Influence of the Surface Roughness of PEEK GRF30 and Ti6Al4V SLM on the Viability of Primary Human Osteoblasts Determined by the MTT Test

Comparative evaluation on surface nanohardness, surface microhardness, surface roughness, and wettability of plant-based organic nanoparticle reinforced polyetheretherketone as an implant material - An in vitro study

AIM

Synthetic inorganic materials are commonly used as reinforcing agents in polyetheretherketone (PEEK) composite, whereas natural organic plant-based reinforcing agents are negligible. Surface hardness, roughness, and wettability are indicative factors of osseointegration behavior to be used as an implant material. This study evaluated micro surface hardness (MSH), nano surface hardness (NSH), surface roughness (SR), and contact angle (CA) of PEEK-Azadirachta indica reinforced at 10 wt%, 20 wt%, and 30 wt%.

SETTINGS AND DESIGN

This was an in vitro study.

MATERIALS AND METHODS

Neem (A. indica) leaf nanoparticles were prepared and reinforced with PEEK powder at 10%, 20%, and 30% weight ratios by injection molding. Sixty specimens underwent the microhardness and CA testing using a digital microhardness tester, and CA goniometer, respectively, and later nanoindentation test to analyze the nanohardness and SR.

STATISTICAL ANALYSIS USED

A one-way ANOVA test with a 95% confidence interval for MSH and NSH, SR, and CA was performed on the samples. A post hoc Bonferroni test was conducted (α = 0.05) to compare the groups.

RESULTS

There was a significant increase in nanohardness (P = 0.000) with zero difference in microhardness (P = 0.514). The addition of 10 wt%, 20 wt%, and 30 wt% nanoparticles increased the SR value of the pure PEEK from 273.19 nm to 284.10 (3.99%), 296.91 (8.68%), and 287.54 (5.24%), respectively. In the analysis of the CA, CA 20% shows the lowest angle (63.69) with the highest for control specimens (82.39). There is an increase in the PEEK composite SR with a decrease in CA.

CONCLUSIONS

The addition of plant-derived nanoparticles into the PEEK matrix has a significant impact on the hardness and hydrophobicity enhancing cell growth and osteoblastic differentiation during osseointegration of dental implants.

Polyetheretherketone bioactivity induced by farringtonite

Polyetheretherketone (PEEK) is considered as an excellent biomaterial for bone grafting and connective tissue replacement. The clinical potential is, however, limited by its bioinertness, poor osteoconduction, and weak antibacterial activity. These disadvantages can be overcome by introducing suitable additives to produce mineral-polymer composites or coatings. In this work, a PEEK-based bioactive composite has been obtained by blending the polymer with magnesium phosphate (Mg3(PO4)2) particles in amounts ranging from 1 to 10 wt.% using the hot press technique. The obtained composite exhibited improved mechanical and physical properties, above the lower limits set for bone engineering applications. The tested grafts were found to not induce cytotoxicity. The presence of magnesium phosphate induced the mineralisation process with no adverse effects on the expression of the marker crucial for osteoblastic differentiation. The most promising results were observed in the grafts containing 1 wt.% of magnesium phosphate embedded within the PEEK matrix. The improved bioactivity of grafts, together with suitable physical-chemical and mechanical properties, indicate this composite as a promising orthopaedic implant material.

Reliable in vitro method for the evaluation of the primary stability and load transfer of transfemoral prostheses for osseointegrated implantation

