in or being explored for the purpose of bone repair and regeneration. After a brief overview of bone biology, including a description of bone cells, matrix, and development, nanostructured materials and different types of nanoparticles are discussed in detail.

Laser-Assisted Nanotexturing and Silver Immobilization on Titanium Implant Surfaces to Enhance Bone Cell Mineralization and Antimicrobial Properties

Despite the great advancement and wide use of titanium (Ti) and Ti-based alloys in different orthopedic implants, device-related infections remain the major complication in modern orthopedic and trauma surgery. Most of these infections are often caused by both poor antibacterial and osteoinductive properties of the implant surface. Here, we have demonstrated a facile two-step laser nanotexturing and immobilization of silver onto the titanium implants to improve both cellular integration and antibacterial properties of Ti surfaces. The required threshold laser processing power for effective nanotexturing and osseointegration was systematically determined by the level of osteoblast cells mineralized on the laser nanotextured Ti (LN-Ti) surfaces using a neodymium-doped yttrium aluminum garnet laser (Nd:YAG, wavelength of 1.06 μm). Laser processing powers above 24 W resulted in the formation of hierarchical nanoporous structures (average pore 190 nm) on the Ti surface with a 2.5-fold increase in osseointegration as compared to the pristine Ti surface. Immobilization of silver nanoparticles onto the LN-Ti surface was conducted by dip coating in an aqueous silver ionic solution and subsequently converted to silver nanoparticles (AgNPs) by using a low power laser-assisted photocatalytic reduction process. Structural and surface morphology analysis via XRD and SEM revealed a uniform distribution of Ag and the formation of an AgTi-alloy interface on the Ti surface. The antibacterial efficacy of the LN-Ti with laser immobilized silver (LN-Ti/LI-Ag) was tested against both Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria. The LN-Ti/LI-Ag surface was observed to have efficient and stable antimicrobial properties for over 6 days. In addition, it was found that the LN-Ti/LI-Ag maintained a cytocompatibility and bone cell mineralization property similar to the LN-Ti surface. The differential toxicity of the LN-Ti/LI-Ag between bacterial and cellular species qualifies this approach as a promising candidate for novel rapid surface modification of biomedical metal implants.

Laser Surface Modification of Powder Metallurgy-Processed Ti-Graphite Composite Which Can Enhance Cells' Osteo-Differentiation

The paper examines the surface functionalization of a new type of Ti-graphite composite, a dental biomaterial prepared by vacuum low-temperature extrusion of hydrogenated-dehydrogenated titanium powder mixed with graphite flakes. Two experimental surfaces were prepared by laser micromachining applying different levels of incident energy of the fiber nanosecond laser working at 1064 nm wavelength. The surface integrity of the machined surfaces was evaluated, including surface roughness parameters measurement by contact profilometry and confocal laser scanning microscopy. The chemical and phase composition were comprehensively evaluated by scanning electron microscopy, energy-dispersive X-ray spectroscopy and X-ray diffraction analyses. Finally, the in vitro tests using human mesenchymal stem cells were conducted to compare the influence of the laser processing parameters used on the cell's cultivation and osteo-differentiation. The bioactivity results confirmed that the surface profile with positive kurtosis, platykurtic distribution curve and higher value of peaks spacing exhibited better bioactivity compared to the surface profile with negative kurtosis coefficient, leptokurtic distribution curve and lower peaks spacing.

Biological Response to Nanosurface Modification on Metallic Biomaterials

PURPOSE OF REVIEW

New biomaterials for biomedical applications have been developed over the past few years. This work summarizes the current cell lines investigations regarding nanosurface modifications to improve biocompatibility and osseointegration.

RECENT FINDINGS

Material surfaces presenting biomimetic morphology that provides nanoscale architectures have been shown to alter cell/biomaterial interactions. Topographical and biofunctional surface modifications present a positive effect between material and host response. Nanoscale surfaces on titanium have the potential to provide a successful interface for implantable biomedical devices. Future studies need to directly evaluate how the titanium nanoscale materials will perform in in vivo experiments. Biocompatibility should be determined to identify titanium nanoscale as an excellent option for implant procedures.

Repeated Exposure of Nanostructured Titanium to Osteoblasts with Respect to Peri-Implantitis

Titanium offers excellent biocompatibility and extraordinary mechanical properties. As a result, it is used as a material for dental implants. Implants infected by peri-implantitis can be cleaned for successful re-osseointegration. Optimal surface properties, such as roughness and wettability, have a significant impact on cell adhesion. The aim of this study was to evaluate the adhesion and proliferation of osteoblasts on the surface of repeatedly cleaned nanostructured titanium samples. Human osteoblast-like cells MG-63 were seeded on nanostructured titanium specimens manufactured from rods produced by the equal channel angular pressing. For surface characterization, roughness and wettability were measured. Cell adhesion after 2 h as well as cell proliferation after 48 h from plating was assessed. We have found that this repeated cleaning of titanium surface reduced cell adhesion as well as proliferation. These events depend on interplay of surface properties, such as wettability, roughness and topography. It is difficult to distinguish which factors are responsible for these events and further investigations will be required. However, even after the several rounds of repeated cleaning, there was a certain rate of adhesion and proliferation recorded. Therefore the attempts to save failing implants by using in situ cleaning are promising.

