Biomedical applications of diamond-like carbon coatings: A review

Hemocompatibility of Super-Repellent surfaces: Current and Future

Virtually all blood-contacting medical implants and devices initiate immunological events in the form of thrombosis and inflammation. Typically, patients receiving such implants are also given large doses of anticoagulants, which pose a high risk and a high cost to the patient. Thus, the design and development of surfaces with improved hemocompatibility and reduced dependence on anticoagulation treatments is paramount for the success of blood-contacting medical implants and devices. In the past decade, the hemocompatibility of super-repellent surfaces (i.e., surfaces that are extremely repellent to liquids) has been extensively investigated because such surfaces greatly reduce the blood-material contact area, which in turn reduces the area available for protein adsorption and blood cell or platelet adhesion, thereby offering the potential for improved hemocompatibility. In this review, we critically examine the progress made in characterizing the hemocompatibility of super-repellent surfaces, identify the unresolved challenges and highlight the opportunities for future research on developing medical implants and devices with super-repellent surfaces.

Progress in cardiovascular biomaterials

In 1986, the European Society of Biomaterials Consensus Conference gave a simplified definition of biomaterials as “a non-viable material used in a medical device intended to interact with biological systems”. This seems to be more appropriate when we look into the versatility of applications of biomaterials in the health sector, especially in cardiovascular practice. This field has expanded exponentially in every direction, with multifunctional capability. Heart valves have undergone an evolution in biomaterials and design. Patches and conduits have been developed to correct anatomical deficits, and solutions have been found for narrowing or ballooning of the arteries. Research is ongoing to find replacements for every part of this system by creating replicas made of various materials. To investigate problems pertaining to the cardiovascular system, catheters have undergone an astounding leap in material optimization. In these three sectors, the trends, successes, and failures are worth discussing. This review mainly focuses on the types of biomaterial used for making cardiovascular devices and their advantages and limitations.

Emerging Encapsulation Technologies for Long-Term Reliability of Microfabricated Implantable Devices

The development of reliable long-term encapsulation technologies for implantable biomedical devices is of paramount importance for the safe and stable operation of implants in the body over a period of several decades. Conventional technologies based on titanium or ceramic packaging, however, are not suitable for encapsulating microfabricated devices due to their limited scalability, incompatibility with microfabrication processes, and difficulties with miniaturization. A variety of emerging materials have been proposed for encapsulation of microfabricated implants, including thin-film inorganic coatings of Al2O3, HfO2, SiO2, SiC, and diamond, as well as organic polymers of polyimide, parylene, liquid crystal polymer, silicone elastomer, SU-8, and cyclic olefin copolymer. While none of these materials have yet been proven to be as hermetic as conventional metal packages nor widely used in regulatory approved devices for chronic implantation, a number of studies have demonstrated promising outcomes on their long-term encapsulation performance through a multitude of fabrication and testing methodologies. The present review article aims to provide a comprehensive, up-to-date overview of the long-term encapsulation performance of these emerging materials with a specific focus on publications that have quantitatively estimated the lifetime of encapsulation technologies in aqueous environments.

Fabrication of Micro- and Nanopillars from Pyrolytic Carbon and Tetrahedral Amorphous Carbon

Pattern formation of pyrolyzed carbon (PyC) and tetrahedral amorphous carbon (ta-C) thin films were investigated at micro- and nanoscale. Micro- and nanopillars were fabricated from both materials, and their biocompatibility was studied with cell viability tests. Carbon materials are known to be very challenging to pattern. Here we demonstrate two approaches to create biocompatible carbon features. The microtopographies were 2 μ m or 20 μ m pillars (1:1 aspect ratio) with three different pillar layouts (square-grid, hexa-grid, or random-grid orientation). The nanoscale topography consisted of random nanopillars fabricated by maskless anisotropic etching. The PyC structures were fabricated with photolithography and embossing techniques in SU-8 photopolymer which was pyrolyzed in an inert atmosphere. The ta-C is a thin film coating, and the structures for it were fabricated on silicon substrates. Despite different fabrication methods, both materials were formed into comparable micro- and nanostructures. Mouse neural stem cells were cultured on the samples (without any coatings) and their viability was evaluated with colorimetric viability assay. All samples expressed good biocompatibility, but the topography has only a minor effect on viability. Two μ m pillars in ta-C shows increased cell count and aggregation compared to planar ta-C reference sample. The presented materials and fabrication techniques are well suited for applications that require carbon chemistry and benefit from large surface area and topography, such as electrophysiological and -chemical sensors for in vivo and in vitro measurements.

