Preparation of graded porous titanium coatings on titanium implant materials by plasma spraying

A novel porous titanium with engineered surface for bone defect repair in load-bearing position

Porous titanium exhibits low elastic modulus and porous structure is thought to be a promising implant in bone defect repair. However, the bioinert and low mechanical strength of porous titanium have limited its clinical application, especially in load-bearing bone defect repair. Our previous study has reported an infiltration casting and acid corrosion (IC-AC) method to fabricate a novel porous titanium (pTi) with 40% porosity and 0.4 mm pore diameter, which exerts mechanical property matching with cortical bone and interconnected channels. In this study, we introduced a nanoporous coating and incorporated an osteogenic element strontium (Sr) on the surface of porous titanium (named as Sr-micro arch oxidation [MAO]) to improve the osteogenic ability of the pTi by MAO. Better biocompatibility of Sr-MAO was verified by cell adhesion experiment and cell counting kit-8 (CCK-8) test. The in vitro osteogenic-related tests such as immunofluorescence staining, alkaline phosphatase staining and real-time polymerase chain reaction (RT-PCR) demonstrated better osteogenic ability of Sr-MAO. Femoral bone defect repair model was employed to evaluate the osseointegration of samples in vivo. Results of micro-CT scanning, sequential fluorochrome labeling and Van Gieson staining suggested that Sr-MAO showed better in vivo osteogenic ability than other groups. Taking results of both in vitro and in vivo experiment together, this study indicated the Sr-MAO porous titanium could be a promising implant load-bearing bone defect.

Porous metal implants: processing, properties, and challenges

Porous and functionally graded materials have seen extensive applications in modern biomedical devices-allowing for improved site-specific performance; their appreciable mechanical, corrosive, and biocompatible properties are highly sought after for lightweight and high-strength load-bearing orthopedic and dental implants. Examples of such porous materials are metals, ceramics, and polymers. Although, easy to manufacture and lightweight, porous polymers do not inherently exhibit the required mechanical strength for hard tissue repair or replacement. Alternatively, porous ceramics are brittle and do not possess the required fatigue resistance. On the other hand, porous biocompatible metals have shown tailorable strength, fatigue resistance, and toughness. Thereby, a significant interest in investigating the manufacturing challenges of porous metals has taken place in recent years. Past research has shown that once the advantages of porous metallic structures in the orthopedic implant industry have been realized, their biological and biomechanical compatibility-with the host bone-has been followed up with extensive methodical research. Various manufacturing methods for porous or functionally graded metals are discussed and compared in this review, specifically, how the manufacturing process influences microstructure, graded composition, porosity, biocompatibility, and mechanical properties. Most of the studies discussed in this review are related to porous structures for bone implant applications; however, the understanding of these investigations may also be extended to other devices beyond the biomedical field.

Improving Biocompatibility for Next Generation of Metallic Implants

The increasing need for joint replacement surgeries, musculoskeletal repairs, and orthodontics worldwide prompts emerging technologies to evolve with healthcare's changing landscape. Metallic orthopaedic materials have a shared application history with the aerospace industry, making them only partly efficient in the biomedical domain. However, suitability of metallic materials in bone tissue replacements and regenerative therapies remains unchallenged due to their superior mechanical properties, eventhough they are not perfectly biocompatible. Therefore, exploring ways to improve biocompatibility is the most critical step toward designing the next generation of metallic biomaterials. This review discusses methods of improving biocompatibility of metals used in biomedical devices using surface modification, bulk modification, and incorporation of biologics. Our investigation spans multiple length scales, from bulk metals to the effect of microporosities, surface nanoarchitecture, and biomolecules such as DNA incorporation for enhanced biological response in metallic materials. We examine recent technologies such as 3D printing in alloy design and storing surface charge on nanoarchitecture surfaces, metal-on-metal, and ceramic-on-metal coatings to present a coherent and comprehensive understanding of the subject. Finally, we consider the advantages and challenges of metallic biomaterials and identify future directions.

Effects of Micro-Arc Oxidation Discharge Parameters on Formation and Biomedical Properties of Hydroxyapatite-Containing Flower-like Structure Coatings

The micro-arc oxidation (MAO) process was used to prepare hydroxyapatite-containing flower-like structure coatings on commercially pure titanium substrates with various values of the applied voltage (330, 390, 450 V), applied current (0.4, 0.5, 0.6 A), and duration time (1, 3, 5 min). It was found that the surface morphology of the coatings was determined primarily by the applied voltage. A voltage of 330 V yielded a flower-like/plate-like structure, while voltages of 390 V and 450 V produced a flower-like structure and a porous morphology, respectively. The applied current and duration time mainly affected the coating formation speed and petal size of the flower-like structures, respectively. The coatings prepared using voltages of 330 V and 390 V (0.6 A, 5 min) both contained Ti, TiO₂-A (anatase), TiO₂-R (rutile), DCPD (CaHPO₄·2H₂O, calcium hydrogen phosphate), and hydroxyapatite (HA). However, the latter coating contained less DCPD and had a higher HA/DCPD ratio and a Ca/P ratio closer to the ideal value of HA. The coating prepared with a voltage of 450 V consisted mainly of Ti, TiO₂-A, TiO₂-R, and CaTiO₃. For the coatings prepared with a voltage of 390 V, the flower-like structures consisted mainly of HA-containing compounds. DCPD plate-like structures were observed either between the HA-containing flower-like structures (330 V samples) or within the flower-like structures themselves (390 V samples). The coating surfaces with flower-like/plate-like or flower-like structures had a greater roughness, which increased their hydrophilicity and resulted in superior bioactivity (SBF immersion) and biocompatibility (MG-63 cell culture). The optimal biomedical performance was found in the 390 V coating due to its flower-like structure and high HA/DCPD ratio.

