Biomedical Applications of Titanium Alloys: A Comprehensive Review

Advancements in 3D printing technologies for personalized treatment of osteonecrosis of the femoral head

Three-dimensional (3D) printing technology has shown significant promise in the medical field, particularly in orthopedics, prosthetics, tissue engineering, and pharmaceutical preparations. This review focuses on the innovative application of 3D printing in addressing the challenges of osteonecrosis of the femoral head (ONFH). Unlike traditional hip replacement surgery, which is often suboptimal for younger patients, 3D printing offers precise localization of necrotic areas and the ability to create personalized implants. By integrating advanced biomaterials, this technology offers a promising strategy approach for early hip-preserving treatments. Additionally, 3D-printed bone tissue engineering scaffolds can mimic the natural bone environment, promoting bone regeneration and vascularization. In the future, the potential of 3D printing extends to combining with artificial intelligence for optimizing treatment plans, developing materials with enhanced bioactivity and compatibility, and translating these innovations from the laboratory to clinical practice. This review demonstrates how 3D printing technology uniquely addresses critical challenges in ONFH treatment, including insufficient vascularization, poor mechanical stability, and limited long-term success of conventional therapies. By introducing gradient porous scaffolds, bioactive material coatings, and AI-assisted design, this work outlines novel strategies to improve bone regeneration and personalized hip-preserving interventions. These advancements not only enhance treatment efficacy but also pave the way for translating laboratory findings into clinical applications.

Regenerative approaches in alveolar bone augmentation for dental implant placement: Techniques, biomaterials, and clinical decision-making: A comprehensive review

OBJECTIVES

This review aimed to evaluate the outcomes of ridge augmentation techniques and bio-materials for alveolar bone regeneration, addressing inconsistencies across studies. A decision tree is provided to guide clinicians in selecting optimal approaches for diverse clinical scenarios.

DATA AND SOURCES

An extensive search was conducted across electronic databases, including PubMed, Scopus, and Embase, alongside dental implant and prosthodontics journal portals. Reference lists of relevant articles were also manually reviewed up to October 2024.

STUDY SELECTION

Inclusion criteria were established to emphasize English-language human clinical trials investigating regenerative techniques and materials utilized for ridge augmentation prior to implant placement.

CONCLUSIONS

Selecting defect-specific regenerative approaches is crucial for successful outcomes in alveolar bone augmentation. While autografts remain the gold standard, advancements in allografts, xenografts, synthetics, and biological enhancers are transforming the field. Distraction osteogenesis is also gaining prominence as a promising technique. Clinicians should leverage these innovations to tailor treatments to individual patient needs for optimal results. The decision tree developed categorizes alveolar bone defects and suggests tailored approaches based on anticipated resorption patterns.

CLINICAL SIGNIFICANCE

Careful patient evaluation and tailored technique selection, combined with advancements in biomaterials and tissue engineering, are essential for achieving optimal outcomes in ridge augmentation, particularly for challenging vertical defects.

Glutenin phase transition as a method of fabricating primer for superhydrophobic and corrosion-resistant coating

Concerns over food safety arising from conventional plastic and resin-based corrosion barriers cannot be underestimated, particularly in light of the potential for plasticizer migration. We introduce an environmental-friendly and sustainable approach to develop superhydrophobic and anticorrosion coatings. This involved a unique process where glutenin, post-reduction with tris(2-carboxyethyl)phosphine, underwent a phase transition, naturally adhering to diverse surfaces to form a foundational primer. The core mechanism of this adhesion lied the β-sheet stacking configuration, confirmed by grazing-incidence wide-angle X-ray scattering. To further elevate the performance, carnauba wax was easily incorporated as a topcoat, forming a superhydrophobic coating that surpassed standalone wax coatings in durability against wear, impact, high temperature, and corrosion. This enhancement was derived from the intricate intermolecular interactions, including hydrogen bonding and hydrophobic interactions, established between the primer and carnauba wax. Notably, the phase-transited coating and superhydrophobic coating maintained a low-frequency impedance of 0.1 and 2.1 MΩ/cm2, respectively, even after prolonged immersion in a 3.5 % NaCl solution for 21 days. The superhydrophobic coating was ideally applicated in an extensive range of canned food products, such as beverages, fruits, etc., that undergo pasteurization. Additionally, both the primer and the superhydrophobic coating exhibited outstanding biocompatibility, as evidenced by red blood cell hemolysis and cytotoxicity assessments. In summary, this research contributes significant knowledge to the development of superhydrophobic coatings and expand applications of protein-based assembly materials.