Micropatterning of a 2-methacryloyloxyethyl phosphorylcholine polymer surface by hydrogenated amorphous carbon thin films for endothelialization and antithrombogenicity

The existing first-generation drug-eluting stent (DES) has caused late and very late stent thrombosis related to incomplete stent endothelialization. Hence, biomaterials that possess sufficient anti-thrombogenicity and endothelialization with the controlled drug release system have been highly required. In this work, we have developed a newly designed drug-release platform composed of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, a non-thrombogenic polymer, and micropatterned hydrogenated amorphous carbon (a-C:H), a cell-compatible thin film. The platelet adhesion and the endothelial cell adhesion behavior on the micropatterned substrates were investigated in vitro. The results indicated that the micropatterned a-C:H/MPC polymer substrates effectively supported the human umbilical vein endothelial cell (HUVEC) proliferation, while suppressing the platelet adhesion. Interestingly, the HUVEC exhibited different shape and behavior by changing the island size of the micropatterned a-C:H. By introducing both a non-thrombogenic polymer and cell-compatible thin films through a simple patterning method, we demonstrated that the platform had the potential to be utilized as a base material for DES with cell controllability. STATEMENT OF SIGNIFICANCE: The current first-generation drug-eluting stents (DES) would cause late and very late stent thrombosis due to the incomplete endothelialization of the metal stent material. In this work, we have developed a new DES platform composed of a 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer micropatterned by hydrogenated amorphous carbon (a-C:H). Two types of differently micropatterned a-C:H stent surface were made. Our studies revealed that the micropatterned a-C:H/MPC polymer substrates could effectively enhance the endothelial cell (EC) proliferation, simultaneously suppressing the platelet adhesion, becoming a highly biocompatible material especially for indwelling devices including a drug-release device. The new drug-release platform could be utilized as a base material for cell-controllable coating on DES.

Immobilization of Detonation Nanodiamonds on Macroscopic Surfaces

Detonation nanodiamonds (NDs) are a novel class of carbon-based nanomaterials, and have received a great deal of attention in biomedical applications, due to their high biocompatibility, facile surface functionalization, and commercialized synthetic fabrication. We were able to transfer the NDs from large-size agglomerate suspensions to homogenous coatings. ND suspensions have been used in various techniques to coat on commercially available substrates of pure Ti and Si. Scanning electron microscopy (SEM) imaging and nanoindentation show that the densest and strongest coating of NDs was generated when using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide and N-hydroxysuccinimide (EDC/NHS)-mediated coupling to macroscopic silanized surfaces. In the next step, the feasibility of DNA-mediated coupling of NDs on macroscopic surfaces is discussed using fluorescent microscopy and additional particle size distribution, as well as zeta potential measurements. This work compares different ND coating strategies and describes the straightforward technique of grafting single-stranded DNA onto carboxylated NDs via thioester bridges.

Heat-treated carbon coatings on poly (l-lactide) foils for tissue engineering

Carbon-based materials have emerged as promising candidates for a wide variety of biomedical applications, including tissue engineering. We have developed a simple but unique technique for patterning carbon-based substrates in order to control cell adhesion, growth and phenotypic maturation. Carbon films were deposited on PLLA foils from distances of 3 to 7 cm. Subsequent heat-treatment (60 °C, 1 h) created lamellar structures with dimensions decreasing from micro- to nanoscale with increasing deposition distance. All carbon films improved the spreading and proliferation of human osteoblast-like MG 63 cells, and promoted the alignment of these cells along the lamellar structures. Similar alignment was observed in human osteoblast-like Saos-2 cells and in human dermal fibroblasts. Type I collagen fibers produced by Saos-2 cells and fibroblasts were also oriented along the lamellar structures. These structures increased the activity of alkaline phosphatase in Saos-2 cells. Carbon coatings also supported adhesion and growth of vascular endothelial and smooth muscle cells, particularly flatter non-heated carbon films. On these films, the continuity of the endothelial cell layer was better than on heat-treated lamellar surfaces. Heat-treated carbon-coated PLLA is therefore more suitable for bone and skin tissue engineering, while carbon-coated PLLA without heating is more appropriate for vascular tissue engineering.

Corrosion of Metallic Biomaterials: A Review

Metallic biomaterials are used in medical devices in humans more than any other family of materials. The corrosion resistance of an implant material affects its functionality and durability and is a prime factor governing biocompatibility. The fundamental paradigm of metallic biomaterials, except biodegradable metals, has been "the more corrosion resistant, the more biocompatible." The body environment is harsh and raises several challenges with respect to corrosion control. In this invited review paper, the body environment is analysed in detail and the possible effects of the corrosion of different biomaterials on biocompatibility are discussed. Then, the kinetics of corrosion, passivity, its breakdown and regeneration in vivo are conferred. Next, the mostly used metallic biomaterials and their corrosion performance are reviewed. These biomaterials include stainless steels, cobalt-chromium alloys, titanium and its alloys, Nitinol shape memory alloy, dental amalgams, gold, metallic glasses and biodegradable metals. Then, the principles of implant failure, retrieval and failure analysis are highlighted, followed by description of the most common corrosion processes in vivo. Finally, approaches to control the corrosion of metallic biomaterials are highlighted.

Biological Response to Carbon-Family Nanomaterials: Interactions at the Nano-Bio Interface

During the last few decades, several studies have suggested that carbon-based nanomaterials, owing to their unique properties, could act as promising candidates in biomedical engineering application. Wide-ranging research efforts have investigated the cellular and molecular responses to carbon-based nanomaterials at the nano-bio interfaces. In addition, a number of surface functionalization strategies have been introduced to improve their safety profile in the biological environment. The present review discusses the general principles of immunological responses to nanomaterials. Then, it explains essential physico-chemical properties of carbon-familynanomaterials, including carbon nanotubes (CNTs), graphene, fullerene, carbon quantum dots (CDs), diamond-like carbon (DLC), and mesoporous carbon biomaterials (MCNs), which significantly affect the immunological cellular and molecular responses at the nano-bio interface. The discussions also briefly highlight the recent studies that critically investigated the cellular and molecular responses to various carbon-based nanomaterials. It is expected that the most recent perspective strategies for improving the biological responses to carbon-based nanomaterials can revolutionize their functions in emerging biological applications.

