Review on titanium and titanium based alloys as biomaterials for orthopaedic applications

A Review on Design and Mechanical Properties of Additively Manufactured NiTi Implants for Orthopedic Applications

NiTi alloy has a wide range of applications as a biomaterial due to its high ductility, low corrosion rate, and favorable biocompatibility. Although Young’s modulus of NiTi is relatively low, it still needs to be reduced; one of the promising ways is by introducing porous structure. Traditional manufacturing processes, such as casting, can hardly produce complex porous structures. Additive manufacturing (AM) is one of the most advanced manufacturing technologies that can solve impurity issues, and selective laser melting (SLM) is one of the well-known methods. This paper reviews the developments of AM-NiTi with a particular focus on SLM-NiTi utilization in biomedical applications. Correspondingly, this paper aims to describe the three key factors, including powder preparation, processing parameters, and gas atmosphere during the overall process of porous NiTi. The porous structure design is of vital importance, so the unit cell and pore parameters are discussed. The mechanical properties of SLM-NiTi, such as hardness, compressive strength, tensile strength, fatigue behavior, and damping properties and their relationship with design parameters are summarized. In the end, it points out the current challenges. Considering the increasing application of NiTi implants, this review paper may open new frontiers for advanced and modern designs.

An In Vitro Evaluation of the Hierarchical Micro/Nanoporous Structure of a Ti3Zr2Sn3Mo25Nb Alloy after Surface Dealloying

A process to dealloy a Ti-3Zr-2Sn-3Mo-25Nb (TLM) titanium alloy to create a porous surface structure has been reported in this paper aiming to enhance the bioactivity of the alloy. A simple nanoporous topography on the surface was produced through dealloying the as-solution treated TLM alloy. In contrast, dealloying the as-cold rolled alloy created a hierarchical micro/nanoporous topography. SEM and XPS were performed to characterize the topography and element chemistry of both porous structures. The roughness, hydrophilicity, protein adsorption, cell adhesion, proliferation, and osteogenic differentiation were tested. The elements of Zr, Mo, Sn, and Nb were depleted at the nanoporous TLM surface with a diameter of 15.6 ± 2.3 nm. Dissolving the microscale α phase from the alloy surface contributed to the formation of the microscale grooves on the surface. The simple nanoporous topographical surface exhibited hydrophilicity and higher protein adsorption ability, which facilitated the early adhesion of osteoblasts compared with the hierarchical micro/nanoporous surface. On the other hand, the hierarchical micro/nanoporous surface improved cell proliferation and differentiation and still retained the contact guidance function, which implied good bonding for osseointegration. This research revealed the effect of phase composition on the surface morphology of dealloying titanium alloy and the synergistic effect of micron and nanometer topography on the function of osteoblasts. This paper therefore provides insights into the surface topological design of titanium-based biomaterials with improved biocompatibility.

The Influence of Nanometals, Dispersed in the Electrophoretic Nanohydroxyapatite Coatings on the Ti13Zr13Nb Alloy, on Their Morphology and Mechanical Properties

In this work, nanohydroxyapatite coatings with nanosilver and nanocopper have been fabricated and studied. The presented results concern coatings with a chemical composition that has never been proposed before. The present research aims to characterize the effects of nanosilver and nanocopper, dispersed in nanohydroxyapatite coatings and deposited on a new, non-toxic Ti13Zr13Nb alloy, on the physical and mechanical properties of coatings. The coatings were obtained by a one-stage electrophoretic process. The surface topography, and the chemical and phase compositions of coatings were examined with scanning electron microscopy, atomic force microscopy, X-ray diffractometry, glow discharge optical emission spectroscopy, and energy-dispersive X-ray spectroscopy. The mechanical properties of coatings were determined by nanoindentation tests, while coatings adhesion was determined by nanoscratch tests. The results demonstrate that copper addition increases the hardness and adhesion. The presence of nanosilver has no significant influence on the adhesion of coatings.

Nanostructure and biomimetics orchestrate mesenchymal stromal cell differentiation: An in vitro bioactivity study on new coatings for orthopedic applications

The choice of the appropriate material having suitable compositional and morphological surface characteristics, is a crucial step in the development of orthopedic implants. The purpose of this paper is to elucidate, on this regard, the influence of two important hits, i.e., biogenic apatite with bone-like composition and nanostructured morphology, providing the evidence of the efficacy of nanostructured biogenic apatite coatings in favoring adhesion, growth, proliferation, and in vitro osteogenic differentiation of human mesenchymal stromal cells (hMSCs) isolated from the bone marrow. The specific features of this coating in terms of topographical and biochemical cues, obtained by Ionized Jet Deposition, are perceived by hMSCs, as suggested by changes in different morphologic parameters as Aspect Ratio or Elongation index, suggesting the impact exerted by the nanostructure on early adhesion events, cytoskeleton organization, and cells fate. In addition, the nanostructured CaP coating sustained the metabolic activity of the cells and facilitated the osteogenic differentiation of MSC by supporting the osteogenesis-related gene expression. These findings support the use of a combined approach between technological advancement and instructive surfaces, both from the topographical and the biochemical point of view, in order to manufacture smart biomaterials able to respond to different needs of the orthopedic practice.

Laser surface texturing of zirconia-based ceramics for dental applications: A review

Laser surface texturing is widely explored for modifying the surface topography of various materials and thereby tuning their optical, tribological, biological, and other surface properties. In dentistry, improved osseointegration has been observed with laser textured titanium dental implants in clinical trials. Due to several limitations of titanium materials, dental implants made of zirconia-based ceramics are now considered as one of the best alternatives. Laser surface texturing of zirconia dental implants is therefore attracting increasing attention. However, due to the brittle nature of zirconia, as well as the metastable tetragonal ZrO₂ phase, laser texturing in the case of zirconia is more challenging than in the case of titanium. Understanding these challenges requires different fields of expertise, including laser engineering, materials science, and dentistry. Even though much progress was made within each field of expertise, a comprehensive analysis of all the related factors is still missing. This review paper provides thus an overview of the common challenges and current status on the use of lasers for surface texturing of zirconia-based ceramics for dental applications, including texturing of zirconia implants for improving osseointegration, texturing of zirconia abutments for reducing peri-implant inflammation, and texturing of zirconia restorations for improving restoration retention by bonding.

