Zinc exhibits ideal physiological corrosion behavior for bioabsorbable stents

Biodegradable Zn-3Mg-0.7Mg2Si composite fabricated by high-pressure solidification for bone implant applications

Zinc (Zn)-based alloys have been considered potential biodegradable materials for medical applications due to their good biodegradability and biocompatibility. However, the insufficient mechanical properties of pure Zn do not meet the requirements of biodegradable implants. In this study, we have developed a biodegradable Zn-3Mg-0.7Mg₂Si composite fabricated by high-pressure solidification. Microstructural characterization revealed that the high-pressure solidified (HPS) composite exhibited uniformly distributed fine MgZn₂ granules in an α-Zn matrix. Comprehensive tests indicated that the HPS composite exhibited exceptionally high compression properties including a compressive yield strength of 406.2 MPa, an ultimate compressive strength of 1181.2 MPa, and plastic deformation up to 60% strain without cracking or fracturing. Potentiodynamic polarization tests revealed that the HPS composite showed a corrosion potential of -0.930 V, a corrosion current density of 3.5 μA/cm², and a corrosion rate of 46.2 μm/y. Immersion tests revealed that the degradation rate of the HPS composite after immersion in Hanks' solution for 1 month and 3 months was 42.8 μm/y and 37.8 μm/y, respectively. Furthermore, an extract of the HPS composite exhibited good cytocompatibility compared with as-cast (AC) pure Zn and an AC composite at a concentration of ≤25%. These results suggest that the HPS Zn-3Mg-0.7Mg₂Si composite can be anticipated as a promising biodegradable material for orthopedic applications.

In vitro and in vivo studies to evaluate the feasibility of Zn-0.1Li and Zn-0.8Mg application in the uterine cavity microenvironment compared to pure zinc

Significant advances have been achieved in the research evaluating Zn and its alloys as degradable metallic biomaterials mainly for application in bone and blood vessels. In the present study, the degradation behaviors of Zn-0.1Li and Zn-0.8Mg alloys in simulated uterine fluid (SUF) were systematically investigated for 300 days. In vitro viability assays were conducted in different uterine cells (HUSMCs, HEECs, and HESCs), and histological examination after the in vivo implantation into the uterine cavity was performed using pure Zn as control. The immersion test results indicated that both Zn-0.1Li and Zn-0.8Mg alloys exhibited better corrosion resistance than pure Zn, with Zn₃(PO₄)₂⋅4H₂O and CaZn₂(PO₄)₂⋅2H₂O being the main corrosion products detected in the SUF in addition to ZnO. The cell cytotoxicity assays revealed that Zn-0.1Li and Zn-0.8Mg exhibited better cytocompatibility than Zn. Moreover, the in vivo experiments demonstrated that the Zn-0.1Li and Zn-0.8Mg alloys induced less inflammation in the uterine tissue than pure Zn, with CaCO₃ and Zn(HPO₄)⋅3H₂O being the major biocorrosion products in addition to ZnO. According to these results, zinc alloys appear to be suitable potential candidate materials for future intrauterine biomedical devices.

Development of high strength and ductile Zn-Al-Li alloys for potential use in bioresorbable medical devices

A series of Zn-Al-Li alloys with potential application in bioresorbable implants were cast, thermomechanically processed and tested. The formation of secondary phases, such as LiZn₄, LiZn₃Al and Al₃Li, contributed to both dynamic recrystallization and grain refinement of the matrix (η-phase) during the hot-extrusion process, leading to grain sizes as small as 1.75 μm for Zn-4Al-0.6Li alloy (wt%). This alloy exhibited an ultimate tensile strength (UTS) of 451 MPa, a total elongation of 46% and a corrosion rate of 60 μm/year in simulated body fluid. The grain refinement played a major role in increasing the strength, but it also weakened the basal texture and promoted non-basal slip and grain boundary sliding, thus contributing to the increased plastic deformation of the alloy. The corrosion rate was affected by a layer of zinc oxide and phosphate formed in the early stages of the immersion tests. The corrosion products protected the substrate and tended to reduce the corrosion rate over time. The developed Zn-4Al-0.6Li and Zn-6Al-0.4Li alloys which showed promising mechanical and corrosion properties appeared to be cytocompatible in the mouse fibroblast cell line and human umbilical mesenchymal stem cells making them promising candidates for bioresorbable stent and implant applications.

Recent research and progress of biodegradable zinc alloys and composites for biomedical applications: Biomechanical and biocorrosion perspectives

Biodegradable metals (BMs) gradually degrade in vivo by releasing corrosion products once exposed to the physiological environment in the body. Complete dissolution of biodegradable implants assists tissue healing, with no implant residues in the surrounding tissues. In recent years, three classes of BMs have been extensively investigated, including magnesium (Mg)-based, iron (Fe)-based, and zinc (Zn)-based BMs. Among these three BMs, Mg-based materials have undergone the most clinical trials. However, Mg-based BMs generally exhibit faster degradation rates, which may not match the healing periods for bone tissue, whereas Fe-based BMs exhibit slower and less complete in vivo degradation. Zn-based BMs are now considered a new class of BMs due to their intermediate degradation rates, which fall between those of Mg-based BMs and Fe-based BMs, thus requiring extensive research to validate their suitability for biomedical applications. In the present study, recent research and development on Zn-based BMs are reviewed in conjunction with discussion of their advantages and limitations in relation to existing BMs. The underlying roles of alloy composition, microstructure, and processing technique on the mechanical and corrosion properties of Zn-based BMs are also discussed.

In vitro and 48 weeks in vivo performances of 3D printed porous Fe-30Mn biodegradable scaffolds

Porous Fe-Mn biodegradable scaffolds fabricated by 3D printing are considered as a promising alternative biomaterial for repairing load-bearing bone defects. However, the mechanical adaptability, the thoughtful in vitro biocompatibility and especially the long-term in vivo osseointegration and biodegradation performances have not been investigated to date. Herein, the porous Fe-30Mn biodegradable scaffolds fabricated by selective laser melting (SLM) had the adjustable elastic modulus ranging from 10.04 GPa to 14.88 GPa by regulating the porosity from 37.89% to 47.17%. In vitro indirect and direct cytotoxicity as well as cell adhesion experiments demonstrated biocompatibility and a large number of cells with stretched filopodia adhered to the scaffolds. 48 weeks in vivo experiments showed that the scaffolds had no harm to liver and kidney, and exhibited long-term in vivo osseointegration performance. Volumes of the scaffolds decreased by 10.1-20.9%, and the retrieved scaffolds showed decreased elastic modulus (decreased by 34.1-42.3%) and yield strength (decreased by 15.8-23.3%) after the 48 weeks in vivo degradation. The Fe-30Mn-femoral condyle complex maintained the same level of stiffness as intact controls during 48 weeks. In summary, the porous Fe-30Mn biodegradable scaffolds fabricated by SLM could be a reliable and practical alternative for repairing load-bearing bone defects.

Cancellous bone-like porous Fe@Zn scaffolds with core-shell-structured skeletons for biodegradable bone implants

Three-dimensional (3D) porous zinc (Zn) with a moderate degradation rate is a promising candidate for biodegradable bone scaffolds. However, fabrication of such scaffolds with adequate mechanical properties remains a challenge. Moreover, the composition, crystallography and microstructure of the in vivo degradation products formed at or near the implant-bone interface are still not precisely known. Here, we have fabricated porous Fe@Zn scaffolds with skeletons consisting of an inner core layer of Fe and an outer shell layer of Zn using template-assisted electrodeposition technique, and systematically evaluated their porous structure, mechanical properties, degradation mechanism, antibacterial ability and in vitro and in vivo biocompatibility. In situ site-specific focused ion beam micromilling and transmission electron microscopy were used to identify the in vivo degradation products at the nanometer scale. The 3D porous Fe@Zn scaffolds show similar structure and comparable mechanical properties to human cancellous bone. The degradation rates can be adjusted by varying the layer thickness of Zn and Fe. The antibacterial rates reach over 95% against S. aureus and almost 100% against E. coli. A threshold of released Zn ion concentration (~ 0.3 mM) was found to determine the in vitro biocompatibility. Intense new bone formation and ingrowth were observed despite with a slight inflammatory response. The in vivo degradation products were identified to be equiaxed nanocrystalline zinc oxide with dispersed zinc carbonate. This study not only demonstrates the feasibility of porous Fe@Zn for biodegradable bone implants, but also provides significant insight into the degradation mechanism of porous Zn in physiological environment.