Advances in Penetrating Multichannel Microelectrodes Based on the Utah Array Platform

The Utah electrode array (UEA) and its many derivatives have become a gold standard for high-channel count bi-directional neural interfaces, in particular in human subject applications. The chapter provides a brief overview of leading electrode concepts and the context in which the UEA has to be understood. It goes on to discuss the key advances and developments of the UEA platform in the past 15 years, as well as novel wireless and system integration technologies that will merge into future generations of fully integrated devices. Aspects covered include novel device architectures that allow scaling of channel count and density of electrode contacts, material improvements to substrate, electrode contacts, and encapsulation. Further subjects are adaptations of the UEA platform to support IR and optogenetic simulation as well as an improved understanding of failure modes and methods to test and accelerate degradation in vitro such as to better predict device failure and lifetime in vivo.

Structure, Mechanical and Tribological Properties of Me-Doped Diamond-Like Carbon (DLC) (Me = Al, Ti, or Nb) Hydrogenated Amorphous Carbon Coatings

Metal containing hydrogenated diamond-like carbon coatings (Me-DLC, Me = Al, Ti, or Nb) of 3 ± 0.2 μm thickness were deposited by a magnetron sputtering-RFPECVD hybrid process in an Ar/H2/C2H2 mixture. The composition and structure were investigated by Energy Dispersive X-ray Spectroscopy (EDS), X-ray Diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopy. The residual stress was measured using the curvature method and nanoindentation was used to determine the hardness and the Young’s modulus. A Ball-on-disk tribometer was employed to investigate the frictional properties and sliding wear resistance of films. The results show that the properties depend on the nature and the Me content in the coatings. The doping of the DLC coatings leads to a decrease in hardness, Young’s modulus, and residual stresses. Wear rate of the films first decreases with intermediate Me contents and then increases for higher Me contents. Significant improvements in the friction coefficient on steel as well as in the wear rate are observed for all Al-DLC coatings, and, concerning the friction coefficient, the lowest value is measured at 0.04 as compared to 0.07 for the undoped DLC.

Nanotribological response of a-C:H coated metallic biomaterials: the cases of stainless steel, titanium, and niobium

Background Wear and corrosion have been identified as two of the major forms of medical implant failures. This study aims to improve the surface, protective and tribological characteristics of bare metals used for medical implants, so as to improve scratch resistance and increase lifetime. Methods Hydrogenated amorphous carbon (a-C:H) films were deposited, using plasma enhanced chemical vapor deposition (PECVD), on stainless steel (SS), titanium (Ti) and niobium (Nb) metal plates. Nanomechanical and nanotribological responses were investigated before and after a-C:H deposition. Film thickness and density were quantified through X-ray reflectivity, and surface morphology before and after deposition were measured using atomic force microscopy, whereas the tribomechanical characteristics were probed using instrumented indentation. Results and conclusions Films of approximately 40 nm in thickness and density of 1.7 g/cm³ were deposited. The a-C:H films reduce the roughness and coefficient of friction while improving the tribomechanical response compared with bare metals for Ti, SS and Nb plates. The very good tribomechanical properties of a-C:H make it a promising candidate material for protective coating on metallic implants.

Graphene Materials in Antimicrobial Nanomedicine: Current Status and Future Perspectives

Graphene materials (GMs), such as graphene, graphene oxide (GO), reduced GO (rGO), and graphene quantum dots (GQDs), are rapidly emerging as a new class of broad-spectrum antimicrobial agents. This report describes their state-of-the-art and potential future covering both fundamental aspects and biomedical applications. First, the current understanding of the antimicrobial mechanisms of GMs is illustrated, and the complex picture of underlying structure-property-activity relationships is sketched. Next, the different modes of utilization of antimicrobial GMs are explained, which include their use as colloidal dispersions, surface coatings, and photothermal/photodynamic therapy agents. Due to their practical relevance, the examples where GMs function as synergistic agents or release platforms for metal ions and/or antibiotic drugs are also discussed. Later, the applicability of GMs in the design of wound dressings, infection-protective coatings, and antibiotic-like formulations ("nanoantibiotics") is assessed. Notably, to support our assessments, the existing clinical applications of conventional carbon materials are also evaluated. Finally, the key hurdles of the field are highlighted, and several possible directions for future investigations are proposed. We hope that the roadmap provided here will encourage researchers to tackle remaining challenges toward clinical translation of promising research findings and help realize the potential of GMs in antimicrobial nanomedicine.