A new era for applications of multi-principal element alloys in the biomedical field

In today's context of an aging population and the gradual decline of human physiological functions, we are increasingly confronted with health issues such as fractures and arthritis. The demand for implants has risen correspondingly, while traditional alloys have become insufficient to meet the developmental needs of this era. The emergence of multi-principal element alloys (or high-entropy alloys) in 2004 has attracted significant attention, leading to extensive research due to their remarkable four core effects. Currently, multi-principal element alloys are gradually demonstrating their potential in the biomedical field. Therefore, a review of multi-principal element alloys in biomedical applications is of high interest. This paper explores the key considerations in the design of biological multi-principal element alloys, focusing on the latest research advancements in areas such as orthopedic implants, dentistry, and cardiovascular stents. We analyze their advantages in mechanical properties and biocompatibility while introducing their preparation methods. Furthermore, the article discusses the challenges faced by biological multi-principal element alloys in current research and anticipates future development directions for these materials. The primary objective of this review is to show the potential applications of multi-principal element alloys in implants, ensuring that the discussion remains engaging and novel. We aim to provide a reference to facilitate development of multi-principal element alloys for practical applications in the biomedical field.

Comparison Between Micro- and Micro-Nano Surface Texturization in the Initial Osseointegration Process: An Experimental In Vitro and In Vivo Preclinical Study

BACKGROUND

The physicochemical changes of the surface aim to improve cell adhesion, proliferation, and differentiation, that is, better biological interaction with the cells and, consequently, with the peri-implant tissues. In the present study, implants with the same macrogeometry were compared in vitro and in vivo, but with two different surfaces: micro-rough and a new micro-nano-rough surface.

MATERIALS AND METHODS

A total of 90 implants were used, 10 of which were used for in vitro surface characterization (n = 5 per group) through scanning electron microscopy (SEM), atomic force microscopy (AFM), and surface roughness measurements. For in vivo tests, 80 implants (n = 40 per group) were used in 20 rabbits (n = 2 implants per tibia). Two experimental groups were created: a control group, where the implants had a surface treated by sandblasting with titanium oxide microparticles, and a test group, where the implants were sandblasted using the same process as the previous group plus acid conditioned. The implant stability quotient (ISQ) was measured by resonance frequency (initially and at both euthanasia times). Animals were euthanized 3 and 5 weeks after implantation (n = 10 animals per time). Ten samples from each group at each time point were evaluated by removal torque (RTv). Another ten samples from each group were evaluated histologically and histomorphometrically, measuring the percentage of bone-to-implant contact (%BIC) and the bone area fraction occupancy (%BAFO).

RESULTS

In vitro, it was possible to observe a more homogeneous surface for the test group compared to the control group. ISQ values showed statistical differences at both 3 and 5 weeks (test > control). For RTv, the values were: 44.5 ± 4.25 Ncm (control group) and 48.6 ± 3.17 Ncm (test group) for the time of 3 weeks; 64.3 ± 4.50 Ncm (control group) and 76.1 ± 4.18 Ncm (test group) at 5 weeks. The %BIC and %BAFO values measured in both groups and at both times did not show significant differences (p > 0.05).

CONCLUSIONS

The higher removal torque and ISQ values presented in the samples from the test group compared to the control group indicate that there was an acceleration in the mineralization process of the newly formed bone matrix.

Innovative 3D printing technologies and advanced materials revolutionizing orthopedic surgery: current applications and future directions

Three-dimensional (3D) printing has rapidly become a transformative force in orthopedic surgery, enabling the creation of highly customized and precise medical implants and surgical tools. This review aims to provide a more systematic and comprehensive perspective on emerging 3D printing technologies-ranging from extrusion-based methods and bioink printing to powder bed fusion-and the broadening array of materials, including bioactive agents and cell-laden inks. We highlight how these technologies and materials are employed to fabricate patient-specific implants, surgical guides, prosthetics, and advanced tissue engineering scaffolds, significantly enhancing surgical outcomes and patient recovery. Despite notable progress, the field faces challenges such as optimizing mechanical properties, ensuring structural integrity, addressing regulatory complexities across different regions, and considering environmental impacts and cost barriers, especially in low-resource settings. Looking ahead, innovations in smart materials and functionally graded materials (FGMs), along with advancements in bioprinting, hold promise for overcoming these obstacles and expanding the capabilities of 3D printing in orthopedics. This review underscores the pivotal role of interdisciplinary collaboration and ongoing research in harnessing the full potential of additive manufacturing, ultimately paving the way for more effective, personalized, and durable orthopedic solutions that improve patient quality of life.

Predicting the biomechanical behavior of lumbar intervertebral Discs: A comparative finite element analysis of a novel artificial disc design

Osseointegration along with better mimicry of natural bone behaviour addresses the long-term performance of artificial intervertebral disc prosthesis. Here the effect of a novel artificial intervertebral disc geometry on stress, deformation and strain on lumbar segments to restore movement of the spine was investigated. The process involved, using CT image data, and solid modelling, simulation-driven design and finite element (FE) analysis, hexahedral mesh sensitivity analysis, implant placements. The range of motion (ROM) was calculated using an ANSYS deformation probe. The intact lumbar spine model established was compared with two implants, replacement at segment L4-L5 level, and biomechanical results were compared using axial loads of 500 N, 800 N, 1000 N and 10Nm moment. The two lumbosacral FE models, a novel implant Titanium Conix (TIC) and another FDA approved SB Charite™ (SBC) implant were considered. Novel TIC implant geometry exhibited comparable ROM values in four physiological motions, which were comparable to as required for restoring natural motion. The result shows that the proposed TIC observed the deformation during flexion, extension, bending and twist as 3.43 mm, 3.19 mm, 3.33 mm and 3.48 mm respectively. Similarly strain of 0.01 during flexion, 0.02 during extension, 0.01 during bending and 0.02 during twist. The implants designed in this study demonstrate the suitability of titanium alloy in endplates and annulus. The FE models in the study with their biomechanical parameters can be considered before clinical implementation of any implants, pre-surgery evaluations, implant placement simulations, postsurgical response, follow-up revisions, implant customization and manufacturing.

