Micropatterned Silica Films with Nanohydroxyapatite for Y-TZP Implants

This investigation aimed at developing micropatterned silica thin films (MSTFs) containing nanohydroxyapatite (nano-HA) microaggregates that were not completely covered by silica so that they could directly interact with the surrounding cells. The objectives were 1) to evaluate the effect of the presence of 2 films (MSTF with or without nano-HA addition) on the characteristic strength (σ₀) and Weibull modulus ( m) of a yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) and 2) to evaluate the effect of these 2 films, as applied onto the Y-TZP surface, on the morphology, orientation, and proliferation of MG63 cells. Sol-gel process and soft lithography were used to apply the MSTF onto the Y-TZP specimens. Three experimental groups were produced: Y-TZP, Y-TZP + MSTF, and Y-TZP + MSTF + sprayed nano-HA. All surfaces were characterized by scanning electron microscopy and energy-dispersive X-ray spectroscopy and tested for 4-point flexural strength ( n = 30) in water at 37 °C. Weibull analysis was used to determine m and σ₀ (maximum likelihood method). In vitro biological behavior was performed with human osteoblast-like cells (MG63). Y-TZP was successfully coated with MSFT and MSFT + nano-HA. Scanning electron microscopy micrographs indicated that the microaggregates of nano-HA were not entirely covered by the silica. There was no statistically significant difference among the experimental groups for σ₀ and m. In the groups containing the films, the cells were elongated and aligned along the lines. The MSFT + nano-HA group showed significantly higher cell metabolic activity than that obtained for the Y-TZP group at day 7. This investigation was successful in producing an MSTF containing nano-HA microaggregates that remained exposed to the environment. The developed films did not jeopardize the structural reliability of a commercial Y-TZP, as confirmed by the Weibull statistics. The MG63 cells seeded over the films became elongated and aligned along the films' micropatterned lines. Y-TZP specimens coated with MSTF and nano-HA showed a higher cell metabolic activity and proliferation after 7 d of culture when compared with uncoated Y-TZP.

Characterization of gelatin and chitosan scaffolds cross-linked by addition of dialdehyde starch

In this study the influence of the addition of dialdehyde starch on the properties of scaffolds based on gelatin and chitosan obtained by the freeze-drying method was investigated. In addition, the adhesion and proliferation of human osteosarcoma SaOS-2 cells on the obtained scaffolds was examined. Chitosan and gelatin were mixed in different weight ratios (75/25, 50/50, 25/75) with 1, 2 and 5 wt% addition of dialdehyde starch. The obtained scaffolds were subjected to mechanical testing, infrared spectroscopy, swelling measurements, low-pressure porosimetry and zeta potential measurement. Internal material structures were observed by scanning electron microscopy. The results showed that the cross-linking process occurred after the addition of dialdehyde starch and resulted in increased mechanical strength, swelling properties, zeta potential and porosity of studied materials. The attachment of SaOS-2 cells to all modified materials was better compared to an unmodified control and the proliferation of these cells was markedly increased on modified scaffolds.

Antibacterial activity and biocompatibility of three-dimensional nanostructured porous granules of hydroxyapatite and zinc oxide nanoparticles--an in vitro and in vivo study

Ceramic scaffolds are widely studied in the bone tissue engineering field due to their potential in regenerative medicine. However, adhesion of microorganisms on biomaterials with subsequent formation of antibiotic-resistant biofilms is a critical factor in implant-related infections. Therefore, new strategies are needed to address this problem. In the present study, three-dimensional and interconnected porous granules of nanostructured hydroxyapatite (nanoHA) incorporated with different amounts of zinc oxide (ZnO) nanoparticles were produced using a simple polymer sponge replication method. As in vitro experiments, granules were exposed to Staphylococcus aureus and Staphylococcus epidermidis and, after 24 h, the planktonic and sessile populations were assessed. Cytocompatibility towards osteoblast-like cells (MG63 cell line) was also evaluated for a period of 1 and 3 days, through resazurin assay and imaging flow cytometry analysis. As in vivo experiments, nanoHA porous granules with and without ZnO nanoparticles were implanted into the subcutaneous tissue in rats and their inflammatory response after 3, 7 and 30 days was examined, as well as their antibacterial activity after 1 and 3 days of S. aureus inoculation. The developed composites proved to be especially effective at reducing bacterial activity in vitro and in vivo for a weight percentage of 2% ZnO, with a low cell growth inhibition in vitro and no differences in the connective tissue growth and inflammatory response in vivo. Altogether, these results suggest that nanoHA-ZnO porous granules have a great potential to be used in orthopaedic and dental applications as a template for bone regeneration and, simultaneously, to restrain biomaterial-associated infections.