Biomineralization of osteoblasts on DLC coated surfaces for bone implants

Diamond like carbon (DLC) films were deposited onto Ti6Al4V and Si wafer substrates by RF plasma enhanced chemical vapor deposition. The influence of dopants such as fluorine (F), silicon (Si), and nitrogen (N) on composition, structure, and biocompatibility was investigated. Ion scattering spectroscopy analysis revealed the presence of dopant atoms in the outer-most layers of the films. Raman studies showed that the position of the G-band shifts to higher frequencies with the fluorine and nitrogen content in the DLC film, whereas the incorporation of Si into DLC induces a decrease of the position of the G peak. The corrosion behavior was studied in simulated body fluid. A higher charge transfer resistance (R_ct) was observed for the doped DLC films. The indirect cytotoxicity was performed using L929 fibroblast cells. The coated surfaces were hemocompatible when tested with red blood cells. DLC films were noncytotoxic to L929 cells over a 24 h exposure. Saos-2 osteoblast cell response to the doped and undoped DLC coated surfaces was studied in adhesion, proliferation, differentiation, and mineralization assays. The production of calcium and phosphate by cells on doped DLC, particularly, nitrogen doped DLC, was higher than that on undoped DLC.

Characterization of sp3 bond content of carbon films deposited by high power gas injection magnetron sputtering method by UV and VIS Raman spectroscopy

This paper presents the results of investigations of carbon films deposited by a modified version of the magnetron sputtering method - HiPGIMS (High Power Gas Injection Magnetron Sputtering). In this experiment, the magnetron system with inversely polarized electrodes (sputtered cathode at ground potential and positively biased, spatially separated anode) was used. This arrangement allowed us to conduct the experiment using voltages ranging from 1 to 2kV and a power supply system equipped with 25/50μF capacitor battery. Carbon films were investigated by VIS/UV Raman spectroscopy. Sp³/sp² bonding ratio was evaluated basing the elementary components of registered spectra. Our investigation showed that sp³ bond content increases with discharge power but up to specific value only. In extreme conditions of generating plasma impulses, we detected a reversed relation of the sp³/sp² ratio. In our opinion, a energy of plasma pulse favors nucleation of a sp³ phase because of a relatively higher ionization state but in extreme cases the influence of energy is reversed.

In vitro cytotoxicity assessment of nanodiamond particles and their osteogenic potential

Scaffolds functionalized with nanodiamond particles (nDP) hold great promise with regard to bone tissue formation in animal models. Degradation of the scaffolds over time may leave nDP within the tissues, raising concerns about possible long-term unwanted effects. Human SaOS-2 osteoblast-like cells and U937 monoblastoid cells were exposed to five different concentrations (0.002-2 mg/L) of nDP (size range: 2.36-4.42 nm) for 24 h. Cell viability was assessed by impedance-based methods. The differential expression of stress and toxicity-related genes was evaluated by polymerase chain reaction (PCR) super-array, while the expression of selected inflammatory and cell death markers was determined by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR). Furthermore, the expression of osteogenic genes by SaOS-2 cells, alkaline phosphatase activity and the extracellular calcium nodule deposition in response to nDP were determined in vitro. Cells responded differently to higher nDP concentrations (≥0.02 mg/L), that is, no loss of viability for SaOS-2 cells and significantly reduced viability for U937 cells. Gene expression showed significant upregulation of several cell death and inflammatory markers, among other toxicity reporter genes, indicating inflammatory and cytotoxic responses in U937 cells. Nanodiamond particles improved the osteogenicity of osteoblast-like cells with no evident cytotoxicity. However, concentration-dependent cytotoxic and inflammatory responses were seen in the U937 cells, negatively affecting osteogenicity in co-cultures. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1697-1707, 2018.

Characterization and electrochemical properties of iron-doped tetrahedral amorphous carbon (ta-C) thin films

Iron-doped tetrahedral amorphous carbon thin films (Fe/ta-C) were deposited with varying iron content using a pulsed filtered cathodic vacuum arc system (p-FCVA). The aim of this study was to understand effects of iron on both the physical and electrochemical properties of the otherwise inert sp³-rich ta-C matrix. As indicated by X-ray photoelectron spectroscopy (XPS), even ∼0.4 at% surface iron had a profound electrochemical impact on both the potential window of ta-C in H₂SO₄ and KOH, as well as pseudocapacitance. It also substantially enhanced the electron transport and re-enabled facile outer sphere redox reaction kinetics in comparison to un-doped ta-C, as measured with electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) using outer-sphere probes Ru(NH₃)₆, IrCl₆, and FcMeOH. These increases in surface iron loading were linked to increased surface oxygen content and iron oxides. Unlike few other metals, an iron content even up to 10 at% was not found to result in the formation of sp²-rich amorphous carbon films as investigated by Raman spectroscopy. Atomic force microscopy (AFM) and transmission electron microscopy (TEM) investigations found all films to be amorphous and ultrasmooth with R_q values always in the range of 0.1–0.2 nm. As even very small amounts of Fe were shown to dominate the electrochemistry of ta-C, implications of this study are very useful e.g. in carbon nanostructure synthesis, where irregular traces of iron can be readily incorporated into the final structures.

Surface iron levels as low as 0.4 at% (XPS) can considerably change the electrochemical properties of initially inert carbon surfaces.

