Biologic effects of surface roughness and fluorhydroxyapatite coating on osteointegration in external fixation systems: an in vivo experimental study

Improved osteoblast function on titanium implant surfaces coated with nanocomposite Apatite-Wollastonite-Chitosan- an experimental in-vitro study

BACKGROUND

There is a continuous research in the area of biomimetic coatings on the titanium (Ti) implant surfaces for improved survival and long-term successful outcomes in the field of dentistry and orthopedics. In-vitro approaches are ideal systems for studying cell-material interactions without complexity and interference observed in in-vivo models.

PURPOSE

The present study was undertaken to evaluate the osteoblast characteristics and function on Ti substrates coated with the novel composite coating of ceramic apatite-wollastonite (AW) and polymer chitosan.

MATERIALS AND METHODS

Ti substrate coated with composite AW-Chitosan was synthesized, using electrophoretic deposition. MG-63 cells were seeded onto the coated substrates and cellular morphology and growth was assessed using Scanning Electron Microscopy (SEM) and Laser Scanning Microscopy (LSM). Osteocalcin expression of the seeded cells was assessed by FITC tagging and LSM analysis. Alizarin Red S staining and Confocal LSM (CSLM) analysis was used to study the in-vitro mineralization on the titanium samples.

RESULTS

The AW-Chitosan coating on Ti samples by electrophoretic deposition exerted significant positive influence on cell proliferation, growth and mineralization as compared to uncoated titanium samples. Scanning electron microscopy and laser confocal microscopy experiments revealed that the coating was non-toxic to cells, enhanced adhesion and proliferation of MG-63 cells. Increased functional activity was observed by increased production of bone-specific protein osteocalcin and mineralized calcium through day 7 and 14.

CONCLUSIONS

The present study underscores that optimal inorganic-organic phase nanocomposite crack-free coating created on Ti by simple, cost-effective electrophoretic deposition technique may have osteoconductive potential and may have wide application in the field of implantology. Graphical abstract.

Biomedical Coatings to Improve the Tissue-Biomaterial Interface

One of the most important factors determining the degree of tissue interaction of an implanted device is the property of its surface. Thus, great importance is given to chemical and morphological characteristics of biomaterial surfaces to improve biocompatibility, cell migration, proliferation and differentiation, mechanical stability and endogenous tissue ingrowth.

In order to obtain new and healing stimulating properties, it is possible to apply a coating or more generally a surface treatment to the surface of a prosthetic device. One of the most versatile methods for coating is thermal spray technology. This paper considers the principle of thermal spray processes and their application in the biomedical field, namely the coatings used for orthopedic prostheses and dental implants. Among thermal spray processes, plasma spray as well as High Velocity Oxygen Fuel (HVOF) processes will be particularly considered and their most important aspects will be illustrated.

Effects of Laser Power Level on Microstructural Properties and Phase Composition of Laser-Clad Fluorapatite/Zirconia Composite Coatings on Ti6Al4V Substrates

Hydroxyapatite (HA) is one of the most commonly used materials for the coating of bioceramic titanium (Ti) alloys. However, HA has poor mechanical properties and a low bonding strength. Accordingly, the present study replaces HA with a composite coating material consisting of fluorapatite (FA) and 20 wt % yttria (3 mol %) stabilized zirconia (ZrO₂, 3Y-TZP). The FA/ZrO₂ coatings are deposited on Ti6Al4V substrates using a Nd:YAG laser cladding system with laser powers and travel speeds of 400 W/200 mm/min, 800 W/400 mm/min, and 1200 W/600 mm/min, respectively. The experimental results show that a significant inter-diffusion of the alloying elements occurs between the coating layer (CL) and the transition layer (TL). Consequently, a strong metallurgical bond is formed between them. During the cladding process, the ZrO₂ is completely decomposed, while the FA is partially decomposed. As a result, the CLs of all the specimens consist mainly of FA, Ca₄(PO₄)₂O (TTCP), CaF₂, CaZrO₃, CaTiO₃ and monoclinic phase ZrO₂ (m-ZrO₂), together with a small amount of θ-Al₂O₃. As the laser power is increased, CaO, CaCO₃ and trace amounts of tetragonal phase ZrO₂ (t-ZrO₂) also appear. As the laser power increases from 400 to 800 W, the CL hardness also increases as a result of microstructural refinement and densification. However, at the highest laser power of 1200 W, the CL hardness reduces significantly due to the formation of large amounts of relatively soft CaO and CaCO₃ phase.