Bioactive glasses and glass-ceramics for hyperthermia treatment of cancer: state-of-art, challenges, and future perspectives

Bioactive glasses and glass-ceramics are well-proven potential biomaterials for bone-tissue engineering applications because of their compositional flexibility. Many research groups have been focused to explore the utility of bioactive glass-ceramics beyond bone engineering to hyperthermia treatment of cancer. Hyperthermia refers to raising the temperature of tumor close to 44°C at which malignant cells perish with negligible harm to normal cells. Hyperthermia can be employed by many means such as by ultrasonic waves, electromagnetic waves, infrared radiations, alternating magnetic fields, etc. Magnetic bioactive glass-ceramics are advantageous over other potential candidates for thermoseeds such as nanofluids, superparamagnetic nanoparticles because they can bond not only to the natural bone but also with soft tissues in few cases, which helps regenerating the affected part due to its bioactive nature. Strict restrictions on clinical settings ( H × f < 5 × 10 9 ) force the research activities to be more focused on material characteristics to raise the implant temperature to required ranges. Lots of efforts have been made in past years to tackle these challenges and design best-suited glass-ceramics for hyperthermia treatment. This review aims to provide essential information on the concept of hyperthermia treatment of cancer and recent developments in the field of bioactive glass-ceramics for cancer treatment. The advantages and disadvantages of magnetic glass-ceramics over other potential thermoseed materials are highlighted. In this field, the major challenges are to develop magnetic glasses, which have fast and bulk crystallization with optimized magnetic phases with lower Curie and Neel temperatures.

Effects of titanium with different micro/nano structures on the ability of osteoblasts to resist oxidative stress

Excessive accumulation of oxidative intermediates in the elderly significantly aggravates bone degradation and hinders the osseointegration of topological titanium (Ti) implants. Thus, it is of great significance to evaluate the antioxidant and osteoinduction capabilities of various nano, micro or micro/nano-composite structures under oxidative stress (OS) microenvironment. In this study, we discovered that 110 nm titania nanotubes (TNTs) enhanced the adsorption of fibronectin (FN) proteins onto smooth and rough titanium surfaces to varying degrees. Compared with Ti and 30 nm TNTs (T₃₀) groups, cells on 110 nm TNTs (T₁₁₀), microstructure/30 nm TNTs (M₃₀) and microstructure/110 nm TNTs (M₁₁₀) had smaller area, lower reactive oxygen species (ROS), and better proliferation/osteogenic differentiation abilities under OS condition, but there was no significant difference among the three groups. In addition, combined with our previous study, we suggested that T₁₁₀, M₃₀ and M₁₁₀ resistance to OS was also strongly associated with the high expression of FN-receptor integrin α5 or β1. All the findings indicated that the micro/nano-composed structures (M₃₀ & M₁₁₀) had similar anti-oxidation and osteogenesis abilities to T₁₁₀, which provided guidance for the application of different titanium implants with different topologies in the elderly.

Dual-purpose surface functionalization of Ti-6Al-7Nb involving oxygen plasma treatment and Si-DLC or chitosan-based coatings

The work presents a detailed study on the diamond-like structures doped with Si atoms and biopolymers-based coatings (chitosan, alginate) enriched with Ag nanoparticles (Ag NPs) deposited on the Ti-6Al-7Nb substrate. Multilayers were obtained by Plasma Enhanced Radio Frequency Chemical Vapour Deposition (PE RF CVD) technique and subsequent deposition of biopolymers by immersion method. The impact of Si atoms and Ag NPs on chemical structure, microstructure, topography, cytotoxicity as well as the hardness and Young modulus of the resulting layers was precisely investigated. The most advantageous conditions of plasma functionalization in RF reactor were the mixture of O₂-Ar-NH₃ in volume ratio of 10/1/9 in the first stage of functionalization (pre-activation). In the case of Si-DLC coatings (up to ca. 19 at.%) the lower silane flow (4 cm³/min) resulted in significant decrease of surface roughness (up to ca. R_a = 0.71 nm) of modified surfaces and increase of hardness reaching ca. 900 nm depth into surface (up to ca. 16 GPa). The most attractive among biopolymer-based coating on Ti-6Al-7Nb in terms of biological activity was chitosan with Ag NPs (diameter of ca. 25 nm) with additional alginate layer. AFM analysis revealed a uniform distribution of Ag NPs in the chitosan matrix. This contributed to advantageous physicochemical and biological properties assuring proper cell adhesion and proliferation. Noteworthy, the resulting surface functionalization of Ti-6Al-7Nb alloy did not cause significant cytotoxicity in vitro, giving a strong hope for perspective applications in implantology.

Influence of Isothermal ω Transitional Phase-Assisted Phase Transition From β to α on Room-Temperature Mechanical Performance of a Meta-Stable β Titanium Alloy Ti-10Mo-6Zr-4Sn-3Nb (Ti-B12) for Medical Application

The microstructural evolution and tensile performance of a meta-stable β-type biomedical Ti−10Mo−6Zr−4Sn−3Nb (Ti-B12) alloy subjected to one-stage aging (OSA) and two-stage aging (TSA) are investigated in this work. The OSA treatment is performed at 510°C for 8 h. The TSA treatments are composed of low-temperature aging and high-temperature aging. In the first step, low-temperature aging is conducted at 325°C for 2 h. In the second step, the aging temperature is the same as that in the OSA. The result of the microstructure evolution shows that the precipitated secondary phase after aging is mainly influenced by the process of phase transition. There is a marked difference in the microstructure of the Ti-B12 alloy subjected to the OSA and TSA treatments. The needle-shaped α phases are precipitated in the parent β phase after the OSA treatment. Conversely, the short shuttle-like α phases precipitated after the TSA treatment are formed in the β matrix with the aid of the role of the isothermal ω transitional phase-assisted phase transition. The electron backscattered diffraction results indicate that the crystallographic orientation relationship of the α phases precipitated during the TSA treatment is basically analogous to those in the OSA treatment. The relatively higher tensile strength of 1,275 MPa is achieved by strengthening the effect of the short shuttle-like α precipitation with a size of 0.123 μm in length during the TSA treatment, associating with a suitable elongation of 12% at room temperature simultaneously. The fracture surfaces of the samples after the OSA and TSA treatments indicate that preventing the coarsening of the α layers in the grain boundaries is favorable for the enhancement of strength of Ti-B12 at room temperature. MTT test was carried out to evaluate the acute cytotoxicity and biocompatibility of the implanted material using L929 cells. The relative proliferation rates of cytotoxicity levels 0, 1, 2, 3, and 4 are ≥100, 80–99, 50–79, 30–49, and 0–29%, respectively. The cytotoxicity of the Ti-B12 alloy is slightly better than that of the Ti−6Al−4V alloy, which can meet the requirements of medical materials for biomedical materials.

Bioactive Coatings Based on Hydroxyapatite, Kanamycin, and Growth Factor for Biofilm Modulation

The occurrence of opportunistic local infections and improper integration of metallic implants results in severe health conditions. Protective and tunable coatings represent an attractive and challenging selection for improving the metallic devices' biofunctional performances to restore or replace bone tissue. Composite materials based on hydroxyapatite (HAp), Kanamycin (KAN), and fibroblast growth factor 2 (FGF2) are herein proposed as multifunctional coatings for hard tissue implants. The superior cytocompatibility of the obtained composite coatings was evidenced by performing proliferation and morphological assays on osteoblast cell cultures. The addition of FGF2 proved beneficial concerning the metabolic activity, adhesion, and spreading of cells. The KAN-embedded coatings exhibited significant inhibitory effects against bacterial biofilm development for at least two days, the results being superior in the case of Gram-positive pathogens. HAp-based coatings embedded with KAN and FGF2 protein are proposed as multifunctional materials with superior osseointegration potential and the ability to reduce device-associated infections.