Chromium oxide coatings with the potential for eliminating the risk of chromium ion release in orthopaedic implants

Chromium oxide coatings prepared by radiofrequency reactive magnetron sputtering on stainless steel substrates were exposed to Ringer's physiological solution and tested for their electrochemical corrosion stability using an open circuit potential measurement, potentiodynamic polarization, electrochemical impedance spectroscopy and Mott-Schottky analysis. The coatings were found to be predominantly Cr₂O₃, based on the observation of the dominance of [Formula: see text] and E_g symmetric modes in our Raman spectroscopic investigation and the E_u vibrational modes in our Fourier transform infrared spectroscopic measurements on the coatings. We investigated for the presence of chromium ions in Ringer's solution after all of the above electrochemical tests using atomic absorption spectroscopy, without finding a trace of chromium ions at the ppm level for coatings tested under open circuit and at the lower potentials implants are likely to experience in the human body. The coatings were further exposed to Ringer's solution for one month and tested for adhesion strength changes, and we found that they retained substantial adhesion to the substrates. We expect this finding to be significant for future orthopaedic implants where chromium ion release is still a major challenge.

Functionalized, biocompatible, and impermeable nanoscale coatings for PEEK

Biologically compatible coatings that provide hermetic seal could resolve a major technological hurdle in the attempt to replace metals with polymers for biochips and active medical implants. The use of amorphous carbon/diamond like carbon (a-C:H) coatings to hermetically seal and biologically enhance polyether-ether-ketone (PEEK) for biomedical device integration in the human body was investigated. The PEEK coating functionality (sp3/sp2 ratio), hardness and thickness (70-200nm) were controlled, by varying H₂ and N₂ concentration during the plasma operation with CH₄. a-C:H coatings having the highest indentation modulus of 13.5GPa, originate out of a CH₄ (90%) rich composition. Even in a mixture of 70/30 H₂/CH₄ the hardness is 4.76GPa, corresponding to hard and dense coatings. In all tested conditions of deposition coatings hardens was sufficient for the purpose of PEEK implants modification. The synthesized (a-C:H) nanoscale coatings were not water permeable as measured by the hydrolysis test, resolving the traditional challenge of swelling in wet environment. The hardness of the coatings showed strong correlations with the thickness, surprisingly however, with no correlations with the sp3/sp2 ratio. Selected non water permeable nanoscale coating on PEEK showed strong bioactivity by being viable for human osteoblast (hFOB) and human fibroblast (hGF) cells without toxicity issues. No correlation was observed between the coatings sp3/sp2 ratio and biological performance.

Albumin (BSA) adsorption onto graphite stepped surfaces

Nanomaterials are good candidates for the design of novel components with biomedical applications. For example, nano-patterned substrates may be used to immobilize protein molecules in order to integrate them in biosensing units. Here, we perform long MD simulations (up to 200 ns) using an explicit solvent and physiological ion concentrations to characterize the adsorption of bovine serum albumin (BSA) onto a nano-patterned graphite substrate. We have studied the effect of the orientation and step size on the protein adsorption and final conformation. Our results show that the protein is stable, with small changes in the protein secondary structure that are confined to the contact area and reveal the influence of nano-structuring on the spontaneous adsorption, protein-surface binding energies, and protein mobility. Although van der Waals (vdW) interactions play a dominant role, our simulations reveal the important role played by the hydrophobic lipid-binding sites of the BSA molecule in the adsorption process. The complex structure of these sites, that incorporate residues with different hydrophobic character, and their flexibility are crucial to understand the influence of the ion concentration and protein orientation in the different steps of the adsorption process. Our study provides useful information for the molecular engineering of components that require the immobilization of biomolecules and the preservation of their biological activity.

Nanoplasmonic Sensing at the Carbon-Bio Interface: Study of Protein Adsorption at Graphitic and Hydrogenated Carbon Surfaces

Various forms of carbon are known to perform well as biomaterials in a variety of applications and an improved understanding of their interactions with biomolecules, cells, and tissues is of interest for improving and tailoring their performance. Nanoplasmonic sensing (NPS) has emerged as a powerful technique for studying the thermodynamics and kinetics of interfacial reactions. In this work, the in situ adsorption of two proteins, bovine serum albumin and fibrinogen, were studied at carbon surfaces with differing chemical and optical properties using nanoplasmonic sensors. The carbon material was deposited as a thin film onto NPS surfaces consisting of 100 nm Au nanodisks with a localized plasmon absorption peak in the visible region. Carbon films were fully characterized by X-ray photoelectron spectroscopy, atomic force microscopy, and spectroscopic ellipsometry. Two types of material were investigated: amorphous carbon (a-C), with high graphitic content and high optical absorptivity, and hydrogenated amorphous carbon (a-C:H), with low graphitic content and high optical transparency. The optical response of the Au/carbon NPS elements was modeled using the finite difference time domain (FDTD) method, yielding simulated analytical sensitivities that compare well with those observed experimentally at the two carbon surfaces. Protein adsorption was investigated on a-C and a-C:H, and the protein layer thicknesses were obtained from FDTD simulations of the expected response, yielding values in the 1.8-3.3 nm range. A comparison of the results at a-C and a-C:H indicates that in both cases fibrinogen layers are thicker than those formed by albumin by up to 80%.