Biodegradable Materials for Sustainable Health Monitoring Devices

The recent advent of biodegradable materials has offered huge opportunity to transform healthcare technologies by enabling sensors that degrade naturally after use. The implantable electronic systems made from such materials eliminate the need for extraction or reoperation, minimize chronic inflammatory responses, and hence offer attractive propositions for future biomedical technology. The eco-friendly sensor systems developed from degradable materials could also help mitigate some of the major environmental issues by reducing the volume of electronic or medical waste produced and, in turn, the carbon footprint. With this background, herein we present a comprehensive overview of the structural and functional biodegradable materials that have been used for various biodegradable or bioresorbable electronic devices. The discussion focuses on the dissolution rates and degradation mechanisms of materials such as natural and synthetic polymers, organic or inorganic semiconductors, and hydrolyzable metals. The recent trend and examples of biodegradable or bioresorbable materials-based sensors for body monitoring, diagnostic, and medical therapeutic applications are also presented. Lastly, key technological challenges are discussed for clinical application of biodegradable sensors, particularly for implantable devices with wireless data and power transfer. Promising perspectives for the advancement of future generation of biodegradable sensor systems are also presented.

Development of a high-strength Zn-Mn-Mg alloy for ligament reconstruction fixation

Although various biodegradable materials have been investigated for ligament reconstruction fixation in the past decades, only few of them possess a combination of high mechanical properties, appropriate degradation rate, good biocompatibility, and osteogenic effect, thus limiting their clinical applications. A high-strength Zn-0.8Mn-0.4Mg alloy (i.e., Zn08Mn04Mg) with yield strength of 317 MPa was developed to address this issue. The alloy showed good biocompatibility and promising osteogenic effect in vitro. The degradation effects of Zn08Mn04Mg interference screws on the interface between soft tissue and bone were investigated in anterior cruciate ligament (ACL) reconstruction in rabbits. Compared to Ti6Al4V, the Zn alloy screws significantly accelerated the formation of new bone and further induced partial tendon mineralization, which promoted tendon-bone integration. The newly developed screws are believed to facilitate early joint function recovery and rehabilitation training and also avoid screw breakage during insertion, thereby contributing to an extensive clinical prospect.

Additively manufactured functionally graded biodegradable porous zinc

Topological design provides additively manufactured (AM) biodegradable porous metallic biomaterials with a unique opportunity to adjust their biodegradation behavior and mechanical properties, thereby satisfying the requirements for ideal bone substitutes. However, no information is available yet concerning the effect of topological design on the performance of AM porous zinc (Zn) that outperforms Mg and Fe in biodegradation behavior. Here, we studied one functionally graded and two uniform AM porous Zn designs with diamond unit cell. Cylindrical specimens were fabricated from pure Zn powder by using a powder bed fusion technique, followed by a comprehensive study on their static and dynamic biodegradation behaviors, mechanical properties, permeability, and biocompatibility. Topological design, indeed, affected the biodegradation behavior of the specimens, as evidenced by 150% variations in biodegradation rate between the three different designs. After in vitro dynamic immersion for 28 days, the AM porous Zn had weight losses of 7-12%, relying on the topological design. The degradation rates satisfied the desired biodegradation time of 1-2 years for bone substitution. The mechanical properties of the biodegraded specimens of all the groups maintained within the range of those of cancellous bone. As opposed to the trends observed for other biodegradable porous metals, after 28 days of in vitro biodegradation, the yield strengths of the specimens of all the groups (σy = 7-14 MPa) increased consistently, as compared to those of the as-built specimens (σy = 4-11 MPa). Moreover, AM porous Zn showed excellent biocompatibility, given that the cellular activities in none of the groups differed from the Ti controls for up to 72 h. Using topological design of AM porous Zn for controlling its mechanical properties and degradation behavior is thus clearly promising, thereby rendering flexibility to the material to meet a variety of clinical requirements.

Mechanical Properties and Degradation Behaviors of Zn-xMg Alloy Fine Wires for Biomedical Applications

Zn and Zn-based alloys exhibit biosafety and biodegradation, considered as candidates for biomedical implants. Zn-0.02 wt.% Mg (Zn-0.02 Mg), Zn-0.05 wt.% Mg (Zn-0.05 Mg), and Zn-0.2 wt.% Mg (Zn-0.2 Mg) wires (Φ 0.3 mm) were prepared for precision biomedical devices in this work. With the addition of Mg in Zn-xMg alloys, the grain size decreased along with the occurrence of Mg₂Zn₁₁ at the grain boundaries. Hot extrusion, cold drawing, and annealing treatment were introduced to further refining the grain size. Besides, the hot extrusion and cold drawing improved the tensile strength of Zn-xMg alloys to 240-270 MPa while elongation also increased but remained under 10%. Annealing treatment could improve the elongation of Zn alloys to 12% -28%, but decrease the tensile strength. Furthermore, Zn-xMg wires displayed an increase in degradation rate with Mg addition. The findings might provide a potential possibility of Zn-xMg alloy wires for biomedical applications.

Antibody CD133 Biofunctionalization of Ammonium Acryloyldimethyltaurate and Vinylpyrrolidone Co-Polymer-Based Coating of the Vascular Implants

Current vascular stents, such as drug eluting stents (DES), have some serious drawbacks, like in stent restenosis and thrombosis. Therefore, other solutions are sought to overcome these post-implantations complications. These include the strategy of biofunctionalization of the stent surface with antibodies that facilitate adhesion of endothelial cells (ECs) or endothelial progenitor cells (EPCs). Rapid re-endothelialization of the surface minimizes the risk of possible complications. In this study, we proposed ammonium acryloyldimethyltaurate/vinylpyrrolidone co-polymer-based surface (AVC), which was mercaptosilanized in order to expose free thiol groups. The presence of free thiol groups allowed for the covalent attachment of CD133 antibodies by disulfide bridges formation between mercaptosilanized surface and cysteine of the protein molecule thiol groups. Various examinations were performed in order to validate the procedure, including attenuated total reflection–Fourier transform infrared spectroscopy (ATR-FTIR) and Fourier transform Raman spectroscopy (FT-Raman), atomic force microscopy (AFM) and scanning electron microscopy (SEM). By means of ATR-FTIR spectroscopy presence of the CD133 antibody within coating was confirmed. In vitro studies proved good biocompatibility for blood cells without induction of hemolytic response. Thus, proposed biofunctionalized CD133 antibody AVC surface has shown sufficient stability for adapting as cardiovascular implant coating and biocompatibility. According to conducted in vitro studies, the modified surface can be further tested for applications in various biological systems.

One-pot preparation of a multi-functional enzymatically generated gelatin hydrogel with controllable antibacterial and hemorheological properties

The creation of multi-functional bio-hydrogels with tunable properties that meet in vivo demands is significant but remains challenging. Inspired by host-guest chemistry, a novel multi-functional gelatin-based bio-hydrogel with tunable antibacterial and hemorheological properties (TAH-GEL) is synthesized via an in situ one-pot strategy. TAH-GEL not only exhibits excellent mechanical properties but also shows promising self-healing and bio-compatibility features. For the first time, this biomaterial presents controllable antibacterial and hemorheological properties by controlling the TAH-GEL polypseudorotaxane motif. The resulting bio-hydrogel is easy to prepare and delivers superior performance, making it a powerful tool for bio-applications, such as hemostatic materials.

