Functional Coatings or Films for Hard-Tissue Applications

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

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

Designing Bio-Inspired Wet Adhesives through Tunable Molecular Interactions

Marine organisms, such as mussels and sandcastle worms, can master rapid and robust adhesion in turbulent seawater, becoming leading archetypes for the design of underwater adhesives. The adhesive proteins secreted by the organisms are rich in catecholic amino acids along with ionic and amphiphilic moieties, which mediate the adaptive adhesion mainly through catechol chemistry and coacervation process. Catechol allows a broad range of molecular interactions both at the adhesive-substrate interface and within the adhesive matrix, while coacervation promotes the delivery and surface spreading of the adhesive proteins. These natural design principles have been translated to synthetic systems toward the development of biomimetic adhesives with water-resist adhesion and cohesion. This review provides an overview of the recent progress in bio-inspired wet adhesives, focusing on two aspects: (1) the elucidation of the versatile molecular interactions (e.g., electrostatic interactions, metal coordination, hydrogen bonding, and cation-π/anion-π interactions) used by natural adhesives, mainly through nanomechanical characterizations; and (2) the rational designs of wet adhesives based on these biomimetic strategies, which involve catechol-functionalized, coacervation-induced, and hydrogen bond-based approaches. The emerging applications (e.g., tissue glues, surgical implants, electrode binders) of the developed biomimetic adhesives in biomedical, energy, and environmental fields are also discussed, with future research directions proposed.

Application of bioactive metal ions in the treatment of bone defects

The treatment of bone defects is an important problem in clinical practice. The rapid development of bone tissue engineering (BTE) may provide a new method for bone defect treatment. Metal ions have been widely studied in BTE and demonstrated a significant effect in promoting bone tissue growth. Different metal ions can be used to treat bone defects according to specific conditions, including promoting osteogenic activity, inhibiting osteoclast activity, promoting vascular growth, and exerting certain antibacterial effects. Multiple studies have confirmed that metal ions-modified composite scaffolds can effectively promote bone defect healing. By studying current extensive research on metal ions in the treatment of bone defects, this paper reviews the mechanism of metal ions in promoting bone tissue growth, analyzes the loading mode of metal ions, and lists some specific applications of metal ions in different types of bone defects. Finally, this paper summarizes the advantages and disadvantages of metal ions and analyzes the future research trend of metal ions in BTE. This article can provide some new strategies and methods for future research and applications of metal ions in the treatment of bone defects.

Recent Advances in Hydroxyapatite-Based Biocomposites for Bone Tissue Regeneration in Orthopedics

Bone tissue is a nanocomposite consisting of an organic and inorganic matrix, in which the collagen component and the mineral phase are organized into complex and porous structures. Hydroxyapatite (HA) is the most used ceramic biomaterial since it mimics the mineral composition of the bone in vertebrates. However, this biomimetic material has poor mechanical properties, such as low tensile and compressive strength, which make it not suitable for bone tissue engineering (BTE). For this reason, HA is often used in combination with different polymers and crosslinkers in the form of composites to improve their mechanical properties and the overall performance of the implantable biomaterials developed for orthopedic applications. This review summarizes recent advances in HA-based biocomposites for bone regeneration, addressing the most widely employed inorganic matrices, the natural and synthetic polymers used as reinforcing components, and the crosslinkers added to improve the mechanical properties of the scaffolds. Besides presenting the main physical and chemical methods in tissue engineering applications, this survey shows that HA biocomposites are generally biocompatible, as per most in vitro and in vivo studies involving animal models and that the results of clinical studies on humans sometimes remain controversial. We believe this review will be helpful as introductory information for scientists studying HA materials in the biomedical field.

Toward long-live ceramic on ceramic hip joints: In vitro investigation of squeaking of coated hip joint with layer-by-layer reinforced PVA coatings

This study attempts to find a promising solution for the squeaking of ceramic on ceramic (COC) bearing surfaces by introducing reinforced poly(vinylalcohol) (PVA) layer-by-layer coatings on the bearing surface of Stryker Trident femoral head. A customized hip simulator was established to provide a realistic simulation of the normal gait (flexion–extension) of the hip joint, and to examine squeaking for coated and uncoated femoral heads. Different characterization techniques were employed to study the coatings’ structure. The PVA macromolecules were successfully cross-linked via epichlorohydrin agent, and chemically bonded onto the surface, forming a superior reinforced PVA coating on the femoral head’s surface. These coatings play a dominant role in increasing the pre-squeaking age of the hip joint due to reduction in hard-on-hard contact and femoral head liner clearance with their good viscoelastic properties. Which cause, damping friction-induced vibrations. This improvement resembles novel-type, long-life, and stable hip joint biomaterials with distinguished and promising pre-squeaking age.

Recent Advancements in Materials and Coatings for Biomedical Implants

Metallic materials such as stainless steel (SS), titanium (Ti), magnesium (Mg) alloys, and cobalt-chromium (Co-Cr) alloys are widely used as biomaterials for implant applications. Metallic implants sometimes fail in surgeries due to inadequate biocompatibility, faster degradation rate (Mg-based alloys), inflammatory response, infections, inertness (SS, Ti, and Co-Cr alloys), lower corrosion resistance, elastic modulus mismatch, excessive wear, and shielding stress. Therefore, to address this problem, it is necessary to develop a method to improve the biofunctionalization of metallic implant surfaces by changing the materials’ surface and morphology without altering the mechanical properties of metallic implants. Among various methods, surface modification on metallic surfaces by applying coatings is an effective way to improve implant material performance. In this review, we discuss the recent developments in ceramics, polymers, and metallic materials used for implant applications. Their biocompatibility is also discussed. The recent trends in coatings for biomedical implants, applications, and their future directions were also discussed in detail.