Laser-Induced µ-Rooms for Osteocytes on Implant Surface: An In Vivo Study

Laser processing of dental implant surfaces is becoming a more widespread replacement for classical techniques due to its undeniable advantages, including control of oxide formation and structure and surface relief at the microscale. Thus, using a laser, we created several biomimetic topographies of various shapes on the surface of titanium screw-shaped implants to research their success and survival rates. A distinctive feature of the topographies is the presence of "µ-rooms", which are special spaces created by the depressions and elevations and are analogous to the µ-sized room in which the osteocyte will potentially live. We conducted the comparable in vivo study using dental implants with continuous (G-topography with µ-canals), discrete (S-topography with μ-cavities), and irregular (I-topography) laser-induced topographies. A histological analysis performed with the statistical method (with p-value less than 0.05) was conducted, which showed that G-topography had the highest BIC parameter and contained the highest number of mature osteocytes, indicating the best secondary stability and osseointegration.

3D printed chitosan-gelatine hydrogel coating on titanium alloy surface as biological fixation interface of artificial joint prosthesis

To improve the fixation of the prosthesis-bone interface and to prevent postoperative infection, a novel antimicrobial hydrogel coating is designed as the biological fixation interface of the artificial joint prosthesis. Antimicrobial chitosan (CS) and gelatine (GT) were used as bioinks to print a CS-GT hydrogel coating with reticulated porous structure on the titanium alloy substrate by 3D printing technology. The experimental results show that the 7CS-10GT hydrogel coating has a macro-grid structure and honeycomb micro-network structure, excellent hydrophilicity (35.64°), high mechanical strength (elastic modulus 0.92 MPa) and high bonding strength (3.36 MPa) with the titanium alloy substrate. In addition, the antimicrobial effect of 7CS-10GT hydrogel against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) is enhanced after immersion in nano‑silver. Moreover, the 7CS-10GT hydrogel displays good cell compatibility and supports proliferation of NIH-3 T3 cells. In summary, the 3D printed CS-GT antimicrobial hydrogel coating provides an ideal microenvironment for cell adhesion and bone growth due to the dual-scale porous network structure, good hydrophilicity and biocompatibility, thus promoting rapid fixation of the bone interface. This technology opens a new possibility for this biological fixation interface in artificial joint replacement.

Comparative analysis of titanium coating on cobalt-chrome alloy in vitro and in vivo direct metal fabrication vs. plasma spraying

Background

Titanium surface coating on cobalt-chromium (CoCr) alloy has characteristics desirable for an orthopedic implant as follows: strength, osteointegrative capability, and biocompatibility. Creating such a coated surface takes a challenging process and two dissimilar metals are not easily welded. In our study, we utilized additive manufacturing with a 3D printing called direct metal fabrication (DMF) and compared it to the plasma spraying method (TPS), to coat titanium onto CoCr alloy. We hypothesized that this would yield a coated surface quality as acceptable or better than the already established method of plasma spraying. For this, we compared characteristics of titanium-coated surfaces created by direct metal fabrication method (DMF) and titanium plasma spraying (TPS), both in vitro and in vivo, for (1) cell morphology, (2) confocal microscopy images of immunofluorescent assay of RUNX2 and fibronectin, (3) quantification of cell proliferation rate, (4) push-out biomechanical test, and (5) bone histomorphometry.

Method

For in vitro study, human osteoblast cells were seeded onto the coated surfaces. Cellular morphology was observed with a scanning electron microscope. Cellular proliferation was validated with ELISA, immunofluorescent assay. For in vivo study, coated rods were inserted into the distal femur of the rabbit and then harvested. The rods were biomechanically tested with a push-out test and observed for histomorphometry to evaluate the microscopic bone to implant ratio.

Result

For cell morphology observation, lamellipodia and filopodia, a cytoplasmic projection extending into porous structure, formed on both surfaces created by DMF and TPS. The proliferation of the osteoblasts, the DMF group showed a better result at different optic density levels (p = 0.035, 0.005, 0.001). Expression and distribution of fibronectin and Runx-2 genes showed similar degrees of expressions. The biomechanical push-out test yielded a similar result (p = 0.714). Histomorphometry analysis also showed a similar result (p = 0.657).

Conclusion

In conclusion, DMF is a method which can reliably create a proper titanium surface on CoCr alloy. The resulting product of the surface shows a similar quality to that of the plasma spraying method, both in vivo and in vitro, in terms of biological and mechanical property.