Enhancing Bioactivity of Titanium-Based Materials Through Chitosan Based Coating and Calcitriol Functionalization

Titanium (Ti)-based materials are favored for hard tissue applications, yet their bioinertness limits their success. This study hypothesizes that functionalizing Ti materials with chitosan nano/microspheres and calcitriol (VD) will enhance their bioactivity by improving cellular activities and mineralization. To test this, chitosan particles were applied uniformly onto Ti surfaces using electrophoretic deposition (EPD) at 20 V for 3 minutes. VD was then loaded onto the coated surfaces, and the release profile of VD was monitored. Human fetal osteoblastic cells (hFOB) were cultured on the VD-loaded Ti surfaces. Cellular activities such as proliferation, Alkaline phosphatase (ALP) activity, osteogenic gene expression (runt-related transcription factor 2 (Runx2), collagen type 1 (Col I), osteocalcin ( OCn), osteopontin (OP)), and mineralization were assessed. Von Kossa staining was performed to analyze mineralization, and the expression of cell adhesion proteins (N-cadherin (NC), integrin alpha V (IaV), integrin beta 3, (Ib3)) was measured. The results showed that approximately 50% of the VD released over 50 hours. The chitosan coating increased surface roughness three-fold, and this, combined with VD release, resulted in reduced cell proliferation but increased ALP activity, suggesting enhanced differentiation. VD-functionalized Ti surfaces showed statistically significant differences in osteogenic gene expressions, particularly on rougher surfaces. Additionally, the expression of cell adhesion proteins (NC, IaV, Ib3) was upregulated on VD-containing coated surfaces. Von Kossa analysis revealed that surface roughness significantly enhanced mineralization, particularly on VD-free surfaces by day 7, while mineralization on VD-containing bare surfaces started on day 14. These findings demonstrate that VD-loaded chitosan coatings significantly enhance the biocompatibility and bioactivity of Ti-based materials, highlighting their potential for applications in bone regeneration.

Electrolytic Routes to Titanium: Methodological Innovations, Key Findings, and Prospects for Sustainable Production

Titanium is an indispensable strategic metal, and the greening of titanium production processes is a key safeguard for the further development of the titanium industry. Traditional titanium extraction methods involve high-temperature molten salts and high energy consumption, accompanied by significant environmental issues. The electrolytic method for the production of titanium is a more environmentally friendly and promising production process. This review examines recent advancements in electrolytic titanium production, focusing on methods like the FFC, OS, SHS-ED, and USTB processes. These methods offer more efficient and environmentally friendly alternatives to traditional titanium extraction. Key findings include improvements in anode materials, electrolyte compositions, and process optimizations, which enhance titanium purity and production efficiency. The SHS-ED method, in particular, has shown significant advantages by shortening the deoxidation reaction path, improving process efficiency, and reducing the formation of undesirable phases. Despite these advancements, challenges remain in improving current efficiency, reducing energy consumption, and scaling up production. This article aims to provide guidance for future research directions and to discuss how to further promote the development of electrolytic titanium technology for more efficient and environmentally friendly titanium production.

Narrative Review and Guide: State of the Art and Emerging Opportunities of Bioprinting in Tissue Regeneration and Medical Instrumentation

Three-dimensional printing was introduced in the 1980s, though bioprinting started developing a few years later. Today, 3D bioprinting is making inroads in medical fields, including the production of biomedical supplies intended for internal use, such as biodegradable staples. Medical bioprinting enables versatility and flexibility on demand and is able to modify and individualize production using several established printing methods. A great selection of biomaterials and bioinks is available, including natural, synthetic, and mixed options; they are biocompatible and non-toxic. Many bioinks are biodegradable and they accommodate cells so upon implantation, they integrate within the new environment. Bioprinting is suitable for printing tissues using living or viable components, such as collagen scaffolding, cartilage components, and cells, and also for printing parts of structures, such as teeth, using artificial man-made materials that will become embedded in vivo. Bioprinting is an integral part of tissue engineering and regenerative medicine. The addition of newly developed smart biomaterials capable of incorporating dynamic changes in shape depending on the nature of stimuli led to the addition of the fourth dimension of time in the form of changing shape to the three static dimensions. Four-dimensional bioprinting is already making significant inroads in tissue engineering and regenerative medicine, including new ways to create dynamic tissues. Its future lies in constructing partial or whole organ generation.