Structural and Material Determinants Influencing the Behavior of Porous Ti and Its Alloys Made by Additive Manufacturing Techniques for Biomedical Applications

One of the biggest challenges in tissue engineering is the manufacturing of porous structures that are customized in size and shape and that mimic natural bone structure. Additive manufacturing is known as a sufficient method to produce 3D porous structures used as bone substitutes in large segmental bone defects. The literature indicates that the mechanical and biological properties of scaffolds highly depend on geometrical features of structure (pore size, pore shape, porosity), surface morphology, and chemistry. The objective of this review is to present the latest advances and trends in the development of titanium scaffolds concerning the relationships between applied materials, manufacturing methods, and interior architecture determined by porosity, pore shape, and size, and the mechanical, biological, chemical, and physical properties. Such a review is assumed to show the real achievements and, on the other side, shortages in so far research.

Nanostructured Coating of Non-Crystalline Tantalum Pentoxide on Polyetheretherketone Enhances RBMS Cells/HGE Cells Adhesion

PURPOSE

As a dental material, polyetheretherketone (PEEK) is bioinert that does not induce cellular response and bone/gingival tissues regeneration. This study was to develop bioactive coating on PEEK and investigate the effects of coating on cellular response.

MATERIALS AND METHODS

Tantalum pentoxide (TP) coating was fabricated on PEEK surface by vacuum evaporation and responses of rat bone marrow mesenchymal stem (RBMS) cells/human gingival epithelial (HGE) were studied.

RESULTS

A dense coating (around 400 nm in thickness) of TP was closely combined with PEEK (PKTP). Moreover, the coating was non-crystalline TP, which contained many small humps (around 10 nm in size), exhibiting a nanostructured surface. In addition, the roughness, hydrophilicity, surface energy, and protein adsorption of PKTP were remarkably higher than that of PEEK. Furthermore, the responses (adhesion, proliferation, and osteogenic gene expression) of RBMS cells, and responses (adhesion and proliferation) of HGE cells to PKTP were remarkably improved in comparison with PEEK. It could be suggested that the nanostructured coating of TP on PEEK played crucial roles in inducing the responses of RBMS/HGE cells.

CONCLUSION

PKTP with elevated surface performances and outstanding cytocompatibility might have enormous potential for dental implant application.

Effect of Pressure on the Film Deposition during RF Magnetron Sputtering Considering Charged Nanoparticles

Non-classical crystallization, in which charged nanoparticles (NPs) are the building blocks of film growth, has been extensively studied in chemical vapor deposition (CVD). Recently, a similar mechanism of film growth has been reported during radio frequency (RF) sputtering with a Ti target and DC magnetron sputtering using an Ag target. In this study, the effect of pressure on the generation of Ti NPs and on the film deposition was studied during RF sputtering with a Ti target. Ti NPs were captured on transmission electron microscopy (TEM) membranes with the electric biases of −30, 0, and +50 V under 20 and 80 mTorr. The number densities of the Ti NPs were 134, 103, and 21 per 100 × 100 nm2, respectively, with the biases of −30, 0, and +50 V under 20 mTorr and were 196, 98, and 0 per 100 × 100 nm2, respectively, with the biases of −30, 0, and +50 V under 80 mTorr, which was analyzed by TEM. The growth rate of Ti films deposited on Si substrates was insensitive to the substrate bias under 20 mTorr but was sensitive under 80 mTorr, with the thicknesses of 132, 133, 97, and 29 nm, respectively, after being deposited for 15 min with the substrate biases of −30, −10, 0, and +50 V. This sensitive dependence of the film growth rate on the substrate bias under 80 mTorr is in agreement with the sensitive dependence of the number density of Ti NPs on the substrate bias under 80 mTorr.

Is the 0.2%-Strain-Offset Approach Appropriate for Calculating the Yield Stress of Cortical Bone?

The 0.2% strain offset approach is mostly used to calculate the yield stress and serves as an efficient method for cross-lab comparisons of measured material properties. However, it is difficult to accurately determine the yield of the bone. Especially when computational models require accurate material parameters, clarification of the yield point is needed. We tested 24 cortical specimens harvested from six bovine femora in three-point bending mode, and 11 bovine femoral cortical specimens in the tensile mode. The Young's modulus and yield stress for each specimen derived from the specimen-specific finite element (FE) optimization method was regarded as the most ideal constitutive parameter. Then, the strain offset optimization method was used to find the strain offset closest to the ideal yield stress for the 24 specimens. The results showed that the 0 strain offsets underestimated (- 25%) the yield stress in bending and tensile tests, while the 0.2% strain offsets overestimated the yield stress (+ 65%) in three-point bending tests. Instead, the yield stress determined by 0.007 and 0.05% strain offset for bending and tensile loading respectively, can effectively characterize the biomechanical responses of the bone, thereby helping to build an accurate FE model.

Comparative Study on 3D Printed Ti6Al4V Scaffolds with Surface Modifications Using Hydrothermal Treatment and Microarc Oxidation to Enhance Osteogenic Activity

Titanium (Ti) and its alloys have been widely used in clinics as preferred materials for bone tissue repair and replacement. However, the lack of biological activity of Ti limits its clinical applications. Surface modification of Ti with bioactive elements has always been a research hotspot. In this study, to promote the osseointegration of Ti6Al4V (Ti64) implants, calcium (Ca), oxygen (O), and phosphorus (P) codoped multifunctional micro–nanohybrid coatings were prepared on a three-dimensional (3D) printed porous Ti64 surface by microarc oxidation (MAO) and a hydrothermal method (HT). The surface morphologies, chemical compositions, and surface/cell interactions of the obtained coatings were studied. In vitro experiments indicated that all hybrid coating-modified Ti64 implants could enhance protein adsorption and MC3T3 osteoblasts’ activity, adhesion, and differentiation ability. In vivo experiments showed that the hybrid coating promoted early osseointegration. By comparison, microarc oxidation-treated Ti64 (M-Ti) has the best biological activity and the strongest ability of osseointegration. It provides important theoretical significance and potential application prospects for improving the biological activity of Ti implants.