Corrosive Studies of a Prosthetic Ni-Cr Alloy Coated with Ti(C,N) Type Layers

Background: Investigating the general corrosion resistance of Ti(C,N) type coatings on a prosthetic nickel alloy in the aspect of their use as protective coatings on prosthetic and orthodontic elements. Methods: Five groups of Ni-Cr alloy samples covered with Ti(C,N) type coatings differing in their carbon and nitrogen contents were used for the tests. The reference group included alloy samples without coatings. The samples were held for 105 days (2520 h) in salt spray chambers and examined by means of the NSS (neutral salt spray) and SWAAT (sea water acetic acid test) tests. After the periods of 14, 28, 81 and 105 days, the samples were removed and weighed, and their weight losses were determined. Results: In the case of each type of Ti(C,N) coating, the mass loss was lower than the mass loss of a sample without a coating, which makes it possible to state that coatings improve the corrosion resistance. No significant differences in the resistance were observed between the particular coatings. The corrosion rate of the examined coatings is close to parabolic. Conclusions: Ti(C,N) type coatings improve the resistance of a prosthetic Ni-Cr alloy and can be used as protective coatings for prosthetic and orthodontic elements.

Changes in the morphology, mechanical strength and biocompatibility of polymer and metal/polymer fabricated hydroxyapatite for orthopaedic implants: a review

Hydroxyapatite (HAp) is a well-known bioceramic known for its high biocompatibility and good bioactivity. The structure of HAp mimics the natural bone structure and thus, it is widely used as implants for hard tissues. Despite possessing the above properties, it lacks mechanical strength, is susceptible to the growth of microbes over time and has low degradability. Polymers can be synthetic or natural. They can be a better choice to be used as additives to improve the properties of HAp due to its better mechanical strength and high biodegradability. A combination of metals and polymers together can overcome the drawbacks of HAp to a greater extent. This review article deals with different polymers and metal/polymer fabricated HAp to show the changes in the properties of HAp following the substitution. It also deals with how better they could be used as a hard tissue implant.

Effect of Cobalt and Chromium Ions on the Chlorhexidine Digluconate as Seen by Intermolecular Diffusion

Metal ions such as cobalt (II) and chromium (III) might be present in the oral cavity, as a consequence of the corrosion of Co-Cr dental alloys. The diffusion of such metal ions into the organism, carried by saliva, can cause health problems as a consequence of their toxicity, enhanced by a cumulative effect in the body. The effect of the chlorhexidine digluconate, which is commonly used in mouthwash formulations, on the transport of these salts is evaluated in this paper by using the Taylor dispersion technique, which will allow an assessment of how the presence of chlorhexidine digluconate (either in aqueous solution or in a commercial formulation) may affect the diffusion of metal ions. The ternary mutual diffusion coefficients of metal ions (Co and Cr) in the presence of chlorhexidine digluconate, in an artificial saliva media, were measured. Significant coupled diffusion of CoCl₂ (and CrCl₃) and chlorhexidine digluconate is observed by analysis of the non-zero values of the cross-diffusion coefficients, D₁₂ and D₂₁. The observed interactions between metal ions and chlorhexidine digluconate suggest that the latter might be considered as an advantageous therapeutic agent, once they contribute to the reduction of the concentration of those ions inside the mouth.

Effect of titanium dioxide intermediate layer on scratch and corrosion resistance of sol-gel-derived HA coating applied on Ti-6Al-4V substrate

Modification of dental and orthopedic implants' surface by coating them with bioactive materials, such as hydroxyapatite (HA), diminishes the implants' fixation time. Appropriate adhesion to the substrate and stability in biological conditions are essential requirements for these coatings. In this study, sol-gel-derived HA coating was applied on the Ti-6Al-4 V substrate, which is a high-performance alloy for manufacturing bone implants. Also, titanium dioxide (TiO₂) which was prepared by the sol-gel method was used as an intermediate layer between HA coating and the substrate. The nano-scratch and potentiodynamic polarization tests were employed to evaluate the effectiveness of TiO₂ intermediate layer on improving the scratch resistance, as an indicator of coating adhesion strength, and the corrosion resistance of the coated samples. The quality of the coating bonded to the substrate was studied by cross-sectional SEM images. The XRD tests indicated that HA and TiO₂ coatings were formed with predetermined phase compositions. The biocompatibility of sol-gel-derived HA coating was established by simulated body fluid (SBF) immersion tests. The SEM images, along with the results of electrochemical and nano-scratch tests, proved the significant effect of a TiO₂ intermediate layer on improving the scratch resistance and stability of HA coating on titanium alloy substrate.

Evaluation of MC3T3-E1 Cell Osteogenesis in Different Cell Culture Media

Many biomaterials have been evaluated using cultured cells. In particular, osteoblast-like cells are often used to evaluate the osteocompatibility, hard-tissue-regeneration, osteoconductive, and osteoinductive characteristics of biomaterials. However, the evaluation of biomaterial osteogenesis-inducing capacity using osteoblast-like cells is not standardized; instead, it is performed under laboratory-specific culture conditions with different culture media. However, the effect of different media conditions on bone formation has not been investigated. Here, we aimed to evaluate the osteogenesis of MC3T3-E1 cells, one of the most commonly used osteoblast-like cell lines for osteogenesis evaluation, and assayed cell proliferation, alkaline phosphatase activity, expression of osteoblast markers, and calcification under varying culture media conditions. Furthermore, the various media conditions were tested in uncoated plates and plates coated with collagen type I and poly-L-lysine, highly biocompatible molecules commonly used as pseudobiomaterials. We found that the type of base medium, the presence or absence of vitamin C, and the freshness of the medium may affect biomaterial regeneration. We posit that an in vitro model that recapitulates in vivo bone formation should be established before evaluating biomaterials.