Development and In Vitro Biodegradation of Biomimetic Zwitterionic Phosphorylcholine Chitosan Coating on Zn1Mg Alloy

Zinc (Zn) alloys are promising alternatives to magnesium (Mg)- and iron (Fe)-based alloys because of their moderate corrosion rate and superior biocompatibility. To reduce the mass release of Zn²⁺ and improve the biocompatibility of Zn implants, the biomimetic zwitterionic polymer layer (phosphorylcholine chitosan-PCCs) was immobilized on the plasma-treated Zn1Mg surface. It is the chemical bonds between the -NH₂ groups of the PCCs chain and O-C═O (C═O) groups on the plasma-treated Zn1Mg (Zn1Mg-PP) that contributes to the strong bonding strength between the film and the substrate, by which the PCCs (approx. 200 nm thick) layer can bear a 5.93 N normal load. The electrochemical impedance spectroscopy (EIS) results showed that the PCCs layer remarkably increased the resistance against corrosion attack, protecting substrates from over-quick degradation, and the protective effect of the layer with a thickness of 200 nm lasts for about 24 h. The corrosion products of Zn1Mg-PP-PCC in NaCl solution were determined as Zn₅(OH)₈Cl₂·H₂O and Zn₃(PO₄)₂. Besides, the bulk Zn1Mg can trigger more aggressive macrophage activity, while the surface of Zn1Mg-PP and Zn1Mg-PP-PCC and their corrosion products (Zn₃(PO₄)₂) tend to promote the differentiation of macrophages into the M2 phenotype, which is beneficial for implant applications.

Ultrafine- and uniform-grained biodegradable Zn-0.5Mn alloy: Grain refinement mechanism, corrosion behavior, and biocompatibility in vivo

An ultrafine- and uniform-grained Zn-0.5Mn alloy (D3 alloy, stands for deformation rate of 99.5%) is fabricated via multi-pass drawing. The alloy features excellent ductility and elongation properties (up to 245.0% ± 9.0% at room temperature). Zn-0.5Mn alloys are composed of two phases, namely, Zn and MnZn₁₃. The MnZn₁₃ phase confers multiple effects during refinement by inducing and pinning low-angle boundaries within grains. Meanwhile, the presence of these phases along grain boundaries prevents the growth of new refined grains. D3 shows uniform corrosion behaviors in c-SBF solution on account of the even distribution of the MnZn₁₃ phase in its microstructure. Animal implantation experiments indicate that D3 has good biocompatibility; it does not cause damage to bone tissue or other organs. Taking the results together, D3 may be developed into a new type of biodegradable material with remarkable elongation and corrosion properties and satisfactory biocompatibility for medical applications.

Investigating the stress corrosion cracking of a biodegradable Zn-0.8 wt%Li alloy in simulated body fluid

Stress corrosion cracking (SCC) may lead to brittle, unexpected failure of medical devices. However, available researches are limited to Mg-based biodegradable metals (BM) and pure Zn. The stress corrosion behaviors of newly-developed Zn alloys remain unclear. In the present work, we conducted slow strain rate testing (SSRT) and constant-load immersion test on a promising Zn-0.8 wt%Li alloy in order to investigate its SCC susceptibility and examine its feasibility as BM with pure Zn as control group. We observed that Zn-0.8 wt%Li alloy exhibited low SCC susceptibility. This was attributed to variations in microstructure and deformation mechanism after alloying with Li. In addition, both pure Zn and Zn-0.8 wt%Li alloy did not fracture over a period of 28 days during constant-load immersion test. The magnitude of applied stress was close to physiological condition and thus, we proved the feasibility of both materials as BM.

•

The deformation mechanisms of pure Zn and Zn-0.8 wt%Li alloy were different.

•

For pure Zn, surface curvatures provided sites for SCC initiation.

•

Only shallow cracks on corrosion layer were observed for Zn-0.8 wt%Li alloy.

•

Both materials did not fracture after constant-load immersion test.

Biodegradable materials for bone defect repair

Compared with non-degradable materials, biodegradable biomaterials play an increasingly important role in the repairing of severe bone defects, and have attracted extensive attention from researchers. In the treatment of bone defects, scaffolds made of biodegradable materials can provide a crawling bridge for new bone tissue in the gap and a platform for cells and growth factors to play a physiological role, which will eventually be degraded and absorbed in the body and be replaced by the new bone tissue. Traditional biodegradable materials include polymers, ceramics and metals, which have been used in bone defect repairing for many years. Although these materials have more or fewer shortcomings, they are still the cornerstone of our development of a new generation of degradable materials. With the rapid development of modern science and technology, in the twenty-first century, more and more kinds of new biodegradable materials emerge in endlessly, such as new intelligent micro-nano materials and cell-based products. At the same time, there are many new fabrication technologies of improving biodegradable materials, such as modular fabrication, 3D and 4D printing, interface reinforcement and nanotechnology. This review will introduce various kinds of biodegradable materials commonly used in bone defect repairing, especially the newly emerging materials and their fabrication technology in recent years, and look forward to the future research direction, hoping to provide researchers in the field with some inspiration and reference.

Biodegradable Zn-Cu alloys show antibacterial activity against MRSA bone infection by inhibiting pathogen adhesion and biofilm formation

Bone and joint-related infections remain the primary and most critical complications of orthopedic surgery. We have innovatively prepared Zn-Cu alloys to achieve outstanding material and antibacterial properties. In this study, we systematically assessed the material properties and antibacterial activity of these Zn-Cu alloys. Our results showed that the Zn-2Cu alloy had the best mechanical properties, biocompatibility, and osteogenic properties. Findings of microbial cultures, CLSM, SEM, and TEM indicated that Zn-2Cu alloy can inhibit both coagulase-positive and coagulase-negative staphylococci, as well as antibiotic-resistant strains (MRSA and MRSE), by preventing the bacteria adhesion and the biofilm formation. Zn-2Cu alloy could broadly affect the expression of MRSA genes associated with adhesion, autolysis, biofilm formation, virulence, and drug resistance. A rat femur intramedullary nail infection-prevention model was established and the Zn-2Cu alloy-treated group showed significant antibacterial activity against MRSA and reduced the inflammatory toxic side-effects and infection-related bone loss. Collectively, our results indicate the potential utility of Zn-Cu alloy implants with 2 wt% Cu in treating orthopedic infections. Statement of significance: Osteomyelitis is a serious complication of orthopedic surgeries. Wide use of antibiotics contributes to the appearance of multi-drug resistant strains like methicillin-resistant staphylococcus aureus (MRSA). Alternatively, anti-osteomyelitis implants with broad-spectrum antibacterial properties can be favorable. Here, the antibacterial performance of biodegradable Zn-Cu alloys was evaluated with four different bacteria strains including antibiotic-resistant strains (MRSA and MRSE). Zn-Cu alloys exert excellent bacterial killing capability in all strains. In a rat femur infection model, the alloy showed significant antibacterial activity against MRSA and reduced inflammatory toxic side-effects as well as infection-related bone loss. The antibacterial property of Zn-2Cu alloy was associated with inhibition of gene expression related to wall synthesis, adhesion, colonization, biofilm formation, autolysis, and secretion of virulence factors in MRSA.

Analysis of vascular inflammation against bioresorbable Zn-Ag based alloys

Zinc (Zn) has emerged as a promising bioresorbable stent material due to its satisfactory corrosion behavior and excellent biocompatibility. However, for load bearing implant applications, alloying is required to boost its mechanical properties as pure Zn exhibits poor strength. Unfortunately, an increase in inflammation relative to pure Zn is a commonly observed side-effect of Zn alloys. Consequently, the development of a Zn-based alloy that can simultaneously feature improved mechanical properties and suppress inflammatory responses is a big challenge. Here, a bioresorbable, biocompatible Zn-Ag-based quinary alloy was comprehensively evaluated in vivo, in comparison to reference materials. The inflammatory and smooth muscle cellular response was characterized and correlated to metrics of neointimal growth. We found that implantation of the quinary alloy was associated with significantly improved inflammatory activities relative to the reference materials. Additionally, we found that inflammation, but not smooth muscle cell hyperplasia, significantly correlates to neointimal growth for Zn alloys. The results suggest that inflammation is the main driver of neointimal growth for Zn-based alloys and that the quinary Zn-Ag-Mn-Zr-Cu alloy may impart inflammation-resistance properties to arterial implants.