Effect of Laser Quenching on Wire-Powder Collaborative Arc Additive Manufacturing of Ti6Al4V-Cu Alloys with 2.4% and 7.9% Copper Content

In this work, Ti6Al4V-Cu alloys with different Cu contents (2.4 and 7.9 wt.%) were fabricated using novel wire-powder synchronous arc additive manufacturing to analyze the effect of laser quenching on Ti6Al4V-Cu alloys. The results show that this method can successfully produce Ti6Al4V-Cu alloys with a uniform composition. As the copper content increased, the alloy transitioned from a Widmanstätten structure to a basketweave structure, and the yield strength and tensile strength of the alloy increased by approximately 35% due to grain refinement and the high volume fraction of Ti2Cu with eutectic lamellae. The microhardness of the alloys significantly increased after laser quenching, particularly for those with low copper contents (from 311 HV to 510 HV). Laser quenching also enhanced the corrosion resistance of the alloy in a 3.5% NaCl solution.

Microstructural and Surface Texture Evaluation of Orthodontic Microimplants Covered with Bioactive Layers Enriched with Silver Nanoparticles

Bacterial infections are a common cause of clinical complications associated with the use of orthodontic microimplants. Biofilm formation on their surfaces and subsequent infection of peri-implant tissues can result in either exfoliation or surgical removal of these medical devices. In order to improve the properties of microimplants, hybrid coatings enriched with silver nanoparticles, calcium, and phosphorus were investigated. The present study aimed to assess the microstructure of commercially available microimplants composed of a medical TiAlV (Ti6Al4V) alloy covered with organic-inorganic layers obtained by the sol-gel method using the dip-coating technique. The microstructures and elemental surface compositions of the sterile, etched, and layer-modified microimplants were characterized by scanning electron microscopy with X-ray energy-dispersive spectroscopy (SEM-EDS). Elements such as silver (Ag), calcium (Ca), phosphorus (P), silicon (Si), oxygen (O), and carbon (C) were detected on the microimplant's surface layer. The SEM observations revealed that control microimplants (unetched) had smooth surfaces with only manufacturing-related embossing, while etching in hydrofluoric acid increased the surface roughness and introduced fluoride onto the microimplants. Layers with only silver nanoparticles reduced the roughness of the implant surface, and no extrusion was observed, while increased roughness and emerging porosity were observed when the layers were enriched with calcium and phosphorus. The highest roughness was observed in the microimplants etched with AgNPs and CaP, while the AgNPs-only layer showed a reduction in the roughness average parameter due to lower porosity. Enhancing the effectiveness of microimplants can be achieved by applying selective surface treatments to different parts. By keeping the outer tissue contact area smooth while making the bone contact area rough to promote stronger integration with bone tissue, the overall performance of the implants can be significantly improved.

Biomaterials for bone tissue engineering: achievements to date and future directions

Advancement in medicine and technology has resulted into prevention of countless deaths and increased life span. However, it is important to note that, the modern lifestyle has altered the food habits, witnessed increased life-style stresses and road accidents leading to several health complications and one of the primary victims is the bone health. More often than ever, healthcare professionals encounter cases of massive bone fracture, bone loss and generation of critical sized bone defects. Surgical interventions, through the use of bone grafting techniques are necessary in such cases. Natural bone grafts (allografts, autografts and xenografts) however, have major drawbacks in terms of delayed rehabilitation, lack of appropriate donors, infection and morbidity that shifted the focus of several investigators to the direction of synthetic bone grafts. By employing biomaterials that are based on bone tissue engineering (BTE), synthetic bone grafts provide a more biologically acceptable approach to establishing the phases of bone healing. In BTE, various materials are utilized to support and enhance bone regeneration. Biodegradable polymers like poly-(lactic acid), poly-(glycolic acid), and poly-(ϵ-caprolactone) are commonly used for their customizable mechanical properties and ability to degrade over time, allowing for natural bone growth. PEG is employed in hydrogels to promote cell adhesion and growth. Ceramics, such as hydroxyapatite and beta-tricalcium phosphate (β-TCP) mimic natural bone mineral and support bone cell attachment, withβ-TCP gradually resorbing as new bone forms. Composite materials, including polymer-ceramic and polymer-glasses, combine the benefits of both polymers and ceramics/glasses to offer enhanced mechanical and biological properties. Natural biomaterials like collagen, gelatin, and chitosan provide a natural matrix for cell attachment and tissue formation, with chitosan also offering antimicrobial properties. Hybrid materials such as decellularized bone matrix retain natural bone structure and biological factors, while functionalized scaffolds incorporate growth factors or bioactive molecules to further stimulate bone healing and integration. The current review article provides the critical insights on several biomaterials that could yield to revolutionary improvements in orthopedic medical fields. The introduction section of this article focuses on the statistical information on the requirements of various bone scaffolds globally and its impact on economy. In the later section, anatomy of the human bone, defects and diseases pertaining to human bone, and limitations of natural bone scaffolds and synthetic bone scaffolds were detailed. Biopolymers, bioceramics, and biometals-based biomaterials were discussed in further depth in the sections that followed. The article then concludes with a summary addressing the current trends and the future prospects of potential bone transplants.