Influence of nanohydroxyapatite surface properties on Staphylococcus epidermidis biofilm formation

Nanohydroxyapatite (nanoHA), due to its chemical properties, has appeared as an exceptionally promising bioceramic to be used as bone regeneration material. Staphylococcus epidermidis have emerged as major nosocomial pathogens associated with infections of implanted medical devices. In this work, the purpose was to study the influence of the nanoHA surface characteristics on S. epidermidis RP62A biofilm formation. Therefore, two different initial inoculum concentrations (Ci) were used in order to check if these would affect the biofilm formed on the nanoHA surfaces. Biofilm formation was followed by the enumeration of cultivable cells and by scanning electron microscopy. Surface topography, contact angle, total surface area and porosimetry of the biomaterials were studied and correlated with the biofilm data. The surface of nanoHA sintered at 830℃ (nanoHA830) showed to be more resistant to S. epidermidis attachment and accumulation than that of nanoHA sintered at 1000℃ (nanoHA1000). The biofilm formed on nanoHA830 presented differences in terms of structure, surface coverage and EPS production when compared to the one formed on nanoHA1000 surface. It was observed that topography and surface area of nanoHA surfaces had influence on the bacterial attachment and accumulation. Ci influenced bacteria attachment and accumulation on nanoHA surfaces over time. The choice of the initial inoculum concentration was relevant proving to have an effect on the extent of adherence thus being a critical point for human health if these materials are used in implantable devices. This study showed that the initial inoculum concentration and surface material properties determine the rate of microbial attachment to substrata and consequently are related to biofilm-associated infections in biomaterials.

Reciprocal induction of human dermal microvascular endothelial cells and human mesenchymal stem cells: time-dependent profile in a co-culture system

OBJECTIVES

Angiogenesis is closely associated with osteogenesis where reciprocal interactions between endothelial and osteoblast cells play an important role in bone regeneration. For these reasons, the aim of this work was to develop a co-culture system to study in detail any time-dependent interactions between human mesenchymal stem cells (HMSC) and human dermal microvascular endothelial cells (HDMEC), co-cultured in a 2D system, for 35 days.

MATERIALS AND METHODS

HMSC and HDMEC were co-cultured at a ratio of 1:4, respectively. Single-cell cultures were used as controls. Cell viability/proliferation was assessed using MTT, DNA quantification and calcein-AM assays. Cell morphology was monitored using confocal microscopy, and real time PCR was performed. Alkaline phosphatase activity and histochemical staining were evaluated. Matrix mineralization assays were also performed.

RESULTS

Cells were able to grow in characteristic patterns maintaining their viability and phenotype expression throughout culture time, compared to HMSC and HDMEC monocultures. HMSC differentiation seemed to be enhanced in the co-culture conditions, since it was observed an over expression of osteogenesis-related genes, and of ALP activity. Furthermore, presence of calcium phosphate deposits was also confirmed.

CONCLUSIONS

This work reports in detail the interactions between HMSC and HDMEC in a long-term co-culture 2D system. Endothelial and mesenchymal stem cells cultured in the present co-culture conditions ensured proliferation and phenotype differentiation of cell types, osteogenesis stimulation and over-expression of angiogenesis-related genes, in the same culture system. It is believed that the present work can lead to significant developments for bone tissue regeneration and cell biology studies.

Adhesion of Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa onto nanohydroxyapatite as a bone regeneration material

In orthopedics due to the enormous number of surgical procedures involving invasive implant biomaterials, infections have a huge impact in terms of morbidity, mortality, and medical costs. In this study the initial adhesion of several strains namely Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa, to nanohydroxyapatite, previously heat-treated at 725 °C and 1000 °C was assessed. Adherent cells were evaluated by scanning electron microscopy and quantified by confocal laser scanning microscopy and as colony forming units after being released by sonication. The wettability and roughness of samples surfaces were assessed by contact angle measurements and atomic force microscopy, respectively. Nanohydroxyapatite heat-treated at 1000 °C appeared to be more resistant to bacterial adhesion, over time, in five of the six tested strains while the clinical strains isolated from orthopedic infections presented superior ability to adhere, as well as better capacity to produce slime. The increase in materials sintering temperature resulted in increased hydrophobicity and roughness; however, other surface features such as the decrease in surface area and on porosity as well as the decrease on zeta potential may be the aspects that contributed to a lower bacterial adhesion on the materials sintered at 1000 °C.

Supplementation of collagen scaffolds with SPARC to facilitate mineralization

The extracellular matrix-associated protein, SPARC (Secreted Protein Acidic and Rich in Cysteine) is known to play a role in the mineralization of collagen in bone formation. The objectives of this study were to determine: 1) if SPARC supplementation of type 1 collagen scaffolds in vitro facilitated the binding of pre-formed HA nanoparticles added to the scaffolds; 2) if SPARC supplementation of the scaffolds enhanced the uptake of calcium and phosphorus from calcium phosphate solutions; and 3) if pretreatment in a calcium phosphate solution enhanced the subsequent binding of the nanoparticles. A related objective was to begin to determine the behavior of mesenchymal stem cells in the scaffolds when the constructs were grown in osteogenic medium. The calcium and phosphorus contents of the scaffolds were evaluated by inductively coupled plasma analysis, and the elastic modulus of the scaffolds determined by unconfined compression testing. Scaffolds were seeded with goat bone marrow-derived mesenchymal stem cells and the cell-seeded constructs grown in osteogenic medium. Supplementation of the scaffolds with as little as 0.008 % SPARC (by wt. of collagen) resulted in an increase in the binding of hydroxyapatite nanoparticles to the scaffold, but had no effect on incorporation of calcium or phosphorus from a calcium phosphate solution. The incorporation of hydroxyapatite nanoparticles into the scaffolds did not result in an increase in modulus. Supplementation of the scaffolds with SPARC and the increase in the binding of hydroxyapatite nanoparticles did not affect the proliferation of mesenchymal stem cells.