Additively manufactured biodegradable porous metals

Partially due to the unavailability of ideal bone substitutes, the treatment of large bony defects remains one of the most important challenges of orthopedic surgery. Additively manufactured (AM) biodegradable porous metals that have emerged since 2018 provide unprecedented opportunities for fulfilling the requirements of an ideal bone implant. First, the multi-scale geometry of these implants can be customized to mimic the human bone in terms of both micro-architecture and mechanical properties. Second, a porous structure with interconnected pores possesses a large surface area, which is favorable for the adhesion and proliferation of cells and, thus, bony ingrowth. Finally, the freeform geometrical design of such biomaterials could be exploited to adjust their biodegradation behavior so as to maintain the structural integrity of the implant during the healing process while ensuring that the implant disappears afterwards, paving the way for full bone regeneration. While the AM biodegradable porous metals that have been studied so far have shown many unique properties as compared to their solid counterparts, the unprecedented degree of flexibility in their geometrical design has not yet been fully exploited to optimize their properties and performance. In order to develop the ideal bone implants, it is important to take advantage of the full potential of AM biodegradable porous metals through detailed and systematic study on their biodegradation behavior, mechanical properties, biocompatibility, and bone regeneration performance. This review paper presents the state of the art in AM biodegradable porous metals and is focused on the effects of material type, processing, geometrical design, and post-AM treatments on the mechanical properties, biodegradation behavior, in vitro biocompatibility, and in vivo bone regeneration performance of AM porous Mg, Fe, and Zn as well as their alloys. We also identify a number of knowledge gaps and the challenges encountered in adopting AM biodegradable porous metals for orthopedic applications and suggest some promising areas for future research.

Highly Ductile Zn-2Fe-WC Nanocomposite as Biodegradable Material

Zinc (Zn) has been widely investigated as a biodegradable metal for orthopedic implants and vascular stents due to its ideal corrosion in vivo and biocompatibility. However, pure Zn lacks adequate mechanical properties for load-bearing applications. Alloying elements, such as iron (Fe), have been shown to improve the strength significantly, but at the cost of compromised ductility and corrosion rate. In this study, tungsten carbide (WC) nanoparticles were incorporated into the Zn-2Fe alloy system for strengthening, microstructure modification, and ductility enhancement. Thermally stable WC nanoparticles modified the intermetallic ζ-FeZn13 interface morphology from faceted to non-faceted. Consequently, WC nanoparticles simultaneously enhance mechanical strength and ductility while maintaining a reasonable corrosion rate. Overall, this novel Zn-Fe-WC nanocomposite could be used as biodegradable material for biomedical applications where pure Zn is inadequate.

Evaluation of in vitro corrosion behavior of zinc-hydroxyapatite and zinc-hydroxyapatite-iron as biodegradable composites

Zinc (Zn) based biomaterials have been emerged as one of the capable biodegradable materials for biomedical applications because of the ideal degradation properties. In the present work, corrosion kinetics of Zn-hydroxyapatite (HA), and Zn-HA-iron (Fe) materials developed using microwave sintering process were investigated. The effect of the inclusion of HA and Fe in Zn on corrosion properties have been evaluated in the simulated body fluid solution. Further, the wettability test of the developed composites was performed to confirm the hydrophilic nature of the surface of all samples. Zn-3HA was found to have better hydrophilicity as compared to other samples. Increased corrosion rate and pH of Zn-5HA-2Fe samples were attributed to the addition of HA and Fe in the Zn matrix. The corrosion rate and weight loss rate from electrochemical and immersion testing of all samples were found in the order from highest to lowest: Zn-5HA-2Fe > Zn-3HA > Zn-3HA-2Fe > Zn. The highest cell viability nearly 100% was obtained for Zn-3HA samples, whereas other samples also showed sufficient biocompatibility to be utilized for biomedical applications.

In vivo biocompatibility evaluation of Zn-0.05Mg-(0, 0.5, 1wt%)Ag implants in New Zealand rabbits

Bio-absorbable Zn alloys have been attractive replacements for the traditionally permanent implants due to their reasonable mechanical strength and elongation, degradation rate, and biocompatibility. The hybridization addition of Mg and Ag elements could greatly improve the mechanical properties and antibacterial ability of Zn, respectively. In the present paper, in vivo biocompatibility for the Zn-0.05Mg-(0, 0.5, 1 wt%) Ag implants in New Zealand rabbit was qualitatively evaluated during the implantation periods of 4, 12, and 24 weeks. The blood serum biochemical parameters and in vivo integrity of the implants in the live rabbits were monitored by using clinical chemistry analyzing and X-ray radiographic imaging techniques during the implantation process, respectively. There is no great difference in the serum biochemical indicator between the implanted rabbits and the control group. Especially the levels of serum Zn and serum Mg normalize after implantation of 24 weeks. The interfacial adherence between the implants and newly formed bones, and the histopathological morphology of heart, liver, and kidney were observed morphologically under the microscope. The new bones formed and grew surrounding the implants after 12 weeks' post-operation, which were well joined with the original cortical bones after post-implantation of 24 weeks. The heart, liver and kidney were not negatively influenced as evidenced from the serum biochemical indicators and morphologies of the tissues. Zn-0.05Mg-(0, 0.5, 1 wt%) Ag alloys are proved to be in vivo biocompatible and potential candidates for the biodegradable medical implants.

Biodegradable Zn-1.5Cu-1.5Ag alloy with anti-aging ability and strain hardening behavior for cardiovascular stents

Zn and its alloys are considered as a new class of biodegradable metals due to their moderate degradation rates and acceptable biocompatibility. However, inadequate mechanical properties limit their further applications, especially for cardiovascular stents. In this study, a novel biodegradable Zn-1.5Cu-1.5Ag (wt%) alloy with excellent mechanical properties was developed, and then its in vitro degradation and cytotoxicity were characterized. Microstructural characterization showed that hot extrusion produced a bimodal distribution of grain size and much finer secondary phase precipitates. The as-extruded alloy exhibited a satisfactory combination of strength and plasticity (yield strength: 162.0 ± 2.94 MPa, ultimate tensile strength: 220.3 ± 1.70 MPa and elongation: 44.13 ± 1.09%). After being aged at room temperature for 8 months, its mechanical properties increased about 10%, implying its good anti-aging ability. The strain hardening exponent (n) calculated from true stress-strain curve showed that this alloy has evident strain hardening. Immersion tests in c-SBF solution revealed that this alloy has a moderate corrosion rate (48.6 ± 4.14 μm/year) and slightly localized corrosion behavior. Electrochemical tests showed that a weak passive film formed on surface during degradation, which has a limited protective effect. The cytotoxicity tests exhibited that this alloy possesses acceptable in vitro biocompatibility, which is comparable to pure Zn. According to the results of mechanical properties, corrosion behavior and cytotoxicity, the Zn-1.5Cu-1.5Ag alloy can be regarded as a potential candidate for cardiovascular stent applications.

Corrosion Resistance of Mg72Zn24Ca4 and Zn87Mg9Ca4 Alloys for Application in Medicine

The aim of this work was to monitor the corrosion rate of the Mg72Zn24Ca4 and Zn87Mg9Ca4 alloys. The purity of the alloying elements was 99.9%. The melt process was carried out in an induction furnace. The melting process took place under the cover of an inert gas (argon). The copper form was flooded by liquid alloy. Then, in order to obtain ribbons, the cast alloy, in rod shape, was re-melted on the melt spinning machine. The corrosion resistance of both alloys has been determined on the basis of the following experiments: measurements of the evolution of OCP (open circuit potential), LSV (linear sweep voltamperometry) and EIS (electrochemical impedance spectroscopy). All corrosion tests were carried out in Ringer's solution at 37 °C and pH 7.2. The corrosion tests have revealed that the zinc alloy, Zn87Mg9Ca4, exhibits significantly higher corrosion resistance in the Ringer solution compared to the magnesium alloy, Mg72Zn24Ca4. Moreover, it has been shown that the cathodic reaction proceeds faster on the surface of ribbons. EIS measurements show that the dissolution of Mg alloy proceeds with two steps: transfer of Mg2+ ions to the Ringer solution and then the formation of the corrosion products, which are deposited on the surface of magnesium alloy. It has been revealed, too, that for both bulk materials, diffusion of chloride ions through the corrosion product's layer takes place.