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

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

Antibacterial Property and Biocompatibility of Silver, Copper, and Zinc in Titanium Dioxide Layers Incorporated by One-Step Micro-Arc Oxidation: A Review

Titanium (Ti) and its alloys are commonly used in medical devices. However, biomaterial-associated infections such as peri-implantitis and prosthetic joint infections are devastating and threatening complications for patients, dentists, and orthopedists and are easily developed on titanium surfaces. Therefore, this review focuses on the formation of biofilms on implant surfaces, which is the main cause of infections, and one-step micro-arc oxidation (MAO) as a coating technology that can be expected to prevent infections due to the implant. Many researchers have provided sufficient data to prove the efficacy of MAO for preventing the initial stages of biofilm formation on implant surfaces. Silver (Ag), copper (Cu), and zinc (Zn) are well used and are incorporated into the Ti surface by MAO. In this review, the antibacterial properties, cytotoxicity, and durability of these elements on the Ti surface incorporated by one-step MAO will be summarized. This review is aimed at enhancing the importance of the quantitative control of Ag, Cu, and Zn for their use in implant surfaces and the significance of the biodegradation behavior of these elements for the development of antibacterial properties.

In Vitro Corrosion and Tribocorrosion Performance of Biocompatible Carbide Coatings

The present study aims to explain the corrosion and the tribocorrosion performance in simulated conditions of the human body by the level of stress, adhesion of coating to substrate, roughness, and hardness. The coatings were synthesized by the cathodic arc evaporation method on 316L stainless steel substrates to be used for load bearing implants. Structure, elemental, and phase compositions were studied by means of energy dispersive spectrometry and X-ray diffraction, respectively. The grain size and strain of the coatings were determined by the Williamson–Hall plot method. Tests on hardness, adhesion, roughness, and electrochemical behavior in 0.9% NaCl solution at 37 ± 0.5 °C were carried out. Tribocorrosion performances, evaluated by measuring the friction coefficient and wear rate, were conducted in 0.9% NaCl solution using the pin on disc method at 37 ± 0.5 °C. TiC and ZrC exhibited a (111) preferred orientation, while TiNbC had a (200) orientation and the smallest crystallite size (8.1 nm). TiC was rougher than ZrC and TiNbC; the lowest roughness was found for TiNbC coatings. The highest hardness and adhesion values were found for TiNbC, followed by TiC and the ZrC. All coatings improved the corrosion resistance of 316L steels, but TiNbC showed the best corrosion behavior. TiNbC had the lowest friction coefficient (1.6) and wear rate (0.99 × 10−5 mm3·N−1∙m−1) values, indicating the best tribocorrosive performance in 0.9% NaCl at 37 ± 0.5 °C.

Functionalization of the NiTi Shape Memory Alloy Surface by HAp/SiO2/Ag Hybrid Coatings Formed on SiO2-TiO2 Glass Interlayer

The surface modification of NiTi shape memory alloys is a method for increasing their multi-functionalities. In our solution, hydroxyapatite powder was mixed with a chemically synthesized silicon dioxide/silver (nSiO2/Ag) nanocomposite in a different weight ratio between components (1:1, 5:1, and 10:1) and then electrophoretically deposited on the surface of the NiTi alloy, under various time and voltage conditions. Subsequently, uniform layers were subjected to heat treatment at 700 °C for 2 h in an argon atmosphere to improve the strength of their adhesion to the NiTi substrate. A change in linear dimensions of the co-deposited materials during the sintering process was also analyzed. After the heat treatment, XRD, Raman, and Scanning Electron Microscopy (SEM) + Energy Dispersive Spectrometer (EDS) studies revealed the formation of completely new composite coatings, which consisted of rutile and TiO2-SiO2 glass with silver oxide and HAp particles that were embedded into such coatings. It was found that spalling characterized the 1:1 ratio coating, while the others were crack-free, well-adhered, and capable of deformation to 3.5%. Coatings with a higher concentration of nanocomposite were rougher. Electrochemical impedance spectroscopy (EIS) tests in Ringer's solution revealed the capacitive behavior of the material with high corrosion resistance. The kinetics and susceptibility to pitting corrosion was the highest for the NiTi electrode that was coated with a 5:1 ratio HAp/nSiO2/Ag hybrid coating.

Antibacterial effects of silver incorporated zeolite coatings on 3D printed porous stainless steels

Functionalization of porous metals with antibacterial coatings is hotly pursued in recent decade. Here we fabricated a highly porous stainless steel component by selective laser melting and then coated with silver incorporated zeolite by in situ hydrothermal crystallization method. The morphology of their surface was investigated by scanning electron microscopy. The inhibition of Escherichia coli and Staphylococcus aureus were identified by bacterial viability studies after 24 h of incubation. More importantly, the obtained coatings show better osteointegration by spreading bone marrow stromal cells (BMSCs) after cultured with different scaffold extract solutions for 1, 3, and 5 days. These results suggest that silver incorporated zeolite coatings on 3D printed porous stainless steels exhibit better antibacterial activity and biocompatibility, showing potential application in the field of medical implant materials.