Effects of a magnetic palatal expansion appliance with reactivation system: An animal experiment

INTRODUCTION

The purpose of this study was to evaluate the effects of a newly designed magnetic palatal expansion appliance with a reactivation system.

METHODS

A magnetic palatal expansion appliance was designed based on the repulsion forces of neodymium-iron-boron magnets combined with a reactivation system. Eighteen prepubertal male beagle dogs were assigned randomly to the magnetic expansion (ME) group, the mechanical screw expansion (SE) group, or the control group. Two pairs of nonmagnetic metal bone marker implants were inserted into palatal bone bilaterally 3 mm lateral to the midpalatal suture and in line with the first and fourth premolars, respectively, in each dog. The 6 animals in each group received (1) newly designed magnetic expanders, (2) jackscrew expanders, or (3) no expansion appliance. Expansion was stopped after 4 weeks when 6 mm of activation was achieved in the 2 treated groups. Three-dimensional evaluations of dental and skeletal effects were performed with cone-beam computed tomography. Histologic examinations were conducted using light microscopy to observe morphologic changes in the midpalatal suture after hematoxylin and eosin staining.

RESULTS

The absolute transversal changes of both treated groups before and after expansion were significantly greater than those in the control group in all parameters (P <0.001). The differences of the distances of bilateral canines in the ME group were significantly greater than in the SE group (1.04 ± 0.16 mm; P <0.001); the differences of the distances between implants adjacent to the first premolars (0.77 ± 0.06 mm; P <0.001) and the distances between implants adjacent to the fourth premolars (0.37 ± 0.06 mm; P <0.001) in the SE group were significantly greater than in the ME group. Histologic observations of the palatal sutures in the ME and SE groups, when compared with the control group, showed widening of the sutures and many fibroblasts in an active, proliferative state. Counts of osteoblasts were increased in both expansion groups. Counts of osteoclasts were increased in the SE group.

CONCLUSIONS

Both appliances expanded the maxilla effectively and induced processes of bone remodeling of the midpalatal sutures during expansion. The new magnetic palatal expansion appliances produced a smaller skeletal effect and a greater dental effect than did the mechanical screw palatal expansion appliances.

Effects of Hard Thin-Film Coatings on Adhesion of Early Colonizer Bacteria Over Titanium Surfaces

PURPOSE

The purpose of this in vitro study was to evaluate the effect of diamond-like carbon (DLC) and titanium (Ti) nitride coatings over Ti surfaces on the adhesion of early colonizer bacteria.

MATERIALS AND METHODS

Specimens were divided into 3 groups (n = 10) according to different surface modifications: titanium nitride (TiN)-coated Ti discs (experimental group 1), DLC-coated Ti discs (experimental group 2), and uncoated polished Ti discs (control group). Discs were incubated in bacterial cell suspension (Streptococcus mutans and Streptococcus sanguis) for 1 hour, and the single colonies formed by adhering bacteria were counted by fluorescence microscopy. Surface roughness and topography were examined by atomic force microscopy.

RESULTS

The surface roughness of DLC was lower than TiN coating and the control group. Statistically significant reduction of the number of adherent bacteria was observed on DLC-coated surfaces.

CONCLUSIONS

DLC coating over Ti surfaces strongly inhibits the adhesion of early colonizer oral bacteria.

Planar Diamond-Based Multiarrays to Monitor Neurotransmitter Release and Action Potential Firing: New Perspectives in Cellular Neuroscience

High biocompatibility, outstanding electrochemical responsiveness, inertness, and transparency make diamond-based multiarrays (DBMs) first-rate biosensors for in vitro detection of electrochemical and electrical signals from excitable cells together, with potential for in vivo applications as neural interfaces and prostheses. Here, we will review the electrochemical and physical properties of various DBMs and how these devices have been employed for recording released neurotransmitter molecules and all-or-none action potentials from living cells. Specifically, we will overview how DBMs can resolve localized exocytotic events from subcellular compartments using high-density microelectrode arrays (MEAs), or monitoring oxidizable neurotransmitter release from populations of cells in culture and tissue slices using low-density MEAs. Interfacing DBMs with excitable cells is currently leading to the promising opportunity of recording electrical signals as well as creating neuronal interfaces through the same device. Given the recent increasingly growing development of newly available DBMs of various geometries to monitor electrical activity and neurotransmitter release in a variety of excitable and neuronal tissues, the discussion will be limited to planar DBMs.

Nitrogen-doped amorphous carbon-silicon core-shell structures for high-power supercapacitor electrodes

We report successful deposition of nitrogen-doped amorphous carbon films to realize high-power core-shell supercapacitor electrodes. A catalyst-free method is proposed to deposit large-area stable, highly conformal and highly conductive nitrogen-doped amorphous carbon (a-C:N) films by means of a direct-current plasma enhanced chemical vapor deposition technique (DC-PECVD). This approach exploits C₂H₂ and N₂ gases as the sources of carbon and nitrogen constituents and can be applied to various micro and nanostructures. Although as-deposited a-C:N films have a porous surface, their porosity can be significantly improved through a modification process consisting of Ni-assisted annealing and etching steps. The electrochemical analyses demonstrated the superior performance of the modified a-C:N as a supercapacitor active material, where specific capacitance densities as high as 42 F/g and 8.5 mF/cm² (45 F/cm³) on silicon microrod arrays were achieved. Furthermore, this supercapacitor electrode showed less than 6% degradation of capacitance over 5000 cycles of a galvanostatic charge-discharge test. It also exhibited a relatively high energy density of 2.3 × 10³ Wh/m³ (8.3 × 10⁶ J/m³) and ultra-high power density of 2.6 × 10⁸ W/m³ which is among the highest reported values.