Biocompatibility and Cellular Behavior of TiNbTa Alloy with Adapted Rigidity for the Replacement of Bone Tissue

In this work, the mechanical and bio-functional behavior of a TiNbTa alloy is evaluated as a potential prosthetic biomaterial used for cortical bone replacement. The results are compared with the reference Ti c.p. used as biomaterials for bone-replacement implants. The estimated mechanical behavior for TiNbTa foams was also compared with the experimental Ti c.p. foams fabricated by the authors in previous studies. A TiNbTa alloy with a 20–30% porosity could be a candidate for the replacement of cortical bone, while levels of 80% would allow the manufacture of implants for the replacement of trabecular bone tissue. Regarding biocompatibility, in vitro TiNbTa, cellular responses (osteoblast adhesion and proliferation) were compared with cell growth in Ti c.p. samples. Cell adhesion (presence of filopodia) and propagation were promoted. The TiNbTa samples had a bioactive response similar to that of Ti c.p. However, TiNbTa samples show a better balance of bio-functional behavior (promoting osseointegration) and biomechanical behavior (solving the stress-shielding phenomenon and guaranteeing mechanical resistance).

Topological, Mechanical and Biological Properties of Ti6Al4V Scaffolds for Bone Tissue Regeneration Fabricated with Reused Powders via Electron Beam Melting

Cellularized scaffold is emerging as the preferred solution for tissue regeneration and restoration of damaged functionalities. However, the high cost of preclinical studies creates a gap between investigation and the device market for the biomedical industry. In this work, bone-tailored scaffolds based on the Ti6Al4V alloy manufactured by electron beam melting (EBM) technology with reused powder were investigated, aiming to overcome issues connected to the high cost of preclinical studies. Two different elementary unit cell scaffold geometries, namely diamond (DO) and rhombic dodecahedron (RD), were adopted, while surface functionalization was performed by coating scaffolds with single layers of polycaprolactone (PCL) or with mixture of polycaprolactone and 20 wt.% hydroxyapatite (PCL/HA). The mechanical and biological performances of the produced scaffolds were investigated, and the results were compared to software simulation and experimental evidence available in literature. Good mechanical properties and a favorable environment for cell growth were obtained for all combinations of scaffold geometry and surface functionalization. In conclusion, powder recycling provides a viable practice for the biomedical industry to strongly reduce preclinical costs without altering biomechanical performance.

Tanfloc/heparin polyelectrolyte multilayers improve osteogenic differentiation of adipose-derived stem cells on titania nanotube surfaces

In this study, a surface modification strategy using natural biopolymers on titanium is proposed to improve bone healing and promote rapid and successful osseointegration of orthopedic implants. Titania nanotubes were fabricated via an anodization process and the surfaces were further modified with polyelectrolyte multilayers (PEMs) based on Tanfloc (a cationic tannin derivative) and glycosaminoglycans (heparin and hyaluronic acid). Scanning electron microscopy (SEM), water contact angle measurements, and X-ray photoelectron spectroscopy were used to characterize the surfaces. Adipose-derived stem cells (ADSCs) were seeded on the surfaces, and the cell viability, adhesion, and proliferation were investigated. Osteogenesis was induced and osteogenic differentiation of human ADSCs on the surfaces was evaluated via mineralization and protein expression assays, immunofluorescent staining, and SEM. The Tanfloc/heparin PEMs on titania nanotubes improved the rate of osteogenic differentiation of ADSCs as well as the bone mineral deposition, and is therefore a promising approach for use in orthopedic implants.

Fabrication of TiO2 microspikes for highly efficient intracellular delivery by pulse laser-assisted photoporation

The introduction of foreign cargo into living cells with high delivery efficiency and cell viability is a challenge in cell biology and biomedical research. Here, we demonstrate a nanosecond pulse laser-activated photoporation for highly efficient intracellular delivery using titanium dioxide (TiO₂) microspikes as a substratum. The TiO₂ microspikes were formed on titanium (Ti) substrate using an electrochemical anodization process. Cells were cultured on top of the TiO₂ microspikes as a monolayer, and the biomolecule was added. Due to pulse laser exposure of the TiO₂ microspike–cell membrane interface, the microspikes heat up and induce cavitation bubbles, which rapidly grow, coalesce and collapse to induce explosion, resulting in very strong fluid flow at the cell membrane surface. Thus, the cell plasma membrane disrupts and creates transient nanopores, allowing delivery of biomolecules into cells by a simple diffusion process. By this technique, we successfully delivered propidium iodide (PI) dye in HeLa cells with high delivery efficiency (93%) and high cell viability (98%) using 7 mJ pulse energy at 650 nm wavelength. Thus, our TiO₂ microspike-based platform is compact, easy to use, and potentially applicable for therapeutic and diagnostic purposes.

The introduction of foreign cargo into living cells with high delivery efficiency and cell viability by laser asisted photoporation on TiO₂ microspikes platform.

Compressive anisotropy of sheet and strut based porous Ti-6Al-4V scaffolds

Porous metallic scaffolds show promise in orthopedic applications due to favorable mechanical and biological properties. In vivo stress conditions on orthopedic implants are complex, often including multiaxial loading across off axis orientations. In this study, unit cell orientation was rotated in the XZ plane of a strut-based architecture, Diamond Crystal, and two sheet-based, triply periodic minimal surface (TPMS) architectures, Schwartz D and Gyroid. Sheet-based architectures exhibited higher peak compressive strength, yield strength and strain at peak stress than the strut-based architecture. All three topologies demonstrated an orientational dependence in mechanical properties. There was a greater degree of anisotropy (49%) in strut-based architecture than in either TPMS architectures (18-21%). These results support the superior strength and advantageous isotropic mechanical properties of sheet-based TPMS architectures relative to strut-based architectures, as well as highlighting the importance of considering anisotropic properties of lattice scaffolds for use in tissue engineering.

Long-Term Non Anesthetic Preclinical Study Available Extra-Cranial Brain Activator (ECBA) System for the Future Minimally Invasive Human Neuro Modulation

In recent years, electroceuticals have been spotlighted as an emerging treatment for various severe chronic brain diseases, owing to their intrinsic advantage of electrical interaction with the brain, which is the most electrically active organ. However, the majority of research has verified only the short-term efficacy through acute studies in laboratory tests owing to the lack of a reliable miniaturized platform for long-term animal studies. The construction of a sufficient integrated system for such a platform is extremely difficult because it requires multi-disciplinary work using state-of-the-art technologies in a wide range of fields. In this study, we propose a complete system of an implantable platform for long-term preclinical brain studies. Our proposed system, the extra-cranial brain activator (ECBA), consists of a titanium-packaged implantable module and a helmet-type base station that powers the module wirelessly. The ECBA can also be controlled by a remote handheld device. Using the ECBA, we performed a long-term non-anesthetic study with multiple canine subjects, and the resulting PET-CT scans demonstrated remarkable enhancement in brain activity relating to memory and sensory skills. Furthermore, the histological analysis and high-temperature aging test confirmed the reliability of the system for up to 31 months. Hence, the proposed ECBA system is expected to lead a new paradigm of human neuromodulation studies in the near future.