Zirconium Carboxyaminophosphonate Nanosheets as Support for Ag Nanoparticles

A layered insoluble inorganic-organic solid, namely zirconium phosphate glycine-N,N-bismethylphosphonate, was used to prepare dispersions of nanosheets to support active metals such as metallic silver nanoparticles and zinc ions. Zr phosphate-phosphonate microcrystals were first exfoliated with methylamine to produce a stable colloidal dispersion and then the methylamine was removed by treatment with hydrochloric acid. The obtained colloidal dispersion of Zr phosphate-phosphonate nanosheets was used to immobilize silver or zinc cations, via ion exchange, with the acidic protons of the sheets. The layered matrix showed a great affinity for the metal cations up taking all the added cations. The treatment of the dispersions containing silver ions with ethanol yielded metal silver nanoparticles grafted on the surface of the layered host. The samples were characterized by X-ray powder diffraction, elemental analysis transmission electron microscopy, and selected samples were submitted to antimicrobial tests. The nanocomposites based on Ag nanoparticles showed good bactericidal properties against the bacterial reference strain Staphylococcus epidermidis (S. epidermidis).

Antibacterial Properties of a Novel Zirconium Phosphate-Glycinediphosphonate Loaded with Either Zinc or Silver

A novel compound consisting of a zirconium phosphate-glycinediphosphonate (ZPGly) has recently been introduced. This 2D-structured material forming nanosheets was exfoliated under appropriate conditions, producing colloidal aqueous dispersions (ZPGly-e) which were then loaded with zinc (Zn/ZPGly) or silver ions. Silver ions were subsequently reduced to produce metallic silver nanoparticles on exfoliated ZPGly nanosheets (Ag@ZPGly). In the search for new anti-infective materials, the present study investigated the properties of colloidal dispersions of ZPGly-e, Zn/ZPGly, and Ag@ZPGly. Ag@ZPGly was found to be a bactericidal material and was assayed to define its minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) on the five most prevalent pathogens of orthopaedic implant infections, namely: Staphylococcus aureus ATCC25923, Staphylococcus epidermidis RP62A, Enterococcus faecalis ATCC29212, Escherichia coli ATCC51739, and Pseudomonas aeruginosa ATCC27853. MIC and MBC were in the range of 125–250 μg/mL and 125–1000 μg/mL, respectively, with E. coli being the most sensitive species. Even colloidal suspensions of exfoliated ZPGly nanosheets and Zn/ZPGly exhibited some intrinsic antibacterial properties, but only at greater concentrations. Unexpectedly, Zn/ZPGly was less active than ZPGly-e.

Ti(C, N) as Barrier Coatings

Metals and their alloys are materials that have long been used in stomatological prosthetics and orthodontics. The side effects of their application include reactions of the body such as allergies. Their source can be corrosion products as well as metal ions released in the corrosion process, which penetrate the surrounding tissue. In order to prevent the harming effect of metal alloys, intensive research has been performed to purify metal prosthetic restorations by way of modifying their surface. The study presents the investigation results of Ti(C, N)-type coatings applied to alloy Ni–Cr by means of the magnetronic method. Five coatings differing in the nitrogen and carbon content were investigated. The studies included the determination of the coatings’ chemical composition, construction, as well as the amount of ions released into the environment: distilled water, 0.9% NaCl and artificial saliva. The performed investigations showed that, in reference to an alloy without a coating, each coating constitutes a barrier reducing the amount of ions transferred into the examined solutions. So, Ti(C, N)-type coatings can be considered for biomedical applications as protective coatings of non-precious metal alloys.

Antimicrobial Porous Surfaces Prepared by Breath Figures Approach

Herein, efficient antimicrobial porous surfaces were prepared by breath figures approach from polymer solutions containing low content of block copolymers with high positive charge density. In brief, those block copolymers, which were used as additives, are composed of a polystyrene segment and a large antimicrobial block bearing flexible side chain with 1,3-thiazolium and 1,2,3-triazolium groups, PS54-b-PTTBM-M44, PS54-b-PTTBM-B44, having different alkyl groups, methyl or butyl, respectively. The antimicrobial block copolymers were blended with commercial polystyrene in very low proportions, from 3 to 9 wt %, and solubilized in THF. From these solutions, ordered porous films functionalized with antimicrobial cationic copolymers were fabricated, and the influence of alkylating agent and the amount of copolymer in the blend was investigated. Narrow pore size distribution was obtained for all the samples with pore diameters between 5 and 11 µm. The size of the pore decreased as the hydrophilicity of the system increased; thus, either as the content of copolymer was augmented in the blend or as the copolymers were quaternized with methyl iodide. The resulting porous polystyrene surfaces functionalized with low content of antimicrobial copolymers exhibited remarkable antibacterial efficiencies against Gram positive bacteria Staphylococcus aureus, and Candida parapsilosis fungi as microbial models.

An overview of graphene-based hydroxyapatite composites for orthopedic applications

Hydroxyapatite (HA) is an attractive bioceramic for hard tissue repair and regeneration due to its physicochemical similarities to natural apatite. However, its low fracture toughness, poor tensile strength and weak wear resistance become major obstacles for potential clinical applications. One promising method to tackle with these problems is exploiting graphene and its derivatives (graphene oxide and reduced graphene oxide) as nanoscale reinforcement fillers to fabricate graphene-based hydroxyapatite composites in the form of powders, coatings and scaffolds. The last few years witnessed increasing numbers of studies on the preparation, mechanical and biological evaluations of these novel materials. Herein, various preparation techniques, mechanical behaviors and toughen mechanism, the in vitro/in vivo biocompatible analysis, antibacterial properties of the graphene-based HA composites are presented in this review.