Review of Functionally Graded Thermal Sprayed Coatings

The paper briefly describes major thermal spray techniques used to spray functionally graded coatings such as atmospheric plasma spraying, high velocity oxy-fuel spraying, suspension and solution precursor plasma spraying, and finally low and high pressure cold gas spray method. The examples of combined spray processes as well as some examples of post spray treatment including laser and high temperature treatments or mechanical one, are described. Then, the solid and liquid feedstocks used to spray and their properties are shortly discussed. The reviewed properties of functional coatings include: (i) mechanical (adhesion, toughness, hardness); (ii) physical (porosity, thermal conductivity and diffusivity, thermal expansion, photo-catalytic activity), and; (iii) bioactivity and simulated body fluid (SBF) corrosion. These properties are useful in present applications of functionally graded coatings as thermal barriers, the bioactive coatings in prostheses, photo-catalytic coatings in water treatment, coatings used in printing industry (anilox and corona rolls). Finally, some of the future possible fields of functional thermal sprayed coatings applications are discussed, e.g., to coat polymer substrates or to use the cheap technology of low pressure cold gas spray method instead of expensive technology of vacuum plasma spraying to obtain bond coatings.

In Vitro Bioactivity and Biocompatibility of Bio-Inspired Ti-6Al-4V Alloy Surfaces Modified by Combined Laser Micro/Nano Structuring

The bioactivity and biocompatibility play key roles in the success of dental and orthopaedic implants. Although most commercial implant systems use various surface microstructures, the ideal multi-scale topographies capable of controlling osteointegration have not yielded conclusive results. Inspired by both the isotropic adhesion of the skin structures in tree frog toe pads and the anisotropic adhesion of the corrugated ridges on the scales of Morpho butterfly wings, composite micro/nano-structures, including the array of micro-hexagons and oriented nano-ripples on titanium alloy implants, were respectively fabricated by microsecond laser direct writing and femtosecond laser-induced periodic surface structures, to improve cell adherence, alignment and proliferation on implants. The main differences in both the bioactivity in simulated body fluid and the biocompatibility in osteoblastic cell MC3T3 proliferation were measured and analyzed among Ti-6Al-4V samples with smooth surface, micro-hexagons and composite micro/nano-structures, respectively. Of note, bioinspired micro/nano-structures displayed the best bioactivity and biocompatibility after in vitro experiments, and meanwhile, the nano-ripples were able to induce cellular alignment within the micro-hexagons. The reasons for these differences were found in the topographical cues. An innovative functionalization strategy of controlling the osteointegration on titanium alloy implants is proposed using the composite micro/nano-structures, which is meaningful in various regenerative medicine applications and implant fields.

Preparation of a Biofunctionalized Surface on Titanium for Biomedical Applications: Surface Properties, Wettability Variations, and Biocompatibility Characteristics

This study developed a promising approach (low-temperature plasma polymerization with allylamine) to modify the titanium (Ti) surface, which helps the damaged tissue to heal faster. The Ti surface was first cleaned by argon (Ar) plasma, and then the functional amino-groups were coated on the Ti surface via plasma polymerization. The topography characteristics, wettability, and optimal plasma modification parameters were investigated through atomic force spectroscopy, secondary ion mass spectroscopy, and response surface methodology (RSM). Analytical results showed that the formation of a porous surface was found on the Ar plasma-modified Ti surfaces after Ar plasma modification with different parameters. The Ar plasma modification is an effective approach to remove surface contaminants and generate a porous topography on the Ti surface. As the Ti with Ar plasma modification was at 100 W and 190 m Torr for 12 min, the surface exhibited the maximum hydrophilic performance. In the allylamine plasma modifications, the contact angle values of the allylamine plasma-modified Ti surfaces varied between 70.15° and 88.26° in the designed parameters. The maximum concentration of amino-groups (31.58 nmole/cm2) can be obtained from the plasma-polymerized sample at 80 W and 150 mTorr for 22 min. Moreover, the cell response also demonstrated that the allylamine plasma-modified Ti sample with an optimal modification parameter (80 W, 22 min, and 150 mTorr) possessed great potential to increase cell adhesion ability. Thus, the optimal parameters of the low-temperature plasma polymerization with allylamine can be harvested using the RSM design. These data could provide new scientific information in the surface modification of Ti implant.

Novel Approach in the Use of Plasma Spray: Preparation of Bulk Titanium for Bone Augmentations

Thermal plasma spray is a common, well-established technology used in various application fields. Nevertheless, in our work, this technology was employed in a completely new way; for the preparation of bulk titanium. The aim was to produce titanium with properties similar to human bone to be used for bone augmentations. Titanium rods sprayed on a thin substrate wire exerted a porosity of about 15%, which yielded a significant decrease of Young′s modulus to the bone range and provided rugged topography for enhanced biological fixation. For the first verification of the suitability of the selected approach, tests of the mechanical properties in terms of compression, bending, and impact were carried out, the surface was characterized, and its compatibility with bone cells was studied. While preserving a high enough compressive strength of 628 MPa, the elastic modulus reached 11.6 GPa, thus preventing a stress-shielding effect, a generally known problem of implantable metals. U-2 OS and Saos-2 cells derived from bone osteosarcoma grown on the plasma-sprayed surface showed good viability.