Structural and mechanical aspects of hypoeutectic Zn-Mg binary alloys for biodegradable vascular stent applications

The study is concerned with the mechanical properties of Zn and three Zn–Mg double alloys with Mg concentrations: 0.5%, 1.0% and 1.5% in the form of rods with a diameter of 5 mm as potential materials for use in biodegradable medical implants, such as vascular stents. The materials were cast, next conventionally hot extruded at 250 °C and finally, hydrostatically extruded (HE) at ambient temperature. Occasionally HE process was carried at liquid nitrogen temperature or in combination with the ECAP process. After HE, the microstructure of the alloys was made up of fine-grained αZn of mean grain size ~1 μm in a 2-phase coat of 50–200 nm nano-grains of the fine αZn + Mg₂Zn₁₁ eutectic. The 3 to 4-fold reduction of grain size as a result of HE allowed an increase in yield strength from 100% to over 200%, elongation to fracture from 100% to thirty fold and hardness over 50% compared to the best literature results for similar alloys. Exceptions accounted for elongation to fracture in case of Zn-0.5 Mg alloy and hardness in case of Zn-1.5 Mg alloy, both of which fell by 20%. For the Zn-0.5 Mg and Zn–1Mg alloys, after immersion tests, no corrosive degradation of plasticity was observed. Achieving these properties was the result of generating large plastic deformations at ambient temperature due to the application of high pressure forming with the cumulative HE method. The results showed that Zn–Mg binary alloys after HE have mechanical and corrosive characteristics, qualifying them for applications in biodegradable implants, including vascular stents.

•

Forming under high pressure allows to generate severe deformation in Zn–Mg alloys.

•

HE reduces grain size of Zn alloys by 3–4 times in comparison to hot extrusion.

•

HE increases YS by 200%, ε_f by 300% and HV by 50% in comparison to literature data.

•

In Zn with 0.5 and 1% Mg no ductility reduction after the corrosion test was observed.

•

Mechanical and corrosion properties qualify Zn alloys after HE for vascular stents.

An In-Depth Study of Zn Metal Surface Chemistry for Advanced Aqueous Zn-Ion Batteries

Although Zn metal has been regarded as the most promising anode for aqueous batteries, it persistently suffers from serious side reactions and dendrite growth in mild electrolyte. Spontaneous Zn corrosion and hydrogen evolution damage the shelf life and calendar life of Zn-based batteries, severely affecting their industrial applications. Herein, a robust and homogeneous ZnS interphase is built in situ on the Zn surface by a vapor-solid strategy to enhance Zn reversibility. The thickness of the ZnS film is controlled via the treatment temperature, and the performance of the protected Zn electrode is optimized. The dense ZnS artificial layer obtained at 350 °C not only suppresses Zn corrosion by forming a physical barrier on the Zn surface, but also inhibits dendrite growth via guiding the Zn plating/stripping underneath the artificial layer. Accordingly, a side reaction-free and dendrite-free Zn electrode is developed, the effectiveness of which is also convincing in a MnO₂ /ZnS@Zn full-cell with 87.6% capacity retention after 2500 cycles.

Albumins inhibit the corrosion of absorbable Zn alloys at initial stages of degradation

Understanding the surface interactions and reactivity of zinc (Zn)-based biomaterials with constituents of physiological fluids such as proteins and ions is essential for an accurate evaluation of biomaterial corrosion initiation and progression. In this paper, the effect of the albumin addition on the corrosion behavior of pure Zn and Zn─4Ag alloy is discussed. The corrosion behavior of Zn-based materials was studied using potentiodynamic polarization, electrochemical impedance spectroscopy, immersion tests and X-ray photoelectron spectroscopy. It was found that the addition of albumins largely affects the chemical composition, morphology and compactness of the protective films formed on biomaterials. A shift of the corrosion regime from localized to more general was observed in the protein-containing electrolytes. The proteins acted as corrosion inhibitors, reducing the corrosion current density and promoting passivation of the metallic surfaces. The increase in the corrosion resistance of the Zn─4Ag alloy is attributed to a selective Zn ion leaching that leaves the metal surface enriched with electrochemically more stable alloying element.

A study of degradation behaviour and biocompatibility of Zn-Fe alloy prepared by electrodeposition

Zinc is a biodegradable metal, which exhibits more moderate biodegradability than magnesium and iron, so that it has great application potential in the field of biomedical materials. Alloying of zinc and iron may lead to producing a new type of implant material Zn-Fe alloy, which might be able to meet the requirements for a moderate degradation rate. However, due to the huge difference in the melting point between zinc and iron, the preparation of Zn-Fe alloy is quite challenging and hence rarely reported. In this study, we show that Zn-Fe alloys can be successfully prepared by electrodeposition technology. The microstructures, composition, degradation properties and biocompatibility of the Zn-Fe alloys were systematically studied. The results showed that the content of iron in the alloys ranged from 0 to 8 wt%, depending on the concentration of Fe ions and the current density. In the alloys, the major's phases were η, δ and Г₁, and they were mainly affected by the ion concentration in the electrolyte. In the in vitro immersion tests, the Zn-Fe alloy ZF2-1 showed the highest immersion corrosion rate, while ZF3-1 showed the highest electrochemical corrosion rate. Moreover, we found that the corrosion rates of the alloys were significantly higher than that of the pure Fe. In the in vivo experiments, we confirmed that the Zn-Fe alloy possessed good biocompatibility. These results demonstrate that the electrodeposition technology is a good method to prepare Zn-Fe alloys, and the Zn-Fe alloys prepared by this method are potentially promising materials for biomedical applications.

A Biomimetic Zinc Alloy Scaffold Coated with Brushite for Enhanced Cranial Bone Regeneration

Bone tissue engineering is considered as a promising pathway for bone regeneration and defect reconstruction, in which scaffolds play an important role. Zn alloy, which is a biodegradable metal material that has advantages of metallic and biodegradable characteristics, has its special features, especially the ideal degradation rate and acceptable biocompatibility, which make it worthy to be further investigated for medical applications. In this study, new biodegradable porous Zn alloy scaffolds with Ca-P coating were attempted to repair cranial bone defect, and in vitro and in vivo assays were conducted to evaluate its biocompatibility, osteo-inductivity, and osteo-conductivity. The results indicated that coated Zn alloy possessed good biocompatibility, with no cytotoxicity. It could also promote osteogenic differentiation and calcium deposition of rabbit BMSCs in vitro, and new bone formation around the scaffold in vivo. The biodegradable porous Zn alloy scaffold with Ca-P coating is considered to be promising in cranial bone defect repair.

Novel artifact-robust and highly visible zinc solid fiducial marker for kilovoltage x-ray image-guided radiation therapy

PURPOSE

To develop a novel biocompatible solid fiducial marker that prevents radiopaque imaging artifacts and also maintains high imaging contrast for kilovoltage x-ray image-guided radiation therapy.

METHODS

The fiducial marker was made of pure zinc. An in-house water-equivalent phantom was designed to evaluate artifacts and visibility under various simulated treatment scenarios. Image artifacts were quantitatively assessed in terms of the metal artifact index (MAI) on kilovoltage computed tomography (CT) and cone-beam CT (CBCT) scans. Marker visibility was evaluated on two types of kilovoltage planar x-ray images in terms of the contrast-to-background ratio (CBR). Comparisons with a conventional gold fiducial marker were conducted.

RESULTS

The use of zinc rather than a gold marker mitigates imaging artifacts. The MAI near the zinc marker decreased by 76, 79, and 77 % in CT, and by 77 (81), 74 (80), and 79 (85) % in CBCT full-fan (half-fan) scans, when using one-, two-, and three-marker phantom settings, respectively. The high-contrast part of the zinc marker exhibited CBRs above 2.00 for 28/32 exposures under four (lung, tissue, low-density bone, and high-density bone) different simulation scenarios, making its visibility comparable to that of the gold marker (30/32 exposures with CBRs > 2.00).