Isotropic micropatterned silica coatings on zirconia induce guided cell growth for dental implants

Titanium implants are the gold standard in dentistry; however, problems such as gingival tarnishing and peri-implantitis have been reported. For zirconia to become a competitive alternative dental implant material, surface modification techniques that induce guided tissue growth must be developed.

OBJECTIVES

To develop alternative surface modification techniques to promote guided tissue regeneration on zirconia materials, for applications in dental implantology.

METHODS

A methodology that combined soft lithography and sol-gel chemistry was used to obtain isotropic micropatterned silica coatings on yttria-stabilized zirconia substrates. The materials were characterized via chemical, structural, surface morphology approaches. In vitro biological behavior was evaluated in terms of early adhesion and viability/metabolic activity of human osteoblast-like cells. Statistical analysis was conducted using one-way ANOVA/Tukey HSD post hoc test.

RESULTS

Isotropic micropatterned silica coatings on yttria-stabilized zirconia substrates were obtained using a combined approach based on sol-gel technology and soft lithography. Micropatterned silica surfaces exhibited a biocompatible behavior, and modulated cell responses (i.e. inducing early alignment of osteoblast-like cells). After 7d of culture, the cells fully covered the top surfaces of pillar microstructured silica films.

SIGNIFICANCE

The micropatterned silica films on zirconia showed a biocompatible response, and were capable of inducing guided osteoblastic cell adhesion, spreading and propagation. The results herein presented suggest that surface-modified ceramic implants via soft lithography and sol-gel chemistry could potentially be used to guide periodontal tissue regeneration, thus promoting tight tissue apposition, and avoiding gingival retraction and peri-implantitis.

Innovative macroporous granules of nanostructured-hydroxyapatite agglomerates: bioactivity and osteoblast-like cell behaviour

To modulate the biological response of implantable granules, two types of bioactive porous granules composed of nanostructured-hydroxyapatite (HA) agglomerates and microstructured-HA, respectively, were prepared using a polyurethane sponge impregnation and burnout method. The resulting granules presented a highly porous structure with interconnected porosity. Both types of granules were characterized using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and mercury intrusion porosimetry. Results showed that nanostructed-HA granules presented higher surface area and porosity than microstructured-HA granules. In vitro testing using MG63 human osteoblast-like cells showed that on both types of surfaces cells were able to adhere, proliferate, and migrate through the macropores, and a higher growth rate was achieved on nanostructured-HA granules than on microstructured-HA granules (76 and 40%, respectively). In addition, these cells maintained similar expression levels of osteoblastic-associated markers namely collagen type I, alkaline phosphatase, bone morphogenetic protein-2, macrophage colony-stimulating factor, and osteoprotegerin. These innovative nanostructured-HA granules may be considered as promising bioceramic alternative matrixes for bone regeneration and drug release application.

Early spreading and propagation of human bone marrow stem cells on isotropic and anisotropic topographies of silica thin films produced via microstamping

While there has been rapid development of microfabrication techniques to produce high-resolution surface modifications on a variety of materials in the last decade, there is still a strong need to produce novel alternatives to induce guided tissue regeneration on dental implants. High-resolution microscopy provides qualitative and quantitative techniques to study cellular guidance in the first stages of cell-material interactions. The purposes of this work were (1) to produce and characterize the surface topography of isotropic and anisotropic microfabricated silica thin films obtained by sol-gel processing, and (2) to compare the in vitro biological behavior of human bone marrow stem cells on these surfaces at early stages of adhesion and propagation. The results confirmed that a microstamping technique can be used to produce isotropic and anisotropic micropatterned silica coatings. Atomic force microscopy analysis was an adequate methodology to study in the same specimen the sintering derived contraction of the microfabricated coatings, using images obtained before and after thermal cycle. Hard micropatterned coatings induced a modulation in the early and late adhesion stages of cell-material and cell-cell interactions in a geometry-dependent manner (i.e., isotropic versus anisotropic), as it was clearly determined, using scanning electron and fluorescence microscopies.

Synthesis and characterization of HAp nanorods from a cationic surfactant template method

Hydroxyapatite (HAp) [Ca(10)(PO(4))(6)(OH)(2)] nanorods were synthesized using a surfactant templating method, with cetyltrimethylammonium bromide (CTAB) micelles acting as template for HAp growth. The effects of the sintering temperature on the morphological and crystallographic characteristics and on chemical composition of the "as-prepared" structures are discussed. The experimental results show that low heat-treatment temperatures are preferred in order to obtain high quality nanorods, with diameters ranging between 20 and 50 nm. High heat-treatment temperatures enhance the thermal decomposition of HAp into other calcium phosphate compounds, and the sintering of particles into micrometer ball-like structures. The stability of aqueous suspensions of HAp nanorods is also discussed.