Calcium orthophosphates (CaPO4): occurrence and properties

The present overview is intended to point the readers' attention to the important subject of calcium orthophosphates (CaPO4). This type of materials is of the special significance for the human beings because they represent the inorganic part of major normal (bones, teeth and antlers) and pathological (i.e., those appearing due to various diseases) calcified tissues of mammals. For example, atherosclerosis results in blood vessel blockage caused by a solid composite of cholesterol with CaPO4, while dental caries and osteoporosis mean a partial decalcification of teeth and bones, respectively, that results in replacement of a less soluble and harder biological apatite by more soluble and softer calcium hydrogenorthophosphates. Therefore, the processes of both normal and pathological calcifications are just an in vivo crystallization of CaPO4. Similarly, dental caries and osteoporosis might be considered as in vivo dissolution of CaPO4. In addition, natural CaPO4 are the major source of phosphorus, which is used to produce agricultural fertilizers, detergents and various phosphorus-containing chemicals. Thus, there is a great significance of CaPO4 for the humankind and, in this paper, an overview on the current knowledge on this subject is provided.

Surface characterization and osteoblast response to a functionally graded hydroxyapatite/fluoro-hydroxyapatite/titanium oxide coating on titanium surface by sol-gel method

OBJECTIVES

To improve efficacy of current titanium and its alloys, in bioactivity and speed of osseointegration, of orthopaedic implants.

MATERIALS AND METHODS

A novel triple-layered functional graded coating, consisting of a porous hydroxyapatite (HA) outermost layer, fluoro-HA (FHA) intermediate layer and titanium oxide (TiO2 ) innermost layer, was created on a titanium substrate by a multistep sol-gel method. X-ray diffraction analysis showed TiO2 anatase and apatite crystallization in the coating.

RESULTS

Morphological analysis performed by scanning electron microscopy showed excellent bonding between coating and substrate, with a thickness of ~2 μm. Scratch testing found favourable adhesion strength of the composite coating. In addition, optical microscope images suggested good biocompatibility. Considering thet in vitro cell response, osteoblasts on the coating exhibited higher cell proliferation and ALP activity compared to pure titanium and HA coating, and demonstrated excellent coating bioactivity.

CONCLUSIONS

Current results indicated that the novel TiO2 /FHA/HA coating has promising clinical applications in orthopaedic and dental implantation.

Structural influence from calcium phosphate coatings and its possible effect on enhanced bone integration

OBJECTIVE

The aim of this review was to summarize our present knowledge about calcium phosphate (CaP) coatings on implants with respect to their topographical appearance at micrometer as well as nanometer level and also the reported influence on bone healing.

MATERIAL AND METHODS

The PubMed database was used with the key words - surface roughness, CaP coating, implant, bone integration, clinical studies, experimental studies - used in different combinations. Only in vivo studies were taken into consideration.

CONCLUSIONS

A significantly improved healing capacity associated with CaP-coated implants is often reported, but individual importance of the several modes of surface changes introduced, deliberately or not, is usually very difficult to interpret. Several studies claim this difference to be due to altered chemistry, but in many the result may equally well be dependent on the surface topography. The few studies that have been published indicate that nanometer structures have an impact on early bone healing. However, the optimal size and distribution of nanometer-sized particles or pores applied on implant surfaces is still unknown, as are the evaluation effects of micrometer roughness. Improved surface characterization is needed if we are to reveal effects dependent on isolated nanometer alterations.

Er:YAG laser-roughened enamel promotes osteoblastic differentiation

OBJECTIVE

The aim of this study was to test whether Er:YAG laser-etched enamel of human teeth could act as a biologically active scaffold for tissue regeneration.

BACKGROUND DATA

Hydroxylapatite (HA) with rough surface created by acid etching treatment has been used as a scaffold for tissue engineering. However, whether tooth HA can be a scaffold for osteoblastic cell seeding is still unclear.

MATERIALS AND METHODS

Enamel samples from human teeth were pretreated with an Er:YAG laser to create a rough surface. Then the surface of the laser-treated enamel was examined using a surface roughness profilometer and a scanning electron microscope. In addition, static water contact angles of the Er:YAG laser-treated enamel samples were measured using goniometry. To observe the effects of cell behavior on an Er:YAG laser-roughened enamel surface, we cultured MG63 osteoblast-like cells on the surface-modified enamel samples. Alkaline phosphatase activity, a marker of cell proliferation and differentiation, was monitored and compared with that in untreated control and acid-etched enamel samples.