Immobilisation of hydroxyapatite-collagen on polydopamine grafted stainless steel 316L: Coating adhesion and in vitro cells evaluation

The utilisation of hydroxyapatite and collagen as bioactive coating materials could enhance cells attachment, proliferation and osseointegration. However, most methods to form crystal hydroxyapatite coating do not allow the incorporation of polymer/organic compound due to production phase of high sintering temperature. In this study, a polydopamine film was used as an intermediate layer to immobilise hydroxyapatite-collagen without the introduction of high sintering temperature. The surface roughness, coating adhesion, bioactivity and osteoblast attachment on the hydroxyapatite-collagen coating were assessed as these properties remains unknown on the polydopamine grafted film. The coating was developed by grafting stainless steel 316L disks with a polydopamine film. Collagen type I fibres were then immobilised on the grafted film, followed by the biomineralisation of hydroxyapatite. The surface roughness and coating adhesion analyses were later performed by using AFM instrument. An Alamar Blue assay was used to determine the cytotoxicity of the coating, while an alkaline phosphatase activity test was conducted to evaluate the osteogenic differentiation of human fetal osteoblasts on the coating. Finally, the morphology of cells attachment on the coating was visualised under FESEM. The highest RMS roughness and coating adhesion were observed on the hydroxyapatite-collagen coating (hydroxyapatite-coll-dopa). The hydroxyapatite-coll-dopa coating was non-toxic to the osteoblast cells with greater cells proliferation, greater level of alkaline phosphate production and more cells attachment. These results indicate that the immobilisation of hydroxyapatite and collagen using an intermediate polydopamine is identical to enhance coating adhesion, osteoblast cells attachment, proliferation and differentiation, and thus could be implemented as a coating material on orthopaedic and dental implants.

Enhanced antimicrobial activity of naturally derived bioactive molecule chitosan conjugated silver nanoparticle against dental implant pathogens

Various metal coated implants have been tested against dental pathogens which causes increased biofilm formation and lead to failure of dental implants. The possibility of using nanoparticle together with native biomolecules to enhance the activity of such bioactive compound is also in progress. In this study we tested the efficacy of Ag conjugated chitosan nanoparticles as a prospective coating material of titanium dental implants. Known bioactive molecule chitosan was extracted from A. flavus Af09 and conjugated with Ag nanoparticle. Fully characterized Ag-chitosan nanoparticle had a sound inhibitory effect on the growth of two major dental pathogens S. mutans and P. gingivalis. It not only inhibits the adhesion of these two tested bacteria but also able to reduce the biofilm formation. Apart from this, nanoparticle was also able to inhibit the QS production in bacteria tested in this study. Naturally extracted chitosan has been known for its antibacterial activity for a different group of bacteria. Nanoparticles are the good option to enhance the biocompatibility. No cell cytotoxicity of nanoparticle indicates its biocompatibility and coating of titanium dental implants with Ag-chitosan may have an added advantage on the corrosion resistance of dental implants and also augments the passivating effect of these implants.

Randomized controlled clinical trial of 2 types of hydroxyapatite-coated implants on moderate periodontitis patients

Purpose

The aim of this study was to compare and analyze the peri-implant tissue conditions and prospective clinical outcomes associated with 2 types of hydroxyapatite (HA)-coated implants: (1) fully HA-coated implants and (2) partially HA-coated implants with resorbable blast medium on the coronal portion of the threads.

Methods

Forty-four partially edentulous patients were randomly assigned to undergo the placement of 62 HA-coated implants, and were classified as the control group (partially HA-coated, n=30) and the test group (fully HA-coated, n=32). All patients had chronic periodontitis with moderate crestal bone loss around the edentulous area. The stability and clinical outcomes of the implants were evaluated using the primary and secondary implant stability quotient (ISQ), as well as radiographic, mobility, and peri-implant soft tissue assessments around the implants. The Wilcoxon signed-rank test and the Mann-Whitney test were used to evaluate differences between and within the 2 groups, with P values <0.05 considered to indicate statistical significance.

Results

The fully HA-coated implants displayed good retention of crestal bone, and insignificant differences were found in annual marginal bone loss between the 2 types of HA-coated implants (P>0.05). No significant differences were found in the survival rate (group I, 100%; group II, 100%) or the success rate (group I, 93.3%; group II, 93.8%). The fully HA-coated implants also did not significantly increase the risk of peri-implantitis (P>0.05).

Conclusions

The fully HA-coated implants did not lead to an increased risk of peri-implantitis and showed good retention of the crestal bone, as well as good survival and success rates. Our study suggests that fully HA-coated implants could become a reliable treatment alternative for edentulous posterior sites and are capable of providing good retention of the crestal bone.

Biomineralization of Engineered Spider Silk Protein-Based Composite Materials for Bone Tissue Engineering

Materials based on biodegradable polyesters, such as poly(butylene terephthalate) (PBT) or poly(butylene terephthalate-co-poly(alkylene glycol) terephthalate) (PBTAT), have potential application as pro-regenerative scaffolds for bone tissue engineering. Herein, the preparation of films composed of PBT or PBTAT and an engineered spider silk protein, (eADF4(C16)), that displays multiple carboxylic acid moieties capable of binding calcium ions and facilitating their biomineralization with calcium carbonate or calcium phosphate is reported. Human mesenchymal stem cells cultured on films mineralized with calcium phosphate show enhanced levels of alkaline phosphatase activity suggesting that such composites have potential use for bone tissue engineering.