Influence of crystallite size of nanophased hydroxyapatite on fibronectin and osteonectin adsorption and on MC3T3-E1 osteoblast adhesion and morphology

The characteristic topographical features (crystallite dimensions, surface morphology and roughness) of bioceramics may influence the adsorption of proteins relevant to bone regeneration. This work aims at analyzing the influence of two distinct nanophased hydroxyapatite (HA) ceramics, HA725 and HA1000 on fibronectin (FN) and osteonectin (ON) adsorption and MC3T3-E1 osteoblast adhesion and morphology. Both substrates were obtained using the same hydroxyapatite nanocrystals aggregates and applying the sintering temperatures of 725°C and 1000°C, respectively. The two proteins used in this work, FN as an adhesive glycoprotein and ON as a counter-adhesive protein, are known to be involved in the early stages of osteogenesis (cell adhesion, mobility and proliferation). The properties of the nanoHA substrates had an important role in the adsorption behavior of the two studied proteins and clearly affected the MC3T3-E1 morphology, distribution and metabolic activity. HA1000 surfaces presenting slightly larger grain size, higher root-mean-square roughness (Rq), lower surface area and porosity, allowed for higher amounts of both proteins adsorbed. These substrates also revealed increased number of exposed FN cell-binding domains as well as higher affinity for osteonectin. Regarding the osteoblast adhesion results, improved viability and cell number were found for HA1000 surfaces as compared to HA725 ones, independently of the presence or type of adsorbed protein. Therefore the osteoblast adhesion and metabolic activity seemed to be more sensitive to surfaces morphology and roughness than to the type of adsorbed proteins.

Heparinized hydroxyapatite/collagen three-dimensional scaffolds for tissue engineering

Currently, in bone tissue engineering research, the development of appropriate biomaterials for the regeneration of bony tissues is a major concern. Bone tissue is composed of a structural protein, collagen type I, on which calcium phosphate crystals are enclosed. For tissue engineering, one of the most applied strategies consists on the development and application of three dimensional porous scaffolds with similar composition to the bone. In this way, they can provide a physical support for cell attachment, proliferation, nutrient transport and new bone tissue infiltration. Hydroxyapatite is a calcium phosphate with a similar composition of bone and widely applied in several medical/dentistry fields. Therefore, in this study, hydroxyapatite three dimensional porous scaffolds were produced using the polymer replication method. Next, the porous scaffolds were homogeneously coated with a film of collagen type I by applying vacuum force. Yet, due to collagen degradability properties, it was necessary to perform an adequate crosslinking method. As a result, N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS) was employed as an efficient and non-toxic crosslinking method in this research. The composites were characterized by means of SEM, DSC and TNBS. Furthermore, heparin was incorporated in order to accomplish sustained delivery of a growth factor of interest namely, bone morphogenetic proteins (BMP-2). BMP-2 binding and release of non-heparinized and heparinized scaffolds was evaluated at specific time points. The incorporation of heparin leads to a reduced initial burst phase when compared to the non heparinized materials. The results show a beneficial effect with the incorporation of heparin and its potential as a localized drug delivery system for the sustained release of growth factors.

In vivo evaluation of highly macroporous ceramic scaffolds for bone tissue engineering

During the last decades, different materials of both natural and synthetic origin have been developed with the aim of inducing and controlling osteogenic differentiation of mesenchymal stem cells (MSCs). In order for that to happen, it is necessary that the material to be implanted obey a series of requirements, namely: osteoconduction, biocompatibility, and biodegradability. Additionally, they must be low-priced, easy to produce, shape, and store. Hydroxyapatite (HA) is a well known ceramic with a composition similar to the mineral component of bone and is highly biocompatible and easy to obtain and/or process. On the other hand, collagen is the main structural protein present in the human body and bone. In this study, a polymer replication method was applied and a highly porous HA scaffold was produced. Collagen was later incorporated to improve the biological properties of the scaffold while resembling the bone composition. The scaffolds were characterized by means of scanning electron microscopy, Fourier transform infrared spectroscopy and energy dispersive spectroscopy. In vitro and in vivo testing was performed in all scaffolds produced. The goal of this study was to evaluate the in vivo osteogenic potential of MSCs from two different species seeded on the different HA basedporous scaffolds with collagen type I. The resultsindicate that all scaffolds exhibit relevant bone formation, being more prominent in the case of the HA scaffolds.

Laser surface treatment of hydroxyapatite for enhanced tissue integration: surface characterization and osteoblastic interaction studies

Biocompatibility has long been associated with surface microtopography, microtexture, and microchemistry. The surface topography eventually affects the nature and the intensity of the interactions that occur at biomaterial-biological interface (cell adhesion, mobility, spreading, and proliferation). Therefore, it is necessary to produce and work with controlled microtopographical surfaces that present reproducible microdomains of a dimension similar to that of the biological elements of interest (in this case, osteoblasts). There are a number of substrates that already have been studied in terms of surface topography; however, few studies are related to hydroxyapatite (HA) substrates. As it is well established, HA is a well-known ceramic that is extremely used in medical applications, namely implants and coatings. In this work, the surface topography of dense HA substrates was altered by using KFr excimer laser. The surface was characterized by atomic force microscopy and contact angle measurements, while the cell distribution and morphology was assessed by scanning electron microscopy and confocal laser scanning microscopy. Results revealed that the surface is characterized by a homogeneous columnar structure with high specific area. Moreover, cells were able to attach and spread on the surface of the samples, and gradually grow into nearly confluent monolayers.