Applications of piezoelectric biomaterials in dental treatments: A review of recent advancements and future prospects

Piezoelectric biomaterials have attracted considerable attention in dental medicine due to their unique ability to convert mechanical force into electricity and catalyze reactions. These materials demonstrate biocompatibility, high bioactivity, and stability, making them suitable for applications such as tissue regeneration, caries prevention, and periodontal disease treatment. Despite their significant potential, the clinical application of these materials in treating oral diseases remains limited, facing numerous challenges in clinical translation. Therefore, further research and data are crucial to advance their application in dentistry. The review emphasizes the transformative impact of multifunctional piezoelectric biomaterials on enhancing dental therapies and outlines future directions for their integration into oral healthcare practices.

Optimizing Suitable Mechanical Properties for a Biocompatible Beta-Titanium Alloy by Combining Plastic Deformation with Solution Treatment

The microstructural and mechanical features were investigated for the alloy Ti-36.5Nb-4.5Zr-3Ta-0.16O (wt.%) subjected to thermo-mechanical processing consisting of a series of hot and cold rolling combined with solution treatments with particular parameters. The objective was to find the optimal thermo-mechanical treatment variant to improve the mechanical properties, and namely, to increase the yield tensile strength (YTS) and the ultimate tensile strength (UTS), with a low modulus of elasticity and with an adequate ductility in order to obtain a good biomaterial appropriate for use in hard tissue implants. X-ray diffraction and SEM microscopy served to investigate the microstructural features: the type of formed phases with their morphology, dimensions, and distribution. The experimental alloy presented mainly a β-phase with some α″-Ti martensitic phase in particular stages of the processing scheme. The main mechanical properties were found by applying a tensile test, from which were determined the yield tensile strength [MPa], the ultimate tensile strength [MPa], Young's modulus of elasticity [GPa], and the elongation to fracture (%).

Evaluation of the In Vitro Behavior of Electrochemically Deposited Plate-like Crystal Hydroxyapatite Coatings

The purpose of coatings is to protect or enhance the functionality of the substrate material, irrespective of the field in which the material was designed. The use of coatings in medicine is rapidly expanding with the objective of enhancing the osseointegration ability of metallic materials such as titanium. The aim of this study was to obtain biomimetic hydroxyapatite (HAp)-based coatings on titanium by using the pulsed galvanostatic method. The morphology of the HAp-based coatings revealed the presence of very thin and wide plate-like crystals, grown perpendicular to the Ti substrate, while the chemical composition highlighted a Ca/P ratio of 1.66, which is close to that of stoichiometric HAp (1.67). The main phases and chemical bonds identified confirmed the presence of the HAp phase in the developed coatings. A roughness of 228 nm and a contact angle of approx. 17° were obtained for the HAp coatings, highlighting a hydrophilic character. In terms of biomineralization and electrochemical behavior, it was shown that the HAp coatings have significantly enhanced the titanium properties. Finally, the in vitro cell tests carried out with human mesenchymal stem cells showed that the Ti samples coated with HAp have increased cell viability, extracellular matrix, and Ca intracellular deposition when compared with the uncoated Ti, indicating the beneficial effect.

Enhancing Antibacterial Properties of Titanium Implants through Covalent Conjugation of Self-Assembling Fmoc-Phe-Phe Dipeptide on Titania Nanotubes

Bacterial infections and biofilm formation are significant challenges for medical implants. While titanium nanotube engineering improves biocompatibility, it cannot prevent bacterial adhesion and biofilm formation. Optimizing the biomaterial's surface chemistry is vital for its desired functioning in the biological environment. This study demonstrates the covalent conjugating of the self-assembling dipeptide N-fluorenylmethyloxycarbonyl-diphenylalanine (Fmoc-FF) onto titanium nanotube surfaces (TiNTs) without altering the topography. Fmoc-FF peptides, in conjugation with TiNTs, can inhibit biofilm formation, eradicate pre-existing biofilms, and kill bacteria. This functionalization imparts antibacterial properties to the surface while retaining beneficial nanotube topography, synergistically enhancing bioactivity. Surface characterization by XPS, FT-IR, EDS, and SEM confirmed the successful functionalization. Bacterial adhesion experiments showed a significantly improved antibacterial activity of the functionalized TiNT surfaces. This study opens future possibilities for associating biomedical applications such as cell-cell interactions, tissue engineering, and controlled drug delivery of multifunctional self-assembling short peptides with implant materials through surface functionalization.

Protein profile at newly restored implants compared to contralateral teeth over 12-months: a pilot study

OBJECTIVES

To determine crevicular fluid alterations in protein expression of newly restored implants during their first year of function and associate them with those of contralateral teeth.

MATERIALS AND METHODS

In ten non-smokers, successfully treated for periodontitis, one newly restored implant (baseline-T0) and one corresponding tooth were followed for 12-months (T1). Oral hygiene was monitored during the study. Periodontal clinical indices and crevicular fluid were collected from an implant-site (PICF) and a tooth-site (GCF). Total proteomic profiles of PICF and GCF were investigated using label-free quantitative proteomics.