Effects of Laser Power Level on Microstructural Properties and Phase Composition of Laser-Clad Fluorapatite/Zirconia Composite Coatings on Ti6Al4V Substrates

Hydroxyapatite (HA) is one of the most commonly used materials for the coating of bioceramic titanium (Ti) alloys. However, HA has poor mechanical properties and a low bonding strength. Accordingly, the present study replaces HA with a composite coating material consisting of fluorapatite (FA) and 20 wt % yttria (3 mol %) stabilized zirconia (ZrO₂, 3Y-TZP). The FA/ZrO₂ coatings are deposited on Ti6Al4V substrates using a Nd:YAG laser cladding system with laser powers and travel speeds of 400 W/200 mm/min, 800 W/400 mm/min, and 1200 W/600 mm/min, respectively. The experimental results show that a significant inter-diffusion of the alloying elements occurs between the coating layer (CL) and the transition layer (TL). Consequently, a strong metallurgical bond is formed between them. During the cladding process, the ZrO₂ is completely decomposed, while the FA is partially decomposed. As a result, the CLs of all the specimens consist mainly of FA, Ca₄(PO₄)₂O (TTCP), CaF₂, CaZrO₃, CaTiO₃ and monoclinic phase ZrO₂ (m-ZrO₂), together with a small amount of θ-Al₂O₃. As the laser power is increased, CaO, CaCO₃ and trace amounts of tetragonal phase ZrO₂ (t-ZrO₂) also appear. As the laser power increases from 400 to 800 W, the CL hardness also increases as a result of microstructural refinement and densification. However, at the highest laser power of 1200 W, the CL hardness reduces significantly due to the formation of large amounts of relatively soft CaO and CaCO₃ phase.

An Investigation on the Wear Resistance and Fatigue Behaviour of Ti-6Al-4V Notched Members Coated with Hydroxyapatite Coatings

In this study, surface properties of Ti-6Al-4V alloy coated with hydroxyapatite coatings were investigated. Wear resistance and fatigue behaviour of samples with coating thicknesses of 10 and 50 µm as well as uncoated samples were examined. Wear experiments demonstrated that the friction factor of the uncoated titanium decreased from 0.31 to 0.06, through a fluctuating trend, after 50 cycles of wear tests. However, the friction factor of both the coated samples (10 and 50 µm) gradually decreased from 0.20 to 0.12 after 50 cycles. At the end of the 50th cycle, the penetration depth of the 10 and 50 µm coated samples were 7.69 and 6.06 µm, respectively. Fatigue tests showed that hydroxyapatite coatings could improve fatigue life of a notched Ti-6Al-4V member in both low and high cycle fatigue zones. It was understood, from fractography of the fracture surfaces, that the fatigue zone of the uncoated specimens was generally smaller in comparison with that of the coated specimens. No significant difference was observed between the fatigue life of coated specimens with 10 and 50 µm thicknesses.

Study on a hydrophobic Ti-doped hydroxyapatite coating for corrosion protection of a titanium based alloy

In the paper, hydroxyapatite coatings enriched with Ti were prepared as a possible candidate for biomedical applications, especially for implantable devices that are in direct contact with bone.

Fabrication of a cubic zirconia nanocoating on a titanium dental implant with excellent adhesion, hardness and biocompatibility

Crystalline cubic zirconia nanocoating on cpTi with enhanced surface hardness, durability and biocompatibility, useful as an advanced oral implant was fabricated by applying layer-by-layer dip-coating at low annealing temperature.

Calcium orthophosphate deposits: Preparation, properties and biomedical applications

Since various interactions among cells, surrounding tissues and implanted biomaterials always occur at their interfaces, the surface properties of potential implants appear to be of paramount importance for the clinical success. In view of the fact that a limited amount of materials appear to be tolerated by living organisms, a special discipline called surface engineering was developed to initiate the desirable changes to the exterior properties of various materials but still maintaining their useful bulk performances. In 1975, this approach resulted in the introduction of a special class of artificial bone grafts, composed of various mechanically stable (consequently, suitable for load bearing applications) implantable biomaterials and/or bio-devices covered by calcium orthophosphates (CaPO4) to both improve biocompatibility and provide an adequate bonding to the adjacent bones. Over 5000 publications on this topic were published since then. Therefore, a thorough analysis of the available literature has been performed and about 50 (this number is doubled, if all possible modifications are counted) deposition techniques of CaPO4 have been revealed, systematized and described. These CaPO4 deposits (coatings, films and layers) used to improve the surface properties of various types of artificial implants are the topic of this review.

Enhancing orthopedic implant bioactivity: refining the nanotopography

Advances in nanotechnology open up new possibilities to produce biomimetic surfaces that resemble the cell in vivo growth environment at a nanoscale level. Nanotopographical changes of biomaterials surfaces can positively impact the bioactivity and ossointegration properties of orthopedic and dental implants. This review introduces nanofabrication techniques currently used or those with high potential for use as surface modification of biomedical implants. The interactions of nanotopography with water, proteins and cells are also discussed, as they largely determine the final success of the implants. Due to the well-documented effects of surface chemistry and microtopography on the bioactivity of the implant, we here elaborate on the ability of the nanofabrication techniques to combine the dual (multi) modification of surface chemistry and/or microtopography.

Comparison of Physical-chemical and Mechanical Properties of Chlorapatite and Hydroxyapatite Plasma Sprayed Coatings

Chlorapatite can be considered a potential biomaterial for orthopaedic applications. Its use as plasma-sprayed coating could be of interest considering its thermal properties and particularly its ability to melt without decomposition unlike hydroxyapatite. Chlorapatite (ClA) was synthesized by a high-temperature ion exchange reaction starting from commercial stoichiometric hydroxyapatites (HA). The ClA powder showed similar characteristics as the original industrial HA powder, and was obtained in the monoclinic form. The HA and ClA powders were plasma-sprayed using a low-energy plasma spraying system with identical processing parameters. The coatings were characterized by physical-chemical methods, i.e. X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy, including distribution mapping of the main phases detected such as amorphous calcium phosphate (ACP), oxyapatite (OA), and HA or ClA. The unexpected formation of oxyapatite in ClA coatings was assigned to a side reaction with contaminating oxygenated species (O2, H2O). ClA coatings exhibited characteristics different from HA, showing a lower content of oxyapatite and amorphous phase. Although their adhesion strength was found to be lower than that of HA coatings, their application could be an interesting alternative, offering, in particular, a larger range of spraying conditions without formation of massive impurities.