Treatments for enhancing the biocompatibility of titanium implants

Titanium surface treatment is a crucial process for achieving sufficient osseointegration of an implant into the bone. If the implant does not heal sufficiently, serious complications may occur, e.g. infection, inflammation, aseptic loosening of the implant, or the stress-shielding effect, as a result of which the implant may need to be reoperated. After a titanium graft has been implanted, several interactions are crucial in order to create a strong bone-implant connection. It is essential that cells adhere to the surface of the implant. Surface roughness has a significant influence on cell adhesion, and also on improving and accelerating osseointegration. Other highly important factors are biocompatibility and resistance to bacterial contamination. Bio-inertness of titanium is ensured by the protective film of titanium oxides that forms spontaneously on its surface. This film prevents the penetration of metal compounds, and it is well-adhesive for calcium and phosphate ions, which are necessary for the formation of the mineralized bone structure. Since the presence of the film alone is not sufficient for the biocompatibility of titanium, a suitable surface finish is required to create a firm bone-implant connection. In this review, we explain and compare the most widely-used methods for modulating the surface roughness of titanium implants in order to enhance cell adhesion on the surface of the implant, e.g. plasma spraying, sandblasting, acid etching, laser treatment, sol-gel etc., The methods are divided into three overlapping groups, according to the type of modification.

Does the implant-abutment interface interfere on marginal bone loss? A systematic review and meta-analysis

The objective of this systematic review was to compare the conical internal connection (IC) with the external hexagonal connection (EH) on the occurrence of marginal bone loss (ΔMBL). Different databases were used to carry out the selection of the elected studies. The studies were judged according to the risk of bias as "high", "low" and "unclear" risk. For the meta-analysis we included only studies that could extract the data of ΔMBL, survival rate (SR) and probing depth (PD). No statistically significant differences were found for ΔMBL data at one, three- and five-year survival rates between implant connections (p <0.05), however statistically significant differences were found for PD between EH and IC implants (1-year follow-up) -0.53 [95%CI -0.82 to -0.24, p = 0.0004]. This present systematic review demonstrated that there are no significant differences between IC and EH implants for both ΔMBL and SR at 1, 3 e 5 years after functional loading, although better PD values were observed for implants pertaining to the IC connections. Considering the high heterogeneity, more well-delineated, randomized clinical trials should be conducted.

A Study of Laser Micromachining of PM Processed Ti Compact for Dental Implants Applications

The paper deals with the experimental study of laser beam micromachining of the powder metallurgy processed Ti compacts applying the industrial grade fibre nanosecond laser operating at the wavelength of 1064 nm. The influence of the laser energy density on the surface roughness, surface morphology and surface elements composition was investigated and evaluated by means of surface roughness measurement, scanning electron microscopy (SEM), energy dispersive X-Ray spectroscopy (EDS) and X-ray diffraction (XRD) analysis. The different laser treatment parameters resulted in the surfaces of very different characteristics of the newly developed biocompatible material prepared by advanced low temperature technology of hydride dehydride (HDH) titanium powder compactation. The results indicate that the laser pulse energy has remarkable effects on the machined surface characteristics which are discussed from the point of view of application in dental implantology.

Bactericidal and Biocompatible Properties of Plasma Chemical Oxidized Titanium (TiOB®) with Antimicrobial Surface Functionalization

Coating of plasma chemical oxidized titanium (TiOB^®) with gentamicin-tannic acid (TiOB^® gta) has proven to be efficient in preventing bacterial colonization of implants. However, in times of increasing antibiotic resistance, the development of alternative antimicrobial functionalization strategies is of major interest. Therefore, the aim of the present study is to evaluate the antibacterial and biocompatible properties of TiOB^® functionalized with silver nanoparticles (TiOB^® SiOx Ag) and ionic zinc (TiOB^® Zn). Antibacterial efficiency was determined by agar diffusion and proliferation test on Staphylocuccus aureus. Cytocompatibility was analyzed by direct cultivation of MC3T3-E1 cells on top of the functionalized surfaces for 2 and 4 d. All functionalized surfaces showed significant bactericidal effects expressed by extended lag phases (TiOB^® gta for 5 h, TiOB^® SiOx Ag for 8 h, TiOB^® Zn for 10 h). While TiOB^® gta (positive control) and TiOB^® Zn remained bactericidal for 48 h, TiOB^® SiOx Ag was active for only 4 h. After direct cultivation for 4 d, viable MC3T3-E1 cells were found on all surfaces tested with the highest biocompatibility recorded for TiOB^® SiOx Ag. The present study revealed that functionalization of TiOB^® with ionic zinc shows bactericidal properties that are comparable to those of a gentamicin-containing coating.