Nanohydroxyapatite microspheres as delivery system for antibiotics: Release kinetics, antimicrobial activity, and interaction with osteoblasts

Severe periodontitis treatment, where massive alveolar bone loss occurs, involves bone defect filling and intensive systemic log-term antibiotics administration. This study aims at developing novel injectable drug delivery systems (nanohydroxyapatite microspheres) with the drug releasing capability for periodontitis treatment and simultaneously initiating the osteointegration process. Materials were characterized by XRD, SEM, inverted stand optical microscope analysis, and mercury porosimetry method. Amoxicillin, amoxicillin + clavulanic acid, and erythromycin were the antibiotics used. Release properties during 28 days from the hydroxyapatite (HA) granules, and two types of nanoHA microspheres were investigated. Biocompatibility was assessed by cytotoxicity assays. HA granules were inadequate, releasing all antibiotic during the first hours. The concentration of antibiotics released in the first days from HA-2 was higher than from HA-1 microspheres, because of the increased porosity and surface area. The release profiles (fast initial release followed by long-term sustained release) of effective doses of antibiotics make these systems good alternatives for antibiotics delivery. Osteoblasts proliferated well on both types of microspheres, being cell growth enhanced in the presence of antibiotics. Erythromycin presented the most beneficial effect. Combining the sustained antibiotic release with the osteoconduction, resorbability, and potential use as injectable bone filling material of porous HA microspheres, these systems provided a forth fold beneficial effect.

Development of a system to adsorb drugs onto calcium phosphate materials

Several studies were carried out in order to reduce the systemic use of antibiotics due to the high concentration required to provide the minimum inhibitory concentration (MIC) at infected sites. The aim of this study was to develop a system of drug adsorption onto commercial hydroxyapatite (HA, Ca10(PO4)6(OH)2) and glass reinforced hydroxyapatite (GR-HA) granules. The drug will then be released for the local treatment of periodontitis. The antibiotics used in this study were metronidazole, a specific antibiotic indicated for the systemic treatment of periodontitis, and ampicillin, a wide spectrum antibiotic. UV spectroscopy was used to measure the amount of drug adsorbed onto HA and GR-HA granules. Results showed that metronidazole was unable to adsorb on the material's surface, as opposed to ampicillin which adsorbed both onto HA and GR-HA. Preliminary release kinetics studies were carried out using a flow through dissolution system. Results are discussed in terms of the influence of the different surface characteristics of the materials on the adsorption processes.

Hydroxyapatite nanoparticles: A review of preparation methodologies

Hydroxyapatite (HA) has been widely used as a biocompatible ceramic in many areas of medicine, but mainly for contact with bone tissue, due to its resemblance to mineral bone. In mammals, the skeleton presents a carbonated and partially substituted apatite, based on nanocrystal aggregates, and associated with collagen, building up 3-D structures present in various bone tissue conformations like trabecular or cancellous bone. There has been growing interest in developing bioactive synthetic ceramics that could closely mimic natural apatite characteristics. This review presents some of the most well known forms of obtaining, by precipitation methods, nanophased HA. Some traditional and more recent developments vis-à-vis the pos-sible HA nanoparticles applications are discussed.

Effect of chemical composition on hydrophobicity and zeta potential of plasma sprayed HA/CaO-P2O5 glass coatings

Multilayered plasma sprayed coatings on the surface of Ti-6Al-4V alloys have been prepared, which were composed of an underlayer of HA and a surface layer of a CaO-P2O5 glass-HA composite, with 2 or 4wt% of glass. Contact angle and surface tension variation with time, for both water and a protein solution, were determined by the sessile and pendent drop methods respectively using the ADSA-P software. Wettability studies showed that hydrophobicity of the coatings increase with the glass addition. The work of adhesion of albumin was also altered in a controlled manner by the addition of the CaO-P2O5 glass, being lower on the composite coatings than on HA. Zeta potential (ZP) results showed that composite coatings presented a higher net negative charge than HA coatings and that ZP values were also influenced by the content of the glass. This study demonstrated that the surface properties of those coatings may be modified by the addition of CaO-P2O5 glass.

HA and double-layer HA-P2O5/CaO glass coatings: influence of chemical composition on human bone marrow cells osteoblastic behavior

Human osteoblastic bone marrow derived cells were cultured for 28 days onto the surface of a glass reinforced hydroxyapatite (HA) composite and a commercial type HA plasma sprayed coatings, both in the "as-received" condition and after an immersion treatment with culture medium during 21 days. Cell proliferation and differentiation were analyzed as a function of the chemical composition of the coatings and the immersion treatment. Cell attachment, growth and differentiation of osteoblastic bone marrow cells seeded onto "as-received" plasma sprayed coatings were strongly affected by the time-dependent variation of the surface structure occurring during the first hours of culture. Initial interactions leading to higher amounts of adsorbed protein and zeta potential shifts towards negative charges appeared to result in surface structures with better biological performance. Cultures grown onto the pretreated coatings showed higher rate of cell proliferation and increased functional activity, as compared to those grown onto the corresponding "as-received" materials. However, the cell behavior was similar in the glass composite and HA coatings. The results showed that the glass composites present better characteristics for bone cell growth and function than HA. In addition, this work also provide evidence that the biological performance of the glass composites can be modulated and improved by manipulations in the chemical composition, namely in the content of glass added to HA.