Enhanced osteogenesis properties of titanium implant materials by highly uniform mesoporous thin films of hydroxyapatite and titania intermediate layer

Titanium (Ti) has been widely used for medical and dental applications; however, bare Ti cannot be properly connected to a living bone, and hence some modifications are needed for this purpose. The present study describes the synthesis of mesoporous hydroxyapatite thin films (MHF) on titanium implant materials for speeding up and shortening the processes of osteointegration. The uniform MHF was coated on a Ti substrate following the insertion of intermediate titania (TiO₂) film via the sol-gel dip-coating method. The intermediate titania layer improved the bonding strength between the MHF and Ti substrate. MHFs were synthesized using a precursor solution containing phosphoric acid, calcium nitrate tetrahydrate, and a nonionic surfactant (C₁₂E₁₀) as the phosphate source, calcium source, and structure-directing agent, respectively. The effect of calcination temperature on phase composition, morphology, microstructure, roughness, and wettability of the MHFs was investigated using XRD, FE-SEM, COM, AFM, and contact angle measurement. The XRD results revealed the crystalline hydroxyapatite phase, which was improved with an increase in the calcination temperature. Moreover, the FE-SEM images showed the crack-free MHFs, uniform thickness of the layer, and mesoporous surface morphology. In addition, it was found that the roughness and wettability of the samples change upon the alteration of calcination temperature. The biological studies demonstrated that MHFs support the adhesion and proliferation of the mesenchymal stem cells (MSCs) and guid them toward osteogenic differentiation. Therefore, the MHFs prepared in this study may be useful in a wide range of applications, particularly in bone regeneration medicine.

Nano-Modified Titanium Implant Materials: A Way Toward Improved Antibacterial Properties

Titanium and its alloys have superb biocompatibility, low elastic modulus, and favorable corrosion resistance. These exceptional properties lead to its wide use as a medical implant material. Titanium itself does not have antibacterial properties, so bacteria can gather and adhere to its surface resulting in infection issues. The infection is among the main reasons for implant failure in orthopedic surgeries. Nano-modification, as one of the good options, has the potential to induce different degrees of antibacterial effect on the surface of implant materials. At the same time, the nano-modification procedure and the produced nanostructures should not adversely affect the osteogenic activity, and it should simultaneously lead to favorable antibacterial properties on the surface of the implant. This article scrutinizes and deals with the surface nano-modification of titanium implant materials from three aspects: nanostructures formation procedures, nanomaterials loading, and nano-morphology. In this regard, the research progress on the antibacterial properties of various surface nano-modification of titanium implant materials and the related procedures are introduced, and the new trends will be discussed in order to improve the related materials and methods.

Surface Modification Techniques of Titanium and its Alloys to Functionally Optimize Their Biomedical Properties: Thematic Review

Depending on the requirements of specific applications, implanted materials including metals, ceramics, and polymers have been used in various disciplines of medicine. Titanium and its alloys as implant materials play a critical role in the orthopedic and dental procedures. However, they still require the utilization of surface modification technologies to not only achieve the robust osteointegration but also to increase the antibacterial properties, which can avoid the implant-related infections. This article aims to provide a summary of the latest advances in surface modification techniques, of titanium and its alloys, specifically in biomedical applications. These surface techniques include plasma spray, physical vapor deposition, sol-gel, micro-arc oxidation, etc. Moreover, the microstructure evolution is comprehensively discussed, which is followed by enhanced mechanical properties, osseointegration, antibacterial properties, and clinical outcomes. Future researches should focus on the combination of multiple methods or improving the structure and composition of the composite coating to further enhance the coating performance.

Development of New Advanced Ti-Mo Alloys for Medical Applications

The use of titanium and titanium-based alloys with applications in implantology and dentistry has made remarkable progress in the promotion of new technologies and new materials that have been developed in recent years. This is justified thanks to their excellent mechanical, physical, and biological performance. Today’s generation promotes new titanium alloys, with nontoxic elements and long-term performance and without rejection of the human body. This book chapter describes new original compositions of Ti-based alloys for medical applications, with improved properties compared to existing classical alloys (C.p. Ti, Ti6Al4V, CoCrMo, etc.). The addition of nontoxic elements such as Mo, Si, Zr, and Ta brings benefits as reduced modulus of elasticity, increased corrosion resistance, and improved biocompatibility.

Effect of Pore Size on the Physicochemical Properties and Osteogenesis of Ti6Al4V Porous Scaffolds with Bionic Structure

Ti6Al4V is widely used in implants in the fields of orthopedics and dentistry due to its high compressive strength and good biocompatibility. Nevertheless, Ti6Al4V has a certain degree of biological inertness and the elastic modulus of Ti6Al4V is much higher than the cortex and trabecular bone. In this study, we designed and printed a new type of pore size Ti6Al4V with like-trabecular structure scaffold (the pore size is 800/900/1000 μm, named P8/P9/P10, respectively) with electron beam melting (EBM). Its elastic modulus, compressive strength, and other physical and chemical properties, as well as cell adhesion, proliferation, and differentiation ability and in vitro biological properties were studied. The physical and chemical performance test results showed that as the pore size increased, the surface wettability increased and the elastic modulus decreased. As the pore size increased, F-actin and alkaline phosphatase (ALP) increased significantly, and osteogenesis-related genes including BMP2, OCN, RUNX2, and ALP were upregulated significantly. The reason may be that the components on the Ti6Al4V pore size may have an influence on intracellular signal conversion and then change the mode of cell proliferation and diffusion. In summary, the like-trabecular porous structure can effectively reduce the elastic modulus of metal materials, thereby avoiding stress concentration and promoting the adhesion and proliferation of osteoblasts. Porous materials with larger pores are more conducive to the proliferation and differentiation of osteoblasts. The irregular porous Ti6Al4V scaffold prepared by the EBM technology has good mechanical properties and the potential to promote adhesion, proliferation, and differentiation of osteoblasts, and has the possibility of application in the field of implantation.

New Ti-Mo-Si materials for bone prosthesis applications

Several newly obtained titanium alloys were characterized in order to evaluate the biocompatibility and their possible application as implants. For improvement of the performances of the TiMo alloys compared to other alloys, silicon was added, targeting good mechanical and technological properties, avoiding the toxic effects for human body. Titanium is very used in medical applications, due to their extremely low toxicity and good chemical stability in different body fluids. Four Ti15MoxSi (where x = 0, 0.5, 0.75, 1.0 wt %), alloys were developed and investigated regarding microstructure, mechanical, chemical and biological behavior (in vitro and in vivo evaluation). By increasing the Si content from 0 to 1% wt., the mechanical properties of the Ti15Mo alloys were significantly improved. By increasing the Si content from 0 to 1% wt., the mechanical properties of the Ti15Mo alloys were significantly improved (about 50%) from 44.50 GPa to 19.81 GPa modulus of elasticity and the hardness values 361.28 to 188.52 HV. The cytocompatibility assessment on human line osteoblasts indicated good cell-material interactions and in vivo tests indicated a successful osseointegration, the surrounding newly bone being formed without any significant inflammatory reaction. Expression of osteopontin in the peri-implant area highlights the presence of osteogenesis and bone mineralization. Metalloproteinase-2 (gelatinase A) and metallopeptidase-9 (gelatinase B) overexpression in osteoblasts, osteoclasts and osteocytes represent the markers of normal bone remodeling. All these results suggest that the TiMoSi alloys are promising materials for orthopedics devices, since mechanical properties and biocompatibility offer conditions for applying them as biomaterial.