Fabrication of hydroxyapatite on pure titanium by micro-arc oxidation coupled with microwave-hydrothermal treatment

Porous hydroxyapatite (HA)-containing composite films were prepared by a novel method consisting of micro-arc oxidation (MAO) combined with microwave-hydrothermal (M-H) treatment. The morphology, composition and phase composition of the bioactive films were investigated with scanning electron microscopy with energy dispersive X-ray spectroscopy and X-ray diffraction. MTT assay was carried out to investigate the in vitro effects of the different surfaces on bone integration properties. The prepared MAO films consisted mainly of anatase, rutile and tricalcium phosphate along with amorphous calcium (Ca) and phosphorus (P) phases. The M-H-treated composite films were composed primarily of anatase, rutile and HA. As the time and temperature of the M-H treatment increased, the number of HA crystals gradually increased. Using the M-H method, HA was obtained at a lower temperature and in a shorter period of time compared to the conventional hydrothermal method. The results suggest that the M-H method significantly decreases the hydrothermal reaction temperature and also greatly shortens the reaction time. Due to the nanocrystallinity and porosity of the prepared composite films, the method presented here shows promise for the formation of bioactive materials for medical applications.

Articulating Biomaterials

This chapter examines the importance of surface characteristics such as microstructure, composition, crystallographic texture, and surface free energy in achieving desired biocompatibility and tribological properties thereby improving in vivo life of artificial articulating implants. Current implants often fail prematurely due to inadequate mechanical, tribological, biocompatibility, and osseointegration properties, apart from issues related to design and surgical procedures. For long-term in vivo stability, artificial implants intended for articulating joint replacement must exhibit long-term stable articulation surface without stimulating undesirable in vivo effects. Since the implant's surface plays a vital and decisive role in their response to biological environment, and vice versa, surface modification of implants assumes a significant importance. Therefore, overview on important surface modification techniques, their capabilities, properties of modified surfaces/implants are presented in the chapter. The clinical performance of surface modified implants and new surfaces for potential next-generation articulating implant applications are discussed at the end.

Novel zirconium nitride and hydroxyapatite nanocomposite coating: detailed analysis and functional properties

A new type of high-quality zirconium nitride (ZrN) and hydroxyapatite (HA) bionanocomposite was prepared by radio-frequency (RF) magnetron sputtering for biomedical applications. Detailed analysis of this composite coating revealed that a higher substrate temperature (ST) (>300 °C) increased its crystallinity, uniformity, and functional properties. This nanocomposite showed some encouraging functional properties. Mechanical analyses of the nanocomposite showed improved hardness, modulus, and wear resistance, which were found to be due to the increasing volume fraction of ZrN at higher ST. Biomineralization and in vitro cell analysis revealed increased weight gain and enhanced cell activity with increased substrate temperature. Overall, the results of the present study indicate that this nanocomposite coating could become a promising alternative for biomedical applications.

Electrophoretic deposition of gentamicin-loaded bioactive glass/chitosan composite coatings for orthopaedic implants

Despite their widespread application, metallic orthopaedic prosthesis failure still occurs because of lack of adequate bone-bonding and the incidence of post-surgery infections. The goal of this research was to develop multifunctional composite chitosan/Bioglass coatings loaded with gentamicin antibiotic as a suitable strategy to improve the surface properties of metallic implants. Electrophoretic deposition (EPD) was applied as a single-step technology to simultaneously deposit the biopolymer, bioactive glass particles, and the antibiotic on stainless steel substrate. The microstructure and composition of the coatings were characterized using SEM/EDX, XRD, FTIR, and TGA/DSC, respectively. The in vitro bioactivity of the coatings was demonstrated by formation of hydroxyapatite after immersion in simulated body fluid (SBF) in a short period of 2 days. High-performance liquid chromatography (HPLC) measurements indicated the release of 40% of the loaded gentamicin in phosphate buffered saline (PBS) within the first 5 days. The developed composite coating supported attachment and proliferation of MG-63 cells up to 10 days. Moreover, disc diffusion test showed improved bactericidal effect of gentamicin-loaded composite coatings against S. aureus compared to control non-gentamicin-loaded coatings.

Significance of calcium phosphate coatings for the enhancement of new bone osteogenesis--a review

A systematic analysis of results available from in vitro, in vivo and clinical trials on the effects of biocompatible calcium phosphate (CaP) coatings is presented. An overview of the most frequently used methods to prepare CaP-based coatings was conducted. Dense, homogeneous, highly adherent and biocompatible CaP or hybrid organic/inorganic CaP coatings with tailored properties can be deposited. It has been demonstrated that CaP coatings have a significant effect on the bone regeneration process. In vitro experiments using different cells (e.g. SaOS-2, human mesenchymal stem cells and osteoblast-like cells) have revealed that CaP coatings enhance cellular adhesion, proliferation and differentiation to promote bone regeneration. However, in vivo, the exact mechanism of osteogenesis in response to CaP coatings is unclear; indeed, there are conflicting reports of the effectiveness of CaP coatings, with results ranging from highly effective to no significant or even negative effects. This review therefore highlights progress in CaP coatings for orthopaedic implants and discusses the future research and use of these devices. Currently, an exciting area of research is in bioactive hybrid composite CaP-based coatings containing both inorganic (CaP coating) and organic (collagen, bone morphogenetic proteins, arginylglycylaspartic acid etc.) components with the aim of promoting tissue ingrowth and vascularization. Further investigations are necessary to reveal the relative influences of implant design, surgical procedure, and coating characteristics (thickness, structure, topography, porosity, wettability etc.) on the long-term clinical effects of hybrid CaP coatings. In addition to commercially available plasma spraying, other effective routes for the fabrication of hybrid CaP coatings for clinical use still need to be determined and current progress is discussed.