Fortifying the Bone-Implant Interface Part 2: An In Vivo Evaluation of 3D-Printed and TPS-Coated Triangular Implants

BACKGROUND

Minimally invasive surgical fusion of the sacroiliac (SI) joint using machined solid triangular titanium plasma spray (TPS) coated implants has demonstrated positive clinical outcomes in SI joint pain patients. Additive manufactured (AM), i.e. 3D-printed, fenestrated triangular titanium implants with porous surfaces and bioactive agents, such as nanocrystalline hydroxyapatite (HA) or autograft, may further optimize bony fixation and subsequent biomechanical stability.

METHODS

A bilateral ovine distal femoral defect model was used to evaluate the cancellous bone-implant interfaces of TPS-coated and AM implants. Four implant groups (n=6/group/time-point) were included: 1)TPS-coated, 2)AM, 3)AM+HA, and 4)AM+Autograft. The bone-implant interfaces of 6- and 12-week specimens were investigated via radiographic, biomechanical, and histomorphometric methods.

RESULTS

Imaging showed peri-implant bone formation around all implants. Push-out testing demonstrated forces greater than 2500 N, with no significant differences among groups. While TPS implants failed primarily at the bone-implant interface, AM groups failed within bone ~2-3mm away from implant surfaces. All implants exhibited bone ongrowth, with no significant differences among groups. AM implants had significantly more bone ingrowth into their porous surfaces than TPS-coated implants (p<0.0001). Of the three AM groups, AM+Auto implants had the greatest bone ingrowth into the porous surface and through their core (p<0.002).

CONCLUSIONS

Both TPS and AM implants exhibited substantial bone ongrowth and ingrowth, with additional bone through growth into the AM implants' core. Overall, AM implants experienced significantly more bone infiltration compared to TPS implants. While HA-coating did not further enhance results, the addition of autograft fostered greater osteointegration for AM implants.

CLINICAL RELEVANCE

Additive manufactured implants with a porous surface provide a highly interconnected porous surface that has comparatively greater surface area for bony integration. Results suggest this may prove advantageous toward promoting enhanced biomechanical stability compared to TPS-coated implants for SI joint fusion procedures.

Evaluation of Highly Porous Dental Implants in Postablative Oral and Maxillofacial Cancer Patients: A Prospective Pilot Clinical Case Series Report

PURPOSE

The aim of this study was to evaluate the clinical efficacy of new porous tantalum trabecular metal (PTTM)-enhanced titanium dental implants used for the prosthodontic rehabilitation of postablative cancer patients. First-year interim results of a prospective clinical case series are presented.

MATERIALS AND METHODS

A total of 25 PTTM-enhanced titanium implants were placed in both maxillas and mandibles of 6 patients, who met specific inclusion criteria. Resonance frequency analysis was conducted, and implant stability was recorded in Implant Stability Quotient (ISQ) values at implant placement and after 2, 4, 6, and 12 months of functional loading. Bone levels were calculated by digitally measuring the distance from the implant shoulder to the first bone-to-implant on periapical radiographs taken at surgery and after 2, 4, 6, and 12 months of functioning.

RESULTS

Cumulative implant survival was 100% (n = 25/25). At implant placement and the 2-, 4-, 6- and 12-month monitoring appointments, mean ISQ values were 72.14 ± 5.61 (range = 50-81), 64.39 ± 8.12 (range = 44-74), 74.26 ± 7.14 (range = 44-74), 76.84 ± 7.65 (range = 60-83), and 78.13 ± 4.14 (range = 64-84), respectively, and mean crestal marginal bone loss was 0.19 ± 0.25, 0.22 ± 0.4, 0.3 ± 0.46, and 0.57 ± 0.62 mm, respectively.

CONCLUSIONS

PTTM-enhanced dental implants were clinically effective in the prosthetic rehabilitation of postoncological patients. Larger long-term follow-up studies will help to evaluate clinical efficacy of PTTM dental implants.

Positive effect of strontium-oxide layer on the osseointegration of moderately rough titanium surface in non-osteoporotic rabbits

OBJECTIVES

To evaluate the effect of strontium-oxide layer on new bone formation and osseointegration of sandblasted large-grit double-acid-etched (SLA) implant.

MATERIAL AND METHODS

Strontium-oxide layer on the SLA surface was produced by hydrothermal treatment using a Sr-containing solution. The surface topographies, roughness, hardness values, chemical elements and ionic release of SLA and the strontium-containing SLA (Sr-SLA) surface were measured by special instruments separately. Sixty-four SLA and Sr-SLA implants were inserted into the proximal tibiae and femoral condyles of sixteen non-osteoporotic New Zealand white rabbits. The biological effects were evaluated by removal torque (RTQ) testing and histomorphometric analysis after 3 and 6 weeks of implantation.