Improving the abrasion resistance of Ti6Al4V alloy by modifying its surface with a diazonium salt and attaching of polyurethane

Commonly used endoprostheses in the orthopedic industry are those made of Ti6Al4V titanium alloy. Unfortunately, this material has low abrasion resistance, and therefore methods of their modification are still sought. A sensible approach is coating the alloy with a layer of a polymer having higher abrasion resistance. The adhesion of polymers to alloy is low, therefore the alloy requires prior modification. In this work, the alloy was modified with three types of diazonium salt and the influence of substituent on the effectiveness of modification was determined. Then, five or ten polyurethane layers were attached to the surface of the modified alloy. Using Raman mapping, the uniform distribution of layers was proved. Layers are stable in simulated human body fluids. The effectiveness of attaching subsequent layers of polyurethane was also confirmed by nanoindentation. The main focus of this work was to improve the wear resistance of the titanium alloy. The obtained results indicate that the titanium alloy with a polyurethane layer has almost ten times lower coefficient of friction compared to pure alloy. Such a low value has not been described in the literature so far. These results are the first step for obtaining endoprostheses with very high abrasion resistance.

Pediatric Open Both-Bone Forearm Fracture Stabilized with Titanium and Stainless Steel Stacked Extension Internal Plating: A Case Report

CASE

A 12-year-old male patient sustained a multisegmental both-bone forearm fracture. Definitive stabilization was ulna intramedullary pinning, with stainless steel plating of the radius followed by a titanium plate stacked atop and extending internal fixation. Currently, 36 months after surgery, he experiences no limitations or complications. All hardware remains in situ.

CONCLUSION

We believe this is the first description of different material plates in direct contact, of stacked plates, and of 1 plate extending another's fixation. No adverse effects developed.

The Influence of Severe Plastic Deformation on Microstructure and In Vitro Biocompatibility of the New Ti-Nb-Zr-Ta-Fe-O Alloy Composition

In this work, severe plastic deformation (SPD) of the newly designed Ti-Nb-Zr-Ta-Fe-O GUM metal was successfully conducted at room temperature using high speed high pressure torsion (HSHPT) followed by cold rolling (CR) to exploit the suitability of the processed alloy for bone staples. The Ti-31.5Nb-3.1Zr-3.1Ta-0.9Fe-0.16O GUM alloy was fabricated in a levitation melting furnace using a cold crucible and argon protective atmosphere. The as-cast specimens were subjected to SPD, specifically HSHPT, and then processed by the CR method to take the advantages of both grain refinement and larger dimensions. This approach creates the opportunity to obtain temporary orthopedic implants nanostructured by SPD. The changes induced by HSHPT technology from the coarse dendrite directly into the ultrafine grained structure were examined by optical microscopy, scanning electron microscopy and X-ray diffraction. The structural investigations showed that by increasing the deformation, a high density of grain boundaries is accumulated, leading gradually to fine grain size. In addition, the in vitro biocompatibility studies were conducted in parallel on the GUM alloy specimens in the as-cast state, and after HSHPT- and HSHPT+CR- processing. For comparative purposes, in vitro behavior of the bone-derived MC3T3-E1 cells on the commercially pure titanium has also been investigated regarding the viability and proliferation, morphology and osteogenic differentiation. The results obtained support the appropriateness of the HSHPT technology for developing compression staples able to ensure a better fixation of bone fragments.

Mechano-Bactericidal Titanium Surfaces for Bone Tissue Engineering

Despite advances in the development of bone substitutes and strict aseptic procedures, the majority of failures in bone grafting surgery are related to nosocomial infections. Development of biomaterials combining both osteogenic and antibiotic activity is, therefore, a crucial public health issue. Herein, two types of intrinsically bactericidal titanium supports were fabricated by using commercially scalable techniques: plasma etching or hydrothermal treatment, which display two separate mechanisms of mechano-bactericidal action. Hydrothermal etching produces a randomly nanostructured surface with sharp nanosheet protrusions killing bacteria via cutting of the cell membrane, whereas plasma etching of titanium produces a microscale two-tier hierarchical topography that both reduce bacterial attachment and rupture those bacteria that encounter the surface. The adhesion, growth, and proliferation of human adipose-derived stem cells (hASCs) on the two mechano-bactericidal topographies were assessed. Both types of supports allowed the growth and proliferation of the hASCs in the same manner and cells retained their stemness and osteogenic potential. Furthermore, these supports induced osteogenic differentiation of hASCs without the need of differentiation factors, demonstrating their osteoinductive properties. This study proves that these innovative mechano-bactericidal titanium surfaces with both regenerative and bactericidal properties are a promising solution to improve the success rate of reconstructive surgery.

Surface Modified Techniques and Emerging Functional Coating of Dental Implants

Dental implants are widely used in the field of oral restoration, but there are still problems leading to implant failures in clinical application, such as failed osseointegration, marginal bone resorption, and peri-implantitis, which restrict the success rate of dental implants and patient satisfaction. Poor osseointegration and bacterial infection are the most essential reasons resulting in implant failure. To improve the clinical outcomes of implants, many scholars devoted to modifying the surface of implants, especially to preparing different physical and chemical modifications to improve the osseointegration between alveolar bone and implant surface. Besides, the bioactive-coatings to promote the adhesion and colonization of ossteointegration-related proteins and cells also aim to improve the osseointegration. Meanwhile, improving the anti-bacterial performance of the implant surface can obstruct the adhesion and activity of bacteria, avoiding the occurrence of inflammation related to implants. Therefore, this review comprehensively investigates and summarizes the modifying or coating methods of implant surfaces, and analyzes the ossteointegration ability and anti-bacterial characteristics of emerging functional coatings in published references.