RESULTS

Clinical recordings remained stable at 12-months on the tooth-/implant-site basis. The comparative analysis of protein enrichment between teeth and implants at T0 revealed 664 human proteins, with 93 found only in teeth and 217 exclusively in implants. Among the 354 overlapping proteins, 46 were upregulated (log2FC > 1) in teeth, while 61 in implants. At T1, 569 human proteins were exclusively identified, with 67 found only in teeth and 193 exclusively in implants. Of the 309 overlapping proteins, 22 were upregulated in teeth, while 48 were in implants. The over-representation enrichment analysis identified "interferon-alpha response" and "allograft rejection" pathways, as significantly regulated categories at T0, with the latter being over-represented at T1.

CONCLUSIONS

Peri-implant tissue maturation was evident during the study. Proteins expressed in crevicular fluid reflected unique patterns between implants and teeth that are worth studying.

CLINICAL RELEVANCE

Different proteomic patterns were observed at the implant-site compared to the contralateral tooth-site towards inflammatory processes that prevail within otherwise clinically healthy peri-implant tissues.

CLINICAL TRIAL REGISTRATION NUMBER

ClinicalTrials.gov ID: NCT06379022.

Development of Biocompatible Coatings with PVA/Gelatin Hydrogel Films on Vancomycin-Loaded Titania Nanotubes for Controllable Drug Release

This study investigates the utilization of poly(vinyl alcohol) (PVA)/gelatin hydrogel films cross-linked with glutaraldehyde as a novel material to coat the surface of vancomycin-loaded titania nanotubes (TNTs), with a focus on enhancing biocompatibility and achieving controlled vancomycin release. Hydrogel films have emerged as promising candidates in tissue engineering and drug-delivery systems due to their versatile properties. The development of these hydrogel films involved varying the proportions of PVA, gelatin, and glutaraldehyde to achieve the desired properties, including the gel fraction, swelling behavior, biocompatibility, and biodegradation. Among the formulations tested, the hydrogel with a PVA-to-gelatin ratio of 25:75 and 0.2% glutaraldehyde was selected to coat vancomycin-loaded TNTs. The coated TNTs demonstrated slower release of vancomycin compared with the uncoated TNTs. In addition, the coated TNTs demonstrated the ability to promote osteogenesis, as evidenced by increased alkaline phosphatase activity and calcium accumulation. The vancomycin-loaded TNTs coated with hydrogel film demonstrated effectiveness against both E. coli and S. aureus. These findings highlight the potential benefits and therapeutic applications of using hydrogel films to coat implant materials, offering efficient drug delivery and controlled release. This study contributes valuable insights into the development of alternative materials for medical applications, thereby advancing the field of biomaterials and drug delivery systems.

Amorphous TiO2nano-coating on stainless steel to improve its biological response

This study delves into the potential of amorphous titanium oxide (aTiO2) nano-coating to enhance various critical aspects of non-Ti-based metallic orthopedic implants. These implants, such as medical-grade stainless steel (SS), are widely used for orthopedic devices that demand high strength and durability. The aTiO2nano-coating, deposited via magnetron sputtering, is a unique attempt to improve the osteogenesis, the inflammatory response, and to reduce bacterial colonization on SS substrates. The study characterized the nanocoated surfaces (SS-a TiO2) in topography, roughness, wettability, and chemical composition. Comparative samples included uncoated SS and sandblasted/acid-etched Ti substrates (Ti). The biological effects were assessed using human mesenchymal stem cells (MSCs) and primary murine macrophages. Bacterial tests were carried out with two aerobic pathogens (S. aureusandS. epidermidis) and an anaerobic bacterial consortium representing an oral dental biofilm. Results from this study provide strong evidence of the positive effects of the aTiO2nano-coating on SS surfaces. The coating enhanced MSC osteoblastic differentiation and exhibited a response similar to that observed on Ti surfaces. Macrophages cultured on aTiO2nano-coating and Ti surfaces showed comparable anti-inflammatory phenotypes. Most significantly, a reduction in bacterial colonization across tested species was observed compared to uncoated SS substrates, further supporting the potential of aTiO2nano-coating in biomedical applications. The findings underscore the potential of magnetron-sputtering deposition of aTiO2nano-coating on non-Ti metallic surfaces such as medical-grade SS as a viable strategy to enhance osteoinductive factors and decrease pathogenic bacterial adhesion. This could significantly improve the performance of metallic-based biomedical devices beyond titanium.

Spark Plasma Sintering of Pure Titanium: Microstructure and Mechanical Characteristics

The versatility of titanium (Ti) allows it to be employed in various industries, from aerospace engineering to medical technology, highlighting its significance in modern manufacturing and engineering processes. Spark plasma sintering (SPS) is currently being explored to enhance its properties further and broaden its application range. The current study focuses on exploring and optimizing the effect of SPS temperature (800, 900, 1000, 1100, 1200, and 1400 °C) on pure Ti sintered at 60 MPa in a controlled argon environment with a dwell time of 5 min. All the prepared samples were highly dense with a relative density above 99%, but exhibited significant variations in grain size (10 to 57 µm), tensile yield strength (488 to 700 MPa), ultimate tensile strength (597 to 792 MPa), and ductility (4 to 7%). A microstructural investigation was performed using XRD, SEM, and EDS to predict the influence of sintering temperature on the formation of different phases. The XRD patterns of all sintered samples showed the presence of single-phase α-Ti with hexagonally close-packed Ti. This work is a step forward in optimizing SPS-processed Ti's physical and mechanical properties for enhanced structural and biomedical applications.