CONCLUSIONS

We developed a biocompatible, artifact-robust, and highly visible solid zinc fiducial marker. Although further evaluation is needed in clinical settings, our findings suggest its feasibility and benefits for kilovoltage x-ray image-guided radiation therapy.

Mechanical performance and biocompatibility assessment of Zn-0.05wt%Mg-(0.5, 1 wt%) Ag alloys

Zn alloys are emerging as promising degradable biomedical materials due to their tailorable mechanical properties and moderate biodegradable rate, compared with conventional biodegradable metallic materials. Ag, as an effective antibacterial and reinforcing element, was incorporated into Zn-0.05Mg alloys. In the present work, the effects of the Ag addition on mechanical, cytotoxic, hemolytic, pyrogenic, histological behaviors of the animal were investigated. The compressive yielding strength is enhanced from 198 MPa for Zn-0.05Mg alloy up to 224 and 234 MPa for Zn-0.05Mg-0.5Ag and Zn-0.05Mg-1Ag alloys, respectively. When the compressive strain was 65%, the strength of the Zn-0.05Mg-1.0Ag alloy reached 833 MPa, which was much higher than that of 721 MPa for Zn-0.05Mg alloy. The relative growth rate (RGR) for the extracts of Zn-0.05Mg-1Ag alloy with the concentrations of 10, 50, and 100% after 5 days incubation reaches 98.5, 95.2, and 94.2%, which are higher than those in extracts of Zn-0.05Mg-0.5Ag alloy (98.2, 93.9, 92.1%). The hemolysis rate of the Zn-0.05Mg alloys with 0.5 and 1 wt% Ag is 2.46 and 2.28%, respectively. The variations of body weight and temperature, postinjection symptoms, pathological morphologies of the visceral organs demonstrate that the alloys are nontoxic according to the toxicity rating standards. Zn-0.05wt%Mg-(0.5, 1 wt%) Ag alloys are experimentally safe materials and promising for the future application as biodegradable medical devices.

Rod-like Eutectic Structure in Biodegradable Zn-Al-Sn Alloy Exhibiting Enhanced Mechanical Strength

Zn alloy is recognized as a promising biodegradable metal for bone implant applications because of its good biocompatibility and moderate degradation rate. Nevertheless, the insufficient strength limits its applications. In this study, a rod-like eutectic structure was fabricated in Zn-Al-Sn alloy with the addition of Sn via selective laser melting. It was found that the Al-enriched phase nucleated primarily during cooling and caused the rapid precipitation of Zn. This inevitably consumed the liquid Zn and increased the ratio of Sn to Zn in the liquid phase, resulting in the formation of the eutectic, which was composed of the Sn-enriched phase and the Zn-enriched phase. More importantly, the coupled growth of the Sn-enriched and Zn-enriched phases and their volume differences together led to a rod-like morphology of the eutectic according to the volume fraction theory. Consequently, the yield and ultimate compressive strengths were enhanced to 180 ± 18.8 and 325 ± 29.6 MPa for the Zn-Al-2Sn alloy, respectively. This could be attributed to the pinning effect of the rod-like eutectic, which could block dislocation motion and result in dislocation pile-up, thereby conducing to the mechanical reinforcement. In addition, the Zn-Al-Sn alloy also exhibited good biocompatibility and increased degradation rate because of the enhanced galvanic corrosion. This study showed the potential of rod-like eutectic for the mechanical enhancement of the biodegradable Zn alloy.

Micro-/Nanotopography on Bioresorbable Zinc Dictates Cytocompatibility, Bone Cell Differentiation, and Macrophage Polarization

Bioresorbable metals are quickly advancing in the field of regenerative medicine for their promises of tissue restoration without adverse consequences from their lifelong presence. Zn has recently risen to the top of bioresorbable metals with great potential as a medical implant. However, cell adhesion and colonization on the Zn substrate surface remains challenging, which could damper interfacial tissue-implant integration. Inspired by the fact that surface topography can regulate cell function and fate, we hypothesize that topography on bioresorbable Zn can dictate material biocompatibility, cell differentiation, and immunomodulation. To verify this, surface-engineered Zn plates with nano-, submicro-, and microtopographies were systematically investigated. The microscale topography exhibited increased adhesion, pronounced self-renewal, and enhanced osteogenic differentiation of bone cells as well as less macrophage inflammatory polarization, reduced platelet adhesion, and better hemocompatibility. Thus, surface topography could be a viable strategy to enhance bioresorbable Zn's biocompatibility and integration with surrounding tissues while reducing inflammation.

Zinc as a Therapeutic Agent in Bone Regeneration

Zinc is an essential mineral that is required for normal skeletal growth and bone homeostasis. Furthermore, zinc appears to be able to promote bone regeneration. However, the cellular and molecular pathways through which zinc promotes bone growth, homeostasis, and regeneration are poorly understood. Zinc can positively affect chondrocyte and osteoblast functions, while inhibiting osteoclast activity, consistent with a beneficial role for zinc in bone homeostasis and regeneration. Based on the effects of zinc on skeletal cell populations and the role of zinc in skeletal growth, therapeutic approaches using zinc to improve bone regeneration are being developed. This review focuses on the role of zinc in bone growth, homeostasis, and regeneration while providing an overview of the existing studies that use zinc as a bone regeneration therapeutic.

Porous zinc scaffolds for bone tissue engineering applications: A novel additive manufacturing and casting approach

As a degradable metal, zinc (Zn) has attracted an immense amount of interest as the next generation of bioresorbable implants thanks to its modest corrosion rate and its vital role in bone remodeling, yet very few studies have thoroughly investigated its functionality as a porous implant for bone tissue engineering purposes. Zn bone scaffolds with two different pore sizes of 900 μm and 2 mm were fabricated using additive manufacturing-produced templates combined with casting. The compressive properties, corrosion rates, biocompatibility, and antibacterial performance of the bioscaffolds were examined and compared to a non-porous control. The resulting textured and porous Zn scaffolds exhibit a fully interconnected pore structure with precise control over topology. As pore size and porosity increased, mechanical strength decreased, and corrosion rate accelerated. Cell adhesion and growth on scaffolds were enhanced after an ex vivo pretreatment method. In vitro cellular tests confirmed good biocompatibility of the scaffolds. As porosity increased, potent antibacterial rates were also observed. Taken together, these results demonstrate that Zn porous bone scaffolds are promising for orthopedic applications.

Extrusion of the biodegradable ZnMg0.8Ca0.2 alloy - The influence of extrusion parameters on microstructure and mechanical characteristics

The Zn-based alloys, alloyed with the elements of the 2nd group of the periodic table, are considered as potential biodegradable materials suitable for the fabrication of small orthopaedic implants or cardiovascular stents. Unfortunately, the as-cast Zn-based alloys do not fulfil the requirements for mechanical properties for such applications. Extrusion is a thermomechanical process which is very powerful for breaking the cast microstructure and enhancing mechanical characteristics of metallic materials. In this study, we focused on the influence of extrusion parameters, such as temperature and extrusion ratio, on microstructural and mechanical characteristics of a ZnMg0.8Ca0.2 (wt.%) alloy. The extrusion led to a significant grain refinement and the formation of a crystallographic texture. Extrusion temperature played a more significant role in the mean grain size compared to the extrusion ratio (ER). At lower extrusion temperatures, the texture was less intensive and the subsequent mechanical anisotropy was weaker. Constants for the prediction of the grain size based on the Zener-Hollomon parameter were obtained. Prediction of mechanical properties using the Hall-Petch relationship appeared to be difficult because of the dependence of the texture on the extrusion temperature. Extrusion at the temperatures of 200 °C (ER = 25:1) and 150 °C (ER = 11:1) led to mechanical performance fulfilling the requirements for implantology.