Investigation of silicon carbon nitride nanocomposite films as a wear resistant layer in vitro and in vivo for joint replacement applications

Silicon-contained CN_x nanocomposite films were prepared using the ion beam assisted magnetron sputtering under different nitrogen gas pressure. With increase of the nitrogen pressure, silicon and nitrogen content of the CN_x films drastically increase, and is saturated as the P_N2 reach about 40%. Surface roughness and the contact angle are increase, while the friction coefficient decreased. The CN_x film with 5.7at.% Si content possess the lowest friction coefficient of only 0.07, and exhibited the best tribological properties. The impact of CN_x films with different silicon content on the growth and the activation of osteoblasts were compared to that of Ti6Al4V. The incorporation of silicon in the CN_x film also showed an increase cell adhesion. Bonding structure and surface energy were determined to be the factors contributing to the improved biocompatibility. Macrophages attached to 5.7at.% Si contained CN_x films down regulated their production of cytokines and chemokines. Moreover, employed with Si contained CN_x coated joint replacements, which were implanted subcutaneously into Sprague-Dawley mice for up to 36days, the tissue reaction and capsule formation was significantly decreased compared to that of Ti6Al4V. A mouse implantation study demonstrated the excellent in vivo biocompatibility and functional reliability of wear resist layer for joint replacements with a Si doped a-CN_x coating for 36days.

Biocompatibility and Inflammatory Potential of Titanium Alloys Cultivated with Human Osteoblasts, Fibroblasts and Macrophages

The biomaterials used to maintain or replace functions in the human body consist mainly of metals, ceramics or polymers. In orthopedic surgery, metallic materials, especially titanium and its alloys, are the most common, due to their excellent mechanical properties, corrosion resistance, and biocompatibility. Aside from the established Ti6Al4V alloy, shape memory materials such as nickel-titanium (NiTi) have risen in importance, but are also discussed because of the adverse effects of nickel ions. These might be reduced by specific surface modifications. In the present in vitro study, the osteoblastic cell line MG-63 as well as primary human osteoblasts, fibroblasts, and macrophages were cultured on titanium alloys (forged Ti6Al4V, additive manufactured Ti6Al4V, NiTi, and Diamond-Like-Carbon (DLC)-coated NiTi) to verify their specific biocompatibility and inflammatory potential. Additive manufactured Ti6Al4V and NiTi revealed the highest levels of metabolic cell activity. DLC-coated NiTi appeared as a suitable surface for cell growth, showing the highest collagen production. None of the implant materials caused a strong inflammatory response. In general, no distinct cell-specific response could be observed for the materials and surface coating used. In summary, all tested titanium alloys seem to be biologically appropriate for application in orthopedic surgery.

Adhesion and differentiation of Saos-2 osteoblast-like cells on chromium-doped diamond-like carbon coatings

Diamond-like carbon (DLC) thin films are promising for use in coating orthopaedic, dental and cardiovascular implants. The problem of DLC layers lies in their weak layer adhesion to metal implants. Chromium is used as a dopant for improving the adhesion of DLC films. Cr-DLC layers were prepared by a hybrid technology, using a combination of pulsed laser deposition (PLD) from a graphite target and magnetron sputtering. Depending on the deposition conditions, the concentration of Cr in the DLC layers moved from zero to 10.0 at.%. The effect of DLC layers with 0.0, 0.9, 1.8, 7.3, 7.7 and 10.0 at.% Cr content on the adhesion and osteogenic differentiation of human osteoblast-like Saos-2 cells was assessed in vitro. The DLC samples that contained 7.7 and 10.0 at.% of Cr supported cell spreading on day 1 after seeding. On day three after seeding, the most apparent vinculin-containing focal adhesion plaques were also found on samples with higher concentrations of chromium. On the other hand, the expression of type I collagen and alkaline phosphatase at the mRNA and protein level was the highest on Cr-DLC samples with a lower concentration of Cr (0-1.8 at.%). We can conclude that higher concentrations of chromium supported cell adhesion; however DLC and DLC doped with a lower concentration of chromium supported osteogenic cell differentiation.

Nanoscale Surface Modifications of Orthopaedic Implants: State of the Art and Perspectives

Background:

Orthopaedic implants such as the total hip or total knee replacement are examples of surgical interventions with postoperative success rates of over 90% at 10 years. Implant failure is associated with wear particles and pain that requires surgical revision. Improving the implant - bone surface interface is a key area for biomaterial research for future clinical applications. Current implants utilise mechanical, chemical or physical methods for surface modification.

Methods:

A review of all literature concerning the nanoscale surface modification of orthopaedic implant technology was conducted.