RESULTS

Er:YAG laser treatment significantly improved the surface roughness of the enamel samples. Furthermore, MG63 osteoblast-like cells cultured on the Er:YAG laser-roughened enamel surface expressed more alkaline phosphatase activity and exhibited greater degrees of cellular differentiation than did cells that had been cultured on untreated enamel samples.

CONCLUSIONS

These results demonstrate that Er:YAG laser-roughened enamel promotes osteoblastic differentiation. This finding suggests that Er:YAG laser-roughened enamel surfaces can potentially serve as a scaffold for tissue engineering.

Calcium orthophosphates: occurrence, properties, biomineralization, pathological calcification and biomimetic applications

The present overview is intended to point the readers' attention to the important subject of calcium orthophosphates. This type of materials is of special significance for human beings, because they represent the inorganic part of major normal (bones, teeth and antlers) and pathological (i.e., those appearing due to various diseases) calcified tissues of mammals. For example, atherosclerosis results in blood vessel blockage caused by a solid composite of cholesterol with calcium orthophosphates, while dental caries and osteoporosis mean a partial decalcification of teeth and bones, respectively, that results in replacement of a less soluble and harder biological apatite by more soluble and softer calcium hydrogenphosphates. Therefore, the processes of both normal and pathological calcifications are just an in vivo crystallization of calcium orthophosphates. Similarly, dental caries and osteoporosis might be considered an in vivo dissolution of calcium orthophosphates. Thus, calcium orthophosphates hold a great significance for humankind, and in this paper, an overview on the current knowledge on this subject is provided.

Fluoridated hydroxyapatite coatings on titanium obtained by electrochemical deposition

Hydroxyapatite (HA) and fluoridated hydroxyapatite (FHA) coatings were deposited on titanium substrates using an electrochemical technique. Different concentrations of F(-) ions were incorporated into the apatite structure by adding NaF into the electrolyte. Typical apatite structures were obtained for all the coatings after electrodeposition and subsequent post-treatment, including alkaline immersion and vacuum calcination. The coatings were uniform and dense, with a thickness of approximately 5 microm. When the F-concentration was higher than 0.012 M in the electrolyte, a saturation of F in the coating occurred and the F/Ca ratio in the coatings became almost constant (F/Ca ratio=0.125). The FHA coatings showed higher bonding strength and lower dissolution rate than HA coating, particularly for those with a fluoridation level of 0.5-0.625. Compared with pure Ti, FHA and HA coatings exhibited higher biological affinity like cell proliferation and alkaline phosphatase activity. Regarding clinical application, it is suggested that a moderate content of F, such as Ca(5)(PO(4))(3)(OH)(0.375-0.5)F(0.5-0.625), be most suitable as a compromise among cell attachment, cell proliferation, apatite deposition and dissolution resistance.

Biocompatibility studies of human fetal osteoblast cells cultured on gamma titanium aluminide

Ti-48Al-2Cr-2Nb (at. %) (gammaTiAl), a gamma titanium aluminide alloy originally designed for aerospace applications, appears to have excellent potential for bone repair and replacement. The biological response to gammaTiAl implant is expected to be similar to other titanium-based biomaterials. Human fetal osteoblast cells were cultured on the surface of gammaTiAl and Ti-6Al-4V disks with variable surface roughness for both SEM and immunofluorescent analysis to detect the presence of collagen type I and osteonectin, proteins of the bone extracellular matrix. Qualitative results show that cell growth and attachment on gammaTiAl was normal compared to that of Ti-6Al-4V, suggesting that gammaTiAl is not toxic to osteoblasts. The presence of collagen type I and osteonectin was observed on both gammaTiAl and Ti-6Al-4V. The results obtained suggest gammaTiAl is biocompatible with the osteoblast cells.

Surface characterization of colloidal-sol gel derived biphasic HA/FA coatings

Hydroxyapatite (HA) powders are ultrasonically dispersed in the precursor of fluoridated hydroxyapatite (FHA) or fluorapatite (FA) to form a "colloidal sol". HA/FA biphasic coatings are prepared on Ti6Al4V substrate via dip coating, 150 degrees C drying and 600 degrees C firing. The coatings show homogenous distribution of HA particles in the FA matrix. The relative phase proportion can be tailored by the amount of HA in the colloidal sol. The surfaces of the coatings consist of two kinds of distinct domains: HA and FA, resulting in a compositionally heterogeneous surface. The biphasic coating surface becomes increasingly rougher with HA powders, from around 200 nm of pure FA to 400-600 nm in Ra of biphasic coatings. The rougher biphasic HA/FA surfaces with chemically controllable domains will favor cell attachment, apatite layer deposition and necessary dissolution in clinical applications.