Recent Advances in Manufacturing Innovative Stents

Cardiovascular diseases are the most distributed cause of death worldwide. Stenting of arteries as a percutaneous transluminal angioplasty procedure became a promising minimally invasive therapy based on re-opening narrowed arteries by stent insertion. In order to improve and optimize this method, many research groups are focusing on designing new or improving existent stents. Since the beginning of the stent development in 1986, starting with bare-metal stents (BMS), these devices have been continuously enhanced by applying new materials, developing stent coatings based on inorganic and organic compounds including drugs, nanoparticles or biological components such as genes and cells, as well as adapting stent designs with different fabrication technologies. Drug eluting stents (DES) have been developed to overcome the main shortcomings of BMS or coated stents. Coatings are mainly applied to control biocompatibility, degradation rate, protein adsorption, and allow adequate endothelialization in order to ensure better clinical outcome of BMS, reducing restenosis and thrombosis. As coating materials (i) organic polymers: polyurethanes, poly(ε-caprolactone), styrene-b-isobutylene-b-styrene, polyhydroxybutyrates, poly(lactide-co-glycolide), and phosphoryl choline; (ii) biological components: vascular endothelial growth factor (VEGF) and anti-CD34 antibody and (iii) inorganic coatings: noble metals, wide class of oxides, nitrides, silicide and carbide, hydroxyapatite, diamond-like carbon, and others are used. DES were developed to reduce the tissue hyperplasia and in-stent restenosis utilizing antiproliferative substances like paclitaxel, limus (siro-, zotaro-, evero-, bio-, amphi-, tacro-limus), ABT-578, tyrphostin AGL-2043, genes, etc. The innovative solutions aim at overcoming the main limitations of the stent technology, such as in-stent restenosis and stent thrombosis, while maintaining the prime requirements on biocompatibility, biodegradability, and mechanical behavior. This paper provides an overview of the existing stent types, their functionality, materials, and manufacturing conditions demonstrating the still huge potential for the development of promising stent solutions.

Characterization of Newly Developed Zinc Composite with the Content of 8 wt.% of Hydroxyapatite Particles Processed by Extrusion

Zinc and its alloys belong to a group of biodegradable materials, which can be potentially used for the preparation of temporary orthopedic implants. The research of biodegradable zinc materials revealed a lot of limitations; however, the new processing approaches of those materials can enhance their properties, which are insufficient for now. In this study, the zinc composite with 8 wt.% of hydroxyapatite (Zn/HA8) prepared for the first time by extrusion process was characterized from the point of view of the structural, mechanical and corrosion properties. The extrusion process led to good integrity of the interfaces between the zinc and hydroxyapatite particles. Mechanical behavior confirmed the role of hydroxyapatite as a defect in the material structure, which led to a decrease of the Zn/HA8 mechanical properties by approximately 30% (compressive yield strength (CYS) = 154 MPa Zn, 113 MPa Zn/HA8). Despite that, the Zn/HA8 composite showed sufficient mechanical properties for cancellous bone replacement and reached the lower limit for cortical bone. Additionally, the presence of hydroxyapatite caused the preferential precipitation of hydroxyapatite (HA) from the solution and can lead to a significant enhancement of the tissue/implant interface interactions.

Antagonist biocompatibilities of Zn-based materials functionalized with physiological active metal oxides

Zinc coated with nanostructured ZnO flowers has received increasing attention as a versatile biomaterial for medical applications. Whatsoever, the potential of these materials to meet specific medical requirements must be explored. Despite in its infancy, surface functionalization is the key strategy to achieve this goal. The functionalization, successfully achieved with cooper (Cu), iron (Fe) or manganese (Mn) oxides (Ox), was highly dependent on the presence of the flowered structures, with the deep physicochemical characterization of these new surfaces revealing specific metal oxide distributions. The functionalization with these metal oxides resulted in distinct biological and in vitro behaviours. The biological response, assessed by fibroblast viability, hemocompatibility, and chick chorioallantoic membrane (CAM), further supported by the in vitro degradation studies, evaluated by immersion and electrochemical techniques, revealed that the deleterious role of CuOx functionalization brought potential for anti-cancer applications; with an antagonist behaviour, the functionalization with MnOx, and in a less extent with FeOx, can be used to favour wound healing in traumatic processes. Despite the possible correlation between biocompatibility and hydroxyapatite precipitation, no correlation could be drawn with the corrosion activity of these surfaces. Overall, the minor addition of relevant physiological as Cu, Fe or Mn oxides resulted in antagonist in vitro responses that can be used as expedite strategies to modulate the behaviour of Zn-based materials, contributing in this way for the design of anti-cancer or wound healing therapies.

Bio-Nanocomposite Hydrogel Based on Zinc Alginate/Graphene Oxide: Morphology, Structural Conformation, Thermal Behavior/Degradation, and Dielectric Properties

Bio-nanocomposite hydrogels based on sodium alginate (SA) as polymer matrix and graphene oxide (GO) nanosheets with zinc as crosslinking agent were synthesized with the aim of incorporating the intrinsic properties of their constituents (bioactivity and antimicrobial activity). Thus, stable and highly interconnected networks were obtained from GO nanosheets dispersed in SA matrices through interactions with low amounts of zinc. The GO nanosheets were successfully incorporated into the alginate matrix in the form of a complex nano-network involving different interactions: Bonds between alginate chains induced by Zn ions (egg box structure), interactions between GO nanosheets through Zn ions and hydrogen bonds between alginate chains, and GO nanosheets. The molecular interactions and morphology were confirmed by Fourier-transform infrared spectroscopy and transmission electron microscopy. The composite’s structural organization showed enhanced thermal stability. The glass transition temperature shifted to a higher temperature due to the reduced mobility induced by additional crosslinking bonds after incorporating the GO nanosheets and Zn into the polymer matrix. Finally, the dielectric behavior revealed that charge carrier mobility was hampered by the compact structure of the nanonetwork, which reduced conductivity. The combined properties of these nanocomposite hydrogels make them attractive biomaterials in the field of regenerative medicine and wound care since both surface bioactivity and antibacterial behavior are two critical factors involved in the success of a biomaterial.

Towards revealing key factors in mechanical instability of bioabsorbable Zn-based alloys for intended vascular stenting

Zn-based alloys are recognized as promising bioabsorbable materials for cardiovascular stents, due to their biocompatibility and favorable degradability as compared to Mg. However, both low strength and intrinsic mechanical instability arising from a strong strain rate sensitivity and strain softening behavior make development of Zn alloys challenging for stent applications. In this study, we developed binary Zn-4.0Ag and ternary Zn-4.0Ag-xMn (where x = 0.2-0.6wt%) alloys. An experimental methodology was designed by cold working followed by a thermal treatment on extruded alloys, through which the effects of the grain size and precipitates could be thoroughly investigated. Microstructural observations revealed a significant grain refinement during wire drawing, leading to an ultrafine-grained (UFG) structure with a size of 700 nm and 200 nm for the Zn-4.0Ag and Zn-4.0Ag-0.6Mn, respectively. Mn showed a powerful grain refining effect, as it promoted the dynamic recrystallization. Furthermore, cold working resulted in dynamic precipitation of AgZn3 particles, distributing throughout the Zn matrix. Such precipitates triggered mechanical degradation through an activation of Zn/AgZn3 boundary sliding, reducing the tensile strength by 74% and 57% for Zn-4.0Ag and Zn-4.0Ag-0.6Mn, respectively. The observed precipitation softening caused a strong strain rate sensitivity in cold drawn alloys. Short-time annealing significantly mitigated the mechanical instability by reducing the AgZn3 fraction. The ternary alloy wire showed superior microstructural stability relative to its Mn-free counterpart due to the pinning effect of Mn-rich particles on the grain boundaries. Eventually, a shift of the corrosion regime from localized to more uniform was observed after the heat treatment, mainly due to the dissolution of AgZn3 precipitates. STATEMENT OF SIGNIFICANCE: Owing to its promising biodegradability, zinc has been recognized as a potential biodegradable material for stenting applications. However, Zn's poor strength alongside intrinsic mechanical instability have propelled researchers to search for Zn alloys with improved mechanical properties. Although extensive researches have been conducted to satisfy the mentioned concerns, no Zn-based alloys with stabilized mechanical properties have yet been reported. In this work, the mechanical properties and stability of the Zn-Ag-based alloys were systematically evaluated as a function of microstructural features. We found that the microstructure design in Zn alloys can be used to find an effective strategy to not only improve the strength and suppress the mechanical instability but also to minimize any damage by augmenting the corrosion uniformity.