Effect of Co-Sputtered Copper and Titanium Oxide Coatings on Bacterial Resistance and Cytocompatibility of Osteoblast Cells

One of the primary risk factors for implant failure is thought to be implant-related infections during the early healing phase. Developing coatings with cell stimulatory behaviour and bacterial adhesion control is still difficult for bone implants. This study proposes an approach for one-step deposition of biocompatible and antimicrobial Cu-doped TiO2 coatings via glow-discharge sputtering of a mosaic target. During the deposition, the bias of the Ti6Al4V substrates was changed. Structure examination, phase analysis, and surface morphology were carried out using X-ray diffraction (XRD) analysis, scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS). The hardness values and hydrophilic and corrosion performance were also evaluated together with cytocompatible and antibacterial examinations against E. coli and S. aureus. The results show great chemical and phase control of the bias identifying rutile, anatase, CuO, or ternary oxide phases. It was found that by increasing the substrate bias from 0 to -50 V the Cu content increased from 15.3 up to 20.7 at% while at a high bias of -100 V, the copper content reduced to 3 at%. Simultaneously, apart from the Cu2+ state, Cu1+ is also found in the biased samples. Compared with the bare alloy, the hardness, the water contact angle and corrosion resistance of the biased coatings increased. According to an assessment of in vitro cytocompatibility, all coatings were found to be nontoxic to MG-63 osteoblast cells over the time studied. Copper release and cell-surface interactions generated an antibacterial effect against E. coli and S. aureus strains. The -50 V biased coating combined the most successful results in inhibiting bacterial growth and eliciting the proper responses from osteoblastic cells because of its phase composition, electrochemical stability, hydrophilicity, improved substrate adhesion, and surface roughness. Using this novel surface modification approach, we achieved multifunctionality through controlled copper content and oxide phase composition in the sputtered films.

Progress in the Optimization of Compositional Design and Thermomechanical Processing of Metastable β Ti Alloys for Biomedical Applications

Over the past few years, significant research and development in the manufacturing industry related to the medical field has been done. The aim has been to improve existing biomaterials and bioimplants by exploring new methods and strategies. Beta titanium alloys, known for their exceptional strength-to-modulus ratio, corrosion resistance, biocompatibility, and ease of shaping, are expected to play a crucial role in manufacturing the next generation of biomedical equipment. To meet the specific requirements of human bone, researchers have employed key techniques like compositional design and thermomechanical processing routes to advance biomaterial development. These materials find extensive applications in orthopedic, orthodontic, and cardiovascular biomedical implants. Several studies have shown that precise material composition, with appropriate heat treatment and suitable mechanical approaches, can yield the desired mechanical properties for bone implants. In this review article, we explore the evolution of alloys at different stages, with a particular focus on their preparation for use in biomedical implants. The primary focus is on designing low-modulus β Ti alloy compositions and employing processing techniques to achieve high strength while maintaining a low young modulus suitable for biomedical applications.

Analyzing the Surface Topography of Hafnium Nitride Coating on Titanium Screws: An In Vitro Analysis

Background The use of surface coatings to enhance the properties lacking in titanium has attracted significant focus in recent times. Hafnium nitride (HfN) coatings could be explored as promising in the osteoinductive properties of titanium implants. HfN exhibits excellent mechanical attributes, such as hardness and wear resistance, and is often used as a coating on high-end equipment for protection. The findings from this research may carve a new path for the production and optimization of HfN coatings to enhance the longevity and augment properties of implant materials. Thus, the present study was orchestrated to elucidate the surface morphology of HfN coating, ultimately contributing to the advancement of dental implant biomaterials. Materials and methods A total of twenty samples of medical grade commercially pure titanium screws (2 mm diameter and 7 mm length) were procured from G. R. Bioure Surgical System Pvt. Ltd., Ravali, Uttar Pradesh, India, and ten samples were reacted with HfN (0.1 M) (Nano Research Elements, Kurukshetra, Haryana, India) in 100% ethanol and stirred continuously for about 48 hours. Then these screw samples were immersed in the prepared colloidal suspension and sintered for two hours at 400 degrees centigrade. The implant screws were affixed onto metal supports. The magnifications for photomicrographs at ×30, ×200, ×1,500, ×3,000, and ×5,000 were standardized. Elementary semi-quantitative analysis of both dental implants was conducted using energy-dispersive X-ray spectrometry (EDX) coupled with the field emission scanning electron microscope (FE-SEM) equipment (JEOL Ltd., Akishima, Tokyo, Japan). The software used for the analysis of the obtained images is SEM Center. Results The surface analysis using the scanning electron microscope (SEM) showed the coating of HfN over titanium screws. The difference in surface morphology of both the group of implant screws can be visualized under 40.0 and 10.0 mm working distance (WD) for both groups. The surface analysis using the EDX of uncoated titanium screws shows five elements in the spectrum: titanium (Ti), oxygen (O), aluminum (Al), carbon (C), and vanadium (V). The EDX of the HfN-coated screws has two additional metals dispersed in the spectrum, hafnium (Hf). The element characteristics are tabulated with their apparent concentration, k ratio, line type, weight percentage, standard label, and factory label for uncoated titanium screws and HfN-coated titanium screws. Conclusion The study evaluated HfN coating over medical grade commercially pure titanium. The surface topography of coated versus uncoated was visualized. The scanning electron microscope (SEM) images showed a homogenous coating over the titanium surfaces, and the EDX showed elemental dispersion of the coated implant. The study aims to provide a comprehensive understanding of the coating's surface morphology, which will aid in the development of more durable and biocompatible implants. This thereby provides a promising scope for further research of this novel metal coating for use in the biomedical sectors, specifically for dental implants.