Osseointegrated transfemoral prostheses experience aseptic complications with an incidence between 3% and 30%. The main aseptic risks are implant loosening, adverse bone remodeling, and post-operative periprosthetic fractures. Implant loosening can either be due to a lack of initial (primary) stability of the implant, which hinders bone ingrowth and therefore prevents secondary stability, or, in the long-term, to the progressive resorption of the periprosthetic bone. Post-operative periprosthetic fractures are most often caused by stress concentrations. A method to simultaneously evaluate the primary stability and the load transfer is currently missing. Furthermore, the measurement errors are seldom reported in the literature. In this study a method to reliably quantify the bone implant interaction of osseointegrated transfemoral prostheses in terms of primary stability and load transfer was developed, and its precision was quantified. Micromotions between the prosthesis and the host bone and the strains on the cortical bone were measured on five human cadaveric femurs with a typical commercial osseointegrated implant. To detect the primary stability of the implant and the load transfer, cyclic loads were applied, simulating the peak load during gait. Digital Image Correlation was used to measure displacements and bone strains simultaneously throughout the test. Permanent migrations and inducible micromotions were measured (three translations and three rotations), while, on the same specimen, the full-field strain distribution on the bone surface was measured. The repeatability tests showed that the devised method had an intra-specimen variability smaller than 6 μm for the translation, 0.02 degrees for the rotations, and smaller than 60 microstrain for the strain distribution. The inter-specimen variability was larger than the intra-specimen variability due to the natural differences between femurs. Altogether, the measurement uncertainties (intrinsic measurement errors, intra-specimen repeatability and inter-specimen variability) were smaller than critical levels of biomarkers for adverse remodelling and aseptic loosening, thus allowing to discriminate between stable and unstable implants, and to detect critical strain magnitudes in the host bone. In conclusion, this work showed that it is possible to measure the primary stability and the load transfer of an osseointegrated transfemoral prosthesis in a reliable way using a combination of mechanical testing and DIC.

In vitro and in silico methods for the biomechanical assessment of osseointegrated transfemoral prostheses: a systematic review

The amputee population according to the World-Health-Organization is about 40 million. However, there is a high abandon rate of socket prostheses for the lower limb (25%-57%). The direct connection between the external prosthesis and the patient's bone makes osseointegrated prostheses for transfemoral amputees advantageous (e.g., improvement of the motor control) compared to socket prostheses, which are currently the gold standard. However, similarly to other uncemented prostheses, the osseointegrated ones are at risk of aseptic loosening and adverse bone remodelling caused by stress-shielding. The preclinical assessment of these prostheses has already been evaluated using different methods which did not provide unanimous and comparable evidence. To compare data from different investigations, a clear and detailed overview of the methods used to assess the performance is necessary. In this review 17 studies investigating the primary stability, stress shielding and stress concentration of osseointegrated transfemoral prostheses are examined. Primary stability consists in the biomechanical stability upon implant insertion. Primary stability is assessed measuring extraction force (either with a pull-out or a push-out test) and micromotion at the interface between the implant and the host bone with LVDT (in vitro test) or numerical models. Stress-shielding causes adaptive changes in the bone density around metal implants, and thus in the bone strength and stiffness. Stress-shielding is assessed with strain gauges or numerical models measuring the load transfer and the strain distribution on the surface of the femur, and between the implant and the bone respectively. Stress concentration can lead to the formation of cracks inside the bone, resulting in fractures. The stress concentration is assessed measuring the load transfer and the strain energy density at the interface between the implant and the bone, using numerical models. As a result, a global view and consensus about the methods are missing from all these tests. Indeed, different setup and loading scenario were used in the in vitro test, while different model parameters (e.g., bone properties) were used in the numerical models. Once the preclinical assessment method is established, it would be important to define thresholds and acceptance criteria for each of the possible failure scenarios investigated.

Customized Barrier Membrane (Titanium Alloy, Poly Ether-Ether Ketone and Unsintered Hydroxyapatite/Poly-l-Lactide) for Guided Bone Regeneration

Sufficient bone volume is indispensable to achieve functional and aesthetic results in the fields of oral oncology, trauma, and implantology. Currently, guided bone regeneration (GBR) is widely used in reconstructing the alveolar ridge and repairing bone defects owing to its low technical sensitivity and considerable osteogenic effect. However, traditional barrier membranes such as collagen membranes or commercial titanium mesh cannot meet clinical requirements, such as lack of space-preserving ability, or may lead to more complications. With the development of digitalization and three-dimensional printing technology, the above problems can be addressed by employing customized barrier membranes to achieve space maintenance, precise predictability of bone graft, and optimization of patient-specific strategies. The article reviews the processes and advantages of three-dimensional computer-assisted surgery with GBR in maxillofacial reconstruction and alveolar bone augmentation; the properties of materials used in fabricating customized bone regeneration sheets; the promising bone regeneration potency of customized barrier membranes in clinical applications; and up-to-date achievements. This review aims to present a reference on the clinical aspects and future applications of customized barrier membranes.