Adsorption and release studies of sodium ampicillin from hydroxyapatite and glass-reinforced hydroxyapatite composites

As a potential therapy for periodontitis, sodium ampicillin, a broad spectrum antibiotic, was adsorbed onto hydroxyapatite (HA) and glass-reinforced hydroxyaptite (GR-HA) composites, and was subsequently released in vitro. The sodium ampicillin, was adsorbed more on HA compared to the GR-HA composites. X-ray diffraction (XRD) and Rietveld analysis were used to identify and quantify the levels of HA and beta-tricalcium phosphate (beta-TCP) in the microstructure of the GR-HA composites. Lattice parameters changes were observed for the beta-TCP phase dependant on the amount of glass added. The release kinetics were shown to be divided into three stages, the first of which where a large amount of sodium ampicillin is released, followed by a slower release rate and then a final stage where the release amount approaches zero, until no more sodium ampicillin was present. X-ray photoeletron spectroscopy (XPS) studies were carried out in order to ensure that the entire antibiotic adsorbed onto the materials had been released. These kinetics studies have indicated the possibility of using these materials as possible carriers for drug delivery.

Push-out testing and histological evaluation of glass reinforced hydroxyapatite composites implanted in the tibia of rabbits

In vitro and in vivo bioactivity studies were performed to assess the biocompatibility of CaO-P2O5 glass-reinforced hydroxyapatite (GR-HA) composites. The ability to form an apatite layer by soaking in simulated body fluid (SBF) was examined and surfaces were characterized using FTIR reflection and thin-film X-ray diffraction analyses. Qualitative histology, histomorphometric measurements, and push-out testing were performed in a rabbit model for characterizing bone/implant bonding. Under the in vitro conditions using SBF, an apatite layer could not be formed on GR-HA composites within 8 weeks. Results of push-out testing showed bonding between the composites and bone, ranging from 130-145 N after 2 weeks of implantation. After the longest implantation period, 16 weeks, the GR-HA composite prepared with the higher content of CaO-P2O5 glass showed the highest bonding force, 606 +/- 45 N, compared to 459 +/- 30 N for sintered HA. Development of immature bone and modifications in the turnover of a more mature bone on the surface of GR-HA composites were similar to those on sintered HA.

Direct and indirect effects of P2O5 glass reinforced-hydroxyapatite composites on the growth and function of osteoblast-like cells

Human osteoblast-like cells were plated on hydroxyapatite and P2O5-glass reinforced hydroxyapatite composite discs. They were also cultured in the presence of media obtained by incubating the discs in the absence of cells. The effects of these direct and indirect interactions were examined by measuring cell proliferation and the expression of certain key extracellular matrix antigens. One composite was found to initially delay cell growth, while the extract of a different composite appeared to down-regulate DNA synthesis. Flow cytometry analysis showed that growth directly on the discs had little effect on collagen type I, but reduced fibronectin and osteocalcin levels. The extracts of the materials generally had less effect, although one extract obtained from the glass-reinforced hydroxyapatite significantly down-regulated fibronectin. These in vitro studies thus suggest that there were only few differences overall in the growth of the cells directly on the glass-reinforced compared with the hydroxyapatite discs and also only relatively small effects of the extracts on the cells. However, the flow cytometry results suggest that both the materials and the extracts may have a potentially important influence on connective tissue production, and that these effects are both material- and antigen-specific.

Flow cytometry analysis of the effects of pre-immersion on the biocompatibility of glass-reinforced hydroxyapatite plasma-sprayed coatings

Multilayered coatings composed of mixtures of HA and P2O5-based bioactive glasses are of potential clinical benefit in orthopaedic and dental surgery. Pre-immersion of these materials has been reported to further enhance their efficacy in vivo, although the precise biological effects of this treatment are not yet known. In this study we have therefore prepared double-layer plasma-sprayed coatings and evaluated the effects of pre-immersion on the growth and function of human osteosarcoma cells in vitro, using the MTT assay and flow cytometry analysis, respectively. The results showed that the increase in numbers of viable cells was the same or elevated following incubation on the pre-immersed HA and glass-reinforced HA coatings compared with the non-immersed materials. In addition, the expression of bone sialoprotein and fibronectin, two key connective tissue antigens, was up-regulated in cultures grown on the pre-immersed surfaces compared with the non-treated materials. Moreover, cell numbers and antigen expression both improved as the proportion of glass increased, particularly in the pre-immersed samples. Our findings thus suggest that the immersion treatment of these materials appeared to improve the response of these bone-like cells.

Microstructural dependence of Young's and shear moduli of P2O5 glass reinforced hydroxyapatite for biomedical applications

P2O5 glass reinforced hydroxyapatite composite materials were prepared through a liquid-phase sintering process. Secondary phases, beta- and alpha-tricalcium phosphates (beta-TCP and alpha-TCP), were formed in the microstructure of the composites, due to the reaction between the liquid glassy phase and the hydroxyapatite matrix. The dynamic Young's modulus (E) and shear modulus (G) of these composites were determined using an impulse excitation method. By applying the Duckworth-Knudsen equation, the elastic property results were correlated with the relative proportion of beta-TCP and alpha-TCP phases and with the porosity percentage present in the microstructure. Glass reinforced hydroxyapatite composites showed lower Young's and shear moduli than unmodified hydroxyapatite, mainly due to the presence of beta-TCP phase. The Duckworth-Knudsen model demonstrated an exponential dependence of E and G modulus with porosity and mathematical equations were derived for composite materials with porosity correction factors (b) of 4.04 and 4.11, respectively, indicating that porosity largely decreased both E and G moduli.