The effects of oxygen addition on microstructure and mechanical properties of Ti-Mo alloys for biomedical application

The effective use of oxygen as an alloying element in Ti alloys is attractive due to the reduction of production cost and the increase in strength and hardness of the alloy. Although the oxygen addition in a Ti alloy increases strength and hardness, it may induce brittleness. An appropriate combination of alloying elements and thermomechanical treatment must be clarified for the use of oxygen as an alloying element. Ti-(0, 1.0, 2.0, 3.0)Mo-(0, 1.5, 3.0)O alloys were developed, and their microstructure and mechanical properties were examined. Ti-1Mo-3O alloy exhibited fine grains of α+β two phases having the tensile strength of 1,297 MPa with 15.5% for total strain at fracture. The Ti-1Mo-3O alloy has 1.5 times the tensile strength and the same total strain as the Ti-6Al-4V ELI alloy. Ti-(1.0, 2.0, 3.0)Mo-1.5O alloys also have excellent mechanical properties, with tensile strength of about 1,050-1,150 MPa and a total strain of about 20%-25%. In order to develop a high strength and moderate ductility Ti-Mo alloy using oxygen as an alloying element, the microstructure should have fine grains of α+β two phases with proper volume fraction of α and β phases and specific molybdenum concentration in β phase.

Finite Element Simulation and Microstructural Evolution Investigation in Hot Stamping Process of Ti6Al4V Alloy Sheets

Titanium alloy hot stamping technology has a wide range of application prospects in the field of titanium alloy part processing due to its high production efficiency and low manufacturing cost. However, the challenges of forming titanium alloy parts with large depths and deformations have restricted its development. In this study, the hot stamping process of a Ti6Al4V alloy box-shaped part was investigated using ABAQUS 2020 software. The thermodynamic properties of a Ti6Al4V alloy sheet were explored at different temperatures (400 °C, 500 °C, 600 °C, 700 °C, 800 °C) and different strain rates (0.1 s-1, 0.05 s-1, 0.01 s-1). In addition, the influence law of hot stamping process parameters on the minimum thickness of the formed part was revealed through the analysis of response surface methodology (RSM), ultimately obtaining the optimal combination of process parameters for Ti6Al4V alloy hot stamping. The experimental results of the hot stamping process exhibited a favorable correlation with the simulated outcomes, confirming the accuracy of the numerical simulation. The study on the microstructure evolution of the formed parts showed that grain refinement strengthening occurred in the part with large deformation, and the formed box-shaped parts exhibited a uniform and fine microstructure overall, demonstrating high forming quality. The achievements of the work provide important guidance for the fabrication of titanium alloy parts with large depths and deformations used in heavy industrial production.

The Influence of the Shielding-Gas Flow Rate on the Mechanical Properties of TIG-Welded Butt Joints of Commercially Pure Grade 1 Titanium

This article proposes as a novelty the differentiation of shielding-gas flow rates from both sides of the tungsten inert gas (TIG)-welded butt joints of commercially pure (CP) grade 1 titanium tubes. Such an approach is aimed at economically reducing the amount of protective gas used in TIG closed butt welding. The effect of the shielding-gas flow rate on the properties of CP grade 1 titanium butt-welded joints made using the tungsten inert gas (TIG)-welding method. Butt-welded joints were made for different values of the shielding-gas flow from the side of the root of the weld. Argon 5.0 was used as the shielding gas in the welding process. As part of the research, the welded joints obtained were analysed using optical and scanning electron microscopy. The microstructural characteristics of the joints were examined using an optical microscope, and the mechanical properties were determined using hardness and tensile tests. It was observed that as the flow of the shielding gas decreases, the hardness of the weld material increases and its brittleness also increases. A similar trend related to the amount of gas flow was also noticeable for the tensile strength of the joints. The increase in the hardness of the weld and the heat-affected zone compared to the base metal is mainly related to the increase in the amount of acicular structure (α' phase). The optimal gas flow rates from the side of the root of weld were found at the values of 12 dm3/min.