Functional Compounds from Banana Peel Used to Decrease Oxidative Stress Effects

Banana peel, a little-used waste, contains a high amount of biologically active compounds. The aim of the study is to demonstrate in vitro, the antioxidant, cytotoxic, and antimicrobial effects of hydroalcoholic extracts from yellow (BP) and red (BPR) banana peels. The analysis of the extracts by Capillary Zone Electrophoresis (CZE) has confirmed the presence of several bioactive compounds. BPR has a higher in vitro antioxidant activity than BP, which correlates with a significant cytotoxic, antimicrobial effect, with a UVA/UVB rate of 0.9. In the case of BPR, the results confirm the presence of isoquercitrin and kaempferol in a 1:3 ratio. The bioactive compounds from the extracts have shown a different interaction with HCT-8 cell lines and with tested bacterial strains with pathogenic properties. The HCA analysis proved the biological value of BPR to reduce oxidative stress and its potential use in natural products.

Mechanical Properties and Residual Stress Measurements of Grade IV Titanium and Ti-6Al-4V and Ti-13Nb-13Zr Titanium Alloys after Laser Treatment

Nowadays, surface engineering focuses on research into materials for medical applications. Titanium and its alloys are prominent, especially Ti-6Al-4V and Ti-13Nb-13Zr. Samples made of pure grade IV titanium and the titanium alloys Ti-6Al-4V and Ti-13Nb-13Zr were modified via laser treatment with laser beam frequency f = 25 Hz and laser beam power P = 1000 W during a laser pulse with duration t = 1 ms. Subsequently, to analyze the properties of the obtained surface layers, the following tests were performed: scanning electron microscopy, chemical and phase composition analysis, wetting angle tests and roughness tests. The assessment of the impact of the laser modification on the internal stresses of the investigated materials was carried out by comparing the values of the stresses of the laser-modified samples to those of the reference samples. The obtained results showed increased values of tensile stresses after laser modification: the highest value was found for the Ti-6Al-4V alloy at 6.7434 GPa and the lowest for pure grade IV titanium at 3.742 GPa. After laser and heat treatment, a reduction in the stress was observed, together with a significant increase in the hardness of the tested materials, with the highest value for Ti-6Al-4V alloy at 27.723 GPa. This can provide better abrasion resistance and lower long-term toxicity, both of which are desirable when using Ti-6Al-4V and Ti-13Nb-13Zr alloys for implant materials.

Osseointegration Improvement of Co-Cr-Mo Alloy Produced by Additive Manufacturing

Cobalt-base alloys (Co-Cr-Mo) are widely employed in dentistry and orthopedic implants due to their biocompatibility, high mechanical strength and wear resistance. The osseointegration of implants can be improved by surface modification techniques. However, complex geometries obtained by additive manufacturing (AM) limits the efficiency of mechanical-based surface modification techniques. Therefore, plasma immersion ion implantation (PIII) is the best alternative, creating nanotopography even in complex structures. In the present study, we report the osseointegration results in three conditions of the additively manufactured Co-Cr-Mo alloy: (i) as-built, (ii) after PIII, and (iii) coated with titanium (Ti) followed by PIII. The metallic samples were designed with a solid half and a porous half to observe the bone ingrowth in different surfaces. Our results revealed that all conditions presented cortical bone formation. The titanium-coated sample exhibited the best biomechanical results, which was attributed to the higher bone ingrowth percentage with almost all medullary canals filled with neoformed bone and the pores of the implant filled and surrounded by bone ingrowth. It was concluded that the metal alloys produced for AM are biocompatible and stimulate bone neoformation, especially when the Co-28Cr-6Mo alloy with a Ti-coated surface, nanostructured and anodized by PIII is used, whose technology has been shown to increase the osseointegration capacity of this implant.