Flow cytometry analysis of effects of glass on response of osteosarcoma cells to plasma-sprayed hydroxyapatite/CaO-P(2)O(5) coatings

Multilayered coatings composed of mixtures of hydroxyapatite (HA) and P(2)O(5)-based bioactive glasses offer potential clinical benefits in orthopedic and dental surgery. In this study double-layer plasma-sprayed coatings were prepared and the biological response evaluated in tissue culture using two human osteosarcoma cell lines, MG63 and HOS TE85 (HOS). The cells were cultured on the materials and the effects on cell growth were determined using a spectrophometric assay of a mitochondrial enzyme that is active in viable cells. While none of the materials influenced the growth of the MG63 cells, the HOS cells appeared to undergo less proliferation on all the HA materials. Flow cytometry analysis was carried out using rabbit antibodies against osteonectin, osteopontin, bone sialoprotein, fibronectin, and collagen type I to measure the effects of the materials on key cellular functions. The results showed that the materials downregulated the expression of these extracellular matrix antigens by MG63 cells whereas they had less effect on the HOS cells compared to the same cells incubated on a plastic surface. Notably, with both cell lines the composite with the higher percentage of glass restored the production of connective tissue proteins to levels that were more similar to those present in the control cells.

Glass-reinforced hydroxyapatite composites: fracture toughness and hardness dependence on microstructural characteristics

Fracture toughness and hardness properties of CaO-P2O5 glass-reinforced hydroxyapatite composites have been assessed using indentation techniques and results calculated according to Laugier and Evans' equations. Both properties showed to be dependent upon several microstructural characteristics, namely residual porosity and the percentage of secondary beta and alpha tricalcium phosphate phases in the structure of the composites. Composites presented a Palmqvist-type indentation crack system, which is the specific crack system addressed by Laugier's approach. Fracture toughness determinations according to Evan's equation, which is a universal one and adapted to both median and Palmqvist crack systems, did not correlate well with Laugier determinations.

Glass-reinforced hydroxyapatite composites: secondary phase proportions and densification effects on biaxial bending strength

CaO-P(2)O(5) glasses with additions of MgO and CaF(2) were used as a sintering aid of hydroxyapatite, and glass-reinforced hydroxyapatite composites obtained. Glasses promoted significant changes in the microstructure of the composites, namely with the formation of tricalcium phosphate secondary phases, beta and alpha-TCP. Quantitative phase analysis was performed by the Rietveld method using General Structure Analysis Software. Grain size measurements were carried out on SEM photomicrographs, using a planimetric procedure according to ASTM E 112-88. Flexural bending strength was determined from concentric ring-on-ring testing. Flexural bending strength (FBS) of glass-reinforced hydroxyapatite composites was found to be about twice or three times higher than that of unreinforced hydroxyapatite and tended to depend more on porosity and beta and alpha-TCP secondary phases, rather than on grain size. Traces of alpha-tricalcium phosphate significantly enhanced the strength of the composites. Using the rule of mixtures to estimate the zero porosity bending strength, the Duckworth-Knudsen model applied to the composites gave a porosity correction factor, b, with a value of 4.02. Weibull statistics were also used to analyze biaxial strength data and the level of reinforcement obtained by comparing failure probability for the composites and for the unreinforced hydroxyapatite. Lower activation energies for grain growth were observed for the composites compared to unreinforced hydroxyapatite, which should be attributed to the presence of a liquid glassy phase that promotes atomic diffusion during the sintering process.

In vitro growth and differentiation of osteoblast-like human bone marrow cells on glass reinforced hydroxyapatite plasma-sprayed coatings

Human osteoblastic bone marrow cells were cultured for periods of up to 28 days in control conditions and on the surface of a glass reinforced hydroxyapatite composite (HA/G1) and commercial hydroxyapatite (HA) plasma-sprayed coatings, in the "as-received" condition and after immersion treatment in culture medium for 21 days. Cultures were characterized for total protein content and alkaline phosphatase activity. Scanning electron microscope analyses were performed on control cultures, seeded materials and materials incubated in the absence of cells. Culture media were analyzed for total and ionized calcium and phosphorus concentrations throughout the incubation period. Immersion of HA/G1 and HA coatings in culture medium resulted in significant alterations to the levels of calcium and phosphorus in the medium, leading to surface modifications. However, seeded material samples showed significant differences in the pattern of variation of the levels of these species. Cell proliferation was observed in the "as-received" HA/G1 composite, but cell mediated formation of mineral deposits was not proved. In contrast, "as-received" HA hardly supported cell growth. Previously immersed material samples showed cell proliferation and evidence of biological formation of mineral deposits. However, the HA/G1 composite presented better surface characteristics for cell growth as the behavior of bone marrow cells was closer to that observed in control cultures.