RESULTS

The surface characteristics showed Sr-SLA surfaces with dotted nanostructures can release appropriate amount of strontium ions into surrounding tissue till 14 days. In vivo, the Sr-SLA implants presented significantly higher RTQ than SLA implants at 3 and 6 weeks (P < 0.05). The Sr-SLA implants presented higher bone-to-implant contact (BIC) than SLA implants in cortical bone at 3 and 6 weeks (P < 0.05). The bone area was slightly higher for the Sr-SLA implants at 3 and 6 weeks (P > 0.05).

CONCLUSIONS

The strontium-oxide layer on the SLA surface has the potential to improve implant osseointegration in non-osteoporotic rabbits.

Microwave-assisted fabrication of titanium implants with controlled surface topography for rapid bone healing

Morphological surface modifications have been reported to enhance the performance of biomedical implants. However, current methods of introducing graded porosity involves postprocessing techniques that lead to formation of microcracks, delamination, loss of fatigue strength, and, overall, poor mechanical properties. To address these issues, we developed a microwave sintering procedure whereby pure titanium powder can be readily densified into implants with graded porosity in a single step. Using this approach, surface topography of implants can be closely controlled to have a distinctive combination of surface area, pore size, and surface roughness. In this study, the effect of various surface topographies on in vitro response of neonatal rat calvarial osteoblast in terms of attachment and proliferation is studied. Certain graded surfaces nearly double the chance of cell viability in early stages (∼one month) and are therefore expected to improve the rate of healing. On the other hand, while the osteoblast morphology significantly differs in each sample at different periods, there is no straightforward correlation between early proliferation and quantitative surface parameters such as average roughness or surface area. This indicates that the nature of cell-surface interactions likely depends on other factors, including spatial parameters.

A novel composite porous coating approach for bioactive titanium-based orthopedic implants

Surface modification of titanium-based implants is considered a highly effective solution to enhance osseointegration. This study describes a novel Ti/hydroxyapatite (HA) composite porous coating produced using a cold spraying technique. Experimental results indicate desirable open-cell structure with 50-150 μm pore size and 60-65% macroporosity. In particular, the reinforced HA particles are exposed to the surface of the coating resulting in enhanced mineralization ability in simulated body fluid. None of the coatings displayed a cytotoxic response in SaOS-2 cells cultured in vitro for up to 48 h. The bond strength between the porous coating and the Ti substrate was found to be 20 MPa. These properties are comparative to or better than products currently on the market and thus this novel coating has potential use in orthopedics.

Bioactive Ti metal analogous to human cancellous bone: Fabrication by selective laser melting and chemical treatments

Selective laser melting (SLM) is a useful technique for preparing three-dimensional porous bodies with complicated internal structures directly from titanium (Ti) powders without any intermediate processing steps, with the products being expected to be useful as a bone substitute. In this study the necessary SLM processing conditions to obtain a dense product, such as the laser power, scanning speed, and hatching pattern, were investigated using a Ti powder of less than 45 μm particle size. The results show that a fully dense plate thinner than 1.8 mm was obtained when the laser power to scanning speed ratio was greater than 0.5 and the hatch spacing was less than the laser diameter, with a 30 μm thick powder layer. Porous Ti metals with structures analogous to human cancellous bone were fabricated and the compressive strength measured. The compressive strength was in the range 35-120 MPa when the porosity was in the range 75-55%. Porous Ti metals fabricated by SLM were heat-treated at 1300 °C for 1h in an argon gas atmosphere to smooth the surface. Such prepared specimens were subjected to NaOH, HCl, and heat treatment to provide bioactivity. Field emission scanning electron micrographs showed that fine networks of titanium oxide were formed over the whole surface of the porous body. These treated porous bodies formed bone-like apatite on their surfaces in a simulated body fluid within 3 days. In vivo studies showed that new bone penetrated into the pores and directly bonded to the walls within 12 weeks after implantation into the femur of Japanese white rabbits. The percentage bone affinity indices of the chemical- and heat-treated porous bodies were significantly higher than that of untreated implants.

In vitro and in vivo studies of alkali- and heat-treated Ti-6Al-7Nb and Ti-5Al-2Nb-1Ta alloys for orthopedic implants

In vitro studies of Ti-6Al-7Nb and Ti-5Al-2Nb-1Ta alloys were carried out by treating the specimens with 10 M NaOH at 60 degrees C for 24 h and subsequently heat-treated at 600 degrees C for 1 h. After the alkali and heat treatments, and on subsequent soaking in simulated body fluid (SBF), the morphological and compositional changes on the surface of the specimens were examined using scanning electron microscope attached with an energy-dispersive electron probe X-ray analyzer. The results revealed a dense and uniform bonelike apatite layer on the surface of treated substrates immersed in SBF solution. In vivo studies were carried out in rats to evaluate osteoconduction of Ti-6Al-7Nb and Ti-5Al-2Nb-1Ta alloys surface after alkali and heat treatments compared with untreated titanium alloys as the control. The following titanium implants were prepared from these species: (1) control without implant; (2) untreated titanium implant; (3) alkali- and heat-treated implant--the implants were immersed in 10 M NaOH solution at 60 degrees C for 24 h and subsequently heated at 600 degrees C for 1 h. The specimens were inserted into the medial side of each tibia of rats. Histologically, direct bone contact with the implant surface was significantly higher in the alkali heat-treated implants than the untreated titanium implants.