Experimental study and numerical simulation for the interaction between laser and PEEK with different crystallinity

Polyetheretherketone (PEEK) sheets with the thickness of 0.5 mm were prepared by compression molding process using Victrex PEEK-450PF, and then PEEK sheets with different crystallinities were obtained by controlling the cooling rate. The optical characteristics of the samples were respectively measured by laser power meter, UV-VIS-IR spectrophotometer. And with the process parameters of laser power density of 245 W/cm2 and moving speed of 5 mm/s, the effect of crystallinity on the laser energy absorption of PEEK and the influence of laser irradiation on the crystallization properties of PEEK sheets were systematically studied. Finally, numerical model of laser energy absorption by PEEK was constructed with COMSOL software. The results show that the reflectivity of PEEK will increase with the increase of crystallinity, while the transmittance decreases. The pure PEEK sheets do not strongly absorb the laser at the wavelength of 1070 nm and the amorphous PEEK is more likely to be ablated. Carbonized samples during the laser irradiation was taken for XRD test and found to be amorphous. After laser irradiation, the crystallinity of the semi-crystalline PEEK material will decrease, but the originally amorphous peek crystallinity will increase slightly. Besides, the numerical simulation results are in good agreement with the experimental results.

Synthesis, X-ray, Hirshfeld surface analysis, exploration of DNA binding, urease enzyme inhibition and anticancer activities of novel adamantane-naphthyl thiourea conjugate

1-(adamantane-1-carbonyl-3-(1-naphthyl)) thiourea (C₂₂H₂₄N₂OS (4), was synthesized by the reaction of freshly prepared adamantane-1-carbonyl chloride from corresponding acid (3) with ammonium thiocyanate in 1:1 M ratio in dry acetone to afford the adamantane-1-carbonyl isothiocyanate (2) in situ followed by treatment with 1-naphthyl amine (3). The structure was established by elemental analyses, FTIR, ¹H, ¹³C NMR and mass spectroscopy. The molecular and crystal structure were determined by single crystal X-ray analysis. It belongs to triclinic system P - 1 space group with a = 6.7832(5) Å, b = 11.1810(8) Å, c = 13.6660(10) Å, α = 105.941(6)°, β = 103.730(6)°, γ = 104.562(6)°, Z = 2, V = 910.82(11) ų. The naphthyl group is almost planar. In the crystal structure, intermolecular CH···O hydrogen bonds link the molecules into centrosymmetric dimers, enclosing R₂²(14) ring motifs, while the intramolecular NH···O hydrogen bonds enclose S(6) ring motifs, in which they may be effective in the stabilization of the structure. The Hirshfeld surface analysis of the crystal structure indicates that the most important contributions for the crystal packing are from H … H (59.3%), H … C/C … H (19.8%) and H … S/S … H (10.1%) interactions. Hydrogen bonding and van der Waals interactions are the dominant interactions in the crystal packing. DFT, molecular docking and urease inhibition studies revealed stability and electron withdrawing nature of 4 as compared to DNA base pairs and residues of urease. The DNA binding results from docking, UV- visible spectroscopy, and viscosity studies indicated significant binding of 4 with the DNA via intercalation and groove binding. Further investigation of the compound was done on hepatocellular carcinoma; Huh-7 cell line as well as normal human embryonic kidney; Hek-293 cell line. The compound showed significant cytotoxic activity against Huh-7 cells in comparison to normal Hek-293 cells indicating selective cytotoxicity towards cancer cells.