Hydrophobicity, surface tension, and zeta potential measurements of glass-reinforced hydroxyapatite composites

Wettability and zeta potential studies were performed to characterize the hydrophobicity, surface tension, and surface charge of P2O5-glass-reinforced hydroxyapatite composites. Quantitative phase analysis was performed by the Rietveld method using GSAS software applied to X-ray diffractograms. Surface charge was assessed by zeta potential measurements. Protein adsorption studies were performed using vitronectin. Contact angles and surface tensions variation with time were determined by the sessile and pendent drop techniques, respectively, using ADSA-P software. The highest (-18.1 mV) and lowest (-28.7 mV) values of zeta potential were found for hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP), respectively, with composite materials presenting values in between. All studied bioceramic materials showed similar solid surface tension. For HA and beta-TCP, solid surface tensions of 46.7 and 45.3 mJ/m2, respectively, were obtained, while composites presented intermediate surface tension values. The dispersive component of surface tension was the predominant one for all materials studied. Adhesion work values between the vitronectin solution and HA and beta-TCP were found to be 79.8 and 88.0 mJ/m2, respectively, while the 4.0 wt % glass composites showed slightly lower values than the 2.5 wt % ones. The presence of beta-TCP influenced surface charge, hydrophobicity, and protein adsorption of the glass-reinforced HA composites, and therefore indirectly affected cell-biomaterial interactions.

CaO-P2O5 glass hydroxyapatite double-layer plasma-sprayed coating: in vitro bioactivity evaluation

Double-layer composite coatings composed of a P2O5-based glass/Ca10(PO4)6(OH)2 (HA) mixture top layer and a simple HA underlayer, on Ti-6Al-4V substrates, were prepared using a plasma-spraying technique. The in vitro bioactivity of these coatings was assessed by immersion testing in simulated body fluid. Both scanning electron microscopy (SEM) analysis and the ionic solution changes followed by atomic absorption spectroscopy and the molybdenum blue method demonstrated that these composite coatings induce a faster surface Ca-P layer formation than the simple HA coatings used as a control. X-ray photoelectron spectroscopy (XPS) analysis demonstrated that the Ca-P layer formed was apatite. The combination of SEM and XPS analyses showed that the apatite layer was a calcium-deficient hydroxyapatite with a Ca/P ranging from 1.3 to 1.4 with CO3(2-) groups contained in the structure.

Flow cytometry for assessing biocompatibility

Flow cytometry (FCM) was examined as a possible procedure for measuring in vitro the biocompatibility of implant materials for orthopedic and dental surgery. The human osteoblast-like cell line MG63 was grown on hydroxyapatite (HA) and P2O5 glass-reinforced HA composite discs and compared with the same cells grown on polystyrene culture dishes. While morphological observation at the light and electron microscopic levels showed no major deleterious effects, FCM indicated that cell size was somewhat reduced, particularly by growth on the HA composite. Morever, this material also appeared to delay the progression of the cells from the G0/G1 into the S phase of the cell cycle. In addition to this low level of inhibition of cell growth relative to control cultures, FCM analysis also demonstrated that the glass-reinforced HA caused some down-regulation of the expression of osteocalcin and fibronectin, two antigens which play a vital part in the integrity and function of bone and soft connective tissue, respectively. These results thus show, first, that although HA and the HA composite used in these experiments were generally biocompatible, they nevertheless had certain suboptimal effects on the cells; and second, that FCM could be a highly useful procedure for effectively screening and evaluating important biological responses to implant materials.

Glass-reinforced hydroxyapatite: a comprehensive study of the effect of glass composition on the crystallography of the composite

Glass-reinforced HA composites were produced using phosphate-based glasses, and a structure refinement was carried out to determine the effect of the glass on the structure of the residual HA. Quantitative phase analysis showed that the glass causes some of the HA to decompose to beta-TCP and, at higher temperatures, to alpha-TCP. It also was indicated that when three phases were present, the formation of the alpha-TCP arose from decomposition of the beta-TCP and not from further decomposition of HA to alpha-TCP. The unit cell dimensions showed a decrease in the a axis and an increase in the c axis, giving an overall unit cell decrease in volume. There also was a significant effect based on the amount of glass added. The changes found in the composite containing the 4 wt% glass were attributed to the loss of carbonate and loss of hydroxyl. This was expected to cause shrinkage in the unit cell; however this was not seen, and therefore the major changes in the unit cell were attributed to the ions from the glass taking an interstitial role in the HA structure, thus not allowing the unit cell to shrink as much as expected.

Surface modifications of glass-reinforced hydroxyapatite composites

Surface modifications of glass-reinforced hydroxyapatite composites immersed in a simulated physiological solution were studied using X-ray photoelectron spectroscopy, scanning electron microscopy and energy dispersive X-ray spectroscopy. In the first stages of the apatite formation process, calcium and silicon ions were leached out from the surface of the composites. After 12 days of immersion, apatite crystals were detected on the surface indicating bioactive behaviour. Sodium ions attributed to sodium sulphate were also found in the apatite layer. Bound water on the surface also increased with immersion time.

Microstructural characterization of glass-reinforced hydroxyapatite composites

The influence of phosphate-based glasses and a bioactive silica glass on the sintering mechanism of hydroxyapatite was studied over a wide range of temperatures. The composites were microstructurally characterized using X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Small additions of phosphate-based glasses proved to be beneficial to the sintering process and fully dense materials were obtained. A significant improvement in mechanical properties was achieved. beta-TCP and alpha-TCP were found in the microstructure depending on the sintering temperature. Additions of bioactive glass led to the development of calcium phosphate silicate.