Porous surface structure fabricated by breath figures that suppresses Pseudomonas aeruginosa biofilm formation

As colonizers of medical-device surfaces, Pseudomonas aeruginosa strains present a serious source of infection and are of major concern. In this study, we fabricated films with porous surfaces by breath figures that disturb mergence by bacterial attachment, thereby impeding biofilm development. Previous studies have shown that microtopography prevents the development of P. aeruginosa biofilms. Accordingly we indented surfaces with patterns of micrometer-sized pores using breath figures at ordinary temperatures and pressures. The antimicrobial effect of surface figures was experimentally investigated by controlling the surface structure. The results suggested that pores of 5-11 μm in diameter effectively inhibit bacterial activity. It appears that biofilm development is precluded by the decreased contact area between the films and bacteria.

Human mesenchymal stem cells response to multi-doped silicon-strontium calcium phosphate coatings

The search for apatitic calcium phosphate coatings to improve implants osteointegration is, nowadays, preferentially focused in the obtaining of compositions closer to that of the inorganic phase of bone. Silicon and strontium are both present in trace concentrations in natural bone and have been demonstrated, by separate, to significantly improve osteoblastic response on calcium phosphate bioceramics. This work aims the controlled and simultaneous multi-doping of carbonated calcium phosphate coatings with both elements, Si and Sr, by pulsed laser deposition technique and the biological response of human mesenchymal stem cells to them. A complete physicochemical characterization has been also performed to analyze the coatings and significant positive effect was obtained at the osteogenic differentiation of cells, confirming the enormous potential of this multi-doping coating approach.

Analyses of antibacterial activity and cell compatibility of titanium coated with a Zr-C-N film

Objective

The purpose of this study was to verify the antibacterial performance and cell proliferation activity of zirconium (Zr)–carbon (C)–nitride (N) coatings on commercially pure titanium (Ti) with different C contents.

Materials and Methods

Reactive nitrogen gas (N₂) with and without acetylene (C₂H₂) was activated by Zr plasma in a cathodic-arc evaporation system to deposit either a zirconium nitride (ZrN) or a Zr–C–N coating onto Ti plates. The bacterial activity of the coatings was evaluated against Staphylococcus aureus with the aid of SYTO9 nucleic acid staining and scanning electron microscopy (SEM). Cell compatibility, mRNA expression, and morphology related to human gingival fibroblasts (HGFs) on the coated samples were also determined by using the MTT assay, reverse transcriptase–polymerase chain reaction, and SEM.

Results

The Zr–C–N coating with the highest C content (21.7 at%) exhibited the lowest bacterial preservation (P<0.001). Biological responses including proliferation, gene expression, and attachment of HGF cells to ZrN and Zr–C–N coatings were comparable to those of the uncoated Ti plate.

Conclusions

High-C-content Zr–C–N coatings not only provide short-term antibacterial activity against S. aureus but are also biocompatible with HGF cells.

Spatial and temporal evaluation of cell attachment to printed polycaprolactone microfibres

Surface topography plays a crucial role in influencing cellular responses and has therefore been utilized in the development of numerous implantable devices. Whilst numerous studies have either investigated cell attachment or migration post-attachment, few have looked at the early-stages of this process temporally. The aim of this study was to evaluate the use of time-lapse microscopy to study the behaviour of fibroblasts cultured with polycaprolactone microfibres and to assess spatially and temporally the cell-structure interaction over a 24h period. Ordered polymeric structures were printed (predetermined) onto glass substrates using an electrohydrodynamic direct write process to produce fine (3-5 μm wide) structures. Fibroblast attachment and migration were characterized as a function of distance perpendicular from structures (∼17.3, 34.6 and 51.9 μm). The use of time-lapse microscopy revealed a gradual decrease in cell attachment as the distance from the microfibres was increased. The technique also revealed that some cells were attaching and detaching from the microfibre multiple times. Our findings demonstrate that time-lapse microscopy is a useful technique for evaluating early-stage cell-biomaterial interaction that is capable of recording important events that might otherwise be overlooked.

Calcium orthophosphate coatings, films and layers

In surgical disciplines, where bones have to be repaired, augmented or improved, bone substitutes are essential. Therefore, an interest has dramatically increased in application of synthetic bone grafts. As various interactions among cells, surrounding tissues and implanted biomaterials always occur at the interfaces, the surface properties of the implants are of the paramount importance in determining both the biological response to implants and the material response to the physiological conditions. Hence, a surface engineering is aimed to modify both the biomaterials, themselves, and biological responses through introducing desirable changes to the surface properties of the implants but still maintaining their bulk mechanical properties. To fulfill these requirements, a special class of artificial bone grafts has been introduced in 1976. It is composed of various mechanically stable (therefore, suitable for load bearing applications) biomaterials and/or bio-devices with calcium orthophosphate coatings, films and layers on their surfaces to both improve interactions with the surrounding tissues and provide an adequate bonding to bones. Many production techniques of calcium orthophosphate coatings, films and layers have been already invented and new promising techniques are continuously investigated. These specialized coatings, films and layers used to improve the surface properties of various types of artificial implants are the topic of this review.