Bioavailability and Bioactivities of Polyphenols Eco Extracts from Coffee Grounds after In Vitro Digestion

Coffee grounds are a valuable source of bioactive compounds. In Romania, most of the amount obtained is lost through non-recovery; the rest is occasionally used as organic fertilizer. The coffee grounds were selected according to the roasting degree: blonde roasted (BR), medium roasted (MR), and dark roasted (DR). The study aimed to evaluate three extracts, obtained with a mixture of ethanol/water/acetic acid (50/49.5/0.5), depending on the roasting degree. The majority phenolic component, the antioxidant, and anti-inflammatory effect, as well as the role that gastrointestinal transit had on the bioavailability of bioactive compounds were determined. Chlorogenic acid was inversely proportional to the roasting degree. BR showed the best correlation between antioxidant and anti-inflammatory activities in vitro/in vivo. The antiproliferative capacity of the extracts determined an inhibitory effect on the tumor cells. Antimicrobial activities, relevant in the control of type 2 diabetes, were exerted through the inhibition of microbial strains (Escherichia coli). Following gastric digestion, BR demonstrated a maximum loss of 20% in the stomach. The recovery of coffee grounds depended on the pattern of functional compounds and the bioavailability of the main component, chlorogenic acid.

Application of additive manufacturing in customized titanium mandibular implants for patients with oral tumors

The application of additive manufacturing (AM) technology has been widely used in various medical fields, including craniomaxillofacial surgery. The aim of the present study was to examine the surgical efficiency and post-operative outcomes of patient-specific titanium mandibular reconstruction using AM. Major steps in directly designing and manufacturing 3D customized titanium implants are discussed. Furthermore, pre-operative preparations, surgical procedures and post-operative treatment outcomes were compared among patients who received mandibular reconstruction using a customized 3D titanium implant, titanium reconstruction plates or vascularized autologous fibular grafting. Use of a customized titanium implant significantly improved surgical efficiency and precision. When compared with mandibular reconstruction using the two conventional approaches, patients who received the customized implant were significantly more satisfied with their facial appearance, and exhibited minimal post-operative complications in the 12-month follow-up period. Patients who underwent mandibular reconstruction using a customized titanium implant displayed improved mandibular contour symmetry, restored occlusal function, normal range of mouth opening and no temporomandibular joint related pain; all complications frequently experienced by patients who undergo conventional approaches of mandibular reconstruction.

New aryl Schiff bases of thiadiazole derivative of ibuprofen as DNA binders and potential anticancer drug candidates

The work presented in this paper describes the synthesis of two new aryl Schiff bases [(E)-N-(4-(benzyloxy)-3-methoxybenzylidene)-5-(1-(4-isobutylphenyl)ethyl)-1,3,4-thiadiazol-2-amine] (ASB-1) and [(E)-N-(4-(benzyloxy)benzylidene)-5-(1-(4-isobutylphenyl)ethyl)-1,3,4-thiadiazol-2-amine] (ASB-2). These compounds were characterized by different analytical techniques and then studied for DNA binding. Binding studies were carried out at neutral pH (7.0) and at 37 °C by theoretical and experimental methods including DFT, molecular docking, spectroscopy (UV-visible, fluorescence), cyclic voltammetry (CV) and viscometry. Further investigations of these compounds were done on hepatocellular carcinoma; Huh-7 cancer cell line. Binding constant, free energy change and binding site size, i.e. K_b, ΔG and n were evaluated which indicated that both ASB-1 and ASB-2 bind significantly and spontaneously with the DNA. However, data revealed relatively greater binding of ASB-1 with DNA. Spectral and voltammetric results were found supportive of each other. Binding site sizes and viscosity measurements verified the mixed binding mode of interactions as observed in molecular docking analysis, i.e. intercalation with groove binding. DNA binding studies were very well correlated with the in-vitro studies performed on Huh-7 cell line as well as normal HEK-293 cell lines. The compound ASB-1 not only showed greater binding affinity toward DNA but also showed greater anticancer potency with least IC₅₀ value as compared to ASB-2.