Mechanical examinations on dental implants with porous titanium coating

Due to its good biocompatibility, porous titanium is an interesting material for biomedical applications. Bone tissue can grow inside the porous structure and maintain a long and stable connection between the implant and the human bone. To investigate its long term stability, the mechanical behavior of porous titanium was tested under static and dynamic conditions and was compared to human bone tissue. A promising application of this material is the coating of dental implants. A manufacturing technique was developed and implants were produced. These implants were fatigue tested according to modified ISO 14801 and the micro structural change was examined. The fatigue test was statically modeled using finite element analysis (FEA). The results show that the implants resist a continuous load which is comparable to the loading conditions in the human jaw. The experiments show that the porous titanium has bone-like mechanical properties. Additionally the porous titanium shows an anisotropic behavior of its mechanical properties depending on the alignment of the pores. Finally, other potential applications of porous titanium are outlined.

Electrochemically formed passive layers on titanium — Preparation and biocompatibility assessment in Hank's balanced salt solution

Uniform and crack-free passive layers on Ti are prepared using AC voltage in 7.5 wt.% aq. NH4·BF4 at 25 °C. The passive layers possess coloration (wide spectrum of colors) that depends on the experimental conditions. The biocompatibility of such prepared passive layers is evaluated using corrosion science and analytical techniques. Their corrosion behavior, Ti-ion release, surface roughness, and wettability in Hank's Balanced Salt Solution (HBSS) at 37 °C are the main focus of this work. Open-circuit potential and polarization measurements demonstrate that the corrosion potential (Ecorr) of the passive layers becomes more positive than that of the untreated Ti. The value of Ecorr increases as we increase the AC voltage (VAC). Their corrosion rate (CR) is lower than that of the untreated Ti, and they reduced the Ti-ion release level from 230 to 15 ppb. An increase in the AC voltage frequency (f) leads to a slightly higher level of the Ti-ion release (~50 ppb). Surface profilometry, optical microscopy, and scanning electron microscopy (SEM) analyses show that prolonged exposure of the passive layers to HBSS results in changes to their surface topography. The passive layers prepared by the application of AC voltage are rougher and more hydrophilic than the untreated Ti. Our methodology of preparing biocompatible passive layers on Ti might be applied as a new surface treatment procedure for Ti implants.Key words: titanium, metal surface treatment, surface roughness, corrosion, metal ion release, contact angle.

Biomechanical and allergological characteristics of a biodegradable poly(D,L-lactic acid) coating for orthopaedic implants

A poly(D,L-lactic acid) surface coating (PDLLA) has been developed to optimize interactions at the implant-tissue interface. Mechanical and allergological characteristics were evaluated in the present study to elucidate possible indications and limitations prior to clinical application. Implants of stainless steel and Ti-6Al-4V and Co-Cr-Mo alloys were coated with PDLLA, and mechanical stability was studied during intramedullary implantation into rat and human cadaver bones and during dilation of coronary artery stents. Elongation resistance was examined on AlMgSi alloy specimens. Furthermore, proliferation of peripheral blood mononuclear cells of nickel-allergic donors and controls and interleukin-4 and interferon-gamma levels were measured in the presence of coated/uncoated implants and after stimulation with phytohemagglutinin or NiSO4. PDLLA remained stable on the implants with a minimum of 96% of the original coating mass and tolerated lengthening of at least 8%. Further lengthening was followed by microcracking and cohesive failure within the coating. PDLLA exerted no suppressive effect upon spontaneous and pan-T-cell mitogen inducible T-cell proliferation. Furthermore, specific proliferation to nickel in cells of nickel-allergic blood donors and production of interleukin-4 and IFN-gamma were not influenced by the coating. PDLLA coating proved high mechanical stability on different orthopaedic implants and did not influence in vitro T-cell reactivity towards specific biomaterials.

Effect of heat-treated titanium surfaces on protein adsorption and osteoblast precursor cell initial attachment

The clinical success of dental implants is governed in part by surface properties of implants and their interactions with the surrounding tissues. The objective of this study was to investigate the effect of heat-treated titanium surfaces on protein adsorption and osteoblast precursor cell attachment in vitro. Passivated titanium samples used in this study were either non heat treated or heat treated at 750 degrees C for 90 minutes. It was observed that the contact angle on heat-treated titanium surfaces was statistically lower compared with the non-heat-treated titanium surfaces. The non-heat-treated titanium surface was also observed to be amorphous oxide, whereas heat treatment of titanium resulted in the conversion of amorphous oxide to crystalline anatase oxide. No significant difference in albumin and fibronectin adsorption was observed between the heat-treated and non-heat-treated titanium surfaces. In addition, no significant difference in initial cell attachment was observed between the two groups. It was concluded that heat treatment of titanium resulted in significantly more hydrophilic surfaces compared to non-heat-treated titanium surfaces. However, differences in oxide crystallinity and wettability were not observed to affect protein adsorption and initial osteoblast precursor cell attachment.