Controllable biodegradation and enhanced osseointegration of ZrO2-nanofilm coated Zn-Li alloy: In vitro and in vivo studies

Zinc and its alloys have emerged as a new research direction of biodegradable metals (BMs) due to the significant physiological functions of Zn²⁺ ions in human body. However, low inhibitory concentration threshold value to cause cytotoxicity by Zn²⁺ ions during in vitro study and delayed osseointegration in vivo are two key flaws for the bulk Zn-based BMs. To combat these issues, we constructed a barrier layer of ZrO₂ nanofilm on the surface of Zn-0.1(wt.%) Li alloy via atomic layer deposition (ALD). A decreased release of Zn²⁺ ions accompanied with accelerated release of Li⁺ ions was observed on account of galvanic coupling between the coating compositions and Zn-0.1Li alloy substrate. Cytocompatibility assay reflected that ZrO₂ nanofilm coated Zn-0.1Li alloy exhibited improved cell adhesion and viability. Histological analysis also demonstrated better in vivo osseointegration for the ZrO₂ nanofilm coated Zn-0.1Li alloy. Hence, the present study elucidated that the ALD of ZrO₂ nanofilm on Zn-based BMs can effectively promote osseointegration and control their biodegradation behavior. STATEMENT OF SIGNIFICANCE: Zn-Li binary alloy was reported recently to be the promising biodegradable metals with ultimate tensile strength over 500 MPa, yet the low inhibitory concentration threshold value to cause cytotoxicity by Zn²⁺ ions is the obstacle needed to be overcome. As a pilot study, a systematic investigation on the ZrO₂ nanofilm coated Zn-Li alloy, prepared by atomic layer deposition (ALD) technique, was conducted in the present study, which involved in the formation process, in vitro and in vivo degradation behavior as well as biocompatibility evaluation. We found a controllable corrosion rate and better in vivo osseointegration can be achieved by ZrO₂ nanofilm coating on Zn-Li alloy, which provides new insight into the surface modification on biodegradable Zn alloys for usage within bone.

Novel Zinc / Tungsten Carbide Nanocomposite as Bioabsorbable Implant

There is a lack of bioabsorbable materials with adequate mechanical strength suitable for implant applications that provide temporary support while tissue integrity is restored, especially for pediatric applications. Bioabsorbable metals have emerged as an attractive choice due to their combination of strength, ductility, and biocompatibility in vivo. Zinc has shown great promise as a bioabsorbable metal, but the weak mechanical properties of pure zinc limit its application as an implant material. This study investigates zinc-tungsten carbide (Zn-WC) nanocomposite as a novel material for bioabsorbable metallic implants. Ultrasound-assisted powder compaction was used to fabricate Zn-WC nanocomposites. This study includes the material characterization of microstructure, microhardness, and degradability. Results showed that tungsten carbide nanoparticles enhanced the mechanical properties of Zn, and maintained the favorable corrosion rate of pure Zn. These results encourage further investigation of Zn-WC nanocomposites for biomedical applications with the ultimate goal of creating safe and efficacious bioabsorbable metallic implants for many clinical applications.

Characterization of a Zn-Ca5(PO4)3(OH) Composite with a High Content of the Hydroxyapatite Particles Prepared by the Spark Plasma Sintering Process

Zinc and zinc alloys have been studied due to their corrosion properties as potentially biodegradable materials. In this study, a zinc/hydroxyapatite composite (Zn/HA) containing 16 wt % HA was prepared by spark plasma sintering and characterized in detail. The microstructure, mechanical and corrosion properties were studied and the mutual relations between properties and microstructure were found. The porosity was evaluated to be approximately 18%. The mechanical properties (ultimate compression strength = 65 MPa and ultimate flexural strength = 120 MPa) are sufficient for the potential scaffolding and augmentation of cancellous bone. The flexural properties of these materials were measured for the first time. Immersion tests and subsequent analyses confirmed no direct participation of hydroxyapatite in the corrosion process and an ideal corrosion rate of approximately 0.4 mm/year. The amount of released zinc was between 4–6 mg/day corresponding with the maximal usable surface area of 25 cm2. All the results suggest that the Zn/HA composite is suitable as a potential biodegradable material (from the point of view of mechanical and corrosion properties) for the replacement of cancellous bones.

Biodegradable Magnesium Bone Implants Coated with a Novel Bioceramic Nanocomposite

Magnesium (Mg) alloys are being investigated as a biodegradable metallic biomaterial because of their mechanical property profile, which is similar to the human bone. However, implants based on Mg alloys are corroded quickly in the body before the bone fracture is fully healed. Therefore, we aimed to reduce the corrosion rate of Mg using a double protective layer. We used a magnesium-aluminum-zinc alloy (AZ91) and treated its surface with micro-arc oxidation (MAO) technique to first form an intermediate layer. Next, a bioceramic nanocomposite composed of diopside, bredigite, and fluoridated hydroxyapatite (FHA) was coated on the surface of MAO treated AZ91 using the electrophoretic deposition (EPD) technique. Our in vivo results showed a significant enhancement in the bioactivity of the nanocomposite coated AZ91 implant compared to the uncoated control implant. Implantation of the uncoated AZ91 caused a significant release of hydrogen bubbles around the implant, which was reduced when the nanocomposite coated implants were used. Using histology, this reduction in the corrosion rate of the coated implants resulted in an improved new bone formation and reduced inflammation in the interface of the implants and the surrounding tissue. Hence, our strategy using a MAO/EPD of a bioceramic nanocomposite coating (i.e., diopside-bredigite-FHA) can significantly reduce the corrosion rate and improve the bioactivity of the biodegradable AZ91 Mg implant.

Molybdenum - A biodegradable implant material for structural applications?

Molybdenum as a potentially new biodegradable material was investigated. Degradation behavior of commercially high purity molybdenum was observed in simulated physiological salt solutions (Kokubo's SBF with/without TRIS-HCl, Cu²⁺ addition and 0.9% NaCl solution). Potentiodynamic polarization, immersion mass loss and ion concentration measurements paired with REM/EDX analysis reveal gradual dissolution of molybdenum in the proper order of magnitude for stent application, associated with formation of thin, non-passivating corrosion products. The underlying corrosion mechanism is discussed as well as a comparison to literature data. However, formation of calcium phosphates (CaP) in SBF significantly decreases corrosion rates. In-situ polarization was found to be a potential way for overcoming this problem and simultaneously enhancing corrosion above the benchmark for a degradable stent material. STATEMENT OF SIGNIFICANCE: Biodegradable metals have the potential to overcome severe complications common to orthopedic and cardio-vascular implants. However, the need for a material with moderate and predictable degradation, high strength and toughness as well as MRI suitability must be satisfied. Molybdenum as potential new biodegradable material may just fulfill these requirements. An overall positive picture of molybdenum as an interesting alternative to recently discussed metallic biodegradable materials can be concluded from the herein presented results and from literature data, showing directions for future research on the topic.

The Potential Impact and Timeline of Engineering on Congenital Interventions

Congenital interventional cardiology has seen rapid growth in recent decades due to the expansion of available medical devices. Percutaneous interventions have become standard of care for many common congenital conditions. Unfortunately, patients with congenital heart disease often require multiple interventions throughout their lifespan. The availability of transcatheter devices that are biodegradable, biocompatible, durable, scalable, and can be delivered in the smallest sized patients will rely on continued advances in engineering. The development pipeline for these devices will require contributions of many individuals in academia and industry including experts in material science and tissue engineering. Advances in tissue engineering, bioresorbable technology, and even new nanotechnologies and nitinol fabrication techniques which may have an impact on the field of transcatheter congenital device in the next decade are summarized in this review. This review highlights recent advances in the engineering of transcatheter-based therapies and discusses future opportunities for engineering of transcatheter devices.