Results:

The techniques and fabrication methods of nanoscale surface modifications are discussed in detail, including benefits and potential pitfalls. Future directions for nanoscale surface technology are explored.

Conclusion:

Future understanding of the role of mechanical cues and protein adsorption will enable greater flexibility in surface control. The aim of this review is to investigate and summarise the current concepts and future directions for controlling the implant nanosurface to improve interactions.

The Potential Role of Graphene in Developing the Next Generation of Endomaterials

Graphene is the first 2-dimensional material and possesses a plethora of original properties. Graphene and its derivatives have exhibited a great potential in a number of fields, both medical and nonmedical. The aim of this review is to set the theoretical basis for further research in developing graphene-based endovascular materials. An extensive search was performed in medical and bioengineering literature. Published data on other carbon materials, as well as limited data from medical use of graphene, are promising. Graphene is a promising future material for developing novel endovascular materials. Certain issues as biocompatibility, biotoxicity, and biostability should be explored further.

A chemical stability study of trimethylsilane plasma nanocoatings for coronary stents

Trimethylsilane (TMS) plasma nanocoatings were deposited onto stainless steel coupons in direct current (DC) and radio frequency (RF) glow discharges and additional NH₃/O₂ plasma treatment to tailor the coating surface properties. The chemical stability of the nanocoatings were evaluated after 12 week storage under dry condition (25 °C) and immersion in simulated body fluid (SBF) at 37 °C. It was found that nanocoatings did not impact surface roughness of underlying stainless steel substrates. X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy were used to characterize surface chemistry and compositions. Both DC and RF nanocoatings had Si- and C-rich composition; and the O- and N-contents on the surfaces were substantially increased after NH₃/O₂ plasma treatment. Contact angle measurements showed that DC-TMS nanocoating with NH₃/O₂ treatment generated very hydrophilic surfaces. DC-TMS nanocoatings with NH₃/O₂ treatment showed minimal surface chemistry change after 12 week immersion in SBF. However, nitrogen functionalities on RF-TMS coating with NH₃/O₂ post treatment were not as stable as in DC case. Cell culture studies revealed that the surfaces with DC coating and NH₃/O₂ post treatment demonstrated substantially improved proliferation of endothelial cells over the 12 week storage period at both dry and wet conditions, as compared to other coated surfaces. Therefore, DC nanocoatings with NH₃/O₂ post treatment may be chemically stable for long-term properties, including shelf-life storage and exposure to the bloodstream for coronary stent applications.

Highly enhanced compatibility of human brain vascular pericyte cells on monolayer graphene

We introduce a method for increasing the compatibility of human brain vascular pericyte (HBVP) cells on a glass substrate, based on wet transferred monolayer graphene without any treatment. As a novel material, graphene has key properties for incubating cells, such as chemical stability, transparency, appropriate roughness, hydrophobicity and high electrical conductivity. These outstanding properties of graphene were examined by Raman spectroscopy, water contact angle measurements and atomic force microscopy. The performance of this graphene-based implant was investigated by a cell compatibility test, comparing the growth rate of cells on the graphene surface and that on a bare glass substrate. After an incubation period of 72 h, the number of live HBVP cells on a graphene surface with an area of 1×1 mm² was 1.83 times greater than that on the glass substrate.

Electronic approaches to restoration of sight

Retinal prostheses are a promising means for restoring sight to patients blinded by the gradual atrophy of photoreceptors due to retinal degeneration. They are designed to reintroduce information into the visual system by electrically stimulating surviving neurons in the retina. This review outlines the concepts and technologies behind two major approaches to retinal prosthetics: epiretinal and subretinal. We describe how the visual system responds to electrical stimulation. We highlight major differences between direct encoding of the retinal output with epiretinal stimulation, and network-mediated response with subretinal stimulation. We summarize results of pre-clinical evaluation of prosthetic visual functions in- and ex vivo, as well as the outcomes of current clinical trials of various retinal implants. We also briefly review alternative, non-electronic, approaches to restoration of sight to the blind, and conclude by suggesting some perspectives for future advancement in the field.

Controlled Distribution and Clustering of Silver in Ag-DLC Nanocomposite Coatings Using a Hybrid Plasma Approach

Incorporation of selected metallic elements into diamond-like carbon (DLC) has emerged as an innovative approach to add unique functional properties to DLC coatings, thus opening up a range of new potential applications in fields as diverse as sensors, tribology, and biomaterials. However, deposition by plasma techniques of metal-containing DLC coatings with well-defined structural properties and metal distribution is currently hindered by the limited understanding of their growth mechanisms. We report here a silver-incorporated diamond-like carbon coating (Ag-DLC) prepared in a hybrid plasma reactor which allowed independent control of the metal content and the carbon film structure and morphology. Morphological and chemical analyses of Ag-DLC films were performed by atomic force microscopy, scanning electron microscopy, and X-ray photoelectron spectroscopy. The vertical distribution of silver from the surface toward the coating bulk was found to be highly inhomogeneous due to top surface segregation and clustering of silver nanoparticles. Two plasma parameters, the sputtered Ag flux and ion energy, were shown to influence the spatial distribution of silver particles. On the basis of these findings, a mechanism for Ag-DLC growth by plasma was proposed.