Fabrication of Porous Titanium with Biomechanical Compatibility

Porous titanium with good strength and three-dimension pore structure was fabricated by using H2O2 as vesicant foaming titanium powder. The compressive strength, bending strength and Young’s modulus of porous titanium with the porosity of 58vol% are 190.7Mpa, 159Mpa and 4.15Gpa, respectively, similar to that of the nature bone. This kind of porous titanium with good bio-mechanical compatibility may be potential to alleviate the problems caused by the mismatch of the strength and Young's modulus between implant (110 GPa for Ti) and bone. Moreover, the pores (mainly in 100-700µm) are all interconnected and there are many microspores (about 10µm) in the wall of the macrospores. This porous structure would endow the materials with better activity.

Comparative study of osteoconduction on micromachined and alkali-treated titanium alloy surfaces in vitro and in vivo

This study sought to evaluate osteoconduction of Ti-6Al-4V surfaces under various conditions, including micro-patterned, alkali-treated, micro-patterned plus alkali-treated, and surfaces without any treatment as the control. The through-mask electrochemical micromachining (EMM) was used to fabricate micro-hole arrays on the titanium alloy surface. In vitro calcium phosphate formation on titanium surfaces was in static and dynamic simulated body fluid (SBF). In vivo comparison was conducted in the medullary cavity of dog femur using the implant cages which could provide the same physiological environment for specimens with different surface conditions. In vitro experiments indicate good conduction of calcium phosphate on the alkali-treated surfaces, and also better calcium phosphate deposition on the micro-hole surface than on the flat surfaces in dynamic SBF. In vivo experiments confirm the beneficial effect of alkaline treatment on osteoconduction. The results of in vivo experiments also indicate a synergistic effect of the alkaline treatment and the topographic pattern on osteoconduction.

Physical characterization of different-roughness titanium surfaces, with and without hydroxyapatite coating, and their effect on human osteoblast-like cells

The aim of this study was to characterize and compare various titanium (Ti) and hydroxyapatite (HA) coatings on Ti6Al4V, in view of their application on noncemented orthopedic implants. Two innovative vacuum plasma sprayed (VPS) coatings, the first of ultrahigh rough and dense Ti (PG60, Ra=74 microm) and the second of ultrahigh rough and dense Ti coated with HA (HPG60, Ra=52 microm), have been developed, and the response of osteoblast-like cells (MG-63) seeded on these new coatings was evaluated in comparison to: a low roughness and sandblasted (Ti/SA, Ra=4 microm) Ti6Al4V surface; Ti medium (TI01, Ra=18 microm), and high (TI60, Ra=40 microm) roughness VPS coatings; and the relative Ti plus HA duplex coatings (HT01, Ra=12 microm and HT60, Ra=36 microm respectively), also obtained by VPS. PG60 coating presented no open porosity, making it dense and potentially intrinsically stronger. Cell adhesion and proliferation on PG60 was similar to those of the smoothest one (Ti/SA) and adhesion on ultrahigh roughness was lower than the medium- and high-roughness coatings, whereas cell proliferation on PG60 was lower than TI60. The HA coating determined significant increases in cell proliferation at medium and high roughness levels when compared to the relative Ti coating, but not compared to the ultrahigh one; all HA-coated surfaces showed a decrease in alkaline phosphatase activity and collagen I production. Surface morphology and the HA coating strongly affected cell behavior. However, ultrahigh values of roughness are not correctly seen by cells, and the presence of HA has no improving effects.

Early detachment of titanium particles from various different surfaces of endosseous dental implants

Titanium (Ti) endosseous dental screws with different surfaces (smooth titanium--STi, titanium plasma-sprayed-TPS, alumina oxide sandblasted and acid-etched--Al-SLA, zirconium oxide sandblasted and acid etched--Zr-SLA) were implanted in femura and tibiae of sheep to investigate the biological evolution of the peri-implant tissues and detachment of Ti debris from the implant surfaces in early healing. Implants were not loaded. Sections of the screws and the peri-implant tissues obtained by sawing and grinding were analysed by light microscopy immediately after implantation (time 0) and after 14 days. All samples showed new bone trabeculae and vascularised medullary spaces in those areas where gaps between the implants and host bone were visible. In contrast, no osteogenesis was induced in the areas where the implants were initially positioned in close contact with the host bone. Chips of the pre-existing bone inducing new peri-implant neo-osteogenesis were surrounded by new bone trabeculae. The threads of some screws appeared to be deformed where the host bone showed fractures. Ti granules of 3-60 microm were detectable only in the peri-implant tissues of TPS implants both immediately after surgery and after 14 days, thus suggesting that this phenomenon may be related to the friction of the TPS coating during surgical insertion.