Enhancing Antibacterial Performance and Biocompatibility of Pure Titanium by a Two-Step Electrochemical Surface Coating

A two-step electrochemical surface treatment has been developed to modify the CP Ti surface on commercially pure titanium grade 2 (CP Ti): (1) anodic oxidation to form TiO₂ nanotube precoatings loaded with silver (Ag) and (2) microarc oxidation (MAO) to produce a porous Ca-P-Ag coating in an electrolyte containing Ag, Ca, and P. One-step MAO in the same electrolyte has also been used to produce porous Ca-P-Ag coatings without anodic oxidation and preloaded Ag as a control. Surface morphologies and alloying chemistry of the two coatings were characterized by SEM, EDS, and XPS. Biocompatibility and antimicrobial properties have been evaluated by the MTT method and co-culture of Staphylococcus aureus, respectively. It is demonstrated that porous coatings with high Ag content can be achieved on the CP Ti by the two-step treatment. The optimized MAO voltage for excellent comprehensive properties of the coating is 350 V, in which a suitable chemical equilibrium between Ag, Ca, and P contents and a Ca/P ratio of 1.67 similar to HA can be obtained, and the Ag particles are in the size of less than 100 nm and embedded into the underneath of the coating surface. After being contacted with S. aureus for 1 and 7 days, the average bactericidal rates were 99.53 and 89.27% and no cytotoxicity was detected. In comparison, the one-step MAO coatings contained less Ag, had a lower Ca/P ratio, and showed lower antimicrobial ability than the two-step treated samples.

In vitro and in vivo studies on the degradation and biosafety of Mg-Zn-Ca-Y alloy hemostatic clip with the carotid artery of SD rat model

An Mg-Zn-Ca-Y alloy operative clip was developed to overcome the drawbacks of the Ti clips such as ion dissolution inflammation, interference imaging diagnosis, and the potential harm that permanent retention brings to the patient. The structure optimization design of the hemostatic clip was carried out by the finite element numerical simulation method to realize the matching between the structure design and the material properties. Hot extrusion and wire cutting process was used to prepare the Mg-Zn-Ca-Y alloy operative clip. Corrosion degradation behavior of Mg-Zn-Ca-Y alloy in vitro was investigated using electrochemical noise (EN) and immersion test in Simulated body fluid (SBF). The carotid artery of SD rats was clipped using the Mg-Zn-Ca-Y operative clip to evaluate occlusion safety and the complete corrosion degradation behavior and biocompatibility of Mg-Zn-Ca-Y alloy clip in vivo were investigated using micro-computed tomography, histological analysis, and blood biochemical indicators. It was found that the newly designed Mg-Zn-Ca-Y clip can successfully ligate the carotid artery, and no blood leakage occurred after surgery. After eight months, the Mg-Zn-Ca-Y clip degraded utterly. Histological analysis and various blood biochemical parameters in SD rat serum samples collected at different time periods showed no tissue inflammation around the clips.

Zn- or Cu-containing CaP-Based Coatings Formed by Micro-Arc Oxidation on Titanium and Ti-40Nb Alloy: Part II-Wettability and Biological Performance

This work describes the wettability and biological performance of Zn- and Cu-containing CaP-based coatings prepared by micro-arc oxidation on pure titanium (Ti) and novel Ti-40Nb alloy. Good hydrophilic properties of all the coatings were demonstrated by the low contact angles with liquids, not exceeding 45°. An increase in the applied voltage led to an increase of the coating roughness and porosity, thereby reducing the contact angles to 6° with water and to 17° with glycerol. The free surface energy of 75 ± 3 mJ/m² for all the coatings were determined. Polar component was calculated as the main component of surface energy, caused by the presence of strong polar PO₄³⁻ and OH⁻ bonds. In vitro studies showed that low Cu and Zn amounts (~0.4 at.%) in the coatings promoted high motility of human adipose-derived multipotent mesenchymal stromal cells (hAMMSC) on the implant/cell interface and subsequent cell ability to differentiate into osteoblasts. In vivo study demonstrated 100% ectopic bone formation only on the surface of the CaP coating on Ti. The Zn- and Cu-containing CaP coatings on both substrates and the CaP coating on the Ti-40Nb alloy slightly decreased the incidence of ectopic osteogenesis down to 67%. The MAO coatings showed antibacterial efficacy against Staphylococcus aureus and can be arranged as follows: Zn-CaP/Ti > Cu-CaP/TiNb, Zn-CaP/TiNb > Cu-CaP/Ti.

Magnetic Abrasive Finishing of Beta-Titanium Wire Using Multiple Transfer Movement Method

Titanium is often used in various important applications in transportation and the healthcare industry. The goal of this study was to determine the optimum processing of magnetic abrasives in beta-titanium wire, which is often used in frames for eyeglasses because of its excellent elasticity among titanium alloys. To check the performance of the magnetic abrasive finishing process, the surface roughness (Ra) was measured when the specimen was machined at various rotational speeds (700, 1500, and 2000 rpm) in the presence of diamond paste of various particle sizes (0.5, 1, and 3 μm). We concluded that the surface roughness (Ra) was the best at 2000 rpm, 1 μm particle size, and 300 s processing time, and the surface roughness of β-titanium improved from 0.32 to 0.05 μm. In addition, the optimal conditions were used to test the influence of the finishing gap, and it was found that the processing power was superior at a gap of 3 mm than at 5 mm when processing was conducted for 300 s.

F-actin Regulates Osteoblastic Differentiation of Mesenchymal Stem Cells on TiO2 Nanotubes Through MKL1 and YAP/TAZ

Titanium and titanium alloys are widely used in orthopedic implants. Modifying the nanotopography provides a new strategy to improve osseointegration of titanium substrates. Filamentous actin (F-actin) polymerization, as a mechanical loading structure, is generally considered to be involved in cell migration, endocytosis, cell division, and cell shape maintenance. Whether F-actin is involved and how it functions in nanotube-induced osteogenic differentiation of mesenchymal stem cells (MSCs) remain to be elucidated. In this study, we fabricated TiO₂ nanotubes on the surface of a titanium substrate by anodic oxidation and characterized their features by scanning electron microscopy (SEM), X-ray energy dispersive analysis (EDS), and atomic force microscopy (AFM). Alkaline phosphatase (ALP) staining, Western blotting, qRT-PCR, and immunofluorescence staining were performed to explore the osteogenic potential, the level of F-actin, and the expression of MKL1 and YAP/TAZ. Our results showed that the inner diameter and roughness of TiO₂ nanotubes increased with the increase of the anodic oxidation voltage from 30 to 70 V, while their height was 2 μm consistently. Further, the larger the tube diameter, the stronger the ability of TiO₂ nanotubes to promote osteogenic differentiation of MSCs. Inhibiting F-actin polymerization by Cyto D inhibited osteogenic differentiation of MSCs as well as the expression of proteins contained in focal adhesion complexes such as vinculin (VCL) and focal adhesion kinase (FAK). In contrast, after Jasp treatment, polymerization of F-actin enhanced the expression of RhoA and transcription factors YAP/TAZ. Based on these data, we concluded that TiO₂ nanotubes facilitated the osteogenic differentiation of MSCs, and this ability was enhanced with the increasing diameter of the nanotubes within a certain range (30-70 V). F-actin mediated this process through MKL1 and YAP/TAZ.

Interleukin-4 assisted calcium-strontium-zinc-phosphate coating induces controllable macrophage polarization and promotes osseointegration on titanium implant

Titanium (Ti) and its alloys are believed to be promising scaffold materials for dental and orthopedic implantation due to their ideal mechanical properties and biocompatibility. However, the host immune response always causes implant failures in the clinic. Surface modification of the Ti scaffold is an important factor in this process and has been widely studied to regulate the host immune response and to further promote bone regeneration. In this study, a calcium-strontium-zinc-phosphate (CSZP) coating was fabricated on a Ti implant surface by phosphate chemical conversion (PCC) technique, which modified the surface topography and element constituents. Here, we envisioned an accurate immunomodulation strategy via delivery of interleukin (IL)-4 to promote CSZP-mediated bone regeneration. IL-4 (0 and 40 ng/mL) was used to regulate immune response of macrophages. The mechanical properties, biocompatibility, osteogenesis, and anti-inflammatory properties were evaluated. The results showed that the CSZP coating exhibited a significant enhancement in surface roughness and hydrophilicity, but no obvious changes in proliferation or apoptosis of bone marrow mesenchymal stem cells (BMMSCs) and macrophages. In vitro, the mRNA and protein expression of osteogenic related factors in BMMSCs cultured on a CSZP coating, such as ALP and OCN, were significantly higher than those on bare Ti. In vivo, there was no enhanced bone formation but increased macrophage type 1 (M1) polarization on the CSZP coating. IL-4 could induce M2 polarization and promote osteogenesis of BMMSCs on CSZP in vivo and in vitro. In conclusion, the CSZP coating is an effective scaffold for BMMSCs osteogenesis, and IL-4 presents the additional advantage of modulating the immune response for bone regeneration on the CSZP coating in vivo.

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A chemical conversion calcium-strontium-zinc-phosphate (CSZP) coating is prepared on titanium.

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The CSZP coating exhibits micellar lamellar crystal morphology in micro-nano scale.

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The CSZP coating has an optimal topography and element composition for osteogenesis.

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Interleukin-4 assisted CSZP coating can obtain better osteoimmunomodulation properties.

Local Cellular Responses to Metallic and Ceramic Nanoparticles from Orthopedic Joint Arthroplasty Implants

Over the last decades, joint arthroplasty has become a successful treatment for joint disease. Nowadays, with a growing demand and increasingly younger and active patients accepting these approaches, orthopedic surgeons are seeking implants with improved mechanical behavior and longer life span. However, aseptic loosening as a result of wear debris from implants is considered to be the main cause of long-term implant failure. Previous studies have neatly illustrated the role of micrometric wear particles in the pathological mechanisms underlying aseptic loosening. Recent osteoimmunologic insights into aseptic loosening highlight the important and heretofore underrepresented contribution of nanometric orthopedic wear particles. The present review updates the characteristics of metallic and ceramic nanoparticles generated after prosthesis implantation and summarizes the current understanding of their hazardous effects on peri-prosthetic cells.

Mechanical and Corrosion Properties of Laser Surface-Treated Ti13Nb13Zr Alloy with MWCNTs Coatings

Titanium and its alloys is the main group of materials used in prosthetics and implantology. Despite their popularity and many advantages associated with their biocompatibility, these materials have a few significant disadvantages. These include low biologic activity—which reduces the growth of fibrous tissue and allows loosening of the prosthesis—the possibility of metallosis and related inflammation or other allergic reactions, as well as abrasion of the material during operation. Searching for the best combinations of material properties for implants in today′s world is not only associated with research on new alloys, but primarily with the modification of their surface layers. The proposed laser modification of the Ti13Nb13Zr alloy with a carbon nanotube coating is aimed at eliminating most of the problems mentioned above. The carbon coating was carried out by electrophoretic deposition (EPD) onto ground and etched substrates. This form of carbon was used due to the confirmed biocompatibility with the human body and the ability to create titanium carbides after laser treatment. The EPD-deposited carbon nanotube coating was subjected to laser treatment. Due to high power densities applied to the material during laser treatment, non-equilibrium structures were observed while improving mechanical and anti-corrosive properties. An electrophoretically deposited coating of carbon nanotubes further improved the effects of laser processing through greater strengthening, hardness or Young′s modulus similar to that required, as well as led to an increase in corrosion resistance. The advantage of the presented laser modification of the Ti13Nb13Zr alloy with a carbon coating is the lack of surface cracks, which are difficult to eliminate with traditional laser treatment of Ti alloys. All samples tested showed contact angles between 46° and 82° and thus, based on the literature reports, they have hydrophilic surfaces suitable for cell adhesion.

Influence of Two-Stage Anodization on Properties of the Oxide Coatings on the Ti–13Nb–13Zr Alloy

The increasing demand for titanium and its alloys used for implants results in the need for innovative surface treatments that may both increase corrosion resistance and biocompatibility and demonstrate antibacterial protection at no cytotoxicity. The purpose of this research was to characterize the effect of two-stage anodization—performed for 30 min in phosphoric acid—in the presence of hydrofluoric acid in the second stage. Scanning electron microscopy, atomic force microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, Raman spectroscopy, glow discharge optical emission spectroscopy, nanoindentation and nano-scratch tests, potentiodynamic corrosion studies, and water contact angle measurements were performed to characterize microstructure, mechanical, chemical and physical properties. The biologic examinations were carried out to determine the cytotoxicity and antibacterial effects of oxide coatings. The research results demonstrate that two-stage oxidation affects several features and, in particular, improves mechanical and chemical behavior. The processes influencing the formation and properties of the oxide coating are discussed.

Biofunctional and Tribomechanical Behavior of Porous Titanium Substrates Coated with a Bioactive Glass Bilayer (45S5-1393)

The porous substrates of commercially pure titanium have been coated with a novel bilayer of bioactive glasses (BGs), 45S5 and 1393, to improve the osseointegration and solve the stress-shielding phenomenon of titanium partial implants. The porosity of the substrates and the scratch resistance and bioactivity of the coating have been evaluated. Results are discussed in terms of stiffness and yield strength of the substrates, as well as the chemical composition, thickness, and design of the bioglass coating (monolithic vs bilayer). The role of the pores was a crucial issue in the anchoring of the coating, both in porosity percentage (30 and 60 vol %) and in pore range size (100-200 and 355-500 μm). The study was focused on the adhesion and infiltration of a 1393 bioglass layer (in contact with a porous titanium substrate), in combination with the biofunctionality of the 45S5 bioglass layer (surrounded by the host bone tissue), as 1393 bioglass enhances the adherence, while 45S5 bioglass promotes higher bioactivity. This bioactivity of the raw powder was initially estimated by nuclear magnetic resonance, through the evaluation of the chemical environments, and confirmed by the formation of hydroxyapatite when immersed in a simulated body fluid. The results revealed that the substrate with 30 vol % of porosity and a range of 355-500 μm pore size, coated with this novel BG bilayer, presented the best combination in terms of mechanical and biofunctional properties.