Geometrically structured implants for cranial reconstruction made of biodegradable polyesters and calcium phosphate/calcium carbonate

The aim of this study was the development of a processing pathway for manufacturing of biodegradable skull implants with individual geometry. The implants on the basis of polylactide and calcium phosphate/calcium carbonate were prepared by a combination of hot pressing and gas foaming. On the inside, the implant consists of a macroporous and faster degradable material (poly(D,L-lactide)+CaCO3) to allow the ingrowth of bone cells. The pore size is in the range of 200-400 microm. On the outside, the implant consists of a compact and slower biodegradable material (poly(L-lactide) and calcium phosphate) to ensure mechanical stability and protection. To overcome problems like inflammatory reactions caused by acidic degradation products of polylactide, the polyester was combined with basic filling materials (calcium salts). The filler neutralises the lactic acid produced during polymer degradation and increases the bioactivity of the material. The stabilised pH was demonstrated by long-term in vitro pH studies. Over a time period of 250 d in demineralised water, the pH was in the physiological range. The in vitro biocompatibility was shown by cell cultures with human osteoblasts. A good proliferation of the cells was observed over the whole test period of 4 weeks.

Plasma treatment increased shear bond strength between heat cured acrylic resin and self-curing acrylic resin

Self-curing acrylic resin is generally used for the repair of a fractured denture base. However, re-fracture of the repaired denture base resin often occurs because of poor bonding strength between the base resin and self-curing repair resin. The effect of plasma treatment on the shear bond strength between heat cured acrylic resin and the self-cured acrylic was examined. It was revealed that plasma irradiation is effective in increasing the shear bond strength. Plasma irradiation does not cause environmental pollution, as it does not require chemicals. It is a useful method to increase adhesive strength between heat cured acrylic resin and self-curing acrylic resin.

Hydroxyapatite/polymer composite flame-sprayed coatings for orthopedic applications

The complex biological and mechanical requirements for implant materials in the human body generally cannot be furnished by one single material. In the present study, hydroxyapatite/polymer composite coatings with different contents of hydroxyapatite were produced using a flame spray system. This processing route is intended to obtain a coating with an optimal combination of biological and mechanical properties of these two materials for skeletal implants. The composite coatings were produced from a mechanical blend of hydroxyapatite and ethylene methacrylic acid copolymer powders, which were delivered from a fluidized bed powder feeder. Characterization of the coating surface morphology, polished coating cross-sections, and fracture surface morphology was conducted by scanning electron microscopy. The dissolution behavior of the coatings was evaluated with a calcium-specific ion meter. The stress-strain behavior was investigated by tensile testing. The biological and mechanical properties were found to be related to the volume and distribution of the hydroxyapatite in the polymer matrix. This technique provides a means of preparing hydroxyapatite/polymer coatings for application as implants.

Bond strength, compositional, and structural properties of hydroxyapatite coating on Ti, ZrO2-coated Ti, and TPS-coated Ti substrate

The effect of titanium plasma-sprayed (TPS) and zirconia (ZrO(2))-coated titanium (Ti) substrates on the adhesive, compositional, and structural properties of plasma-sprayed hydroxyapatite (HA) coatings were evaluated. X-ray diffraction, Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy, energy dispersive spectroscopy, surface roughness, and adhesive strength were used to characterize the coatings. Apatite-type and alpha-tricalcium phosphate phases were observed for all HA coatings. A structural change due to the absence of a 960 cm(-1) peak during FTIR analysis was observed for all HA coatings. The coating surfaces appeared rough and melted, with surface roughness correlating to the size of the starting powder. No significant difference in the Ca/P ratio of HA on Ti and TPS-coated Ti substrates was observed. However, the Ca/P ratio of HA on ZrO(2)-coated Ti substrate was significantly increased. Interfaces between all coatings and substrates were observed to be dense and tightly bound, except for HA coatings on TPS-coated Ti substrate interface. However, an intermediate TPS or ZrO(2) layer between the HA and Ti substrate resulted in a lower adhesive strength as compared to HA on Ti substrate.

Morphological behavior of osteoblast-like cells on surface-modified titanium in vitro

In recent papers, we reported the results of a study on the graded porous titanium coatings on titanium by plasma spraying and amino-group ion implantation. The paper is to preliminarily evaluate the biocompatibility of surface-modified titanium through 2, 5 and 7 days cell culture in vitro. Cell morphology was observed by a scanning electron microscope. Cell proliferation and type I collagen synthesis were measured by 3(4.5-dimethyl-thiazole-2-yl)2,5-diphenyl tetrazolium bromide (MTT) and enzyme-linked immunosorbent assay (ELISA), respectively. Our experimental results showed that osteoblast-like cells attached and spread well on surface-modified titanium. Cells were observed to grow into the pores and form extracellular matrix. MTT and ELISA results showed no detrimental effect on the development of cell. These studies support the biocompatibility of surface-modified titanium.

Surface modification of titanium through amino group implantation

We modified Ti surfaces by implantation of amino (NH(2+)) groups at 10(16) and 10(17) cm(-2). The implanted surfaces were characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning Auger electron spectroscopy (AES), and second ion mass spectroscopy (SIMS). The experimental results showed that the implanted Ti specimens were covered by a dominant hydrocarbon overlayer due to contamination and the surface oxide layer of implanted specimens became thicker. XPS, AES, and SIMS depth profiles showed that implanted elements had a typical ion implantation distribution and that titanium nitride (TiN) was formed.